Anti-inflammatory and Analgesic Activity of Cleome brachycarpa Ethanolic Extract in Lower Mammals and Effects on Blood and Liver Enzymes


avatar Hira Naeem 1 , avatar Somia Gul 2 , * , avatar Maria Khan 3 , avatar Shaista Hamid 4 , avatar Qurratul Ain Leghari 5 , avatar Hina Yasin 6 , avatar Rehana Perveen 1

Department of Pharmacology, Baqai Medical University, Karachi, Pakistan
Department of Pharmaceutical Chemistry, Jinnah University for Women, Karachi, Pakistan
Department of Anatomy, Dr. Ishrat-ul-Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan
Department of Pharmaceutics, Jinnah University for Women, Karachi, Pakistan
Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Hamdard University, Karachi, Pakistan
Department of Pharmacognosy, Dow University of Health Sciences, Karachi, Pakistan

how to cite: Naeem H, Gul S, Khan M, Hamid S, Leghari Q A, et al. Anti-inflammatory and Analgesic Activity of Cleome brachycarpa Ethanolic Extract in Lower Mammals and Effects on Blood and Liver Enzymes. Jundishapur J Nat Pharm Prod. 2023;In Press(In Press):e132712.



Cleome brachycarpa, magical species full of phytochemicals, has magical medicinal properties and should be evaluated extensively.


We evaluated the anti-inflammatory and analgesic activity of Cleome brachycarpa and the effect of its extract on various hematological parameters, cholesterol levels, and liver enzymes to ensure the safe use of this natural product.


Cleome brachycarpa was evaluated for its anti-inflammatory and analgesic effects at 200 mg/kg compared to diclofenic sodium and morphine, respectively. For anti-inflammatory activity, Wistar strain albino rats were pooled and divided into four groups: Negative control (normal saline), positive control (2% acetic acid), standard (Diclofenic sodium 10 mg/kg), and test (Cleome brachycarpa extract orally) groups for 10 days. For analgesic evaluation, mice were divided into control (normal saline), standard (morphine 10 mg/kg), and test (Cleome brachycarpa extract 200 mg/kg) groups and analyzed by the tail-flick method from zero to six hours. An assortment of blood parameters was evaluated, including white cells, red cells, hemoglobin level, hematocrit value, mean corpuscular volume, and mean corpuscular hemoglobin concentration. Besides, we computed the number of platelets, cholesterol, and enzyme (liver) level to ensure the safe use of this natural product. For this purpose, 60 rabbits were collected and divided into groups: Group A (control group) of 30 rabbits pooled without any treatment and Group B (treated group) of 30 rabbits receiving 200 mg/kg of Cleome brachycarpa. After 30 days, 4 mL blood sample was obtained by cardiac puncture.


Plethysmometer evaluation of anti-inflammatory effects showed maximum inflammatory inhibition of 29.42% at the sixth hour. Moreover, tail flick analysis showed maximum pain inhibition of 55.10% at the sixth hour, comparable to the standard drug. Furthermore, hematological data were analyzed statistically and showed insignificant results (P ≥ 0.05), indicating no prominent changes in hematological parameters, except for SGPT, a liver enzyme that increased after 30 days of treatment (P ≤ 0.05). Elevated levels of SGPT are usually reported with several drug administrations like NSAIDs and anti-TB drugs, but still, it should be further investigated.


Cleome brachycarpa showed promising anti-inflammatory and analgesic effects without producing any potent change in enzymes except SGPT, which would be evaluated further.

1. Background

Herbal medicine is an essential part of conventional remedies. The World Health Organization (WHO) delineates conventional remedy as diverse beliefs, practices, techniques, and knowledge that employs minerals, plants, animals, meditation, and spiritual training alone or combined for diagnosis, well-being maintenance, prevention, and treatment of illness (1). Underdeveloped countries frequently use different basils to indulge diseases because it is considered inexpensive and safer than allopaths. According to WHO, 80% of the Asian and African populations consume herbal medicine (2), as they contain phytochemicals, which possess diverse biological significances (3) and could be beneficial in treating different diseases (4). Medicinal plants have the greatest potential for transformation into medical relevance due to essential oils, terpenes, flavonoids, glucosinolates, and alkaloids. Cleome's pharmacological effects are associated with its phytoconstituents, resulting in fever, pain relief, and inflammatory reduction (5).

Cleome brachycarpa is a woody herb with yellow flowers (6), mostly cultivated in different areas of India, Iran, and Pakistan. It has miscellaneous usages for improving joint pain (7), soreness, tenderness, itching, leprosy, leucoderma, scabies, intestinal pain (8), and swelling; it also has anti-rheumatic (9, 10), vermicidal, anthelmintic (11), antioxidant (12), and antiemetic effects (13). Cleome brachycarpa have exceptional chemical composition like triterpenoid dilactone, deacetoxy brachycarpone (Figure 1) (14), triterpenoid cleocarbpone, ursolic acid, and cabralealactone. These compounds make the whole plant medicinal and are useful in bronchitis, diarrhea, malaria, heart failure, seizures, immune system deficiencies, jaundice, fever, chills, and treating swollen body parts (15-17). Likewise, sesquiterpenes and flavonoids make Cleome more anti-fungal, anti-bacterial, and antitumor with good cytotoxic effects (5). It strongly kills plant pests and microbes (18) and is a tranquilizer (19). Hence, this species of Cleome is vital in its properties and composition (20-22).

Structure of brachycarpone
Structure of brachycarpone

This study evaluated Cleome brachycarpa for its anti-inflammatory and analgesic activity and effects on the hematopoietic system. Inflammation is the protective response to eliminate the initial cause of injury. Different chemicals like prostaglandins, nitric oxide, leukotrienes, and histamines are released throughout inflammation that encourage smooth muscle tightening, boost movement of neutrophils, amplify the permeability of vessels, pain initiation, and damage (23), and increase chemical mediators like COX-2 (24). These changes after acute inflammation cause edema, usually measured by an instrument, e.g., a plethysmometer (25, 26). Following a similar path, the anti-inflammatory activity of Cleome brachycarpa was assessed by producing inflammation and edema by acetic acid (27) compared to a well-known marketed drug, diclofenac sodium, by measuring any change in the paw volume of the edematous rat.

Similarly, the analgesic or pain-combating property of the mentioned Cleome species was evaluated compared to morphine by inducing pain in mice. Hot water is one way to produce pain that increases pain-generating mediators such as Prostaglandin E, bradykinin, and histamine. Pain reaction in rodents was quantified by the tail-flick method, and the efficacy of analgesic medicine was noted by observing the time in which the tail was flicked in response to heat.

2. Objectives

To date, no study has investigated the anti-inflammatory and analgesic properties of Cleome brachycarpa. Thus, this study aimed to evaluate its analgesic and anti-inflammatory properties and effects on different blood parameters and liver enzymes. We assessed WBC, RBC, Hb level, hematocrit value, MCV, MCH, MCVC, platelet count, cholesterol SGPT, and ALP enzymes.

3. Methods

3.1. Compliance With Ethical Standards

All procedures in the study followed the Helsinki Declaration (1964), and the Ethics Committee of Baqai Medical University officially permitted the entire investigational trial with letter no. BMU-EC/05-2022.

3.2. Collection of Plant Material

The plant was collected from the Department of Pharmacognosy, Faculty of Pharmaceutical Sciences, University of Karachi.

3.2.1. Extraction of Plant Material

The entire Cleome brachycarpa plant was first splashed with water to condense the contagious load. Afterward, it was cut into pieces and dehydrated at a high temperature of 50ºC. It was then crushed and extracted. Later, it was soaked in 95% ethanol for three days, then sieved and dried under pressure. A two-time maceration was done, then dried in the evaporator. In this way, 5% Cleome brachycarpa was obtained (28).

3.2.2. Experimental Animals

Three types of lower mammals were pooled, including rats, mice, and rabbits, for anti-inflammatory, analgesic, and hematological evaluation, respectively. A total of 40 Wistar strain albino rats of 200 ± 5 g (10 weeks of age), 30 mice of 30 ± 2 g (10 weeks of age), and 60 rabbits of 1000 - 1500 g (10 months of age) were gathered from a retained and renowned animal house of Baqai Institute of Pharmaceutical Sciences (BIPS). Rabbits were selected for this evaluation because they have similar hematological variations to humans (29). All animals were housed in the animal house for 12/12-hour light/dark cycles at 25 ± 2°C temperature. Well-balanced laboratory feed was provided to all animals, and one week before the study, the weight of all animals was noted.

3.2.3. Test Doses

We used Cleome brachycarpa 200 mg/kg/body weight (21, 28, 30), morphine (31), and diclofenac sodium (32).

3.3. Investigational Plan for Anti-inflammatory Activity

3.3.1. Materials

We used a plethysmometer (UGO BASILE 7140), adult male albino rats (Wistar strain), ethanol extract of Cleome brachycarpa, feeding tube, acetic acid, diclofenic sodium, and distilled water.

3.3.2. Methodology of Anti-inflammatory Activity

Group A: Control animals (n = 10) were administered normal saline orally for 10 days. Group B: Positive control Wistar strain rats (n = 10) were administered acetic acid (2%) in the right hind paw plantar surface to develop inflammation during the trial. Group C: Standard rats (n = 10) were administered a standard drug (Diclofenic sodium, 10 mg/kg/body weight) orally one hour ahead of the injection of acetic acid. Group D: Test rats (n = 10) were orally administered Cleome brachycarpa extract (200 mg/kg) for 10 days.

The volume of the rat paw was measured by a plethysmometer (No. 7140) from zero to the eighth hour after the acetic acid injection. Percentage inhibition was estimated by the Newbould method:

% Inhibition of paw volume (mL) = Control mean - treated meanControl mean× 100

The outcomes were articulated as ± standard error mean (SEM), and the statistical significance of differences among the groups was investigated via ANOVA (Amol and Rajeshkhar, 2011).

3.4. Investigational Plan for Analgesic Activity

3.4.1. Material

We used Cleome brachycarpa 200 mg/kg/body weight, morphine, a feeding tube, a water bath, gloves, and a stopwatch.

3.4.2. Methodology of Analgesic Activity

Group A: Control mice (n = 10) were administered normal saline orally for 10 days. Group B: Standard mice (n = 10) were administered morphine 10 mg/kg/body weight orally on the experiment day. Group C: Test mice (n = 10) were orally administered Cleome brachycarpa extract 200 mg/kg for 10 days.

Analgesic activity was evaluated by the tail-flick method. An appropriate restrainer was utilized to keep each mouse in a suitable position keeping the tail extending out. The tail was immersed in a water bath (51 ± 1°C), and tail flicking time from hot water was noted as the retention time. The observations were taken from zero to the sixth hour. Percentage inhibition was analyzed as follows:

% Pain inhibition = T1-T0T1× 100

where T1 is post-drug latency, and T0 is pre-drug latency. The data were statistically evaluated by SPSS version 23 (33).

3.5. Investigational Plan for Hematological Analysis

3.5.1. Materials

We used vacutainers containing anticoagulant/gel, syringes, gloves, Labfuge (centrifuge machine), Vitalab Micro® (Merck), Sysmex® KX-21, Fluitest® ALP DGKC kit for alkaline phosphatase (ALP), ALAT (SGPT) (IFCC mod.) kit for alanine aminotransferase (ALAT), and Cholesterol Innoline kit for cholesterol.

3.5.2. Research Methodology

Group A: Control rabbits (n = 30) did not receive treatment. Group B: Treated rabbits (n = 30) received 200 mg/kg ethanol extract of Cleome brachycarpa orally for 10 days. Sample collection: By cardiac puncture, 4 mL of blood samples were drawn from the animals after 10 days of dosing. Serum separation for enzymes: Blood was first centrifuged by Labfuge (model 80 - 2S) at 4°C and 3000 rpm for about 20 minutes. Serum was separated and used for analysis.

3.5.3. Analysis of Hematological Parameters

Complete Blood Count: WBC, RBC, Hb, HCT, MCV, MCH, MCHC, and platelet count were scrutinized via an automated hematology analyzer, Sysmex® KX-21 (Newland, 2007). Liver Enzymes: ALP and SGPT levels were analyzed in treated rabbits with Vitalab Micro® (Merck) and respective kits. Cholesterol was also analyzed with the help of Vitalab Micro® (Merck) using a cholesterol Innoline kit. Statistical analysis of the above parameters was performed using a student t-test at P < 0.05 as significant, P < 0.001 as extra significant, and P < 0.0001 as extremely significant.

4. Results

4.1. Anti-Inflammatory Activity

Many anti-inflammatory medicines are available, but they all have many side effects. This research aimed to discover a unique anti-inflammatory agent with minimal unwanted effects (27). Changes in edematous volume by Cleome brachycarpa were measured by a plethysmometer that displayed a significant anti-inflammatory response, as shown in Table 1 and Figure 2. The herb produced very close results to Diclofenac sodium, proving Cleomes' high efficacy in managing inflammation. However, the tested extract showed maximum inhibition of 29.42% in the sixth hour, as shown in Table 2 and Figure 3. Statistical analysis was done by ANOVA at P-value < 0.05 as significant.

Comparison of anti-inflammatory activity of Cleome brachycarpa
Comparison of anti-inflammatory activity of Cleome brachycarpa
Comparison of percentage inhibition between Cleome brachycarpa and diclofenic sodium
Comparison of percentage inhibition between Cleome brachycarpa and diclofenic sodium
Table 1.

Anti-inflammatory Effect of Cleome brachycarpa in Albino Rats a

GroupsTime, h
Control2.57 ± 0.012.57 ± 0.012.57 ± 0.012.57 ± 0.012.57 ± 0.012.57 ± 0.012.57 ± 0.01
Acetic acid2.60 ± 0.153.68 ± 0.053.89 ± 0.064.21 ± 0.164.515 ± 0.164.755 ± 0.124.86 ± 0.14
Diclofenic sodium2.61 ± 0.133.12 ± 0.093.34 ± 0.16***3.55 ± 0.23*3.49 ± 0.29***3.48 ± 0.21***3.31 ± 0.17***
Cleome brachycarpa2.61 ± 0.0033.53 ± 0.283.50 ± 0.093.665 ± 0.073.50 ± 0.12**3.46 ± 0.13***3.43 ± 0.11***
Table 2.

Percentage (%) Inhibition of Cleome brachycarpa

GroupsTime, h
Diclofenic sodium15.2114.1315.6722.6126.4231.80
Cleome brachycarpa4.0710.0213.0622.3927.1529.42

4.2. Analgesic Effect

Pain is an emotional and obnoxious event because of the actual or potential tissue injury (34) treated by various analgesics, producing sleep and drowsiness (35). Cleome brachycarpa was carefully chosen to evaluate its analgesic effect (36), and the outcomes were compared with the standard agent, morphine. The results of Cleome brachycarpa were noted compared to morphine. As shown in Table 3 and Figure 4, morphine started to reduce pain in the first hour, while Cleome extracts produced a similar effect in the third hour, which was very close to the standard one. Cleome showed maximum inhibition of 55.10% in the sixth hour, as shown in Table 4 and Figure 5.

Analgesic effect of Cleome brachycarpa in mice
Analgesic effect of Cleome brachycarpa in mice
Comparison of analgesic activity between ethanol extract of Cleome brachycarpa and morphine
Comparison of analgesic activity between ethanol extract of Cleome brachycarpa and morphine
Table 3.

Analgesic Effect of Cleome brachycarpa in Mice a

GroupsTime, h
Control3.52 ± 0.153.52 ± 0.153.52 ± 0.153.52 ± 0.153.52 ± 0.153.52 ± 0.153.52 ± 0.15
Morphine3.65 ± 0.205.81 ± 0.28***7.50 ± 0.36***7.82 ± 0.28***8.6286 ± 0.16***9.00 ± 0.00***9.00 ± 0.00***
Cleome brachycarpa3.07 ± 0.224.21 ± 0.245.00 ± 0.47*6.57 ± 0.49***7.07 ± 0.29***7.35 ± 0.34***7.84 ± 0.20***
Table 4.

Percentage (%) Inhibition of Cleome brachycarpa in Mice

GroupsTime, h
Cleome brachycarpa16.3829.6046.4250.2152.1055.10

4.3. Hematological Evaluation

The effects of Cleome brachycarpa on complete blood count, cholesterol, and liver enzyme were statistically evaluated by student t-test. Examination showed little increases in Hb, HCT, MCH, WBC, RBC, PLT, and ALP values, but they were insignificant (P > 0.05). It also produced slight decreases in MCV, MCHC, and cholesterol values but insignificantly. On the other hand, it significantly increased SGPT from 52.83 ± 15.2 to 151.83 ± 8.37 (P = 0.000), as elucidated in Table 5 and Figure 6.

Table 5.

Effect of Cleome brachycarpa on Blood Parameters in Rabbits a

Hb10.9 ± 0.18613.10 ± 0.2420.6550.527
HCT34.91 ± 0.91735.66 ± 0.8360.7250. 485
MCV64.26 ± 1.57961.66 ± 1.2820.2950.77
MCH19.58 ± 0.41120.83 ±
MCHC29.85 ± 0.29929.00 ± 0.4260.6080.557
RBC5.38 ± 0.1135.554 ± 0.150.3500.734
WBC6.56 ± 0.1456.88 ± 0.2541.0790.306
PLT413.66 ± 27.78422.33 ± 27.100.2230.828
Cholesterol56.83 ± 21.3340.5 ± 25.310.9370.361
ALP67.16 ± 21.771.0 ± 14.40.360.76
SGPT52.83 ± 15.2151.83 ± 8.3713.960.000
Effect of Cleome brachycarpa on blood parameters in rabbits. Hb, hemoglobin in g/dL; HCT, hematocrit in % (percentage); MCV, mean corpuscular volume in fL; MCH, mean corpuscular hemoglobin in pg; MCHC, mean corpuscular hemoglobin concentration in g/dL; Cholesterol, mg/dL; WBC, white blood cells in 103/µL; RBC, red blood cells in 106/µL; SGPT, glutamate pyruvate transaminase U/L; ALP, alkaline phosphatase; Pltelets= 109/µL.
Effect of Cleome brachycarpa on blood parameters in rabbits. Hb, hemoglobin in g/dL; HCT, hematocrit in % (percentage); MCV, mean corpuscular volume in fL; MCH, mean corpuscular hemoglobin in pg; MCHC, mean corpuscular hemoglobin concentration in g/dL; Cholesterol, mg/dL; WBC, white blood cells in 103/µL; RBC, red blood cells in 106/µL; SGPT, glutamate pyruvate transaminase U/L; ALP, alkaline phosphatase; Pltelets= 109/µL.

5. Discussion

Since prehistoric times, herbs have been exploited as therapeutic agents because of their salutary efficiency and ease of availability. In the present era, much research is being done on plants. Family Cleomaceae possesses several therapeutic species, including Cleome brachycarpa, a plant with plenty of beneficial effects.

The optimistic pain-challenging ability of this herb could be a great source for treating fever and abdominal and rheumatic pains (37, 38). It has 43 components of essential oils (39) which could be the source of these medicinal properties (16). Our current research evaluated Cleome brachycarpa as a good analgesic and anti-inflammatory herb, showing significant results compared to the marketed drugs.

The anti-inflammatory activity of the methanol extract of Cleome (200 mg/kg) was evaluated by producing edema through sub-plantar injection of 2% acetic acid, and the volume was measured following volume displacement methods. The variation between early and after-treatment paw volumes pointed towards the degree of inflammation and reported the comparable effects of test species (P < 0.001***) to that of standard drug.

At the 200 mg/kg dose, the Cleome extract showed maximum inhibition of the edema (29.42%) compared to standard diclofenac (31.80%) at the sixth hour. The hang-up effects of the Cleome extract might probably be due to cyclooxygenase inhibition, which ultimately decreased prostaglandin production. In our experiment, pre-treated animals with Cleome extract showed a significant edema inhibitory response in the second hour following injection. This result suggests that Cleome extract might suppress the later stage of inflammation via decreasing cyclooxygenase. Consequently, induced paw edema was reduced after using crude extract, representing its inhibitory effects on prostaglandins.

According to the literature review, Cleome is rich in triterpenoids, brachycarpone, deacetoxybrachycarpone, cabralealactone, and ursolic acid (40). Triterpenoids hold analgesic (41), anti-inflammatory (42, 43), and antiemetic (44) possessions. Analgesic and anti-inflammatory behavior of ursolic acid has also been established (45). Many inflammatory diseases are common in society throughout the world, and natural products offer a great hope to discover new and safe bioactive lead compounds.

The analgesic activity of Cleome brachycarpa was compared with morphine. It showed a significant decrease in pain (P < 0.001***), as shown in Table 3 and Figure 4. According to the literature review, different Cleome species are efficient against acetic acid-induced writhing in mice and have been recommended as peripherally acting painkillers and CNS depressants (46) through hindering prostaglandin synthesis and release along with other endogenous GISTs. Similarly, the analgesic mechanism of ethanolic extract of brachycarpa may be linked to the inhibition of cyclooxygenases (47), as it showed significant pain inhibition (55.10%) in the sixth hour comparable to the reference morphine (60.88%) as shown in Table 4 and Figure 5.

Our hematological study showed a little increase in Hb, HCT, MCH, WBC, RBC, PLT, and ALP, showing that the extract might possess some phytochemical moiety that stirred erythropoietin oozing in bone marrow cells. Hemoglobin is reflected as a major oxygen transporter (48); consequently, our extract potentially rallies the oxygen transport as it augmented the Hb value. This outcome might be due to phenolic compounds (49). Also, MCH is hemoglobin per red blood cell in blood as Hb concentration was elevated in our results, so MCH is increased, too. Besides, WBC constitutes an important part of the immune system, protects from infectious diseases, and is important in wound healing. Its increased value from baseline displayed wound-healing properties, possibly, due to ursolic acid as immunosuppression. Our results showed a slight decrease in MCV, possibly because the body's compensatory mechanism was activated by increasing the erythropoietic system.

Platelets usually govern the hemostasis process. In our study, there was little increase in PLT which might be due to the triterpenoid derivatives and could be of great source in preventing bleeding disorders, as also reported by Sarfaraz et al., 2018 that the increase in hematological parameters might be due to any phytochemical entity which boosts up the release of erythropoietin from marrow cells (28).

Cleome brachycarpa could be a great source for pharmaceutical companies to formulate and check the effect of this herb on different doses to evaluate its best dose to treat bleeding disorders and viral diseases like dengue to encounter the problem of low levels of platelet counts. It has been anticipated from the above results that Cleome brachycarpa owns hematopoietic effects that might be advantageous in treating various types of anemia and immunosuppressive disorders. Moreover, the plant extract decreased cholesterol levels which work as the foremost causative feature in the pathogenesis of atherosclerosis and consequently in cardiovascular diseases and hence could be a source of cholesterol-lowering agents in the future, protecting various cardiovascular diseases, as also mentioned by Sarfaraz et al. (50).

Cleome brachycarpa significantly increased SGPT without disturbing ALP levels which should be further evaluated (51). Elevated levels of SGPT are usually reported with several administration drugs like NSAIDs and Anti-TB drugs (52, 53). Thus, monitoring liver physiology remains recommended while using such drugs.

Because of the therapeutic efficacy, low cost, and safety profile, discussion on herbal preparations has become very frequent as a source of medicinal agents. Family Cleomaceae still has not been immensely evaluated, even though it has been publicized for several therapeutic belongings. Our results claim that Cleome brachycarpa is a wonderful anti-inflammatory and analgesic agent that can greatly improve complete blood count.

Pain and inflammatory diseases are the most common conditions that resist and decrease a patient's functional status. Many synthetic products are available, like NSAIDs, taking significant anti-inflammatory and analgesic effects but resulting in numerous side effects. The main factor which limits the use of NSAIDs is their gastrointestinal (GI) toxicity. Epidemiologic studies point out that their use boosts the danger of GI problems. Studies put forward serious clinical gastric events yearly due to NSAID use resulting in a huge economic burden (54).

Still, researchers investigate continuously for improving the pharmacokinetics, pharmacodynamics, efficacy, and safety profile of drugs. Based on this concept, Cleome brachycarpa extract was evaluated and presented for pharmacological effects, especially anti-inflammatory and analgesic activity, with lesser side effects. The current study concluded the well-comparable effects of Cleome brachycarpa extract. It worked as an analgesic mediator, possibly because of hindering Kapa receptors in the brain stem and thalamus, resulting in pain relief and sedation, and Delta receptors widely circulated in the brain, spinal cord, and digestive system, as it gave comparable results to morphine. Further, the results revealed the extract's anti-inflammatory effect, which may be due to inhibiting both leukocyte migration and COX-1 and COX-2 enzymes.

The other perspective may be that any of the components of Cleome brachycarpa has therapeutic and healing properties for inflammation. However, further advanced (clinical) studies are compulsory to approve these effects.

From the clinical point of view, the above study on Cleome brachycarpa at 200 mg/kg is very important, as it could be used to treat many diseases with no alteration in hematological parameters with continuous monitoring of LFT. Further clinical trials are recommended for further authentication. The findings draw attention to Cleome brachycarpa as a possible nominee for research and isolation because of its vital composition, which has pronounced beneficial effects in various diseases.

As a result, healthcare professionals and scientists may deem the Cleome genus in mounting evidence-based alternative remedies to treat a range of pathologies without causing any severe undesirable effects. Future potential research work should isolate specific components as the center of attention to determine the specific pathways involved in various biological activities. In vitro and in vivo analysis of various plant extracts authenticate their conventional use, yet clinical trials must be conducted to establish the translational approach. Furthermore, evaluating the plant phytochemicals is compulsory to determine their therapeutic range for potential drug design, development, and discovery.

5.1. Conclusions

The current study concluded the well-comparable effects of Cleome brachycarpa extract and found it a potent anti-inflammatory and analgesic agent comparable to diclofenac sodium and morphine, respectively. Moreover, various hematological parameters, WBC, RBC, Hb, HCT, MCV, MCH, MCHC, platelet count, cholesterol levels, and liver enzymes, were also evaluated to ensure the safe use of this natural product. It is found that no significant changes were observed in tested parameters, while it is noticeable that it may help improve platelet count and decrease cholesterol level, although the results are not supported to significant levels.


  • 1.

    Shaikh BT, Hatcher J. Complementary and Alternative Medicine in Pakistan: Prospects and Limitations. Evid Based Complement Alternat Med. 2005;2(2):139-42. [PubMed ID: 15937553]. [PubMed Central ID: PMC1142200].

  • 2.

    Fabricant DS, Farnsworth NR. The value of plants used in traditional medicine for drug discovery. Environ Health Perspect. 2001;109 Suppl 1(Suppl 1):69-75. [PubMed ID: 11250806]. [PubMed Central ID: PMC1240543].

  • 3.

    Liu RH. Health benefits of fruit and vegetables are from additive and synergistic combinations of phytochemicals. Am J Clin Nutr. 2003;78(3 Suppl):517S-20S. [PubMed ID: 12936943].

  • 4.

    Tapsell LC, Hemphill I, Cobiac L, Patch CS, Sullivan DR, Fenech M, et al. Health benefits of herbs and spices: the past, the present, the future. Med J Aust. 2006;185(S4):S1-S24. [PubMed ID: 17022438].

  • 5.

    Afifi MS. Phytochemical and biological investigation of Cleome brachycarpa Vahl. growing in Egypt. Int J Pharm Sci Res. 2014;5(9):4008.

  • 6.

    Flora of Pakistan. eFloras; 2015. Available from:

  • 7.

    Ahmad M, Khan MA, Manzoor S, Zafar M, Sultana S; Mushtaq Ahmad. Checklist of medicinal flora of tehsil Isakhel, district Mianwali-Pakistan. Ethnobotanical Leaflets. 2006;2006(1):41-8.

  • 8.

    Marwat SK, Khan MA, Ahmad M, Zafar M, Ur-Rehman F. Ethnophytomedicines for treatment of various diseases in DI Khan district. Sarhad J Agric. 2008;24(2):306-16.

  • 9.

    Rahman MA, Mossa JS, Al-Said MS, Al-Yahya MA. Medicinal plant diversity in the flora of Saudi Arabia 1: a report on seven plant families. Fitoterapia. 2004;75(2):149-61. [PubMed ID: 15030919].

  • 10.

    Qureshi R, Bhatti GR, Memon RA. Ethnomedicinal uses of herbs from northern part of Nara desert, Pakistan. Pak J Bot. 2010;42(2):839-51.

  • 11.

    Hameed M, Ashraf M, Al-Quriany F, Nawaz T, Ahmad MSA, Younis A, et al. Medicinal flora of the Cholistan desert: a review. Pak. J. Bot. 2011;43(2):39-50.

  • 12.

    Ali JK, Cheruth AJ, Salem MA, Maqsood S. Evaluation of antioxidant activity of Cleome brachycarpa Vahl ex DC, an under-exploited desert plant of United Arab Emirates. Pharmacology. 2012;3:167-73.

  • 13.

    Muhammad AN, Salman AA. Anti-emetic activity of Cleome brachycarpa and Cleome Viscosa in chicks. Univers J Pharm. 2013;1(1):96-9.

  • 14.

    Ahmad VU, Alvi KA, Khan MA. The Molecular Structure and Absolute Configuration of Brachycarpone, a New Trinortriterpenoid Dilactone from Cleome brachycarpa. J Nat Prod. 2004;49(2):249-52.

  • 15.

    McNeil MJ, Porter RB, Williams LA. Chemical composition and biological activity of the essential oil from Jamaican Cleome serrata. Nat Prod Commun. 2012;7(9):1231-2. [PubMed ID: 23074917].

  • 16.

    Youssef RS. Medicinal and non-medicinal uses of some plants found in the middle region of Saudi Arabia. J Med Plants Res. 2013;7(34):2501-13.

  • 17.

    Schmelzer GH, Gurib-Fakim A. Medicinal plants 2. 2. Wageningen, Netherland: Prota foundation; 2013. p. 56-7.

  • 18.

    Ikram N, Dawar S. Efficacy of wild plant in combination with microbial antagonists for the control of root rot fungi on mungbean and cowpea. Pak. J. Bot. 2015;47(4):1547-51.

  • 19.

    Phondani PC, Bhatt A, Elsarrag E, Horr YA. Ethnobotanical magnitude towards sustainable utilization of wild foliage in Arabian Desert. J Tradit Complement Med. 2016;6(3):209-18. [PubMed ID: 27419083]. [PubMed Central ID: PMC4936766].

  • 20.

    Singh H, Mishra A, Mishra AK. The chemistry and pharmacology of Cleome genus: A review. Biomed Pharmacother. 2018;101:37-48. [PubMed ID: 29477056].

  • 21.

    Naeem H, Perveen R, Zaidi SSM, Zia Z, Fatima K, Akram Z, et al. Cleome brachycarpa: A review on ethnobotany, phytochemistry, and pharmacology. RADS Journal of Pharmacy and Pharmaceutical Sciences. 2019;7(2):107-11.

  • 22.

    Saleem T, Sumra A, Khan S, Zain M, Hassan W, Mehdi S, et al. A Green Nutraceutical Study of Antioxidants Extraction in Cleome brachycarpa ­ An Ethnomedicinal Plant. Sains Malaysiana. 2020;49(8):1915-24.

  • 23.

    Coleman JW. Nitric oxide: a regulator of mast cell activation and mast cell-mediated inflammation. Clin Exp Immunol. 2002;129(1):4-10. [PubMed ID: 12100016]. [PubMed Central ID: PMC1906415].

  • 24.

    Nakamura Y, Kozuka M, Naniwa K, Takabayashi S, Torikai K, Hayashi R, et al. Arachidonic acid cascade inhibitors modulate phorbol ester-induced oxidative stress in female ICR mouse skin: differential roles of 5-lipoxygenase and cyclooxygenase-2 in leukocyte infiltration and activation. Free Radic Biol Med. 2003;35(9):997-1007. [PubMed ID: 14572603].

  • 25.

    Patil P, Bera T, Patil V, Patil S, Patil R, Vijaynath V. Improvised plethysmometer for the detection of anti-inflammatory activity of drugs. J Pharmaceut Biomed Sci. 2010;4:1-5.

  • 26.

    Parham P. The immune system. Elements of the immune systems and their roles in defense. New York, USA: Garland Science; 2014. p. 1-14.

  • 27.

    Ribeiro RA, Vale ML, Thomazzi SM, Paschoalato AB, Poole S, Ferreira SH, et al. Involvement of resident macrophages and mast cells in the writhing nociceptive response induced by zymosan and acetic acid in mice. Eur J Pharmacol. 2000;387(1):111-8. [PubMed ID: 10633169].

  • 28.

    Ikram R, Osama M, Gul S; Sarfaraz. Evaluation Of Hematopoeitic Effects Of Cleome Brachycarpa In Albino Rabbits. Pak J Pharmacol. 2018;35(1 & 2):13-9.

  • 29.

    Khan RA, Aslam M, Ahmed S. Evaluation of Toxicological Profile of a Polyherbal Formulation. Pharmacol Pharm. 2016;7(1):56-63.

  • 30.

    Malik A, Arooj M, Butt TT, Zahid S, Zahid F, Jafar TH, et al. In silico and in vivo characterization of cabralealactone, solasodin and salvadorin in a rat model: potential anti-inflammatory agents. Drug Des Devel Ther. 2018;12:1431-43. [PubMed ID: 29872266]. [PubMed Central ID: PMC5973396].

  • 31.

    Gades NM, Danneman PJ, Wixson SK, Tolley EA. The magnitude and duration of the analgesic effect of morphine, butorphanol, and buprenorphine in rats and mice. Contemp Top Lab Anim Sci. 2000;39(2):8-13. [PubMed ID: 11487232].

  • 32.

    Hajzadeh MR, Rakhshandeh H, Esmaeilzadeh M, Ghorbani A. Analgesic and anti-inflammatory effects of Portolaca oleracea extracts in mice and rat. J Semnan Univ Med Sci. 2004;5(3-4):113-20.

  • 33.

    Rizwani GH, Mahmud S, Shareef H, Perveen R, Ahmed M. Analgesic activity of various extracts of Holoptelea integrifolia (Roxb.) Planch leaves. Pak J Pharm Sci. 2012;25(3):629-32. [PubMed ID: 22713952].

  • 34.

    Moayedi M, Davis KD. Theories of pain: from specificity to gate control. J Neurophysiol. 2013;109(1):5-12.

  • 35.

    Rang S, van Montfrans GA, Wolf H. Serial hemodynamic measurement in normal pregnancy, preeclampsia, and intrauterine growth restriction. Am J Obstet Gynecol. 2008;198(5):519 e1-9. [PubMed ID: 18279824].

  • 36.

    Yaqeen Z, Naqvi NH, Imran H, Fatima N, Sohail T, Rehman Z, et al. Evaluation of analgesic activity of P. domestica L. Pak J Pharm Sci. 2013;26(1):91-4. [PubMed ID: 23261732].

  • 37.

    Bouriche H, Selloum L, Tigrine C, Boudoukha C. Effect of Cleome arabica Leaf Extract on Rat Paw Edema and Human Neutrophil Migration. Pharmaceutical Biology. 2008;41(1):10-5.

  • 38.

    Bose A, Mondal S, Gupta JK, Ghosh T, Dash GK, Si S. Analgesic, anti-inflammatory and antipyretic activities of the ethanolic extract and its fractions of Cleome rutidosperma. Fitoterapia. 2007;78(7-8):515-20. [PubMed ID: 17651915].

  • 39.

    Rassouli E, Dadras OG, Bina E, Asgarpanah J. The Essential Oil Composition of Cleome brachycarpa Vahl ex DC. J Essent Oil-Bear Plants. 2014;17(1):158-63.

  • 40.

    Ahmad VU, Alvi KA. Deacetoxybrachycarpone, a trinortriterpenoid from Cleome brachycarpa. Phytochemistry. 1986;26(1):315-6.

  • 41.

    Biswas M, Biswas K, Ghosh A, Haldar P. A pentacyclic triterpenoid possessing analgesic activity from the fruits of Dregea volubilis. Pharmacogn Mag. 2009;5(19):90-2.

  • 42.

    Singh B, Sahu PM, Lohiya RK, Sharma MK, Singh HL, Singh S. Anti-inflammatory activity of alkanoids and triterpenoids from Trichodesma amplexicaule Roth. Phytomedicine. 2006;13(3):152-6. [PubMed ID: 16428021].

  • 43.

    Gautam R, Jachak SM. Recent developments in anti-inflammatory natural products. Med Res Rev. 2009;29(5):767-820. [PubMed ID: 19378317].

  • 44.

    Kinoshita K, Kawai T, Imaizumi T, Akita Y, Koyama K, Takahashi K. Anti-emetic principles of Inula linariaefolia flowers and Forsythia suspensa fruits. Phytomedicine. 1996;3(1):51-8. [PubMed ID: 23194861].

  • 45.

    Vasconcelos MA, Royo VA, Ferreira DS, Crotti AE, Andrade e Silva ML, Carvalho JC, et al. In vivo analgesic and anti-inflammatory activities of ursolic acid and oleanoic acid from Miconia albicans (Melastomataceae). Z Naturforsch C J Biosci. 2006;61(7-8):477-82. [PubMed ID: 16989305].

  • 46.

    Sarfaraz S, Najam R, Azhar I, Riaz B, Anser H. Anxiolytic and CNS depressant effects of ethanolic extract of cleome brachycarpa revealed after neuropharmacological screening. World J Pharm Sci. 2014:605-10.

  • 47.

    Ahmed S, Sultana M, Mohtasheem M, Hasan U, Azhar I. Analgesic and antiemetic activity of Cleome viscosa L. Pak J Bot. 2011:119-22.

  • 48.

    Zhao G, Xiang Z, Ye T, Yuan Y, Guo Z. Antioxidant activities of Salvia miltiorrhiza and Panax notoginseng. Food Chem. 2006;99(4):767-74.

  • 49.

    Maqsood S, Benjakul S, Shahidi F. Emerging role of phenolic compounds as natural food additives in fish and fish products. Crit Rev Food Sci Nutr. 2013;53(2):162-79. [PubMed ID: 23072531].

  • 50.

    Sarfaraz S, Najam R, Azhar I, Ahmed S, Sarwar G. Evaluation of Hypolipidemic and Hepatoprotective Effects of Ethanolic Extract of Cleome Brachycarpa on Albino Rabbits. J Anal Pharm Res. 2017;5(6).

  • 51.

    Higher Level of SGPT Risks. Indus Health Plus; 2022, [cited 2022 August 15]. Available from:

  • 52.

    Rasyid SA, Lio TMP; Armayani; Yuniati. Analysis of serum glutamic pyruvic transaminase and serum glutamic oxaloacetic transaminase levels in tuberculosis patients who are undergoing oat treatment in Kendari City General Hospital, Kota Kendari, Indonesia. Infect Dis Rep. 2020;12(Suppl 1):8737. [PubMed ID: 32874466]. [PubMed Central ID: PMC7447934].

  • 53.

    Fries JF, Singh G, Lenert L, Furst DE. Aspirin, hydroxychloroquine, and hepatic enzyme abnormalities with methotrexate in rheumatoid arthritis. Arthritis Rheum. 1990;33(11):1611-9. [PubMed ID: 2242059].

  • 54.

    Laine L. Gastrointestinal effects of NSAIDs and coxibs. J Pain Symptom Manage. 2003;25(2 Suppl):S32-40. [PubMed ID: 12604155].

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