Andrographis paniculata (Burm. f.) Wall. ex Nees: An Updated Review of Phytochemistry, Antimicrobial Pharmacology, and Clinical Safety and Efficacy

Hossain, Md. Sanower; Urbi, Zannat; Karuniawati, Hidayah; Mohiuddin, Ramisa Binti; Qrimida, Ahmed Moh; Allzrag, Akrm Mohamed Masaud; Ming, Long Chiau; Pagano, Ester; Capasso, Raffaele

doi:10.3390/life11040348

Cited by 139 publications

(108 citation statements)

References 210 publications

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“…A recent comprehensive review on antimicrobial pharmacology, clinical safety, and efficacy of Andrographis paniculata, demonstrated its high potential for effective and safe COVID-19 treatment, and there was a need for clinical data. (Hossain et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of Andrographis paniculata extract in patients with mild COVID-19: A randomized controlled trial

Wanaratna¹,

Leethong²,

Inchai³

et al. 2021

Preprint

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ObjectiveTo assess the efficacy and safety of Andrographis paniculata extract (APE) in adults with mild COVID-19.MethodsThe alcoholic extract of the aerial part of A. paniculata was used. In this randomized, double-blinded, placebo-controlled trial, adults with laboratory-confirmed COVID-19, and mild symptoms were randomized 1:1 to receive APE (60 mg andrographolide,t.i.d,for 5 days) versus placebo, plus standard supportive care. Blood tests for CRP, liver and renal assessment were performed on Days 1, 3, and 5.The outcomes were occurrence of pneumonia detected by chest X-ray, nasopharyngeal SARS-CoV-2detection by rRT-PCR, changes of CRP levels, and adverse drug reactions.ResultsPatients were randomized to receive APE (n=29) or placebo (n=28). Pneumonia occurrence during illness was 0/29 (0%) versus 3/28 (10.7%), (p=0.039); andpatients with nasopharyngeal SARS-CoV-2detectionon Day 5 were10/29 (34.5%) versus 16/28 (57.1%), (p=0.086), for those who received APE and placebo, respectively. All three patients with pneumonia had substantially rising serum CRP; and high CRP levels on Day 5. None had evidence of liver or renal impairment.ConclusionThisAP-extract treatmentregimen was potentially effective and safe in adults with mild COVID-19. The rising of CRP suggested disease progression. Further studies are needed.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of Andrographis paniculata extract in patients with mild COVID-19: A randomized controlled trial

Wanaratna¹,

Leethong²,

Inchai³

et al. 2021

Preprint

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“…Respiratory and gastrointestinal diseases are common but are also commonly incorrectly managed by using antibiotics, and physicians needlessly write antibiotic prescriptions, increasing the chances of ABR prevalence [2,7,11,16]. A recent systematic review and meta-analysis has reported that antibiotics are used inappropriately by the general population, as seen in behaviours such as purchasing antibiotics from pharmacies without a prescription, demanding antibiotics from physicians, not following prescribed antibiotics, and using antibiotics as prophylaxis for non-indicated diseases [17].…”

Section: Introductionmentioning

confidence: 99%

Assessment of Knowledge, Attitude, and Practice of Antibiotic Use among the Population of Boyolali, Indonesia: A Cross-Sectional Study

Karuniawati

Hassali

Suryawati

et al. 2021

IJERPH

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Misuse and overuse of antibiotics are potential causes of the increasing prevalence of antibiotic resistance (ABR). Having information about the knowledge, attitude, and practices concerning antibiotics use by the public might help control ABR growth. Therefore, this cross-sectional study aimed to investigate the levels and associated factors of knowledge, attitude, and practice (KAP) of antibiotics use among the public. A questionnaire was designed and validated, which consisted of a total of 51 questions with four sections: demographics (6), knowledge (20), attitude (12), and practice (13) to measure KAP. Univariate analysis (using Mann–Whitney U and Kruskal–Wallis analysis) was applied to assess the differences in the mean scores of KAP. Linear regression analysis was performed to identify factors associated with KAP. Finally, using Spearman analysis we have examined the correlation between responses to the KAP. The sample size of this study was 575, with a 99.96% response rate. Regarding knowledge, 73.12% of respondents stated that antibiotics could be used to treat viral infections, and 63.35% of respondents answered that antibiotics could reduce fever. Concerning attitude, 50% of respondents had considered stopping taking antibiotics as soon as symptoms had disappeared. In analyzing practice, we found 40% of respondents obtained antibiotics from a pharmacy without a prescription from a physician, a nurse, or a midwife. Statistical analysis revealed that KAP about antibiotic use was significantly associated with gender, area of residence, level of education, and monthly income (p < 0.05). Our findings concluded that men, respondents with low income, those with low-level education, and those living in rural areas are more prone to excessive use of antibiotics without knowing the adverse effects of improper use and how it can contribute to high ABR. So it is urgently necessary to strengthen policies on antibiotics use, including drug provision, distribution, and sales. In addition, people with low KAP should be a priority consideration in education outreach initiatives.

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“…Andrographolide is a natural terpenoid of the Acanthaceae family, commonly termed “King of the bitters” or “Kalmegh” [ 136 ], that exerts antioxidant, anti-inflammatory, and antiapoptotic effects [ 137 ]. Liu et al [ 138 ] showed that andrographolide inhibited production of the inflammatory factors COX-2 and PGE2, while reversing MMP3, MMP13, ADAMTS-4, and ADAMTS-5 overexpression, by inhibiting NF- κ B activation.…”

Section: Natural Pharmacological Productsmentioning

confidence: 99%

Natural Products of Pharmacology and Mechanisms in Nucleus Pulposus Cells and Intervertebral Disc Degeneration

Chen

Zhang

Liu

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Intervertebral disc degeneration (IDD) is one of the main causes of low back pain (LBP), which severely reduces the quality of life and imposes a heavy financial burden on the families of affected individuals. Current research suggests that IDD is a complex cell-mediated process. Inflammation, oxidative stress, mitochondrial dysfunction, abnormal mechanical load, telomere shortening, DNA damage, and nutrient deprivation contribute to intervertebral disc cell senescence and changes in matrix metabolism, ultimately causing IDD. Natural products are widespread, structurally diverse, afford unique advantages, and exhibit great potential in terms of IDD treatment. In recent years, increasing numbers of natural ingredients have been shown to inhibit the degeneration of nucleus pulposus cells through various modes of action. Here, we review the pharmacological effects of natural products on nucleus pulposus cells and the mechanisms involved. An improved understanding of how natural products target signalling pathways will aid the development of anti-IDD drugs. This review focuses on potential IDD drugs.

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Andrographis paniculata (Burm. f.) Wall. ex Nees: An Updated Review of Phytochemistry, Antimicrobial Pharmacology, and Clinical Safety and Efficacy

Cited by 139 publications

References 210 publications

Efficacy and safety of Andrographis paniculata extract in patients with mild COVID-19: A randomized controlled trial

Efficacy and safety of Andrographis paniculata extract in patients with mild COVID-19: A randomized controlled trial

Assessment of Knowledge, Attitude, and Practice of Antibiotic Use among the Population of Boyolali, Indonesia: A Cross-Sectional Study

Natural Products of Pharmacology and Mechanisms in Nucleus Pulposus Cells and Intervertebral Disc Degeneration

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