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INTERNATIONAL JOURNAL OF IMMUNOPATHOLOGY AND PHARMACOLOGY Vol. 27, no.

3, 313-319 (2014)

EDITORIAL
REVIEW ON MEDICINAL USES, PHARMACOLOGICAL, PHYTOCHEMISTRY AND
IMMUNOMODULATORY ACTIVITY OF PLANTS

M. AKRAMl, A. HAMID 2, A. KHALIU, A. GHAFFAR4, N. TAYYABA5, A. SAEED6,


M. ALF and A. NAVEED8

Department ofEastern Medicine and Surgery, University ofPoonch, Rawalakot, Azad Jammu
I

and Kashmir, Pakistan; 'Department ofHorticulture, Faculty ofAgriculture, University ofPoonch,


Rawalakot, Azad Jammu and Kashmir, Pakistan; 'University College ofConventional Medicine,
The Islamia University ofBahawalpur, Pakistan; "Department ofLife Sciences, The Islamia
University ofBahawalpur, Pakistan; 'Department ofApplied Psychology, Bahauddin Zakaria
University Sub Campus Sahiwal, Pakistan; "Cholistan Institute ofDesert Studies, The Islamia
University ofBahawalpur, Pakistan; 'Department ofEastern Medicine and Surgery, Govt College
University Faisalabad; "Faculty ofPharmacy, The Islamia University ofBahawalpur, Pakistan

Received September 6, 2013 - Accepted August 6, 2014

Since ancient times, plants have been an exemplary source of medicine. Researchers have discovered
some important compounds from plants. The present work constitutes a review of the medicinal plants
whose immunomodulant activity has been proven. We performed PUBMED, EMBASE, Google scholar
searches for research papers of medicinal plants having immunomodulant activity. Medicinal plants used
by traditional physicians or reported as having immunomodulant activity include Acacia concocinna,
Camellia sinensis, Lawsonia inermis Linn, Piper longum Linn, Gelidium amansii, Petroselinum crispum,
Plantago major and Allium sativum. Immunomodulant activities of some of these medicinal plants have
been investigated. The medicinal plants documented have immunomodulant activity and should be
further investigated via clinical trial.

Immunomodulators are natural or synthetic agents Terminalia amazonica, Triplaris americana,


which, by modifying the immune system, affect a Uncaria tomentosa, Euterpe precatoria, Citrullus
therapeutic benefit. Different regions of the World colocynthis, Urtica dioica, Elettaria cardamomum,
have a long history of traditional medicine as well Capparis spinosa, Piper cubeba, Aristolochia longa,
as its continuing use. Many traditional products have Datura stramonium, Marrubium vulgare, Sinapis
been used for a considerable period oftime, therefore, nigra, Delpiynium staphisagria, Lepidium sativum,
are thought to be safe and effective. Medicinal Ammi visnaga, Tetraclinis articulata, Euphobia
plants are commonly used in immunomodulation hirta, Larix decidua, Thymus vulgaris, Salix alba,
and are known as immunomodulant, for example Helianthus annuus, Mangifera indica, Dionysia
Astronium urundeuva, Cochlospermum vitifolium, termeana, Salvia macrociphon and Ferulago

Key words: immunomodulant, medicinal plants, efficacy, literature review

Mailing address: Dr Muhammad Akram


Department of Eastern Medicine and Surgery, 0394-6320 (2014)
Faculty of Medical and Health Sciences, Copyright © by BIOLIFE, s.a.s.
The University of Poonch, This publication and/or article is for individual use only and may not be further
Azad Jammu and Kashmir, Pakistan reproduced without written permission from the copyright holder.
Unauthorized reproduction may result in financial and other penalties
Tel.: +92 3343367632 Fax: +92 2136440079
e-mail: makram_0451@hotmail.com 313 DISCLOSURE: ALL AUTHORS REPORT NO CONFLICTS OF
INTEREST RELEVANT TO THIS ARTICLE.
314 M. AKRAM ET AL.

angulata. Specific healing herbs have the strongest It exhibits immunostimulatory effect by enhancing
immune system boosters. Nervous and hormonal serum immunoglobulin levels, phagocytic activity
systems are normalized and strengthened by use and cell mediated immunity (3).
of immunomodulator herbs. Some of these herbs
have an antioxidant activity that reduces the aging Acacia concinna
process and boosts immunity (I). Herbal medicine Family: Mimosaceae. Parts used: Pods and
is an integral part of the development of modern leaves. Chemical constituents: Lupeol, ascorbic
civilization. In herbal medicine single plants and acid, calyctomine nicotine, spinasterol, acacic acid,
complex formulations are prescribed to treat diseases. arabinose and rhamnose, hexacosanol, oxalic acid,
The present work is a review on the medicinal tartaric acid, citric acid, succinic acid, spinasterone,
plants with immunomodulatory activity performed Medicinal uses: It is used in dandruff, malaria and
by searching through PUBMED, EMBASE and jaundice. Pharmacological activity: It is laxative and
Google scholar. We have listed a series of plants immunomodulant. Mechanism: It enhances activity
and explained their characteristics and effects and of Th I and Th2 helper T cells. It has reported the
concluded that they should be further investigated immunological adjuvant activities of saponin
via clinical trial. extracts from the pods of A. concinna (4).

MEDICINAL PLANTS Allium sativum


Family:Amaryllidaceae. Partsused:Bulb.Chemical
Abrus precatorius L constituents: Scordinin, alliin, acrolein, phytocidin,
Family: Fabaceae. Parts used: Seed and root. diallyl-trisulphide, diallyl-disulphide. Medicinal
Chemical constituents: Squalene, trigonelline, uses: It is used in atherosclerosis, hyperlipidemia,
glycyrrhizin, precabrine, hypaphorine, gallic acid, hypertension, diabetes mellitus, dyspepsia, bacterial
5- beta cholanic acid, abrusic acid, abrine, abraline. infections, fever, cancer, tuberculosis, intestinal
Medicinal uses: It is used in helminthiasis, cough, worms. Pharmacological activity: It is antiviral,
vomiting, malaria, jaundice, cancer and venereal antihypertensive, anti-hypercholestrolemic,
diseases. Pharmacological activity: It is antimalarial, carminative, stimulant, cholagogue, tonic, febrifuge,
demulcent, aphrodisiac, emetic, alexiteric, blood purifier, rubifacient, antibiotic, aphrodisiac,
anthelmintic, diaphoretic, expectorant and vermifuge. anti-allergic, antifungal, diuretic, anticoagulant,
Mechanism: It exhibits immunosuppression effect by antirheumatic and antispasmodic. Mechanism: It
reducing antibody titer, delayed type hypersensitivity exhibits immunostimulatory effect by enhancing
response. It is used to treat liver disorders. Tripathi mitogenic activity towards human peripheral blood
et al. reported the immunomodulatory activity of A. lymphocytes, murine splenocytes and thymocytes (5).
precatorius (2). Aly et al. reported the immunostimulant activity of A.
sativum (6).
Acacia catechu
Family: Fabaceae. Parts used: Bark, wood, gum. Andrographis paniculata
Chemical constituents: Catechin, quercetin, gum, Family: Acanthaceae. Parts Used: Root, bark and
tannin, catechu red, catechutannnic acid. Medicinal leaf. Chemical constituents: Apigenin, potassium
uses: It is used in spongy gums, toothache, bleeding salt, sodium chloride, kalmeghin, andrographolide.
gums, bed sores, pharyngitis, dysentery, stomatitis, Medicinal uses: It is used in jaundice, helminthiasis,
gingivitis, leucorrhoea, and diabetes mellitus. diabetes mellitus, cholera and dyspepsia.
Pharmacological activity: It is antidiarrheal, Pharmacological activity: It is hypoglycemic,
antiseptic, anthelmintic, dessicative, blood purifier cholagogue, tonic, alterative, febrifuge,
and astringent. Ismail et al. concluded that the anthelmintic, hepatoprotective, anodyne, astringent
aqueous extract of Acacia catechu at doses of 5mg/ and immunostimulant. Mechanism: A. paniculata
kg and 50mg/kg has a significant effect on both cell exhibits immunostimulatory activity by enhancing
mediated and humoral immunity (3). Mechanism: antibody and delayed type hypersensitivity (7).
Int. J. Immunopathol. Pharmacol.
315

tamala Linn exhibits immunosuppressant effect by


Ascophyllum nodosum suppressing phagocytosis activity and by reduced
Family: Fucaceae. Parts used: Stem. Chemical production of superoxide, and cellular NADPH (11).
constituents: Phlorotannins, tetraphlorethol
C, tetrafucol A Medicinal uses: It is used in Cissampelos pareira L.
inflammation. Pharmacological activity: It is anti- Family: Menispermaceae. Parts used: Root, twig
inflammatory and immunostimulant. Mechanism: and leaf. Chemical constituents: Apigenin, bisbenzyl
It exhibits immunostimulatory effect by enhancing isoquinoline alkaloids, fixed oil, quercitol, hayatine,
natural killer (NK) cell activity (8). hayatinine, hayatidine, berberine, norruffscine,
norimelutein, azafluoranthene, pareirubrines,
Boerhavia diffusa tropoloisoquinoline, isomerubine, grandirubine,
Family: Nyctaginaceae. Parts used: Leaves. corytuberine, magnoflorine, bulbocarpine,
Chemical constituents: Punarnavine, sitosterol, laudanosine, insularine, dicentrine, dehydrocentrine,
palmitic acid, tetracosanoic, hexacosonoic, cyclearine, cyclonoline, pareirine, menismine,
triacontanol, ecdysone, hentriacontane, ursosilic isochodrodendeine. Medicinal uses: It is used in
acid, arachidic acid. Medicinal uses: It is used uterine disorders and arthritis. Pharmacological
in diabetes mellitus, bacterial infection, cancer, activity: It is emmenagogue, expectorant and diuretic.
amoebiasis and leukemia. Pharmacological activity: Mechanism: C. pareira exhibits immunosuppression
It is hypoglycemic, antibacterial, antioxidant, effect by lowering humoral antibody titer and delayed
hepatoprotective, anticancer, antiestrogenic, type hypersensitivity. Anand et al. concluded that
immunomodulant. Mechanism: It exhibits immunosuppressive and antioxidant activities of C.
immunosuppressant effect by inhibiting human NK pareira are due to alkaloidal fraction (12).
cell, production of NO, IL-2 and TNF-alpha (9).
Euphorbia hirta L.
Camellia sinensis Family: Euphorbiaceae. Parts used: Latex.
Family: Theaceae. Parts used: Leaves. Chemical Chemical constituents: Choline, shikimic acid,
constituents: It contains tannic acid, gallic acid, triterpenes, taraxerol, alpha amyrin, resins, glucose,
quercetin, theine, xanthine, adenine, saponin, fructose, sucrose, gallic acid, campesterol, sitosterol,
theophylline, catechin, epicatechin, epicatechin stigmasterol, quercetin, quercitrin, leucocyanidine,
gallate and epigallocatechin gallate. Medicinal uses: It xanthorhamnin. Medicinal uses: It is used in warts,
is used in asthma, angina pectoris, cancer and bacterial vomiting, fever, respiratory problems, dysentery,
infections. Pharmacological activity: It is anti- asthma, bronchitis, syphilis, helminthiasis,
asthmatic, anti-cancer, antibacterial and antioxidant. gonorrhea, backache, indigestion, measles and
Mechanism: Catechin polysaccharide complex hypertension. Pharmacological activity: It is tonic,
is important molecule in the immunostimulatory anthelmintic, antisyphilitic and diuretic. Mechanism:
activity. Study: Chattopadhyay et al. reported that C. It exhibits immunostimulatory activity by enhancing
sinensis shows immunomodulatory properties on an phagocytic activity (13).
experimental animal model and in human peripheral
mononuclear cells. This study justifies its use as Ficus benghalensis L.
immunomodulant drug (10). Family: Moraceae. Parts used: Leaves,
seeds, latex, bark and tender ends of the aerial
Cinnamomum tamala roots. Chemical constituents: ~ sitosterol
Family: Lauraceae. Parts used: Bark and essential and caoutchouc. Medicinal uses: It is used in
oil. Chemical constituents: Phenyl propanoids, diarrhea, diabetes mellitus, inflammation, sepsis,
eugenol, eugenyl acetate, n-phellandrene. vomiting, pyrexia, piles, gonorrhea, syphilis,
Medicinal uses: It is used in diabetes mellitus, dysentery, spermatorrhoea, premature ejaculation,
cardiovascular disorders. Pharmacological activity: haemoptysis, bruises, sores, ulcers, arthritis,
It is hypoglycemic and anti-oxidant. Mechanism: C. lumbago and toothache. Pharmacological activity:
316 M. AKRAM ET AL.

It is styptic, aphrodisiac, analgesic, anodyne, antimutagenic, antiviral and hypoglycemic.


antipyretic, astringent, antidiarrheal, refrigerant, Mechanism: Martino et al. reported the in vitro
tonic, antibilious, antigonorrheal, antihemorrhoidal, immunomodulatory efficacy of fractions of L.
concotive, vunerary, antidiabetic, anti-inflammatory, divaricata on mouse peritoneal macrophages.
antiseptic and antiemetic. Gabhe et al. investigated A fraction from aqueous extract of L. divaricata
the immunomodulatory activity of this plant in rats increases TNF-alpha release and exhibits the strongest
and concluded that it stimulates cell-mediated and expression of inducible nitrogen oxide synthase (18).
antibody-mediated immune responses in rats. It is
involved in phagocytic activity ofneutrophils, in vitro Lawsonia inermis Linn
(14). Mechanism: It exhibits immunostimulatory Family: Lythraceae. Parts used: Leaves.
effect by enhancing serum lysozyme, tissue super Chemical constituents: Lawsone, alpha ionone,
oxide dismutase (SOD), total serum proteins, gallic acid, hennotannic acid. Medicinal uses: It is
immunoglobulins, nitric oxide (15). used in inflammation, diabetes mellitus, bacterial
infections, cancer, rheumatoid arthritis, jaundice and
Hibiscus sabdarifJa Linn. leprosy. Pharmacological activity: It is antidiabetic,
Family: Malvaceae. Parts used: Leaves and seeds. hypolipidemic, immunomodulant, hepatoprotective
Chemical constituents: Potash, tartaric acid, malic and antioxidant. Mechanism: Naphthoquinone
acid, palmitic acid, oleic acid, vitamin C, calcium fraction of L. inermis exhibits immunostimulatory
oxalate. Medicinal uses: It is used in scurvy, dysuria, activity. L inermis exhibits immunostimulant
fever, cough and hypertension. Pharmacological activity by promotion ofT-lymphocyte proliferative
activity: It is tonic, stomachic, sedative, resolvent, responses (19).
purgative, diuretic, digestive, cholagogue,
astringent, aphrodisiac, antiseptic, antiscorbutic, Leptadenia reticulata
stimulant, demulcent, emollient immunomodulant. Family: Asclepidaceae. Parts used: Leaves and
Mechanism: It exhibits immunostimulatory effect by unripe fruits. Chemical constituents: Alpha amyrin,
enhancing the production of interleukin and tumor beta amyrin, stigmasterol, ferulic acid, beta sitosterol,
necrosis factor (16). luteolin, hentriacontanol, apigenin, tocopherol,
saponin, flavonoids, lupanol-o-diglucoside. Medicinal
Ipomoea carnea Jacq. uses: It is in used sexual disorders. Pharmacological
Family: Convulvulaceae. Parts used: activity: It is galactagogue and anti-bacterial.
Latex. Chemical constituents: Swainsonine, Mechanism: It exhibits immunostimulatory effects by
epilentiginosine, calystegine, methyl trans-4- enhancing antibody titer and phagocytosis (20).
hydroxyl-l-proline. Medicinal uses: It is used
in carcinoma, bacterial infections, skin diseases, Mangifera indica L.
inflammation and insomnia. Pharmacological Family: Anacardiaceae. Parts used: Flower,
activity: It is immunostimulant and a wound seed and bark. Chemical constituents: Mangiferin,
healer. Ipomoea carnea contain a component called xanthone, flavonoids, triterpenoids, glycosides,
swainsonine that is involved in immunomodulation isomangiferin, tannins, gallic acid, shikimic acid,
process. Mechanism: It exhibits immunostimulatory kinic acid, amino butyric acid, glycine, alanine,
activity by enhancing phagocytosis activity (17). catechin, protocatechic acid. Medicinal uses: It is
used in diabetes mellitus, inflammation and pyrexia.
Larrea divaricata Pharmacological activity: It is hypoglycemic,
Family: Zygophyllaceae. Parts used: Leaves. analgesic, anti-inflammatory and immunostimulant.
Chemical constituents: Lignans, guaiaretic Mechanism: Makare et al. reported the
acid, catechol, furanoid 1aryl tetralin lignans, immunomodulatory activity of alcoholic extract of
podophyllotoxins, triterpenes, sapogenins, sterols. M indica in mice. It exhibits immunostimulatory
Medicinal uses: It is used in tumor and diabetes effect by enhancing humoral antibody (HA) titer and
mellitus. Pharmacological activity: It is antioxidant, delayed type hypersensitivity (21).
Int. J. ImmunopathoI. Pharmacol. 317

Murraya koenigii Saccharum officinarum


Family: Rutaceae. Parts used: Leaves. Chemical Family: Poaceae. Parts used: Root. Chemical
constituents: Grinimbine, sugar, tannin, vitamin constituents: Carotene, thiamine, ascorbic acid,
C, protein, phosphorus, potassium, calcium, riboflavin, glucose, flavone C and 0 glycosides
magnecium, iron. Medicinal uses: It is used in Medicinal uses: It is used in bacterial infection,
diabetes mellitus. Pharmacological activity: It is anti- diarrhea,arthritis,tumor,respiratorytract infectionsand
hyperglycemic and immunomodulant. Mechanism: gonorrhea.Pharmacologicalactivity: It is antimicrobial,
Immunomodulatory activity of methanolic extract anticancer, antidiarrheal, laxative, stomachic and anti-
of M koenigii leaves has been reported. It exhibits inflammatory. Mechanism: Hikosaka et al. reported
immunostimulatory effect by stimulating humoral that polyphenol-rich fraction of sugar cane exhibits
immunity and phagocytic function (22). immunostimulating effects in chickens. Phenol-rich
fraction of S. officinarum exhibits immune-stimulatory
Petroselinum crispum effectby enhancingthe phagocyticactivityofperipheral
Family: Apiaceae. Parts used: Root and leaves. blood leukocytes (26).
Chemical constituents: Flavonoids, phthalides,
vitamins, coumarins. Medicinal uses: It is used Tinospora cordifolia
in kidney stones, dropsy, jaundice, anemia, Family: Menispermaceae. Parts used: Root,
amenorrhea and cancer. Pharmacological activity: It fruit, leaves and stem. Chemical constituents:
is uterotonic and antioxidant. Mechanism: It exhibits Tinosporic acid, tinosporol, berberine, giloin, gilo-
immunosuppressant effect by suppressing both NO sterol, columbin, palmarin, tinosporin, chasmanthin.
production and the functions of macrophages as the Medicinal uses: It is used in jaundice, cough,
main innate immune cells (23). piles, fever, respiratory tract infection, intestinal
pain, inflammation, gout, rheumatism, leprosy,
Piper longum L. urinary affections and diarrhea. Pharmacological
Family: Piperaceae. Parts used: Immature activity: It is anti-inflammatory, anti-emetic, anti-
berries. Chemical constituents: Piperine, pipilartine, arthritic, anti-diabetic. Sudhakaran et al. reported
piperlongumine, pipemonaline, piperundecalidine, immunostimulatory effect ofthis plant in Oreochromis
aristolactums, dioxoaphines, alkaloids like mossambicus (27). Mechanism: T. cordifolia exhibits
cepharadione, norcephradione and resin. Medicinal significant immunomodulatory activity by enhancing
uses: It is used in pyrexia, bacterial infections, phagocytic activity ofWBC (28).
malaria, nausea, vomiting, cough and inflammation
of pelvis. Pharmacological activity: It is stimulant, Tinospora sinensis
carminative, aphrodisiac, anti-pyretic, anti-bacterial Family: Menispermaceae. Parts used: Leaves and
and anti-dote. Mechanism: Pipemic acid of Piper stems. Chemical constituents: Tinosenin, berberine,
longum L. exhibits immunomodulation through 4-methyl-heptadec-6-enoic acid ethyl ester, 3
suppression of proinflammatory cytokines (24). hydroxy-2, 9, II-trimethoxy-5,6-dihydro isoquinol.
Medicinal uses: It is used in diabetes mellitus
Plantago major and inflammation. Pharmacological activity: It is
Family: Plantaginaceae. Parts used: Seeds. immunomodulant, anti-inflammatory, hypoglycemic
Chemical constituents: Mucilage, fixed oil, starch, and antileishmanial (29). Mechanism: Manjrekar
protein and tannin. Medicinal uses: It is used in et al. reported the immunomodulatory activity of
wounds, inflammation, bacterial infection, diarrhea, T. sinensis. It exhibits immunomodulating effect
hemorrhoids, ulcers and bronchitis. Pharmacological by inhibiting cyclophosphamide induced anemia
activity: It is laxative, anti-gout, anti-inflammatory, (Manjrekar et aI, 2000).
antipyretic, astringent, antibacterial and immune
enhancer. Mechanism: It exhibits immunostimulatory CONCLUSION
effect by enhancing lymphocyte proliferation and
secretion of interferon-gamma (25). Immunomodulant activities of some of these
318 M. AKRAM ET AL.

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