Healing leishmaniasis in Amazonia: review of ethnomedicinal concepts and pharmaco-chemical analysis of traditional treatments to inspire modern phytotherapies

Publication date: Available online 25 January 2017
Source:Journal of Ethnopharmacology
Author(s): Guillaume Odonne, Emeline Houël, Geneviève Bourdy, Didier Stien
Ethnopharmacological relevanceCutaneous/mucocutaneous leishmaniasis are neglected tropical diseases occurring in all intertropical regions of the world. Amazonian populations developed an abundant knowledge related to the disease and its remedies. Therefore, we undertook to review traditional antileishmanial plants in Amazonia, and developed new tools to analyze this somewhat dispersed information.Material and MethodsA review of the literature concerning traditional remedies against cutaneous/mucocutaneous leishmaniasis in the Amazon was conducted, and the obtained data used for the calculation of distribution indexes designed to highlight the most relevant uses in Amazonia. The cultural distribution index represents the distribution rate of a given taxon among different cultural groups and was calculated as the ratio of the number of groups using the taxon to the total number of groups cited. The geographical distribution index allowed us to quantify spatial distribution of a taxon's uses in Amazonia and was calculated geometrically by measuring the average distance between the points where uses have been reported and the barycenter of those points. The general distribution index was defined as an arithmetic combination of the previous two, and gives information on both cultural and spatial criteria.Results475 use reports, concerning 291 botanical species belonging to 83 families, have been depicted from 29 sources. The uses concern 34 cultural groups. While the use of some taxa appears to be Pan-Amazonian, some others are clearly restricted to small geographical regions. Particular attention has been paid to the recipes and beliefs surroundings the treatments. Topical application of the remedies dominated the other means of administration, which deserves particular attention as the main treatments against Neotropical leishmaniasis are painful systemic injections. The data set was analyzed using the previously defined distribution indexes, and the most relevant taxa were further discussed from a phytochemical and pharmacological point of view.ConclusionsThe Amazonian biodiversity and cultural heritage host a fantastic amount of data whose systematic investigation should allow a better large-scale understanding of traditional therapies' dynamic and the consequent discovery of therapeutic solutions for neglected diseases. Distribution indexes are indeed powerful tools for emphasizing the most relevant treatments against a given disease and should be very useful in the meta-analysis of other regional pharmacopeia. Eventually, this focus on renowned remedies which do however not yet benefit from extended laboratory studies could stimulate future research for new treatments from natural origin against leishmaniasis.

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