Evidence for the medicinal value of Squama Manitis (pangolin scale): A systematic review

Abstract

Background Squama Manitis (pangolin scale) has been used in traditional Chinese medicine for thousands of years. However, its efficacy has not been systematically reviewed. This review aims to fill the gap. Methods We searched six electronic databases including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure Database (CNKI), WanFang Database and SinoMed from inception to May 1, 2020. Search terms included “pangolin”, “Squama Manitis”, “Manis crassicaudata”, “Manis javanica”, “Malayan pangolins”, “Manis pentadactyla”, “Ling Li”, “Chuan Shan Jia”, “Shan Jia”, “Pao Jia Zhu”, “Jia Pian” and “Pao Shan Jia”. The Cochrane Risk of Bias (RoB) assessment tool and Newcastle-Ottawa Scale (NOS) were used to evaluate the risk of bias of the included randomized controlled trials (RCTs) and case control studies (CCSs). Results After screening, 15 articles that met the inclusion criteria were finally included. There were 4 randomized controlled trials, 1 case control study, 3 case series and 7 case reports. A total of 15 different diseases were reported in these studies, thus the data could not be merged to generate powerful results. Two RCTs suggested that Squama Manitis combined with herbal decoction or antibiotics could bring additional benifit for treating postpartum hypogalactia and mesenteric lymphadenitis. However, this result was not reliable due to low methodological quality and irrational outcomes. The other two RCTs generated negative results. All the non-RCTs did not add any valuable evidence to the efficacy of Squama Manitis beacause of small samples, incomplete records, non-standardized outcome detection. In general, currently available evidence cannot support the clinical use of Squama Manitis. Conclusion There is no reliable evidence that Squama Manitis has special medicinal value. The removal of Squama Manitis from Pharmacopoeia is rational.

Can Substitutes Reduce Future Demand for Wildlife Products: A Case Study of China’s Millennial Generation

“…Table 6 Examples of substitutes tried by respondents who have used substitutes and intend to continue using (n = 52) Table 6 displays the positive substitution experiences of those respondents who stated they had used wildlife product substitutes before and intended to continue using wildlife product substitutes (n = 52). This table lists the wildlife product substitutes cited by respondents when asked to recall the name and type of substitute they'd used most recently under national legislation, and subsequent removal of pangolin scales (Squama Manitis) as a listed raw ingredient in the Pharmacopeia 2020 edition (Jin et al, 2020;State Forestry & Grassland Bureau, 2020). Indeed, Fabinyi and Liu (2014) and Fabinyi (2012) highlighted how such consumption is not necessarily an unalterable tradition, but rather a historically based social practice that is subject to change.…”

Sunda pangolins show inconsistent responses to disturbances across multiple scales

“…Pangolins are reservoirs of multiple pathogens associated with ixodid ticks and possibly SARS‐CoV and their poaching and consumption precipitate zoonotic disease spillover (Jabin et al, 2019; Khatri‐Chhetri et al, 2016; Liu et al, 2019; Wacharapluesadee et al, 2021; Xiao et al, 2020). Demand for pangolin meat and products is driven by traditional Chinese medicine (TCM) despite the lack of scientific evidence to support the health benefits (Challender et al, 2015; Harrison et al, 2016; Jacobs et al, 2019; Jin et al, 2020; Nijman et al, 2016). Pangolins are now “the most heavily trafficked wild mammal in the world” despite all species being internationally protected and CITES Appendix I (Challender et al, 2014, 2020; Heinrich et al, 2017), and pangolin trends continue to decline sharply with six out of eight extant Manidae species being Endangered or Critically Endangered (Challender & O'Criodain, 2020; Gaubert et al, 2018; Heinrich et al, 2016).…”

The knowledge, attitude and practice of local Sabahan in Malaysia on Sunda pangolin

“…Among the eight species of pangolin worldwide, the Sunda pangolin (Manis javanica) and Chinese pangolin (Manis pentadactyla) are two of the most widely traded, usually to supply the traditional Chinese medicine practitioners and as delicacies in China (Cabana et al 2017;Xing et al 2020). Although it was scientifically proven that its scales and meat have no medicinal properties (Jin et al 2021), the uses of pangolin's derivatives in traditional medicines in Asia are mostly due to cultural beliefs (Xing et al 2020).…”