Medicines from Nature: Adventures of a medical ethnobotanist

Cassandra L. Quave, Ph.D. Assistant Professor

Emory University

Department of Dermatology (SOM)

Center for the Study of Human Health (ECAS)

E-mail: cquave@emory.edu

Website: http://etnobotanica.us/

How I got started…

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Early days of adventure…from the swamps to the high seas

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Early days of adventure… botanic gardens

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Deter other

plant species

from growing

nearby

Fight off

microbial

invasion &

infection

Attract pollinators Defense against

herbivory

Secondary Metabolites

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Ethnobotanical Approach to Drug Discovery

• Ethnobotany (from

ethnology, study of

culture, and botany,

study of plants) is the

scientific study of the

relationships that exist

between peoples and

plants.

• Ethnobotany is the

science of survival.

Ethnobotanical-directed study of plants used for infectious disease is often more

effective than a random approach.

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Ethnobotany is Multidisciplinary

Ethnobotany

Botany

Chemistry

Microbiology

Anthropology

Linguistics

Pharmacology

• Medicine • Conservation

• Food security

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The Ethnobotanical Approach

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• Layers of Consent:

▫ Prior informed consent

▫ Access and benefit

sharing

▫ Plant permits

• Data Collection:

▫ Semi-structured

interviews

▫ Focus groups

▫ Participant-observation

• Biological Sampling:

▫ Voucher collection

▫ Bulk specimen collection

Methods: Ethnobotanical Research

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Plant Collecting

DNA barcoding

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Herbarium Vouchers

Plant Extraction

Dried 48-72 hrs

Vacuum-sealed

with silica packets Pulverized with a

grinder

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Plant Extraction

1:10 extraction in

95% EtOH or

MeOH for 72 hrs. or

boiled in water for

30 minutes

Plant materials

separated from

extract with

vacuum

filtration

Solvent removed

under reduced

pressure with a

rotary evaporator

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Plant Extraction

After freezing at -80°C,

extracts are lyophilized Dried extracts

scraped out

and weighed

DMSO added,

creating a drug

solution for

antibacterial

testing

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Thinking outside of the box…

Classic antibiotic drug

discovery New

Direction for Drug

Discovery

Immune adjuvants

Conjugation

Biofilms

Quorum sensing

Efflux pumps

Synergy

Clinically relevant isolates

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Applying ethnobotany to new drug

discovery tools!

Peru: 1999-2000 Impact of Western biomedicine

on local health, a case study of

childhood helminthiasis

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Iquitos: Belen Market

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Tropical Ecology and the Amazon Rain Forest

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The varzea

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Don Antonio Montero Pisco

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Bixa orellana L., Bixaceae

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Ficus insipida Willd. , Moraceae

ojé

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(+)-Tubocurarine

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Carica papaya L., Caricaceae

chymopapain

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Aromatic baths for good fortune

Southern Italy, 2001-present Wild foods and medicinal

plants used by Arberëshë

(ethnic Albanians) and Italians

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Study Sites in the Mediterranean

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Mount Vulture – Basilicata, Italy

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Southern Italy

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Agroecology of vineyards

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Truffle Hunting in Southern Italy

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Plant Collecting

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Plant Collecting

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Plant Collecting

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Rosa canina L., Rosaceae

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Borago officinalis L., Boraginaceae

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Malva sylvestris L., Malvaceae

“La malva, da ogni mal ti

salva.”

Traditional medicine: mastitis,

colds/flu, post-partum

depurative, panacea

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Marrubium vulgare L., Lamiaceae Matricaria recutita L., Asteraceae

Origanum heracleoticum L., Lamiaceae

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Elmleaf Blackberry • Traditional uses in S. Italy:

▫ Leaves: furuncles, abscesses,

and other skin inflammations

▫ Roots: hair loss

▫ Fruits: eaten fresh and in

marmalades

• One of 116 remedies related to

SSTIs and other topical

dermatological treatments

identified

• 168 extracts screened

• Anti-biofilm activity first identified & published in 2008 and # 220 marked as possible lead

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Rubus ulmifolius Schott. (Rosaceae):

The source of the bioactive

composition “220D-F2”.

Quave, C.L., A. Pieroni, and B.C. Bennett (2008) Dermatological remedies in the traditional pharmacopoeia of Vulture-Alto Bradano,

inland southern Italy. Journal of Ethnobiology and Ethnomedicine 4:5. Quave, C.L., L.R.W. Plano, *T. Pantuso, and B.C. Bennett (2008). Effects of extracts from Italian medicinal plants on planktonic growth,

biofilm formation and adherence in MRSA. Journal of Ethnopharmacology 118: 418-428

Following bioassay-guided fractionation steps, ellagitannins and

glycosylated ellagic acid derivatives were isolated from the extract.

Activity of blackberry root extract is based on several natural products

Quave, C.L., M.E. Carmona, C.M. Compadre, *G. Hobby, H. Hendrickson, K. Beenken, and M.S. Smeltzer. (2012). Ellagic acid

derivatives from Rubus ulmifolius inhibit Staphylococcus aureus biofilm formation and improve response to antibiotics. PLoS ONE. 7(1): e28737.

220D-F2 is effective against all clonal lineages of S.

aureus, regardless of antibiotic resistance profile and is

nontoxic to mammalian cell lines.

Blackberry root extract prevents Staphylococcus aureus biofilms from forming

Quave, C.L., M.E. Carmona, C.M. Compadre, *G. Hobby, H. Hendrickson, K. Beenken, and M.S. Smeltzer. (2012). Ellagic acid

derivatives from Rubus ulmifolius inhibit Staphylococcus aureus biofilm formation and improve response to antibiotics. PLoS ONE. 7(1): e28737.

220D-F2 improves response to functionally distinct classes of antibiotics,

including daptomycin, clindamycin, vancomycin, and oxacillin.

Blackberry root extract improves antibiotic efficacy in clearing Staphylococcus

aureus biofilms

Quave, C.L., M.E. Carmona, C.M. Compadre, *G. Hobby, H. Hendrickson, K. Beenken, and M.S. Smeltzer. (2012). Ellagic acid

derivatives from Rubus ulmifolius inhibit Staphylococcus aureus biofilm formation and improve response to antibiotics. PLoS ONE. 7(1): e28737.

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C

Killing of planktonic pneumococci by 220D-F2. Streptococcus pneumoniae strain D39 was

inoculated in 24 well-plates containing THY and treated with DMSO or the indicated concentration of 220D-F2; treated cultures were incubated for 3 h at 37°C. Planktonic cells were removed (A) and then biofilms were washed and removed (B). Both populations were diluted and plated onto BAP to obtain CFU/ml. (C) Planktonic pneumococci treated for 3 h were also stained by the LIVE/DEAD assay and imaged using a fluorescent microscope.

Talekar, S.J., S. Chochua, K. Nelson, K.P. Klugman, C.L. Quave and J.E. Vidal (2014). 220D-F2 from Rubus ulmifolius kills Streptococcus pneumoniae planktonic cells and pneumococcal biofilms. PLoS ONE 9(5): e97314.

Blackberry root extract destroys Streptococcus pneumoniae biofilms and kills cells

NE Albania, 2012 Wild foods and medicinal

plants used by Albanians and

the Gorani

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Mountain Landscapes – NE Albania

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Kukes District, Albania

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Local economy

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Fermented Foods

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Quave, C.L. and A. Pieroni (2014) Fermented foods for food sovereignty and food security in the Balkans: A case study of the Gorani people of northeastern Albania. Journal of Ethnobiology 34(1): 28-43.

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Terrace farming

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Local Economy

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Lulë balsami

Hypericum perforatum L., Hypericaceae

St. John’s Wort

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Plantago spp., Plantaginaceae

Plantago lanceolata L.

Plantago major L.

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Pantelleria, Italy 2014 Wild foods and medicinal

plants and fungi used on a

volcanic isle in the

Mediterranean

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Specchio di Venere

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Pantescan Gardens

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Zibibbo grapes: passito wine

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Caperi

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Capparis spinosa subsp. rupestris (Sm.) Nyman, Capparaceae

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Lactic-acid

fermentation

of the flower

buds in salt

to make

capers!

Basket weaving for Agricultural & Fishing Tools

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Daphne gnidium L., Thymelaeaceae

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Opuntia ficus-indica (L.) Mill. ,

Cactaceae

“ficcund’india” ;“prickly pear”;

“indian fig”

Food, medicine and hunting tool!

“Alone we can do so little; together we can do so much” ― Helen Keller

Thanks to my research team,

colleagues, study participants,

collaborators and funding

sources!

Philanthropic Donors

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