title: Protective activity of medicinal plants and their isolated compounds against the toxic effects from the venom of Naja (cobra) species.
abstract: BACKGROUND
  Various medicinal plants have protective properties against the toxicities of the venom of cobra snake (Naja species). They may be used as local first aid for the treatment of snakebite victims, and can significantly inhibit lethality, cardio-, neuro-, nephro- and myotoxicity, hemorrhage, and respiratory paralysis induced by the cobra snake venom. The plants or their extracts may also complement the benefits of conventional anti-serum treatment.
  
  
  OBJECTIVE
  This review provides information on the protective, anti-venom, properties of medicinal plants against snakebites from cobras. In addition, it identifies knowledge gaps and suggests further research opportunities.
  
  
  METHODS
  The literature was searched using databases including Google Scholar, PubMed, ScienceDirect, Scopus and Web of Science. The searches were limited to peer-reviewed journals written in English with the exception of some books and a few articles in foreign languages.
  
  
  RESULTS
  The plants possess neutralization properties against different cobra venom enzymes, such as hyaluronidase, acetylcholinesterase, phospholipase A2 and plasma proteases. Different active constituents that show promising activity against the effects of cobra venom include lupeol acetate, β-sitosterol, stigmasterol, rediocides A and G, quercertin, aristolochic acid, and curcumin, as well as the broad chemical groups of tannins, glycoproteins, and flavones. The medicinal plants can increase snakebite victim survival time, decrease the severity of toxic signs, enhance diaphragm muscle contraction, block antibody attachment to venom, and inhibit protein destruction. In particular, the cardiovascular system is protected, with inhibition of blood pressure decline and depressed atrial contractility and rate, and prevention of damage to heart and vessels. The designs of experimental studies that show benefits, or otherwise, of use of medicinal plants have some limitations: deficiency in identification and isolation of active constituents responsible for therapeutic activity; lack of comparison with reference drugs; and little investigation of the mechanism of anti-venom activity.
  
  
  CONCLUSIONS
  Despite some current deficiencies in experimental or clinical analysis, medicinal plants with anti-venom characteristics are effective and so are candidates for future therapeutic agents. We suggest that emphasis on identification and testing of active ingredients in research in the future will assist better understanding of their anti-venom activity.
authors.affiliation: Department of Pharmacy, COMSATS Institute of Information Technology, Abbottabad 22060 Pakistan. Electronic address: charham007@hotmail.com.
authors.forename: Arham
authors.initials: A
authors.lastname: Shabbir
authors.affiliation: Department of Pharmacology, University of Health Sciences, Lahore, Pakistan; Centre for Kidney Disease Research, Translational Research Institute, School of Medicine, The University of Queensland, Australia. Electronic address: shahzad912@hotmail.com.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Shahzad
authors.affiliation: Venomics Research Centre, Translational Research Institute, School of Medicine, The University of Queensland, Australia. Electronic address: p.masci@uq.edu.au.
authors.forename: Paul
authors.initials: P
authors.lastname: Masci
authors.affiliation: Centre for Kidney Disease Research, Translational Research Institute, School of Medicine, The University of Queensland, Australia. Electronic address: g.gobe@uq.edu.au.
authors.forename: Glenda C
authors.initials: GC
authors.lastname: Gobe
mesh_terms: D000818:Animals; D000997:Antivenins / Q000302:isolation & purification / Q000494:pharmacology*; D004546:Elapid Venoms / Q000037:antagonists & inhibitors; D017815:Elapidae; D006801:Humans; D028321:Plant Preparations / Q000494:pharmacology*; D010946:Plants, Medicinal / Q000737:chemistry*; D012909:Snake Bites / Q000188:drug therapy
chemical_list: D000997:Antivenins; D004546:Elapid Venoms; D028321:Plant Preparations
keywords: Anti-venom; Cobra; Medicinal plants; Naja genus