Malaria is an infectious life-threatening ailment caused by the bites of Anopheles mosquitoes. The mosquito (an intracellular parasite of the genus
Plasmodium) (
26) infects the host’s erythrocytes and utilizes hemoglobin as a nutrient source by degrading this protein to amino acids, which are used for energy production, growth, and maturation. Previous reports revealed that up to 80% of the host’s hemoglobin is degraded by these microorganisms (
27). Hemoglobin degradation by protease enzymes releases the heme (ferrous) that is then oxidized to the ferric form. The latest form is toxic to the parasite and can damage biological membranes and suppress enzymes such as proteases. The parasite, which requires a mechanism to detoxify the released heme, has solved this problem by transforming the ferric heme to an insoluble, inactive, and crystalline form named hemozoin (i.e., the malaria-pigment) (
28). Thus, inhibiting hemozoin formation can be a potential therapeutic method for this disease.
Scientific reports revealed the efficacy of several medicinal plants (e. g., different species of Artemisia, Cinchona, Cryptolepis, and Tabebuia genera) and their secondary metabolites in the treatment of malaria and pointed out their advantages over modern remedies (e.g., low cost, fewer side effects, etc.). For example, chloroquine is a principal natural anti-malaria medication derived from quinine (
29).
In this study, nine different extracts of various parts and six fractions of the MeOH root extract of E. elaterium were assessed for their antimalarial activities in vitro. Among the different extracts assessed, the MeOH seed and root extracts (with the minimum IC50 of 0.458 ± 0.094 and 0.124 ± 0.0002, respectively) considerably inhibited heme to hemozoin transformation compared to the control (DMSO) (P < 0.001).
Although different studies have noted that the main ingredients of plants such as sesquiterpenoids and tri-terpenoids (Cucurbitacin E and α-Elaterin) (
30), as potent antimalarial agents (
31), are accumulated in fruits, we here observed that the antimalarial activity of the MeOH fruit extract was negligible (a high IC
50) compared to the MeOH root extract.
According to the obtained results, we performed the fractionation of the extracts that potentially had potent antimalarial components with high polarities using the SPE method on a C
I Sep-Pak cartridge with solvent combinations with reducing polarities (
21). All of the SPE fractions with different concentrations, except for the 10% fraction, inhibited the formation of hemozoin compared to the control group (P < 0.001). Furthermore, among the fractions, the 20% SPE fraction obtained the minimum IC
50. Other fractions (80%, 60%, and 100%) also were distinguished with significant and potent antimalarial activity (P < 0.001) (
Figure 1).
Comparison of the inhibition percentage of heme crystallization between the E. elaterium MeOH root extract and its active fractions. Chloroquine diphosphate served as the positive control in the β-hematin formation assay.
A preliminary phytochemical analysis of the most potent antimalarial fractions was performed using the TLC method. In addition, the Libermann-Buchard and Shinoda tests were applied to confirm TLC analysis results. The findings suggested the presence of flavonoids in the 20% and 60% fractions and flavonoids and triterpenoids in the 80% and 100% fractions.
Previous phytochemical investigations on
E. elaterium demonstrated that the plant is a rich source of phenolic compounds such as flavonoids, flavanols, tannins, and carotenoids, as well as proteins triterpenoids, and lipids (
32,
33). Cucurbitacin derivatives with triterpenic structures are among the main phytochemicals of
E. elaterium and have been investigated for their anti-proliferative, anti-cancer, anti-inflammatory, and antimicrobial properties (
34,
35).
According to previous studies, flavonoids and triterpenoids can be responsible for potent antimalarial effects (
36,
37). For example, Cucurbitacin glycosides from Datisca glomerata (C. Presl) Baill showed antiplasmodial activities (
38). Moreover, earlier studies showed that flavonoids had potential synergistic anti-malaria effects with artemisinin (the main antimalarial constituent of
Artemisia annua L.) (
39). Considering our findings and those of previous studies, it is necessary to focus on
E. elaterium pure ingredients and investigate their biological (such as antimalarial) effects.
5.1. Conclusions
Out of the nine extracts with different polarities of E. elaterium different parts, the MeOH root extract was the most potent part in terms of the IC50 obtained in the cell-free beta-hematin formation assay. A primary phytochemical analysis on the SPE fractions of the most effective extracts suggested the need for purifying their active constituents and investigating their biological effects in animal models.