In vitro neurogical toxicity of Artemisinin-based Combination Therapy and medicinal plants (Published)
Introduction: The traditional medicine seems to be one of the factors associated with the occurrence of severe neurological adverse events described, after the use of artemisinin-based combination therapy. The aim of this study was to study the toxicity from the association of artemisinin-based combination therapy with the herbal medicine over the nerve cells. Material and Methods: Some nerve cells (N2a) were cultivated (0.5*105 cell/ml) and brought in contact with antimalarial preparations and / or antimalarial plants.The products used were artesunate100mg/amodiaquine 270mg (ASAQ) and artemether 80mg/lumefantrine 480mg (AL) as antimalarial drug and Sida acuta (PSA) and Enantia polycarpa (PEP) at 10µg/ml as antimalarial medicinal plant. After 5 days of incubation, a cell counting has been carried out with a hemocytometer. Results: A significant nerve cells destruction, compared to the control was observed for ASAQ between day 2 and day 4 (p<0.001). We also noted a significant difference between the control and AL, between day 1 (p<0.05) and day 3(p<0.001), between the control and Sida acuta, at day 2 and day 5 (p<0.001). In the tubes treated with ASAQ and Sida acuta, cell mortality was greater than 30%. Finally, a cell destruction statistically significant in the tubes treated via the combination of antimalarials and traditional plants compared to the control tube was observed from day 3(p<0.001). Discussion / Conclusion: Plants appeared to enhance the neurological toxicity of in vitro conventional antimalarials. The combination of conventional antimalarials with the traditional therapy, during malaria treatment should be avoided.
Keywords: Antimalarials, artemisinin-based combination therapy, cytotoxicity, herbal medicine, nerve cells