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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5442_Библиотеки_им_академика_М_И_Перельмана.pdf
red-orange compact racemes. The succulent leaves are dark green in color with dark red
thorns along the leaf margins. Leaves of juvenile plants of this species have spines running
along the entire leaf epidermis to deter herbivores but often contribute to the misidentifi-
cation of this species as Aloe ferox. However, the racemes of this species are far shorter and
slightly curved in comparison to that of Aloe ferox. Mature A. excelsa plants are established
after 36 years of germination and flower over August and September during the late
winter and early spring period (
Coopoosamy & Magwa, 2007).
Traditional usage
Aloe excelsa is used by traditional healers throughout South Africa but is particularly
popular amongst Sotho-speaking indigen ous people, to treat a variety of ailments.
Traditional healers prepare the leaves of A. excelsa in various ways depending on the
intended medicinal use or route of administration. Decoctions of the whole leaf are pre-
pared by boiling the leaves in water; the mixture is subsequently strained and adminis-
tered as a tea. Tea made from A. excelsa is said to have purgative, blood purifying, and
immune-boosting effects (
Coopoosamy & Magwa, 2006). Gel exudates of the leaves are
used to treat skin irritations such as rashes and burns by direct application of the sap to
TABLE 4.2 In vitro and in vivo wound-healing activity of plants traditionally used in South Africa.
Plant species/
family
Extraction
solvent Plant part Wound-healing activity Reference
Aloe ferox Miller/
Xanthorrhoeaceae
Leaf material was
homogenized
and filtered
Whole leaf Wound severity scores were significantly
lower in rats treated with A. ferox and rats
treated with A. ferox followed by S. aureus,
when compared to the group that did not
receive treatment. Showed 51.77 6 0.75%
wound closure when compared to the
untreated control which showed
42.88 6 1.23% closure after 32 h exposure
Fox et al.
(2017), Jia
et al. (2008)
Leaf gel was
liquidized
Leaf gel Showed 82.41 6 16.30% wound closure when
compared to the untreated control which
showed 52.04 6 3.39% closure after 32 h
exposure
Fox et al.
(2017)
Hot water Leaves At 10 and 100 μg/mL there was a significant
increase in human primary epidermal
keratinocytes (HPEK) cell migration,
proliferation, and differentiation
Moriyama
et al. (2016)
Urtica urens L./
Urticaceae
Ethanol Leaves,
stems, bark,
and roots
Showed an increase in wound contraction in
rabbits inoculated with P. aeruginosa (in vivo)
when tested at 25% in an ointment
formulation
Taqa,
Mustafa, &
Al-Haliem
(2014)
Water Leaves,
stems, bark,
and roots
Did not show an increase in wound-healing
contraction in rabbits
154 4. Medicinal plants used in South Africa as antibacterial agents for wound healing
Medicinal Plants as Anti-infectives
TABLE 4.3 Toxicity of South African medicinal plants used for wound healing.
Plant species/family Extraction solvent Plant part Toxicity potential Reference
Aloe barberae Dyer/
Asphodelaceae
Petroleum ether Upper stem Nonmutagenic at 50, 500, and 5000 μg/mL using
Salmonella typhimurium strain TA98
Ndhlala et al. (2009a)
Dichloromethane
Ethanol
Water
Petroleum ether Young bark Nonmutagenic at 50, 500, and 5000 μg/mL using
Salmonella typhimurium strain TA98
Dichloromethane
Ethanol
Water
Petroleum ether Mature bark Nonmutagenic at 50, 500, and 5000 μg/mL using
Salmonella typhimurium strain TA98
Dichloromethane
Ethanol
Water
Petroleum ether Leaves Nonmutagenic at 50, 500, and 5000 μg/mL using
Salmonella typhimurium strain TA98
Dichloromethane
Ethanol
Water
Petroleum ether Roots Nonmutagenic at 50, 500, and 5000 μg/mL using
Salmonella typhimurium strain TA98
Dichloromethane
Ethanol
Water
(Continued)
TABLE 4.3 (Continued)
Plant species/family Extraction solvent Plant part Toxicity potential Reference
Aloe ferox Miller/
Xanthorrhoeaceae
Leaf material was
homogenized and
filtered
Whole leaf No erythema or edema was observed in Guinea pigs after
a single dose application of A. ferox up to 72 h and no
erythema or swelling was observed in Guinea pigs after
multiple applications of A. ferox over a 10-day course
Andersen (2007), Fox
et al. (2017)
, Jia et al.
(2008)
No skin irritation was observed in mice with healthy skin
or rats with damaged skin over a 14-day period
Negligible cytotoxicity observed against human
keratinocytes (HaCat) at concentrations of 0.4, 0.6, and
1.3 mg/mL
Considered a nonirritant when tested on damaged and
nondamaged skin of New Zealand rabbits
Water Did not show toxicity in rats in acute, subacute, and
chronic toxicity studies and no behavioral or
physiological changes were observed at doses of 50, 100,
200, and 400 mg/kg.
Mwale and Masika (2012)
Oil Application of a 0.2% concentration showed no dermal
phototoxicity on both irradiated and nonirradiated skin
Andersen (2007)
Leaf gel was
liquidized
Leaf gel Negligible cytotoxicity observed against human
keratinocytes (HaCat) at concentrations of 0.4, 0.6, and
1.3 mg/mL
Fox et al. (2017)
Evaporation of latex
which drains from
the leaves
Resin Single oral dose of the resin at 5.0 g/kg in Wistar rats did
not show signs of toxicity or death (LD
50
. 5.0 g/kg).
Celestino et al. (2013)
Fresh Nectar of
flowers
Persistent ingestion of the nectar has caused joint
weakness and partial paralysis
Watt and Breyer-
Brandwijk (1962)
Elephantorrhiza
elephantina (Burch.)
Skeels/Fabaceae
Aqueous extract Rhizome Acute toxicity: decreased respiratory rate after 10 min of
administration in rats at 1600 mg/kg
Maphosa, Masika, and
Moyo (2010)
Subacute toxicity: increased white blood cell and
monocyte counts at 400 and 800 mg/kg and increased the
serum levels of creatine at 400 and 800 mg/kg
Acetone Leaves LC
50
: 416.40 μg/mL on Vero cells Kudumela, McGaw, and
Masoko (2018)
Water Rhizomes LC
50
: 5.8 ppm against Brine Shrimp Mpofu, Msagati, and
Krause (2014)
Methanol LC
50
: 1.8 ppm against Brine Shrimp
Chloroform fraction LC
50
: 10 ppm against Brine Shrimp (KwaZulu-Natal
cultivar)
Ethyl acetate fraction LC
50
: 7.9 ppm against Brine Shrimp (KwaZulu-Natal
cultivar)
Methanol fraction LC
50
: 15 ppm against Brine Shrimp (KwaZulu-Natal
cultivar)
Fresh Seed/bean Roasted beans have been used as a substitute for coffee.
The seed is toxic to rabbits, sheep, and guinea pigs,
causing gastroenteritis
Watt and Breyer-
Brandwijk (1962)
Aqueous Seeds An equivalent dose of 0.75 g caused necrosis at the
injection point in guinea pigs and caused gastroenteritis
and pulmonary edema upon subcutaneous injection
Oral LD
50
in rabbits is between 5 and 7.5 g, causing death
within 24 h. Ingestion caused apathy, loss of appetite,
diarrhea, and extreme exhaustion
Oral dose of 250 g in sheep caused death within 24 h
causing gastroenteritis, hemorrhaging, and degeneration
of the liver
Erythrina lysistemon
Hutch./Fabaceae
The plant and seeds have been reported to contain
alkaloids which are highly toxic
Mbambezeli and Notten
(2002)
Dichloromethane Stem bark Mortality rate of 10.2% and 16.7% at 24 and 48 h,
respectively, in brine shrimp
Sadgrove et al. (2020)
Methanol Stem bark Mortality rate of 23.5% and 37.1% at 24 and 48 h,
respectively, in brine shrimp
Galenia africana L./
Aizaoceae
80% Ethanol Unspecified Acute oral toxicity: oral administration of
Ng’uni, Klaasen, and
Fielding (2018)
300 and 2000 mg/kg doses to SpragueDawley rats
showed no adverse reactions and no deaths were
recorded
(Continued)
TABLE 4.3 (Continued)
Plant species/family Extraction solvent Plant part Toxicity potential Reference
Acute dermal toxicity: 2000 mg/kg topical application on
SpragueDawley rats showed no systemic signs of
toxicity and no deaths were recorded (LD
50
. 2000 mg/
kg). Necroscopy abnormalities were noted, which have
been reported to be common background finding in
SpragueDawley rats
Skin irritation: 20% wt./vol. concentration and 1% vol./
vol. dilution showed a viability of 84.756 11.26 and
92.97 6 14.63% on the Episkin, respectively. Therefore,
considered a nonirritant
Dermal sensitization: application of 50, 100, and 200 mg/
mL/kg doses did not cause signs of systemic toxicity and
did not cause dermal sensitization
Gold nanoparticles
prepared from hot
water (decoction)
Fresh aerial Cell viability .80 and . 70% at concentrations of 8 and
32 nM, respectively, against human fibroblasts (KMST-6)
Elbagory et al. (2017)
Fresh Whole plant Causes waterpens in small ruminants such as sheep and
goats. Waterpens are characterized by extensive ascites
and liver cirrhosis
Watt and Breyer-
Brandwijk (1962)
Grewia occidentalis L./
Malvaceae
Listed as nonpoisonous and the fruits are used
traditionally to make beer and milkshake (boiled in milk)
Turner (2008),
Hepplewhite and
Witkoppen Wildflower
Nursery (2018)
The yellow berry is eaten by both the Xhosa and Zulu
communities
Watt and Breyer-
Brandwijk (1962)
Melianthus comosus
Vahl/Melianthaceae
Ethanol Leaves IC
50
: 51.40 μg/mL on Vero cells Heyman et al. (2009)
Decoction Leaves and
stems
A 5% decoction caused vomiting and gastrointestinal
irritation
Watt and Breyer-
Brandwijk (1962)
Aqueous infusion Roots Subcutaneous injection in animals caused lassitude, loss
of appetite, vomiting, and resulted in death. Necrosis was
observed at the injection site and organs showed signs of
congestion
Dried plant parts Leaves,
flowers, and
young fruit
A sheep drenched with 80 g of leaves, flowers, and young
fruit, died within 45 h after administration by causing
hemorrhaging and inflammation of the duodenum,
jejunum, and other organs
Acetone-enriched
extract
Leaves No toxicity observed against brine shrimps at a
concentration of 0.1, 0.2, and 0.5 mg/mL. At 1.0 and
2.0 mg/mL, 9.76% and 21.65% mortality rate was
recorded, respectively (LC
50
. 2.0 mg/mL)
Angeh (2006)
IC
50
: 0.0442 mg/mL on Vero cells
Plectranthus fruticosus/
Lamiaceae
Distillation water
extracted with
diethyl ether
Leaves The plant is embryo- and foetotoxic to rodents
Chamorro, Salazar,
Fournier, and Pages
(1991)
Sutherlandia frutescens
(L.) R.Br/Fabaceae
Ethanol Leaves LD
50
: 40.54 μg/mL (zebrafish larvae) Chen et al. (2018),
Zonyane et al. (2019)
At 5 μg/mL the hatching rate of zebrafish was not
affected
There was a 0% hatch rate and 100% mortality rate at
300 μg/mL
Mortality rate increased from 22.2% to 95.5% at
concentrations ranging from 10 to 30 μg/mL
Concentrations . 30 μg/mL led to abdominal excess fluid
and yolk sac edema. At 200 μg/mL, there was a 38%
frequency of abnormal morphological features
Decreased heart rate (28 6 1 beats/10 s to 27 6 3 beats/
10 s) at 5 μg/mL
Water LD
50
: 297.57 μg/mL (zebrafish larvae)
At 5 μg/mL the hatching rate of zebrafish was not
affected
(Continued)
TABLE 4.3 (Continued)
Plant species/family Extraction solvent Plant part Toxicity potential Reference
There was a 0% hatch rate and 100% mortality rate at
300 μg/mL
Mortality rate increased from 0% to 33.3% at
concentrations ranging from 0 to 200 μg/mL
Concentrations . 30 μg/mL led to abdominal excess fluid
and yolk sac edema
No decrease in heart rate at 5 μg/mL, however, a decrease
was noted at 10 and 30 μg/mL
Ethyl acetate Whole plant Antimutagenic activity at a concentration of 5%, 10%, and
20% per plate using Salmonella typhimurium strains TA97a,
TA98, and TA100
50% Methanol At 50% the methanolic extract showed pro-mutagenic
effects in comparison with the diagnostic mutagen 2-
acetamidofluorene for S. typhimurium strain TA98. The
same extract also exhibited pro-mutagenic effects in
comparison with Aflatoxin B1 using the S. typhimurium
strain TA100. In both cases the revertant colonies were
higher than that of the mutagenic compounds in the
presence of the S9 rat liver enzyme fraction
Ntuli, Gelderblom, and
Katerere (2018)
800 mg/day leaf
powder capsules for
3 months
No significant difference was noted in the physical, vital,
blood, and biomarker indices when compared to the
placebo group. No general adverse events were observed
Johnson, Syce, Nell,
Rudeen, and Folk (2007)
Urtica urens L./
Urticaceae
50% Aqueous ethanol Aerial parts No cytotoxic effects exhibited on mouse macrophages
(RAW 264.7) or hepatocyte (HepG2) cells
Carvalho et al. (2017)
The plant is used as a
relish by African
communities
Watt and Breyer-
Brandwijk (1962)
Aqueous Leaves No harmful effects were noted against skin fibroblasts
(HSF) at 5 and 10 μg/mL
Al Doghaither, Omar,
Rahimulddin, & Al-
Ghafari (2016)
the affected area. The gel exudates are also administered orally to act as an immune
booster, improve digestion, and alleviate constipation. Similar to other Aloe species, the gel
of Aloe excelsa is directly applied to dermal wounds to accelerate wound closure and to
moisturize the skin (
Coopoosamy & Magwa, 2007).
Aloe ferox Miller
Aloe ferox Miller, also known as the bitter aloe, is an arborescent species belonging to
the Xanthorrhoeaceae family. It is indigenous to southern Africa but is found mainly in
KwaZulu-Natal. The name “ferox,” which translates to “ferocious,” describes the morphol-
ogy of the large spiny leaves. It is single-stemmed, grows to an average height of 3 m, and
forms rosettes of large fleshy leaves. The leaves are thick and dull green in color with red-
brown spines along the edges of each leaf and smaller spines along the entire leaf epider-
mis. The flowers are uniform, red-orange in color, and grow between 0.5 and 1.22 m above
the leaves into multibranched inflorescences with tightly compacted conical racemes. It
takes 24 years to reach maturity and flowers between May and August over the winter
period (
O’Brien, Van Wyk, & Van Heerden, 2011).
Traditional usage
There are ancient depi ctions of Aloe ferox in cave paintings in the Aliwal North area of
South Africa (over 250 years old) and scriptures by the Greek physician Dioscorides
(CE AD) indicating that the plant has been used for its medicinal properties for centuries.
The gel is known for its antiinflammatory and hydrating properties and is therefore used
in wound healing and cosmetic products that treat unfavorable skin conditions such as
eczema, conjunctivitis, or sunburn (
O’Brien et al., 2011).
Aloe ferox is commonly used in the production of purgative medication such as “aloe
bitters” or “aloe lump.” Aloe bitters are made from the dark sap of the aloe, the sap
between the leaf epidermis and the gel of the leaf, which is extracted and dried to make a
dark crystalline substance. The crystals are used in the Eastern and Western Cape pro-
vinces of South Africa to alleviate sym ptoms of arthritis but are mainly used to treat con-
stipation. The purgative effects of the dark sap are attributed to the action of reducing
water reabsorption into the intestine and by directly stimulating the smooth muscle of the
gut (
Chen, Van Wyk, Vermaak, & Viljoen, 2012). The dark sap and gel of Aloe ferox are
used by the Xhosa in the treatment of dermal wounds and are believed to stimulate
wound closure as well as provide antimicrobial and antiinflammatory activity. Slices of
the leaves are placed in the drinking water of livestock to provide immune-boosting prop-
erties. Traditional healers of the Eastern Cape use it to treat wounds developed from sexu-
ally transmitted infections such as gonorrhea and syphilis. Decoctions of the fresh and
dried leaves are administered orally or directly applied as a gel to wounds to prevent bac-
terial infection and promote wound healing (
Kambizi, Sultana, Afolayan, & Afolayan,
2008
). Additionally, the Zulu’s prepare a decoction from the leaves, which is applied to
venereal sores (Watt & Breyer-brandwijk, 1962).
161South African medicinal plant species with activity against wound-associated bacteria
Medicinal Plants as Anti-infectives
Elephantorrhiza elephantina (Burch.) Skeel
Elephantorrhiza elephantina, which forms part of the Fabaceae family, is a species of a
small genus, consisting of nine species that are distributed over the African continent. In
southern Africa specifically, E. burkhei, E. elephantina, E. goetzei, and E. suffruticosa are used
for their medicinal properties. This plant has a wide distribution throughout southern
Africa including South Africa, Namibia, Botswana, Zimbabwe, Mozambique, Swazi land
(now Eswatini), and Lesotho. It thrives in hot and dry grasslands and open scrub. This
species is described as a perennial suffrutex or low shrub, producing annual stems grow-
ing up to 90 cm tall, with a thickened 8 m long rhizome. The bipinnately compound leaves
are arranged alternately, described as almo st glabrous with a petiole of up to 8 cm long.
The raceme inflorescence is axillary and commonly confined to the lower stem occurring
solitary or clustered. The yellow-white bisexual flowers have reddish-brown glands at the
base, with linear-oblong petals that are connate at the base. The fruit is described as a
compressed-oblong, straight, or slightly curved pod that is reddish-brown in color and
swollen over the seeds (
Maroyi, 2017).
Traditional usage
The species is used to treat various gastrointestinal and dermatological ailments in
South Africa, including diarrhea, dysentery, stomach pain, ulcers, acne, male pattern
baldness, and hemorrhoids. Some nonmedicinal uses include the use of the rhizome
and/or bark as a dye to tan animal hides. Young shoots are used as livestock feed and the
seeds are often roasted and used as a substitute for coffee. In Lesotho the plant is used
to prevent bleeds, syphilis, and disorders of the intestinal tract.
Maroyi (2017) has recorded
numerous ethnomedicinal uses, including its use for dermatological ailments. An infusion
of the rhizomes and roots is used in South Africa for acne and to treat shingles in combi-
nation with other species. Rhizome and root decoctions are administered orally, both
alone and in combination with other species to treat sores. A rhizome decoction is used
to relieve itching. The underground parts are used to treat sunburn. In Lesotho, a root
decoction is applied directly to bleeding wounds and is also taken orally as a blood
purifier.
Erythrina lysistemon Hutch
Erythrina lysistemon, commonly known as the coral tree, forms part of the Fabaceae fam-
ily. It is a medium-sized tree, reaching heights of up to 10 m, and is well known for its
bright red flowers which bloom during spring (August to September). The leaves, which
can reach a size of up to 17 3 18 cm, are compound and have three leaflets. Long and slen-
der fruit pods, which can be up to 15 cm long contain bright red seeds, which are easy to
germinate for propagation. Erythrina lysistemon is found throughout South Africa as well
as in southern Africa, such as Botswana, Angola, and Zimbabwe. It can be found in the
Eastern Cape, North West, KwaZulu-Natal, Gauteng, Limpopo, and Mpumalanga, where
it can be found growing in various habitats such as rocky slopes, dry woodlands, and
savannah, as well as forest and coastal areas (
Mbambezeli & Notten, 2002).
162 4. Medicinal plants used in South Africa as antibacterial agents for wound healing
Medicinal Plants as Anti-infectives
Traditional usage
The leaves are crushed and used as a dressing for wounds that have been infested with
maggots. A poultice prepared from the bark is used to treat abscesses, wounds, and sores
as well as arthritis. Other uses include infusions prepared from the leaves which are
applied as ear drops to alleviate earaches and root decoctions which are used on sprains
(
Mbambezeli & Notten, 2002).
Galenia africana L
Galenia africana, known as the kraalbos, forms part of the Aizoaceae family. It is a shrub
that can reach a meter in height. It is most often found in the Namaqualand and Karoo
regions of South Africa, growing in areas that have been disturbed, such as roads, old
lands, and kraals. The leaves are oppositely arranged, hairless, and can reach a length
of up to 5 cm. As the shrub starts to mature, the leaves start to turn yellow (
Vries et al.,
2005
).
Traditional usage
A study performed in the south-eastern Karoo reported that the species is boiled in salt-
water and used to wash wounds. The stems, which have been steeped in water are
applied topically to treat rough skin. Other medicinal properties include bathing in a weak
infusion for the treatment of rheumatism (
van Wyk, 2008). Watt and Breyer-brandwijk
(1962)
reported that a decoction of G. africana is used to prepare a lotion for the treatment
of wounds in humans and animals. It was also reported that people in the Western Cape,
used a decoction to treat skin diseases. An ointment to dress leg wounds, more specifically
in women, is made by frying G. africana in butter together with the plant species Cyanella
lutea, Lobostemon fruticosus, Melianthus major, Melianthus comosus “Tiendaegeneesblare”
and “Jakkalsoorblare” has been reported. External lesions associated with syphilis are
washed using a decoction prepared from G. africana, L. fruticosus, M. major, and M. comosus
(
Watt & Breyer-brandwijk, 1962).
Grewia occidentalis L
Grewia occidentalis, commonly known as cross-berry or four-corner, belonging to the
Malvaceae family, is an indigenous South African shrub, which can reach heights of up to
3 m. It can be found in a variety of habitats such as wooded grasslands, arid Karoo and
Highveld, coastal and mountain slopes, or forest areas. It is widely distributed throughout
South Africa ranging from the Western Cape, throughout the Eastern Cape, Gauteng,
Limpopo, Free State, and North West, Mpumalanga and KwaZulu-Natal, and is also
found in Zimbabwe and Mozambique (
Foden & Potter, 2005). During the summer months
(OctoberJanuary), purple star-shaped flowers appear, which in turn develop into four-
lobed red-brown to purple fruits, from which the common name is derived. The simple,
alternate leaves are dark green and shiny, with hairs that appear on both sides (
Grierson
& Afolayan, 1999; Turner, 2008).
163South African medicinal plant species with activity against wound-associated bacteria
Medicinal Plants as Anti-infectives