title: Azadirachta indica extract-artesunic acid combination produces an increased cure rate of Plasmodium berghei-infected mice.
abstract: BACKGROUND
  Available artemisinin-combination therapies (ACTs) are expensive. Various traditional herbal remedies for malaria involve plants, proven scientifically to have antiplasmodial effects, e.g., Azadirachta indica A. Juss. (Meliaceae).
  
  
  OBJECTIVE
  Combination of an artemisinin-based compound and a medicinal herb extract will provide an indigenous alternative/herb-based ACT.
  
  
  METHODS
  The in vivo schizontocidal activity of the crude aqueous extract of 100, 500, and 1000 mg/kg of A. indica fresh leaves (NCE) and 6, 15, and 20 mg/kg of artesunic acid were determined, alone and in combination, while keeping the dose of artesunic acid constant at 15 mg/kg, using the Peter's 4-day suppressive test and Swiss albino mice. The ED50 was calculated from the dose-response relationships. Percentage survival and cure were also determined.
  
  
  RESULTS
  The average yield of two extractions of NCE was 8.33 ± 1.67%. Combination of 1000 mg/kg of NCE and 15 mg/kg of artesunic acid, produced a significant reduction of parasitemia (96.87%), compared to 20 mg/kg of artesunic acid alone (68.14%). The combination had an ED50 of 0.58 mg/kg while that of artesunic acid alone was 8.814 mg/kg. The combinations of NCE with artesunic acid produced a cure, although the artesunic acid did not produce a cure in 30 d.
  
  
  CONCLUSIONS
  NCE increased the activity of artesunic acid in terms of reduction in parasitemia, and increased survival time and cure rate.
  
  
  CONCLUSIONS
  The combination of an artemisinin and aqueous extract of neem leaf is possible, providing a potentiated reduction of parasitemia, and increased cure rate.
authors: Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University , Awka , Nigeria .
authors: Onyeka Linda
authors: OL
authors: Anagu
authors: Anthony Amaechi
authors: AA
authors: Attama
authors: Vincent Chima
authors: VC
authors: Okore
authors: Harrison Thaddeus
authors: HT
authors: Gugu
authors: Augustine Arinze
authors: AA
authors: Ngene
authors: Charles Okechukwu
authors: CO
authors: Esimone
mesh_terms: D000818:Animals; D000962:Antimalarials / Q000494:pharmacology / Q000627:therapeutic use*; D037621:Artemisinins / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D031601:Azadirachta / Q000737:chemistry*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D008288:Malaria / Q000188:drug therapy* / Q000469:parasitology; D051379:Mice; D018512:Parasitemia / Q000188:drug therapy / Q000469:parasitology; D008517:Phytotherapy; D010936:Plant Extracts / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use*; D018515:Plant Leaves / Q000737:chemistry; D010962:Plasmodium berghei / Q000187:drug effects*; D052939:Schizonts / Q000187:drug effects; D013386:Succinates / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D000962:Antimalarials; D037621:Artemisinins; D010936:Plant Extracts; D013386:Succinates; C111789:artesunic acid
keywords: Artemisinin-based combination therapy; drug resistance; malaria parasites