Loranthus europaeus (LE) is a well-known medical plant that has been used as a folk medicine for long time ago. Recently many different researches have shown that it contains many bioactive compounds like: flavonoids, alkaloids, terpenoides, phenolic acids and others. Cutaneous Leishmaniasisis (CL) is an endemic disease in Iraq since ancient time and now it is running major outbreaks. There are many modalities of treatments but researchers are always seeking for new treatments. Most recently Loranthus europaeus has been tried in treatment of CL in a form of 40% ointment and gives a very encouraging result when compared with other standard treatments.
Cutaneous Leishmaniasisis (CL), is a parasitic disease caused by 20 Leishmania species, and it is considered a major public health issue as it currently affects 12 million people [
The reason for seeking an alternative medicine is increasing because the modern drugs are simply not available, expensive or due to resistance to the treatment and emergence of new species of parasite. Perhaps 80% of the world’s populations rely solely upon medicinal plants as the source of remedies for treatment of the disease. Herbal remedies have been used for long period of time in both traditional and modern medicine around world, where different plants of medical value are traditionally used worldwide for treatment of leishmaniasis [
Many in vitro studies done about natural product from plants for treatment of leishmaniasis with the excellent activity against leishmania parasite, and the most common bioactive natural compounds are: Alkaloids, quinones, terpenes (monoterpens and triterpenes), saponins, flavonoids especially quercetin [
In this review we selected the medicinal plant Loranthus europaeus based on the fact that this plant was not previously used as antileishmanial agent, and because it contains many of the bioactive compound that had been extracted from many plants and investigated in many in vitro studies and showed a well antileishmanial activity.
Synonoms: (Latin name [
Loranthus is a genus of parasitic plants that grow on the branches of woody trees. It belongs to the family Loranthaceae (the showy mistletoe family) and this genus has 1253 species (
LE is a hemi-parasite mistletoe, it is a deciduous plant (flower are produced in May and June) with dull brown twinges, the fruit is yellow roundish berry, which remain sticky even after dried, the fruits ripen in late autumn and gradually fall off in late winter, the plant grows vigorously on aging trees mostly on branches of oak, and chestnut as host trees and once established, the mistletoe take minerals and water from the host tree, and block sunlight through its dense foliage, the most important vectors of yellow mistletoe are birds [
LE is widely distributed in south-west Europe, south Russia, Anatolia, Iran and Iraq [
LE had a known importance in Iraqi folk medicine for long time ago, for treating boils and abscesses, where a dry fruit used in form of poultice after mastication and moisture in the mouth, it is claimed that the poultice cause maturation and acceleration in the drain of pus from the boils, however the mechanism of action was unknown, until 2006, a study from Iraq done to evaluate the anti-inflammatory effect of the plant in animals, which explained the effect of LE oil extract in pyogenic inflammation and concluded that the oil extract may act as immunomodulator during bacterial infection and may contain substance act as a chemotactic agent for neutrophile and promote macrophage activity [
Loranthus species are known to produce a variety of bioactive compounds and some of them used in a variety of disease such as:
1) Sesquiterpene lactones from L. parasiticus used for the treatment of schizophrenia [
2) (+)-catechin, 3,4-dimethoxycinnamylalcohol and 3,4,5-trimethoxycinnamyl alcohol extracted from L. globosus for antimicrobial and antifungal properties [
3) Triterpenoids from L. grewinkii and L. falcatus [
4) Kaempferol 3-O-α-D-rhamnoside, kaempferol 3,7-di-O-β-D-glucoside, quercetin 3-O-α-D-rhamnoside and quercetin 3-O-β-D-glucoside from L. kaoi and L. europaeus [
5) A cytotoxin from L. parasiticus [
6) Flavonol rhmnoside from L. tanakae and cytoxic effects on the human tumour cell line [
Many of these compound have a biological activities such as antihypertensive and anti-diabetic effect of L. bengwensis [
Loranthus europaeus is one species of Lorantheceae, and many studies showed that LE contain many biological compounds including: Flavonoids (kaempherol, quercetin [
Many of these active ingredients had been extracted from different plants and investigated in many in vitro studies for antileishmanial activity, such as: Alkaloids that are able to intercalate DNA or interfere with the metabolism of aromatic amino acids in the parasite [
As the iron (Fe2+) are essential for organism growth and replication inside macrophage, a chelator effect of the quercetin had been evaluated in interference of parasite’s iron metabolism and showed leishmanicidal action [
The leishmanicidal activity of caffeic acid may attribute to the interaction of with iron and it could cause change in the structure of cytoplasmic proteins that inhibit cell division [
In addition to the above antileishmanial effect, the LE contain polysaccharide and Aldehyde that showed action in an accelerate wound healing [
In one study revealed that the presence of monoterpene in oily extract of LE seeds account for antioxidative action [
The efficacy of topical oily extract of LE seeds was investigated in wound healing on excision wound in 18 rabbits [
The study showed that macrophage activated by polysaccharide which stimulates the fibroblast proliferation with subsequent of myoproliferation at periphery of the wound which has important role in wound contraction [
In other study, when a hot watery and alcoholic extract of seeds of LE with different concentration used topically in treatment of burns in mice showed complete cure of burns [
The effects of topical LE seeds oil extract had been investigated on pyogenic inflammation in excision wound created in the 24 rabbits were the wound of the animals contaminated by staphylococcus aurous bacteria, then the wound evaluated macroscopically which showed increase in hyperemia and exudation in the first days and then gradually disappearance, while microscopically show significant neutrophil and macrophage infiltration. During bacterial infection there was a massive production of pro-inflammatory cytokines including IL1 and IL 6 [
The inflammatory effect of ethyl acetate and methanol extract of LE were evaluated in the acute inflammation in rats when the extract given intraperitoneal, preliminary phytochemical investigated revealed the presence of Flavonoids (quercetin, kaempherol and rutin) and trace of alkaloids plays a crucial role in the ability of suppression of acute inflammation [
Mistletoe extract have been widely used in complementary cancer therapy in Europe [
When the flavonoids and terpenoides isolated from LE and tested on mouse spleen lymphocyte proliferation, both compounds show activation of unstimulated lymphocytes in dose dependent manner, so considered as potential immunomodulators [
In vitro study LE fruits show antioxidant and neuroprotective effect in whom Ibn Sian described it in Cannon of Medicine in management of stroke [
Topical poultice of dry fruit of LE after mastication in mouth used in treatment of boils and abscess which cause maturation and drain of pus from it and this way used for long time ago in folk medicine in Iraq and no any topical and systemic sides effects had been mentioned in medical literatures from use it topically.
In recent years many in vitro studies showed sides effects from used it systemically including:
LE chloroform extract was prepared and used orally for investigation of genotoxic effects in different doses, on bone marrow and peripheral blood cells of mice. Result showed large dose of extract decrease mitotic index and increase chromosomal aberration and significantly decrease the total and different white blood cell counts when compared with lower dose [
In other study, gene toxicity of chloroform and ethyl acetate extract of LE fruits evaluated with different doses on bone marrow and spleen cells of mice in comparable with methotrexate, the extracts contain different amount of alkaloids and flavonoid, showed increasing the amount of alkaloids leads to increase clastogenicity effect while increasing in the amount of flavonoids offer anti-clastogenic effect, and the genotoxic effect after seven successive days was less toxic than methotrexate [
Most recently [
When the 2 groups compared with each other there was no statistical significant difference where the p value after 6 weeks was 0.648.
As Loranthus europeaus contains many active bioactive agents, further studies are highly recommended for assessing these active medicinal agents for treatment other skin disease as this plant is safe to be used on the skin.
This study was an independent study and not funded by any drug companies.
Khalifa E.Sharquie,Adil A.Noaimi,Banaz A.Saleh, (2016) Loranthus europaeus as an Alternative Medicine in Treatment of Acute Cutaneous Lesihmaniasis: Review Article. Journal of Cosmetics, Dermatological Sciences and Applications,06,24-33. doi: 10.4236/jcdsa.2016.61004