دراسة تأثيرات خلاصة قشور ثمار الفستق الحلبي و خلاصة صمغ شجرته المضادة لليشمانيا الجلدية CL كعلاج مساعد لأنتيموانات الميغلومين

Abstract EN

According to the World Health Organization (WHO), more than 80% of the world′s population relies on traditional medicine for their primary health care needs.

In the past decades, the advent of synthetic antimicrobial drugs has caused reluctance in plants as a rich resource of antimicrobial agents.

Since vaccines are not yet available for Cutaneous Leishmaniasis, the maintenance and improvement of the existing treatment regimens and discovery initiatives have been found to be the only ways of controlling this important tropical disease.

Natural products provide unlimited opportunities for new drug discoveries, because of the unmatched availability of chemical diversity.

Since the pistachios are widely distributed in Syria, our research has mainly focused on the use of the usually unused parts of Pistacia vera L.

in producing new pharmaceutical products, that can be used in the treatment of Cutaneous Leishmaniasis, by using the extract of Pistacia vera L.

skin peels and gums as an supportive treatment.

We have used them in developing a dermal cream that can be used as a supportive treatment for the Cutaneous Leishmaniasis.

Knowing that Aleppo is historically considered the home for this disease, and that's why, this disease is called "Aleppo Boil".

Throughout the years of the unjust war against Syria, the spread of this epidemic has markedly increased.

There is no vaccine for Leishmaniasis and the available chemical treatment, that includes several anti parasites such as the Pentium-equivalent antimony derivatives, including antimoniate meglumene and sodium stibogluconate, has several limitations including among others, its variable efficacy depending on the type of parasite and the potential resistance for it, its high toxicity for the liver and heart, the long treatment duration and its high cost.

Due to the above mentioned facts, the drugs co-treatments (chemical-chemical) is getting more consideration.

Besides, the natural products have recently become an unlimited source for developing anti Leishmania drugs, given that they provide better level of efficacy and safety, along with lower levels of toxicity, in addition to their lower cost.

We have assessed the efficacy of the ethanolic extracts of Pistacia vera L.

as anti Leishmaniasis in both in vitro and clinical study through local administration.

The in-vitro tests were conducted using the ethanolic extracts of Pistacia vera tree's gum and the L.tropica parasites viability.

The results showed a good biological effect when treating the parasites with gradually increased concentrations of the ethanolic extracts during the 48 hours of incubation.

The double- blinded clinical study was conducted on 102 patients at the Leishmania center in Aleppo.

The clinical results and observations showed that the local complementary treatment with the extracts, of both the skin peels of Pistacia vera L.

fruits and the gum of Pistacia vera L.

tree, could support the chemical treatment with antimoniate meglumene (administered through local injection) in treating the Cutaneous Leishmaniasis.

In the statistical study of the results, we note that the method of treatment B, which used the pistachio cream with the topical injection of the Antimoniate Meglumene, improved about five times more (OR = 5.5) than the treatment method A, Placebo with topical injections of Antimoniate Meglumene, with a statistically significant difference (p <0.01) during the same period (4 weeks).

The above mentioned support is manifested with reducing the injured area and its hardness, in addition to reducing the edema and the redness.

Besides, the above mentioned extracts could significantly support the treatment of the secondary infection and its associated ulcer.