Abstract:
Herbal medicines have been invaluable as therapeutic agents since history of mankind, with
current wide public acceptance of these as a safe mode of therapy. Thus prudent use of traditional
medicinal knowledge may support the search for effective plant based drug leads. The leaf
concentrate of Carica papaya is a traditionally acclaimed phytotherapy against haematological
and immunological disorders, and cancers. Nonetheless, comprehensive scientific validation of
these claims remains obscure. A comprehensive study was thus carried out to corroborate the
haematological, immunomodulatory and cancer chemopreventive activities of the mature leaf
concentrate of C. papaya Sri Lankan wild type cultivar (MLCC) using in vitro, ex vivo and in
vivo murine models, accompanied by toxicological evaluation and chemical characterization of
the MLCC.
Oral gavage of the MLCC to thrombocytopenicWistar rats at three doses ([low dose (LD)-0.18,
human equivalent dose (HED)-0.36 and high dose (HD)-0.72 ml/lOOg BW] manifested
significant platelet increasing activity (p<0.05). In vitro up regulated synthesis of interIukin-6
(IL-6) in bone marrow cultures and in vivo regulation of serum thrombopoetin (TPO) and platelet
activiating factor (PAF) levels may have revealed the potential mechanism of platelet increasing
activity. Moreover, pre incubation of platelets with the MLCC mounted significant protection
against platelet cytotoxicity (p<0.05). In parallel, the MLCC exhibited haemostatic activity
through modulating both coagulation and fibronolytic pathways of rat blood, in vitro. Counts of
rat platelet, total and differential leukocytes, bone marrow cells (BMCs) and of phagocytic
activity of rat peritoneal macrophages were significantly augmented (p<0.05) with significant
decrease in plasma concentrations of IL-6 and TNFa following oral gavage of the MLCC (HD)
(p<0.05). At low concentrations the MLCC elicited ex vivo proliferation of rat BMC and
phagocytic activity of peritoneal macrophages while high concentrations manifested cytotoxicity
of both these cell types. Oral gavage of the MLCC, markedly inhibited leukocyte migration,
prostaglandin E2 (PGE2) and TNFa levels (p<0.05) of the carrageenan induced rat peritonitis
model. Membrane stabilization potential of the MLCC reiterated antiinflammatory activity of the
MLCC.
The MLCC explicated strong anti-proliferative activity against HEp-2 cells (human laryngeal
carcinoma cells; ICso:56 pgmL'1). Though, the anti-proliferative activity of the MLCC was lower
than of the reference drug cyclophosphamide, it imparted cytoprotection on normal rat BMCs.
The MLCC enhanced antitumor immunity by up-regulation of IFNy of both cancer and normal
cell types. Quenching of ABTS, DPPH, NO, SO and H2O2 and enhancement of endogenous
antioxidant enzymes, superoxide dismutase (SOD), glutathione peroxidase (GPX) and glutathione
reductase (GR) in oxidative stressed rats reiterated the antioxidant activity of the MLCC
(p<0.05). In vivo sub-acute toxicological evaluation of the MLCC demonstrated that it was
devoid of general toxicity, plus hepato, nephro and endocrine toxicities. The GC-MS/LC-MS
analyses of the MLCC explicated the presence of several immunomodulatory and cytotoxic
compounds. When the MLCC was fractionated using the Kupchan method, the high and mid
polar fractions showed higher cytotoxicity while in vitro phagocytic activity was lower than of
the crude MLCC. This may reflect the synergistic activity of the bioactive compounds of the
MLCC that may well contribute to the immunomodulatory activity of the MLCC.
In the light of the above findings, the present study provided ample affirmation of the traditional
claims of the MLCC as a hematological, an immunomodulatory and a cancer chemopreventive
remedy; Extensive examination of the MLCC is therefore strongly warranted both as a safe,
inexpensive and readily available multi-component formulation, and as starting material to
explore for novel drug lead(s).