Aloe vera may help malaria treatment, work best with standard malaria drug   — Study

Scientists are continuing to look for new ways to fight malaria, a serious health problem, especially for pregnant women and children under five. Malaria medicines are becoming less effective because the parasite is changing and becoming resistant to treatment. 

Now, in a study, researchers discovered that Aloe vera compounds called anthraquinones sharply reduced malaria parasite levels, especially at low doses.

When combined with amodiaquine, a common malarial drug, the treatment worked even better, in some cases completely clearing the infection.

Aloe vera has long been used in traditional medicine across Africa and the Middle East. In Yemen, Aloe juice is commonly mixed with other ingredients to treat malaria-like symptoms, while in Nigeria it is frequently used by herbal practitioners to manage fevers.

The researchers had focused on anthraquinones, naturally occurring compounds found in Aloe vera, and tested their effectiveness against Plasmodium berghei, a malaria-causing parasite, using infected laboratory mice.

The study, in Tropical Journal of Natural Product Research, included Abdulazeez A. Abubakar, Temidayo D. Adeniyi, Shukura Salau, Jacob O. Arawande and Akinpelu Moronkeji from the University of Medical Sciences, Ondo as well as Oluwagbenga Aina at the Nigerian Institute of Medical Research, Yaba.

In laboratory tests, researchers used laboratory mice infected with malaria. They gave some mice Aloe vera extract; some standard malaria medicine and another group received a combination of Aloe vera and malaria medicine.

Each day, they checked the blood of the mice to see how many malaria parasites were still there and whether the number was going up or down.

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They discovered that Aloe vera compounds called anthraquinones significantly reduced malaria parasite levels in infected mice, especially at low doses.

Among the different extracts tested, the methanolic fraction proved most effective, achieving the lowest parasite density at a dose of 200 microgrammes per kilogramme, with parasite levels dropping to 0.53 parasites per microlitre of blood.

Other extracts made with ethyl acetate and n-hexane also showed parasite suppression, though to a lesser extent. Overall, the extracts demonstrated strong suppressive, preventive, and curative effects, meeting established benchmarks for antimalarial activity.

In addition, the study reported that when combined with the antimalarial drug amodiaquine, the treatment worked even better, in some cases completely clearing the infection.

At a dose of 200 microgrammes per kilogramme of anthraquinones combined with 40 milligrammes per kilogramme of amodiaquine recorded the highest parasite suppression.

While higher anthraquinone doses produced lower suppression rates in short-term tests, they showed strong curative effects over longer treatment periods, with complete parasite clearance observed by day six at the highest dose tested.

In addition, the study recorded no deaths or obvious toxicity in mice at the doses tested, suggesting a favourable safety profile at the experimental level.

Though the mechanisms of action are not yet fully established, they suggested that the combination might have inhibited various stages of the parasite’s growth and reproduction, altered the permeability and integrity of parasite membranes and ultimately led to the death of the parasite.

“Anthraquinones, a component of the combination, may modulate the host’s immune response, thereby enhancing the host’s natural defences against malaria,” they declared.

The researchers suggested therefore that Aloe vera derived compounds may enhance the effectiveness of existing antimalarial drugs, a strategy increasingly encouraged by the World Health Organisation to slow the development of drug resistance.

“If the potential of the compound is properly harnessed, the severity and number of malaria cases will be reduced, ultimately leading to a reduction in morbidity and mortality rates,” they said.

However, researchers said that the findings are based on animal models and as such human studies are essential before any clinical recommendations can be made.

They also called for further research into how the compounds work; including understanding how it works with malaria medicines, correct dosing, and potential long-term effects.

Apart from Aloe vera, several plants that can boost the effectiveness of malaria medicines like artemisinin have been identified.

In the 2022 edition of the South African Journal of Botany study, scientists found Stemonocoleus micranthus stem in combination with artemisinin enhanced the antimalarial potency of the two drugs involved, compared to when used as individual drugs.

Stemonocoleus micranthus is known as “nre” in the South-east of Nigeria. Its stem bark decoction is most widely used traditionally as a remedy for various diseases such as malaria and boil.

Also, in another study, researchers found the combination of Securidaca longipedunculata with Artemether and Lumefantrine a more potent antimalarial treatment in combating resistance.

Securidaca longipedunculata, commonly called Violet tree, “uwar maganigunar” in Hausa, “Ipeta” in Yoruba and “ezeogwu” in Ibo has been used as a remedy for various disease conditions in traditional medicine.

Previously, scientists found stem bark of Khaya grandifoliola, bitter leaf, Cryptolepis sanguinolenta (paran pupa in Yoruba), mangosteen rind, Gynostemma pentaphyllum (Asofeyeje in Yoruba) and Moringa oleifera (Ewe Igbale or drumstick tree) leaf extracts as partner drugs of artemisinin for treating malaria. Their combination with artemisinin had a very strong antimalarial effect and as such a low dose of artesunate will be required in treating malaria.