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J. Tchamgoue et al.
Globally, 20% of adult deaths is related to unhealthy diet [5]
and the WHO estimates that the number of deaths due to
NCDs (non-communicable diseases) will rise to 55million
per year by 2030 [1]. For centuries, many plants have been
used for their curative and preventive capacities against animal and human diseases owing to their content of bioactive
compounds. The nutritional and therapeutic benets and
biological properties of a good number of medicinal and
edible plants have been intensively investigated in the recent
years. The role of these plants in the prevention and treatment of LSD has been broadly conrmed by several scientic studies. Numerous plant derived foods and remedies
used in different cultural traditions around the world have
countless benecial effects on these diseases [6]. Scientic
interest in studying plants for drug discovery has increased
substantially due to the fact that the bioactive natural products contain in herbal plants have synergistic therapeutic
ability that is important in the prevention and treatment of
LSD [7]. In this chapter, a résumé of plants often used in the
management of LSD and the techniques employed for the
extraction of their phytoconstituents are presented.
2 Plants Frequently Used
intheTreatment ofLSD andTheir
Phytoconstituents
Since time immemorial medicinal plants have been used for
the treatment of NCDs [8]. Interest in medicinal plants has
been shown worldwide due to the safety and efciency of
plant derived products [9]. They are a reservoir of several
classes of bioactive compounds that can interact with functional proteins and produce various pharmacological effects.
Moreover, these compounds are scaffolds of the signaling
pathways involved in an organism [10]. Several studies based
on traditional assets have highlighted the benecial effect of
plants in the management of LSD [4, 5]. In the present section, the role of plants in the management of LSD will be
discussed and the compounds identied in some of these
plants will be highlighted.
2.1 Plants Used intheTreatment
ofCardiovascular Diseases andTheir
Phytoconstituents
Cardiovascular diseases (CVD) represent the largest share of
chronic non-communicable diseases and have as risk factors
(RF), non-modiable RF (age, sex, family history of CVD,
ethnicity) and modiable RF (physical inactivity, smoking,
lifestyle, metabolic syndrome) [11].
Prior to the discovery of modern medicines, many
plants were intensively used by humans for handling CVD
and their complications [12]. Since the pathophysiology of
CVD is heterogeneous, the cardioprotective properties of
different plants may be imputed to their capacity to target
CVD risk factors including their antioxidant, anti-atherosclerosis, anti- ischemic, and platelet aggregation inhibition activities [13]. It is worth mentioning that
atherosclerosis is the most preponderant cardiometabolic
risk [14].
2.1.1 Allium sativum (Amaryllidaceae)
Allium sativum commonly known as garlic is an indigenous
plant of South Asia, Central Asia, and Northeastern Iran. It
has been used for many years as a spice and has many properties that help treat conditions related to CVD.These properties include lowering cholesterol and low-density
lipoprotein (LDL) levels, reducing the lipid content of blood
vessel wall cells, and blood vessel growth. Previous studies
have shown that garlic can help improve conditions related
to atherosclerosis and hypertension and also has antiatherosclerotic effects [15]. Garlic extract has been shown
to impair sialidase activity in plasma and cause atherogenic
LDL formation [16]. Furthermore, garlic downregulates
lipid metabolism-related genes fatty acid synthase (FAS),
acyl-CoA cholesterol acyltransferase (ACAT), acetyl-CoA
carboxylase (ACC), HMGR, and sterol regulatory element
binding protein-1c (SREBP-1c) [17]. Chemical analyzes of
A. sativum bulbs reveal the presence of ajoene (E-ajoene,
Z-ajoene), thiosulnate (allicin), vinyldithiine (2-vinyl(4H)-1,3-dithiine, 3-vinyl), etc. It also indicates the presence of sulfur compounds like suldes (diallyl disulde and
diallyl trisulde ) [18]. In general, garlic was reported to
contain a wide variety of organic sulfur compounds,
selenium- containing natural products, saponins, amino
acids, phenylpropanoids, steroids, avonoids, fatty acids,
and alkaloids.
2.1.2 Glycyrrhiza glabra (Fabaceae)
Licorice (Glycyrrhiza glabra) is an herb that has been used
since ancient times in food and as medicine. Due to its very
sweet taste it was named “sweet root.” The ethanolic extract
of licorice was reported to effectively prevent the progression of arteriosclerosis [19]. Its action is due to its ability to
lower TC, LDL, and TG levels, increase HDL, and reduce
aortic atherosclerotic lesions [19]. Recently, glabridin, a avonoid isolated from this plant, was shown to inhibit LDL
oxidation and reduce LDL [20]. Chemical studies have
shown that licorice extract contains several organic acids,
liquirtin, rhamnoliquirilin, liquiritigenin, prenyllicoavone
A, glucoliquiritin apioside, 1-methoxyphaseolin, shinpterocarpin, shinavanone, licopyranocoumarin, glisoavone,
licoarylcoumarin, glycyrrhizin, isoangustone A, semilicoisoavone B, licoriphenone,1-methoxycifolinol, kanzonol R,
and some volatile components [21].
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2.1.3 Morusalba (Moraceae)
Morus alba, commonly called “white mulberry” is common
in Asia, Africa, America, and parts of Europe. Mulberries are
generally taken as fruit, juices, or jams [22]. They have large
amounts of active components that may be related with
potentially health-promoting medicinal properties. Studies
have shown that mulberries have diverse health benets,
inclusive of hepatoprotective effects, anti-cholesterol, and
anti-obesity properties [22]. Additionally, the leaves of this
plant are applied in folk medicine to treat hypertension and
atherosclerosis. Mulberry leaf extract has cardioprotective
[23], anticoagulant, and antithrombotic properties by stopping aggregation and platelet activation, thrombus formation, serotonin secretion, and thromboxane B2 formation
[24]. Chemical investigation has revealed that M. alba leaves
contain rutin, quercetin-3-β-D-glucose, isoquercetin, quercetin, and quercetin-3-O-glucose-6″-acetate [25]. In addition, mulberries were also reported to contain polyphenols
and alkaloids [22].
2.1.4 Curcuma longa (Zingiberaceae)
Curcuma longa, well-known as turmeric or “Indian saffron,”
is a condiment also used in medicinal concoctions [26]. It is
also applied as food coloring additive and dye in the textile
industry because of its pronounced yellow color [27].
Turmeric has been demonstrated to possess a wide range of
biological properties including against CVD and atherosclerosis [26]. Recent evidence has shown that the administration of 2.1 g of turmeric rhizome powder per day for 8weeks
meaningfully reduces BMI and plasma LDL, TC, and TG
[28]. Chemical analysis showed that ar-turmerone,
β-sesquiphellandrene, curcumenol, and curcumin are the
main compounds of Curcuma longa [13]. Curcumin is the
major active component of turmeric and was reported to possess anti-atherosclerotic, antioxidant, anti-inammatory, and
hepatoprotective properties [29]. Numerous studies have
described the benecial effect of curcumin in the mitigation
of CVD via its anti-inammatory capacities and its ability to
repair chemokine secretion and chemokine receptors [30].
2.1.5 Detarium microcarpum (Fabaceae)
Detarium microcarpum (commonly known as sweet detar) is
an indigenous African plant widespread in savannah regions.
The fruits and leaves ofD. microcarpum are mainly used for
their nutritive and medicinal properties [31]. In folk medicine, all parts of D. microcarpum (leaves, fruits, stems, and
roots) are used for the management of many diseases including CVD [31]. Results of a recent study highlighted the ability of the aqueous extract of the stem bark of this plant to
prevent weight gain and regulate plasma lipid/lipoprotein
levels in rats which was imputed to the presence of polyphenols [32]. Myricetin-3-O-rhamnoside, quercetin-3-O-
glucoside, methyl gallate, lup-20(29)-ene-2α,3β-diol, lupeol,
campesterol, protocatechuicacid, stigmasterol, vanillic, hexanedioic acid, sucrose, and myo-inositol are compounds
reported to be responsible for the observed biological activities of D. microcarpum [33].
2.1.6 Ginkgo biloba (Ginkgoaceae)
Ginkgo biloba also called “maidenhair tree” is listed among
the most ancient plant species. Its leaves extract is one of the
most frequently used plants and is vulgarized for its alleged
stimulant effect and likely healing and restorative abilities
[34]. There is growing evidence of the potential role of the
leaves extract of G. biloba in the treatment of CVD [35]. It
was reported to exert vascular protective functions and preliminary results showed that it may be useful in the management (prevention and treatment) of CVD, particularly
ischemic heart syndrome [36]. Recently, Wang and coauthors demonstrated that G. biloba extract improves atherosclerosis by rebalancing gut ora and microbial metabolism
[37]. G. biloba contains Kaempferol, a natural avonoid use
to prevent and treat atherosclerosis [37].
2.1.7 Quercus infectoria (Fagaceae)
The different species of Quercus are native from Middle East
(Turkey, Iran, and Iraq) but are now widespread in Europe,
Asia, and North Africa. The Mazu medicine prepared from
Q. infectoria is well described in the Perso-Arabic traditional
medicine and have been reported to possess various actions
such as hypoglycemic and anti-inammatory [38]. The plant
also has strong antioxidant potential through the inhibition
of the production of Ox-LDL, thus avoiding the development
of atherosclerosis. In addition, Quercus infectoria (known as
Aleppo Oak) extract reduces total cholesterol, LDL, and triglyceride levels in plasma, highlighting its role in preventing
and treating atherosclerosis [39]. Q. infectoria was reported
to contain alkaloids, steroids, saponins, triterpenes, tannins,
avonoids, and phenols [40].
2.1.8 Panax notoginseng (Araliaceae)
Panax notoginseng commonly referred to as Chinese ginseng is abundantly found in China, Yunnan, and it is broadly
used in cosmetics, healthcare, and other industries [41]. P.
notoginseng possesses a large range of biological activities,
including anti-atherosclerotic activity and cardiovascular
protection [41]. Ginseng saponins have been used as a natural cure for CVD in Asian countries including Japan, South
Korea, and China [42]. They upregulate the expression of
hepatic X receptor alpha (LXRα) and cause subsequent overexpression of ABCA1 and ABCG1. In addition, they inhibit
the DNA binding activity of NF-κB.As a receptor, LXRα
controls macrophage functions involved in inammation and
lipid metabolism [43]. The ginsenoside derivative, ginsenoside Rd has the ability to block voltage-gated Ca2+ channels
and signicantly reduce the dimension of atherosclerotic
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plaques [44]. Fifty six types of saponins have been isolated
and elucidated from Noto ginseng, 35 of which belong to the
protopanaxadiol group and 21 to the protopanaxatriol group
[45]. Phytochemical studies on P. notoginseng have shown
that the olean-type saponins found in ginseng from Asia (P.
ginseng) and America (P. quinquefolius) are missing in this
species.
2.1.9 Artemisia judaica (Asteraceae)
Artemisia judaica known as “Beithran” in Arabic is a therapeutic and sweet-smelling plant that particularly grows in the
southern Jordanian desert [46]. In Jordan, A. Judaica is
widely used for the treatment of heart and inammatory diseases, and atherosclerosis [46]. A 2016 report stated that
controlled concentrations of its essential oil effectively
inhibited lipopolysaccharide-induced NO production in
macrophages, highlighting the potential anti-inammatory
assets of A. judaica [46]. Artemisinin, a compound in this
plant, reduces atherosclerotic lesions by reducing macrophage inammation through modulation of the AMPK/
NF-κB/NLRP3 inammasome signaling pathway [47].
Chemical analysis of this plant revealed eight avones,
namely apigenin, diosmetin, cirsimaritin, isovitexin, luteolin, luteolin-4′-methyl ether, 7-O-β-D-4C1-glucopyranoside,
8-methoxyapigenin, 7-O-β-D-4C1-galactopyranoside, and
8-methoxyluteolin 7-O-β-D-4C1-glucopyranoside [48]
(Fig.1 and Table1).
2.2 Plants Frequently Used
intheTreatment ofCancer andTheir
Phytoconstituents
Cancer is a major cause of increasing numbers of deaths in
the world. It is the second most common lifestyle-related disease. Standard cancer treatment is usually based on the use
Fig. 1 Pictures of selected plants used in the treatment of CVD
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Table 1 Cardioprotective potential, chemical constituents, and mechanisms of action of selected medicinal plants
Plant Species Chemical constituents Biological activities Mechanism of actions References
Allium sativum
(Amaryllidaceae)
Glycyrrhiza glabra
(Fabaceae)
Morus alba
(Moraceae)
Curcuma longa
(Zingiberaceae)
Detarium
microcarpum
(Fabaceae)
Ginkgo biloba
(Ginkgoaceae)
Quercus infectoria
(Fagaceae)
Panax notoginseng
(Araliaceae).
Artemisia judaica
(Asteraceae)
Saponines, avonoids,
phenylpropanoids,
alkaloids, sulfur
compounds, and sterols
Flavonoids, isoavonoids,
coumarins, glycyrrhizic
acid
Flavonoids, alkaloids and
polyphenols
Polyphenols, avonoids,
triterpenoids
Polyphenols, phenolic
acids, terpenoids, steroids,
carbocyclic sugar,
avonoids
Flavonoids Anti-atherosclerosis Rebalancing gut ora and microbial metabolism [34–37]
Polyphenols, steroids,
triterpenes, saponins and
alkaloids
Saponins, polyacetylenes,
phytosterols, avonoids
Flavonoids, sesquiterpene
lactone
Anti-atherosclerosis Inhibition of sialidase activity in plasma causing LDL
formation and downregulates lipid metabolism-related
genes acyl-CoA cholesterol acyltransferase
(ACAT),Acetyl-CoA carboxylase (ACC), fatty acid
synthase (FAS),HMGR, and sterol regulatory element
binding protein-1c (SREBP-1c)
Anti-atherosclerosis Inhibition of LDL oxidation and LDL reduction [19–21]
Cardioprotective Blocking the activation and aggregation of platelet,
serotonin secretion, thromboxane B2 formation, and
thrombus formation
Anti-atherosclerosis
and
anti-inammatory
Antiatherogenic Regulate plasma lipid/lipoprotein levels (LDL-c,
Anti-atherosclerosis Inhibition of oxidized LDL production and reduces
Anti-atherosclerosis
and
anti-inammatory
Antiatherosclerosis,
anti-inammatory
Repair of chemokine secretion and chemokine
receptors
VLDL-c, TC, TG, HDL-c, and non-HDL-c)
total cholesterol, triglyceride and LDL levels in plasma
Up-regulates expression of hepatic alpha X receptor
(LXRα) and causes subsequent overexpression of
ABCG1 and ABCA1. Inhibits the DNA binding
property of NF-κB.
Inhibition of lipopolysaccharide-induced NO
production in macrophages and modulation of the
AMPK/NF-κB/NLRP3 inammasome signaling
pathway
[15–18]
[22–25]
[13,
26–30]
[31–33]
[38–40]
[41–45]
[46–48]
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of cytotoxic drugs, radiation therapy, chemotherapy, and surgery. However, plants play a role as an alternative treatment
in the management of cancer [49]. They contain terpenoids,
saponins, volatile oils, and avonoid phytoconstituents,
which give them anticancer activities. Several investigations
have already shown the protecting effect of plants on cancers
that occur due to lifestyle [49].
2.2.1 Camellia sinensis (Theaceae)
Camellia sinensis (tea plant) is native to Asia, but is now
grown in subtropical and tropical regions in the world. It is
one of the most consumed drinks in the world. White tea is
made by steaming and drying the buds and young leaves of
tea plants to minimize oxidation. The antioxidant and antiproliferative properties of this drink on cancer cells have
already been described [50]. The extract improved the activity levels of intracellular caspase-3, 8, and 9 and protected
3T3-L1 cells from DNA damage by H2O2 [50]. Phytochemical
studies identied several phenolic compounds from C. sinen-
sis including avonoids such as quamoreokchaside I-II,
kamoreokchaside I,(-)-epigallocatechin, (-)-epicatechin, and
(-)-epigallocatechin-3-O-gallate [178, 179].
2.2.2 Annona muricata (Annonaceae)
Annona muricata is a Central and Tropical South American
native plant popularly known as “soursop,” “graviola,” or
“guanabana” which has been globally used in folk medicine
against many diseases. Its biological properties include antiviral, antihypertensive, antidiabetic, and anticancer activities
highlighting its potential in the management of LSD [51].
The main active components of A. muricate are avonoids,
acetogenin, and alkaloids. The chemical screening of its leaf
extract revealed the presence of coumarins, anthraquinones,
avonoids, terpenoids, saponins, lactones, glycosides, tannins, and phytosterols [51]. The reported anticancer property
of A. muricata is due to its cytotoxicity against cancer cells
including colorectal, prostate, and lung cancers [52]. A
recent study demonstrated that the seeds, fruit, twigs and
stems’ extracts of A. muricata inhibited matrix metalloproteinases (MMPs) such as MMP-9andMMP-2, which are having primordial roles in the progression of cancer [53].
2.2.3 Eleutherococcus senticosus (Araliaceae)
Eleutherococcus senticosus also known as Siberian ginseng
is native to Northeast Asia. It is primarily used as an adapto-
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gen and has immune stimulating properties. Carbohydrates
found in Siberian ginseng appear to have not only immunostimulatory effects, but also antitumor and anticancer properties [54]. The treatment of the lung cancer cells A-549 with
the methanolic extract of E. senticosus displayed a
concentration- dependent inhibition tendency, slightly suppressing the growth of QBC-939 cells. In addition, XWLC05 cells (Yunnan lung cancer cell line), NEC cells (human
nasopharyngeal cancer cell line) exhibited dose-dependent
proliferative responses, and Beas-2 cells (human lung cancer
cell line) exhibited dose-dependent responses. Weak inhibitory activity in colon cancer cell line (HCT-116) was also
reported [54]. Phytochemical studies indicate that leaves of
E. senticosus contain avonoids, organic acid derivatives,
and triterpene glycosides [55].
2.2.4 Mangifera indica (Anacardiacea)
Mangifera indica (Mango) is native to tropical Asia. Its
active components are mainly present in the trunk bark,
roots, heartwood, leaves, and fruits and have anti-allergic,
antitumor, antioxidant, anti-inammatory, radioprotective,
immunomodulatory, antidiabetic, monoamine oxidase inhibition, antiviral, anti-resorptive, and antifungal properties
[56]. The anti-breast cancer properties of extracts of different
parts of M. indica have been previously reported [57].
Aqueous extract from the bark of M. indica has shown various anticancer and anti-inammatory activities. M. indica
was also reported to dose-dependently and signicantly
inhibit the spread of MDA-MB-231 cells. A related research
report pointed out the capacity of M. indica nuclear extracts to
decrease the MCF-7 (Luminal A; PR-positive, ER-positive,
HER2-negative cells), MDA-MB-231, and MDA-MBviability. M. Indica pulp and bark extracts were more often
reported for their anti-breast cancer property as compared to its
other parts [58]. Previous phytochemical proles of pulp and
bark extracts of M. indica displayed the presence of gallic acid
and galloyl derivatives, and high levels of methyl gallate [59].
2.2.5 Raphia vinifera (Arecaceae)
Rafa vinifera popularly called “West African piassava palm,”
“bamboo palm,” or “West African brous palm” belongs to the
Rafa genus [60]. It is native to Cameroon, Togo, Ghana, Benin,
Gambia, Nigeria, Central African Republic, and Democratic
Republic of the Congo. A recent investigation of Nguenang and
collaborators highlighted that botanical from R. inifera fruits
were cytotoxic on 18 cancer cell lines and was found nontoxic
on the result of its toxicological assessments [61]. The chemical
components of this plant includesitosterol,diosgenin-3-O-β-D- -
glucopyranoside, and 26-O-β-D-glucopyranosyl-(22R,
25R)-3β,26-trihydroxyfrost-5-ene-3-O-β-D- glucopyranoside
[62]. The pulp and rind of R. vinifera fruits contained high concentrations of alkaloids, saponins, and oxalates, medium concentrations of avonoids, steroids, and tannins, and low
concentrations of phytic acid, phenols, and glycosides which
are source of its medicinal properties [63]. R. inifera provides
steroidal saponins that are useful for tumor prevention and treatment of many types of cancer, with low toxic effects and high
potency [64] (Fig.2 and Table2).
Fig. 2 Pictures of selected plants used in the treatment of cancer
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Table 2 Anticancer potential, chemical constituents, and mechanisms of action of selected medicinal plants
Plant species Chemical constituents Biological activities Mechanism of actions References
Camellia sinensis
(Theaceae)
Annona muricata
(Annonaceae)
Eleutherococcus
senticosus
(Araliaceae)
Mangifera indica
(Anacardiacea)
Raphia vinifera
(Arecaceae)
Flavonoids and
polyphenolic
compounds
Acetogenin, alkaloids,
and avonoids
Triterpene glycosides,
organic acid derivatives
and avonoids
Phenolic acid
derivatives (high levels
of methyl gallate)
Saponins, alkaloids,
avonoids, and steroids
Antioxidant and
antiproliferative
Antiproliferative
property
Antitumor and
anticancer properties
Anticancer,
antioxidant, and
anti-inammatory
Antitumor Cytotoxic effect on cancer cell lines [60–64]
Improved the activity levels of intracellular
caspase-3, -8, and -9. The extract protected 3T3-L1
cells from DNA damage by H2O
Inhibition of matrix metalloproteinases (MMPs) such
as MMP-2 and MMP-9
Disruption of MMPs, reactive oxygen species (ROS)
generation, and the G0/G1
Inhibition of colon cancer cell line (HCT-116) [54, 55]
Inhibition of the spread of MDA-MB-231 cells,
decrease the viability of MCF-7 (Luminal A;
ER-positive, PR-positive, HER2-negative cells),
MDA-MB-231, and MDA-MB
2
[50, 178,
179]
[51–53]
[56–59]
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2.3 Plants Frequently Used
intheTreatment ofChronic Respiratory
Diseases andTheir Phytoconstituents
Chronic respiratory diseases including obstructive pulmonary disease, interstitial lung disease, and asthma are listed
by the WHO as one of the major chronic diseases posing
great challenge to both public health and socio-economic
growth. Reliance on conventional treatments has proven
unsuccessful as many patients are poorly controlled with
poor quality of life. This has prompted researchers to investigate natural products in order to search for new drugs which
could improve treatment outcomes [65]. In this session, the
roles some plants could play in the management of chronic
respiratory diseases are presented as well as their
phytoconstituents.
2.3.1 Vitex rotundifolia (Lamiaceae)
Vitex rotundifolia commonly called “beach vitex” or “roundleaf vitex” is a coastal herb that has traditionally been applied
for the treatment of different ailments such as respiratory
arrest, colds, headaches, and sore eyes [66]. V. rotundifolia
aqueous extract was reported to have the ability to signicantly inhibit goblet cell hyperplasia, OVA-induced eosinophilia, and smooth muscle mass production [67]. Casticin,
isolated from V. rotundifolia, inhibits the expression of pro-
inammatory cytokines, chemokines, and ICAM-1 through
suppression of PI3K/Akt, NF-κB, and MAPK signaling
pathways in inamed lungs. Reports have provided evidence
that it has anti-inammatory effects in blocking epithelial
cells stimulated by IL-1β. Co-culturing MAPK, NF-κB, and
PI3K inhibitors with casticin also resulted in more signicant suppression of ICAM-1 expression in A549 inammatory cells. The latter inhibits the phosphorylation of Akt,
phosphatidylinositol-3-kinase (PI3K), and mitogen-activated
protein kinase (MAPK) and translocates the p65 protein, a
subunit of the nuclear transcription factor kappa-B (NF-κB)
blocked nucleus [68]. Chemical analysis indicates the presence of avonoids, phenolic acids, and terpenes in V. rotun-
difolia [66].
2.3.2 Pistacia weinmannifolia (Anacardiaceae)
Pistacia weinmannifolia is a rare and endangered plant
endemic to Southwestern China and Northern Myanmar that
has many economic uses. An invitro investigation conrmed
the anti-inammatory properties of the root extract of P.
weinmannifolia on NCI-H292 epithelial cells stimulated by
phorbol myristate acetate or tumor necrosis factor α (TNF-α)
by decreasing the expression of mucin A5 (MUC5AC) and
interleukin (IL)-8, IL-6 which are closely linked to the pulmonary inammatory response in the pathogenesis of COPD
[69]. In addition, it downregulated nuclear factor κB activation and phosphodiesterase 4 expression in lung tissue [70].
Phytochemical analysis showed that P. weinmannifolia
mainly contains phenolic compounds, including gallotanins,
pistafolin A, and pistafolin B [70].
2.3.3 Camphora chartophylla (Lauraceae)
Camphora chartophylla previously called Cinnamomum
chartophyllum is found mainly in subtropical and tropical
regions, with certain species distributed in the Neotropics,
Australia, and Africa [71]. Species of this genus are often
used in community and folk medicine to treat several conditions such as indigestion, colds, coughs, and microbial
infections [72]. C. chartophylla (known as bushy mat grass)
protects human bronchial epithelial cells from oxidative
stress by activating Nrf2 [73]. Systemic chemical investigations of the aerial parts of C. chartophylla revealed α,β-
unsaturated keto groups, 3S-(+)-9-oxonerrolidol (NLD),
and diphenyl, 3,3, which shares a phenolic group.
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Sesquiterpenoids were also reported [73]. The latter activates Nrf2 and its downstream genes, NAD(P)H-quinone
oxidoreductase 1 (NQO-1), and γ-glutamylcysteine synthase (γ-GCS), and induces nuclear translocation of Nrf2in
human lung epithelial cells and increased stabilization [73].
2.3.4 Allium sativum (Amaryllidaceae)
Crude garlic extracts were reported to possess anti-asthmatic
properties and are utilized as anti-inammatory agent [15].
Garlic extracts decreased the total number of inammatory
cells and eosinophil inltration and decreased the production
of IgE dermatophagoides pteronyssinus in serum and Th1/
Th2/Th3 cytokine in bronchoalveolar uid. Enzyme-linked
immunosorbent assay demonstrated that garlic extracts
downregulated the levels of cytokines and chemokines,
namely IL-4, IL-5, and IL-13 related to Th2; but they simultaneously upregulated the expression of Th1-related IFN-γ,
IL-12, and TGF-β in BALF [74].
2.3.5 Moringa oleifera (Moringaceae)
Moringa oleifera (drumstick tree) is a versatile plant eaten as
food and known for its medicinal uses. It is a plant native to
India, growing in the foothills of the Himalayas and parts of
Africa [75]. The alcoholic extract of seed kernels of this
plant was reported to signicantly increase preconvulsion
time in guinea pigs exposed to either acetylcholine or histamine aerosol. The authors suggested that the anti-asthmatic
property of the seed kernels of M. oleifera might be imputed
to its anti-inammatory, antimicrobial, bronchodilator, and
mast cell stabilization activities [76]. Seed powder administered to asthmatic patients was reported to reduce asthma
attacks [77]. Chemical analysis of M. oleifera identied
2,6-dihydroxybenzoic acid, threonine, and fatty acids [78].
2.3.6 Magnolia ocinalis (Magnoliaceae)
Magnolia ofcinalis commonly known as magnolia bark is
used in Chinese folk medicine for the treatment of cough,
diarrhea, and allergic rhinitis [180]. It is also used to relieve
asthma and cough, to prevent cerebrovascular and cardiovascular diseases, and to treat depression and anxiety [79]. In
response to formyl-L-methionyl-L-leucyl-L-phenylalanine/
cytochalasin B, the methanolic extract of the stem bark of M.
ofcinalis exhibited signicant inhibitory effects on superoxide anion generation and elastase release by human neutrophils [80]. Chemical investigation has revealed lignans,
alkaloids, and volatile oils to be the main of M. ofcinalis
[79] (Fig.3 and Table3).
2.4 Plants Frequently Used
intheTreatment ofDiabetes
andHyperglycemia andTheir
Phytoconstituents
Type 2 diabetes is the most common form of diabetes and
accounts for about 90% of all diabetes cases with insulin
resistance and abnormalities in insulin secretion. The primary objective of antidiabetic treatment is to stimulate the
Fig. 3 Pictures of selected plants used in the treatment of chronic respiratory diseases
Extraction ofPhytoconstituents forLifestyle Diseases
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Table 3 Selected medicinal plants commonly used against chronic respiratory diseases, their chemical constituents and mechanisms of action
Plant species Chemical constituents Biological activities Mechanism of actions References
Vitex rotundifolia
(Lamiaceae)
Pistacia
weinmannifolia
(Anacardiaceae)
Cinnamomum
chartophyllum
(Lauraceae)
Allium sativum
(Amaryllidaceae)
Moringa oleifera
(Moringaceae)
Magnolia ofcinalis
(Magnoliaceae)
Flavonoids, phenolic acids,
and terpenes
Phenolic compounds Anti-inammatory
Phenolic compounds and
sesquiterpenoids
Saponins, phenylpropanoids,
avonoids, alkaloids, sulfur
compounds, and sterols
Fatty acids, alkenes, phenolic,
threonine
Lignans, alkaloids and
volatile oils
Anti-asthmatic Inhibits the expression of pro-inammatory
Bronchoprotective Activating Nrf2 [71–73]
Anti-asthmatic and
anti-inammatory
Anti-asthmatic Reduction in the elevated release of histamine
Anti-asthmatic Inhibitory effects on superoxide anion
cytokines, chemokines, and ICAM-1 through
suppression of PI3K/Akt, NF-κB, and MAPK
signaling pathways in inamed lungs
Downregulated nuclear factor κB activation and
phosphodiesterase 4 expression in lung tissue
Up-regulated the expression of Th1-related
IFN-γ, IL-12, and TGF-β in BALF
from the lungs of sensitized guinea pigs
generation and elastase release by human
neutrophils
[66–68]
[69, 70]
[15, 74]
[75–78]
[180, 79,
80]
41
secretion of insulin, reinforce immunity, and/or reduce glucose in the blood. Although many synthetic antidiabetic
compounds were discovered, their usefulness has been hampered due to their side effects and limited efcacy [81].
Plants occupy a prominent place in diabetes’ management by
providing important elements (secondary metabolites, bers,
vitamins, and minerals) that are able to modulate various
metabolic pathways to relieve diabetic patients [82]. Thus,
several investigations have demonstrated the antidiabetic
efcacy of plants.
2.4.1 Teucrium polium (Lamiaceae)
Teucrium polium (aka Teucrium capitatum or felt germander) is rampant in stony and dry areas of nearly all
Mediterranean countries, Europe, Northern Africa, and
Southwest of Asia [83]. T. polium is utilized in Iranian herbal
remedies for the treatment of many ailments including type 2
diabetes [83]. A recent study demonstrated the insulinsecreting ability of an “aqueous” extract of T. polium on
BRIN-BD11 rat pancreatic cells [84]. At the same time,
treatment with T. polium extract increased GLUT2 expres-
sion and glucokinase activity [84]. Chemical analysis indicates that quercetin is a avonoid that naturally occurs as a
glycoside like rutin (quercetin-3-rutinose) in T. polyum [85].
Another study showed that T. polyum essential oil was domi-
nated by the presence of terpenes including spathulenol,
caryophyllene (E),sabinene, limonene, myrcene, germacren D, β-pinene, and α-pinene [86].
2.4.2 Rauvola vomitoria (Apocynaceae)
Rauvola vomitoria known as the “poison devil’s-pepper” is
found in Africa and Asia tropical regions [87]. R. vomitoria
has been associated with various curative properties, includ-
ing antidiabetic assets [87]. The hydromethanolic extract of
R. vomitoria and its main component, phytol, were reported
to lower blood sugar levels [87]. GC-MS analysis of hydromethanol extracts from leaves of R. vomitoria showed the
occurrence of compounds such as propanamide, 2-methyl,
1H-indole-2-ethanol, β-(3-ethylidene-1-methyl-4- piperidinyl)-3-methyl, hexadecanoic acid, methyl ester,
n-hexadecanoic acid, 9,12,15-octadecatrien-1-ol, (Z)9octadecenoic acid, methyl ester, phytol, methyl stearate, and
9,12-octadecadienoic acid (Z,Z)-methyl ester [87].
2.4.3 Baillonella toxisperma (Sapotaceae)
Baillonella toxisperma popularly known as “African pearwood,” “djave nut,” or “moabi” is a large tree that grows in
the rainforests of Africa. Its woods and bark are used for
their medicinal properties, while its fruits are employed for
culinary and cosmetic objectives, and the pulp is directly
consumed [88]. The hydroethanolic extract of the fruit of B.
toxisperma was reported to have antihyperglycemic potential
by reducing glucose levels after sucrose and starch administration in rats with normal blood sugar level [89]. It was also
reported to increase glucose absorption by muscle and yeast
cells [90]. The hydroethanolic extract of the pulp of B. toxi-
sperma pulp was reported to exhibit metal-chelating, reducing, antiradical, glucose-binding, and insulin-sensitizing
activities [90]. The phytochemical analysis of this extract
indicates a high content of avonoids and polyphenols [90].
2.4.4 Tetrapleura tetraptera (Fabaceae)
Tetrapleura tetraptera (Aidan Tree) fruit is the most available and frequently used spices in Cameroon [91]. They are
non-wood forest derived products and are known to possess
numerous ethnobotanical uses (antidiabetic, antimalarial,
42
https://t.me/medicina_free
J. Tchamgoue et al.
anti-inammatory, anticonvulsant, anticancer, etc.) in Central
African countries [92]. Aqueous extracts of T. tetraptera fruit
have hypoglycemic properties [93]. Phytochemical analyzes
have shown the presence of terpenoids, steroids, saponins,
alkaloids, avonoids, tannins, and phenols in ethanolic and
aqueous extracts of different plant parts of T. tetraptera [94].
2.4.5 Alstonia boonei (Apocynaceae)
Alstonia boonei, popularly known as God’s tree, is a plant
mostly found in many African countries [95]. Its bark aqueous extract was reported to possess antidiabetic effects and
increase DNA methylation in the liver. The chemical screening of its stems and leaves highlighted the presence of alkaloids, avonoids, tannins, phenols, saponosides, and
terpenoids [96]. GC-MS exploration of the dichloromethane
leaf extract showed that eugenol was the major component
while the dichloromethane bark extract mainly contain
1,2-benzenedicarboxylic acid [97].
2.4.6 Pseudarthria hookeri (Fabaceae)
Pseudarthria hookeri commonly known as “Zem lekouet” in
Western Cameroon is a tropical African plant widespread in
South Africa, Ethiopia, Angola, and Cameroon. The leaves
of this plant are used for the treatment of several ailments
such as diarrhea, coughs, tuberculosis and malaria [98]. The
ethnopharmacological investigation of this plant revealed its
antidiabetic, estrogenic, cytotoxic, and antimicrobial properties [99]. Isolated avonoids from this plant were assessed
for their antidiabetic activity particularly for their ability to
stimulate the secretion of insulin and were found to display
signicant insulin secretory activity higher than that of tolbutamide [98] (Fig.4 and Table4).
2.5 Plants Frequently Used
intheTreatment ofHypertension
andTheir Phytoconstituents
Hypertension is a chronic condition in which arterial blood
pressure increases. Constant hypertension is a risk factor for
myocardial infarction, aneurysms, stroke, and heart failure.
It is one of the major sources of chronic kidney disease [100].
A moderate increase in blood pressure reduces life expectancy. Medicinal plants have gained interest as a potential
means of preventing and treating hypertension due to their
multiple benecial effects [101].
2.5.1 Allium cepa (Amaryllidaceae)
Allium cepa originated from Central Asia and many of its
relatives still grow wild. It is widely cultivated and consumed throughout the world. Its bulb, which has a characteristic avor, is the third most essential spice with a
signicant commercial value. Besides its culinary assets, it
is also largely used as herbal medicine in several indigenous cultures. Several scientic investigations were done in
other to ascertain its traditional claims [102]. The main
Fig. 4 Pictures of selected plants used in the treatment of diabetes and hyperglycemia
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Table 4 Antidiabetic and anti-hyperglycemic potential, chemical constituents, and mechanisms of action of selected medicinal plants
Plant species Chemical constituents Biological activities Mechanism of actions References
Teucrium polium
(Lamiaceae)
Rauvola vomitoria
(Apocynaceae)
Baillonella
toxisperma
(Sapotaceae)
Tetrapleura tetraptera
(Fabaceae)
Alstonia boonei
(Apocynaceae)
Pseudarthria hookeri
(Fabaceae)
Flavonoids and monoterpenes Antidiabetic Insulin-secreting, increased GLUT2
expression, and glucokinase activity
Fatty acids Antidiabetic – [87]
Polyphenols and avonoids Antihyperglycemic and
hypoglycemic
Flavonoids, terpenoids, tannins,
alkaloids, steroids, saponins, and
phenols
Phenols, avonoids, alkaloids,
tannins, saponosides, and
terpenoids
Flavonoids Insulin secretory – [98,99]
Hypoglycemic – [91–94]
Antidiabetic Increase DNA methylation in the liver [95–97]
Glucose-binding, insulin-sensitizing,
increased glucose uptake by yeast and
muscle cells
[83–86]
[88–90]
43
pharmacological application is for preventing hypertension
and arteriosclerosis through its hypotensive ability [103].
Flavonoids, saponins, sterols, and sulfur compounds were
reported as its main components [103]. The sulfur compounds are well-known for their antiplatelet aggregation
and hypotensive properties.
2.5.2 Apium graveolens (Apiaceae)
Apium graveolens, commonly called celery, is a biennial
plant of the Apiaceae family [104]. Various parts of this plant
are used in traditional medicine. A. graveolens was reported
to possess hypolipidemic, antifungal, hepatoprotective, anticancer, diuretic, and hypotensive properties [105]. In mainland China, celery was prescribed for high blood pressure
associated with pregnancy and menopause. It also lowers
diastolic and systolic blood pressure [106]. Phytochemical
proling of the essential oils of A. graveolens stem (S) and
leaves (L) revealed the presence of limonene, α-phellandrene,
β-pinene, and α-pinene with the latter being the major component [107, 108].
2.5.3 Olea europaea (Oleaceae)
Olea europaea (olive plant) is a plant widely distributed in
Africa, Mascarenes, Arabia, India, and China. Olea euro-
paea (leaf, bark, and root) extract is widely used in Africa
to treat various ailments, but little pharmacological research
has been done. A randomized and actively controlled clinical study demonstrated the hypotensive effect and tolerance
of the leaf extract of this plant in stage 1 hypertensive
patients [109]. Studies have also revealed the antihypertensive, anti- atherosclerotic, diuretic, antidiarrheal, antioxidant, and hypoglycemic effects of olive leaf extracts.
Phytochemical studies have shown isolated compounds
such as oleuropein, oleanolic acid, ursolic acid, aesculin,
and scopolina [109].
2.5.4 Ocimum gratissimum (Lamiaceae)
Ocimum gratissimum (African basil) is native to Africa,
South Asia, and the Bismarck Islands. A recent study showed
the antihypertensive properties of the plant, possibly due to
its avonoid content [110]. O. gratissimum was reported to
reduce blood pressure in hypertensive rats in a dosedependent way, its effect was ameliorated as collated to that
of controls without nephrectomy. The improvement was primarily related to increased smooth vasorelaxation by O. gra-
tissimum [111]. O. gratissimum leaves are rich in
polyphenolic acids, avonoids, and ellagic acid [112].
2.5.5 Terminalia superba (Combretaceae)
Terminalia superba is a 30–50m tall tree distributed in the
forests of West and Central Africa. In common medical practice in Central Cameroon, T. superba is considered to be a
useful antihypertensive agent [113]. The intravenous injection of T. superba aqueous extract induced an antihyperten-
sive response. When taken orally, the extract prevented the
increase in blood pressure in rats with glucose hypertension
[113]. Phytochemical examination of the hydroethanolic and
ethanolic extracts of the bark of T. superba showed the
occurrence of avonoids, tannins (catechin and gallic acids),
saponins, and anthracene derivatives [114] (Fig. 5 and
Table5).
2.6 Plants Used intheManagement
ofObesity andTheir Phytoconstituents
Obesity prevalence keeps on rising, leading to a worldwide
outbreak that displays no sign of abating [115]. It is a critical
lifestyle-related disorder. There are many synthetic remedies
for obesity, but with serious side effects. Taken into
consideration the current situation, researchers have been
focusing their efforts on the development of herbal based
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