Malarial Inflammation-Driven Pathophysiology and Its Attenuation by Triterpene Phytotherapeutics

Abstract

Malaria driven pathophysiology inimically conjoined to systemic inflammation response cascade in a vicious feed-forward cycle destined to a terrible debilitation or demise of the host. The Plasmodium parasite initiates physiological changes when it is transmitted into the human host by intermediate host and vector. Sporozoites injection elicits immunological and inflammatory response suppression facilitating movement into the blood stream undetected, destined to hepatocyte. Subsequently, hepatocyte invasion culminates in intracellular growth and conversion of the parasites rapturing hepatocytes releasing merozoites into the extrahepatic circulation. Inflammatory and immunological response initiation results in overt malarial disease symptoms. Initially, inflammatory response alleviates and curtails infection. Activation of leukocytes, lymphocytes, monocytes, and phagocytes secretes inflammatory mediators, chemokines, cytokines cytoadhering molecules which accelerate infection patency. Hormonal processes influence disease tolerance without necessarily interfering with parasitemia. Current treatment is anti-parasitic. Phytotherapeutic intervention in malaria is anti-parasitic and anti-disease effects that terminate the vicious cycle and alleviating disease. The phytochemicals, in malarial experimental and clinical work, include asiatic acid, maslinic acid, oleanolic acid, and inflammatory and immunological aberrations evolving in malaria and the effects of phytochemical therapeutics in the alleviation of the disease to enable leverage of future treatment regimens through harnessing existing plants materials is explored.

Potential of Triterpenic Natural Compound Betulinic Acid for Neglected Tropical Diseases New Treatments

“…Once there is a rupture of this balance, it may contribute to CM pathogenesis; therefore, therapeutic approaches could target cytokines and chemokines associated with CM severity. In this sense, triterpenes have been assessed in malaria experimentally and its antioxidant and pro-oxidant properties demonstrate a moderate phytotherapeutic effect for both decreasing parasitemia and alleviating inflammation [82][83][84].…”

Assessment of the immunomodulatory activity of Artavol aqueous extract in Plasmodium berghei infected mice

“…ARTAVOL® contains phytochemicals like coumarins, flavonoids, triterpenes, and sterols among others. Flavonoids and triterpenes have been reported to induce the release of flavonoids, NF-α, and to modify intracellular signaling pathways in immune cells (Afolayan et al, 2020;Brindha, 2016;Mavondo et al, 2019).…”

Effect of neem leaf therapy (Azadirachta indica) on TNF-α expression and hepatocyte apoptosis of balb/c mice infected with Plasmodium berghei anka

“…Infected liver cells will burst and enter the circulation to attack erythrocytes [9,10]. Infected erythrocytes will rupture and release toxins such as GPI (Glycosylhophatidylinositol), hemozoin, uric acid, and parasite DNA [11]. This toxin can stimulate the TNF-α which trigger the formation of reactive oxygen species (ROS).…”