An inventory of medicinal plants used for treatment of cancer in Kwara and Lagos state, Nigeria

Journal Pre-proof An inventory of medicinal plants used for treatment of cancer in Kwara and Lagos state, Nigeria Ibrahim Babangida Abubakar, Angela Nnenna Ukwuani-Kwaja, Folami Sulaimon Olayiwola, Ibrahim Malami, Aliyu Muhammad, Sanusi Jega Ahmed, Quadri Olaide Nurudeen, Mansurat Bolanle Falana

PII:

S1876-3820(19)31238-7

DOI:

https://doi.org/10.1016/j.eujim.2020.101062

Reference:

EUJIM 101062

To appear in:

European Journal of Integrative Medicine

Received Date:

12 November 2019

Revised Date:

2 February 2020

Accepted Date:

3 February 2020

Please cite this article as: Babangida Abubakar I, Nnenna Ukwuani-Kwaja A, Sulaimon Olayiwola F, Malami I, Muhammad A, Jega Ahmed S, Olaide Nurudeen Q, Falana MB, An inventory of medicinal plants used for treatment of cancer in Kwara and Lagos state, Nigeria, European Journal of Integrative Medicine (2020), doi: https://doi.org/10.1016/j.eujim.2020.101062

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Title page Title: An inventory of medicinal plants used for treatment of cancer in Kwara and Lagos state, Nigeria. Authors: Ibrahim Babangida Abubakara*, Angela Nnenna Ukwuani-Kwajaa, Folami Sulaimon Olayiwolaa, Ibrahim Malamib, Aliyu Muhammadc, Sanusi Jega Ahmeda Quadri Olaide Nurudeend, Mansurat Bolanle Falanad

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Name and address of affiliations: a

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Department of Biochemistry, Faculty of Life Sciences, Kebbi State University of Science and Technology, Aliero, PMB 1144, Kebbi State, Nigeria. b

Department of Pharmacognosy and Ethnopharmacy, Faculty of Pharmaceutical Sciences, Usmanu Danfodio University Sokoto, Nigeria. c

Department of Biological Sciences, Al-Hikmah University, Ilorin, Nigeria.

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Department of Biochemistry, Faculty of Life Sciences, Ahmadu Bello University Zaria, 810271, Nigeria.

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Correspondence to Ibrahim Babangida Abubakar* Email: [email protected]

ANUK: [email protected]

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FSO: [email protected]

IM: [email protected] AM: [email protected] SJA: [email protected]

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QON: [email protected] MBF: [email protected]

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Abstract Introduction: The southwestern and northcentral parts of Nigeria are highly endowed with medicinal plants that have been used for decades to cancer. However, the herbal recipes and traditional medicinal practices used in treating cancer have been scarcely investigated and documented. New uninvestigated plants could serve as potential sources of novel cytotoxic agents. This study was aimed at documenting the traditional medicinal practices used for treating cancers in Ilorin and Lagos metropolis.

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Methods: Information on herbal practices, medicinal plants and personal information of herbal practitioners was collected via questionnaire and oral interviews and analyzed. Plants cited were collected, identified and assigned voucher numbers. The names of plants were further authenticated using the plant list (www.the plantlist.org) and the world flora (www.worldfloraonline.org).

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Results: A total of 41 plants were identified via oral interviews and questionnaires from 65 willing respondents within Ilorin and Lagos metropolis, respectively. Pistia stratiotes was the most frequently cited plant with a citation frequency of 57.1 % whereas, Mangifera indica Linn was the least cited plant with a citation frequency of 2.9%. Plants parts including leaf, bark, root, and seed were prepared as concoctions, decoctions or powders and administered topically or orally to treat breast, prostate, cervical, skin and ovarian cancer.

Plants;

Cancer;

Traditional

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Nigeria;

Cytotoxicity;

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Keywords: Medicinal Ethnopharmacology

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Conclusion: The study revealed that medicinal plants previously shown to have cytotoxicity in vitro are currently used for cancers in traditional medicine practice. Twenty six medicinal plants are mentioned here for the first time as anticancer plants and could serve as sources for novel cytotoxic agents against cancers.

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1. Introduction

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Globally, cancer is a major public health problem and the second most deadly disease surpassed only by cardiovascular diseases. The incidence of cancer and cancer related mortality is still increasing globally especially in developing and underdeveloped parts of the world. For instance, a total of 1,762,450 new cases and 606,880 cancer deaths have been projected to occur in the United States of America [1]. Likewise, the incidence of cancer and cancer related deaths is constantly increasing in parts of Africa especially Nigeria and this may be attributed to the lack of affordable healthcare for early diagnosis and treatment. Breast cancer (32.29%) and cancer of the digestive system (19.67%) account for the most frequently diagnosed cancer in Ilorin, Kwara state [2]. Whereas, breast cancer (38.1%) and prostate cancer (12.8%) account for the most commonly diagnosed cancer in female and male residents of Lagos state, respectively [3].

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Natural products, especially of plant origin have continuously served as major sources of drugs against diseases such as cancer, diabetes and microbial infections amongst others. Plants have been continuously explored as potential sources of cytotoxic agents since the discovery of vinca alkaloids and the championing of drug discovery from natural products by the national cancer institute in 1960s. In fact, over 60% of anticancer drugs are derived from plants [4]. To date, the majority of the population in the developing and underdeveloped parts of the world especially Africa still rely on herbal medicine for cancer treatment.

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In particular, the majority of the Nigerian populace, especially in rural areas, rely on herbal medicine for the treatment of various ailments such as cancer and diabetes amongst others. Recent ethnobotanical studies have revealed several plants used for the treatment of diseases by Nigerian herbal practitioners [5,6]. The southwestern part of Nigeria comprises six states namely; Ekiti, Lagos, Ogun, Ondo, Osun, and Oyo with Yoruba as the predominant tribe. The region is also flanked by neighboring north-central states such as Kwara state with Yoruba as a major ethnic group. Undoubtedly, this region of Nigeria is highly endowed with medicinal plants and has a rich history of traditional medicinal practices. In fact, recent ethnobotanical studies revealed a pool of plants used in treating diseases such as malaria [7,8] and cancer [9]. However, the medicinal plants and medicinal practices used in treating cancer in the aforementioned region especially in Lagos state have been scarcely investigated. In fact, no study has documented the medicinal plants and herbal practices used in treating cancer in Ilorin metropolis to date. Additional studies could reveal uninvestigated plants that could serve as potential sources of novel cytotoxic compounds. Therefore, the present study was aimed at documenting the medicinal plants and practices used in treating cancer in Lagos and Kwara states. 2. Methods Ethnobotanical survey

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Structured questionnaires (Appendix A) were administered along with oral interviews conducted for willing herbal medicine practitioners according to previously described methods [5]. Ethical approval (KSUSTA/FLS/UREC/18-03) was granted by Kebbi State University of Science and Technology. Firstly, a leading herbal medicine practitioner was contacted who provided the contacts and links to various herbal practitioners in Lagos and Ilorin metropolis. Thereafter, oral consent was sought from herbal informants and only consenting informants were interviewed. Information on medicinal practices, types/parts of plants, mode of preparation and route of administration was collected. Furthermore, personal information on herbal practitioners such as age, educational status, gender as well as method(s) for diagnosing cancer was also collected and subsequently analysed. A total of sixty-five herbal healers out of the 95 contacted were interviewed. The study was conducted in Lagos and Ilorin metropolis of Lagos and Kwara States respectively (Fig 1 a, b), from November 2018 to September 2019.

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Plant collection and identification

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All plants mentioned in the questionnaire were collected and taxonomically identified by a botanist, Mr. Bolu Ajayi of the department of Botany, University of Ilorin. Thereafter, the plants were assigned voucher numbers and deposited in the herbarium of the University of Ilorin. Furthermore, plant names were authenticated using the plant list (www.the plantlist.org) and the world flora online (www.worldfloraonline.org).

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Statistical methods

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Frequency of citation

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Data on medicinal plants, types of cancer treated and demographic information on herbal practitioners from Lagos and Ilorin metropolis were collected, grouped and analysed. In addition, descriptive statistical analysis was used and quantitative indices including citation frequency, informant consensus factor, and fidelity levels were determined.

The frequency of citation determines how often a plant was cited by informants and was determined according to a previously described method [5]: FC=NC/TI x 100. Where NC indicates the number of citations for a plant and TI indicates the total number of informants. Informant consensus factor (ICF)

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ICF was calculated according to the previously described method [10] and used to determine the similarity of the types of plants used by herbal practitioners in treating various categories of diseases. An ICF value close to 0 or 1 indicates that the choice of plant for diseases category is random or that the majority of herbal practitioners agree on the use of plants for a particular disease, respectively. ICF= Nur-Nt/ Nur-1 Where Nur is the number of usages reported for a particular disease category, Nt indicates the number of taxa used for a particular disease. 4

Fidelity level The fidelity level was determined according to a previously described method [10] and used to determine the plant preferentially used to treat specific diseases. High fidelity value is indicative of the frequency of use of a particular plant to treat a specific disease FL= Ip/Iu x 100. Where Ip is the number of informants that indicated the use of a specific plant to treat a disease category, Iu represents the total number of informants that have confirmed the use of the plant for any category of diseases. 3. Results

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3.1 Demographic profile and Frequency of citation

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A complete list of plants mentioned by the herbalist and identified by the taxonomist is given in Table 1. Of the 95 healers approached, 65 respondents comprising 30 from Ilorin and 35 from Lagos state agreed to participate and were interviewed. A total of 41 plants were identified across various areas of Ilorin and Lagos metropolis, respectively. Pistia stratiotes was the most frequently cited plant with a citation frequency of 57.1% and 56.7% in Lagos and Ilorin metropolis, respectively. Whereas, Mangifera indica Linn was the least cited plant with a citation frequency of 2.9% and 6.7% in Lagos and Ilorin metropolis, respectively (Table 1). Demographic data showed that all practitioners had at least primary school education, whereas the majority had secondary school education in Ilorin (18.5%) and Lagos (12.3%) states (Table 2). Furthermore, the majority of the practitioners were aged between 31-50 years and are predominantly males (Table 2). Besides, there were more respondents from Ilorin-west and Lagos Island from Kwara and Lagos state, respectively. 3.2 Diagnosis and treatment of cancer

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Traditional herbalists diagnosed various types of cancer through the identification of skin rashes that secrete fluids and external tumor growth in various parts of the body. Whereas is some cases, the patients have already been diagnosed with cancer in hospitals before opting for herbal medicine. Furthermore, the leaves were predominantly used for the preparation of various herbal recipes as concoction including decoction, infusion and powdered form for oral or topical administration. Besides, breast cancer accounted for the most frequently treated cancer by herbal practitioners as shown in Table 3. This was followed by prostate cancer, cervical, skin and ovarian cancers. 3.3 Informant consensus factor The informant consensus factor as shown in Table 3 showed the classification of cancer treated into various types. The ICF value ranged from 0.00 to 0.804 and showed that breast cancer had the highest ICF value in Lagos (0.804) and Ilorin (0.803) metropolis whereas, ovarian cancer had the lowest ICF value of 0.00 for Lagos and Ilorin metropolis, respectively (Table 4). 3.4 Fidelity level 5

The Fidelity level is used to determine the preference of a particular medicinal plant by traditional healers towards treating a particular disease. As shown in Table 5, traditional healers in Lagos and Ilorin metropolis preferentially used Pistia stratiotes to treat breast cancer with 54.3% and 63.3%, respectively. Whereas, Bryophyllum pinnatum was preferentially used to treat Prostate cancer in Lagos and Ilorin metropolis respectively. For cervical cancer, Euphorbia heterophylla (17.6%) and Petiveria alliacea (10%) were the preferred plants in Lagos and Ilorin metropolis respectively. 4. Discussion

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Ethnobotanical studies provide platforms for phytochemical and pharmacological studies that could produce novel bioactive compounds from uninvestigated or scarcely investigated plants. Undoubtedly, Nigeria is highly endowed with medicinal plants and herbal practices that have been used for decades to treat diseases. However, these medicinal plants have been scarcely investigated as potential sources of bioactive chemotherapeutic agents. Although, recent studies have reported medicinal plants used in treating diseases such as malaria, diabetes, and measles [8,11,12]. In fact, a recent study in the southwestern part of Nigeria revealed a total of ninety plants used for the treatment of cancer by the Ijebu ethnic group [9]. Herein, the study across two states, namely Lagos and Kwara identified a total of 41 medicinal plants. Pistia stratiotes was ranked as the most frequently cited plant in Kwara and Lagos state. This is contrary to a recent study that identified Securidaca longipedunculata as the most frequently mentioned plant used in treating cancer [9]. However, it is noteworthy to mention that the study only focused on the Ijebus an ethnic Yoruba group. Interestingly, a total of 22 medicinal plants reported herein were also reportedly used by the Ijebu ethnic group to treat cancer. Similarly, various plants mentioned herein including Kigelia africana, P. stratiotes, Chenopodium ambrosioides, Nymphaea lotus, Parquetina nigrescens, Nicotiana tabacum, Alstonia congensis, Elaeis guineensis, Piper guineense, Aframomum melegueta, Petiveria alliacea were reportedly used for cancer treatment by herbalists in Ogun state, southwest Nigeria [13]. Furthermore, an ethnobotanical study also identified a total of 73 medicinal plants used in treating cancer in Ogun state with Xylopia aethiopica, Garcina kola, Kingelia africana, Anthocleista djalonensis identified as the most prominently used plants [14]. This is contrary to the present study that identified Pistia stratiotes L and Bryophyllum pinnatum as the frequently used plants. Nevertheless, plants identified in this study including A. congensis, P. stratiotes, S. afzelii, K. africana, A. comosus, B. pinnatum, O. basilicum, A. ascalonicum, M. sapientium, N. lotus, E. guineense, P. nigrescens, P. alliacea, P. guineense, P. zeylanicca, S. officinarum, N. latifolia, N. tabacum, A. melegueta and Z. officinale were also reportedly used to treat cancer in Ogun state [14]. In addition, a survey conducted across four southwestern states comprising Ogun, Oyo, Lagos, and Ekiti state identified 45 plant species used for cancer treatment by 30 traditional medicine practitioners [15]. These included plants such as A. melegueta, A. ascalonicum, E. heterophylla, E. hirta, K. africana, N. latifolia, N. lotus, X. aethiopica and Z. officinale that were identified in the present study. Undoubtedly, there are similarities with regard to the type of plants used in cancer treatment across southwestern states. However, there are differences in the choice of the most frequently used medicinal plant. Though the residents of the southwestern 6

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states of Nigeria are generally regarded as the Yoruba-speaking tribes, nonetheless, there is still the cultural diversity that includes different dialects. Therefore, the differences observed with regards to the preferred choice of plant and the diversity of the types of plants used for cancer treatment could be attributed to the cultural diversity within the Yoruba tribe. Knowledge of traditional medicine practices is usually gained and developed through several years of practice by ethnic groups and such knowledge is passed on to future generations through family inheritance or apprenticeship. The respondents in the present study indicated that the cancer treatment period is between four to five months and their preference of a particular treatment is due to 40 - 80% positive response from cancer patients. However, it is noteworthy to mention that the present study did not verify such claim as neither the patients nor the pharmacological studies to confirm the cytotoxicity of the herbal recipes were considered for this study. Contrarily, a recent study conducted in the northeastern part of Nigeria revealed a total of 65 different plants with Securidaca longepedunculata and Andira inermis as the most frequently used plants to treat cancer by herbal medicine practitioners residing in Askira/Uba local government area of Borno state [16]. Notwithstanding, plants including Vernonia amygdalina and Momordica charantia that were identified in the study were also listed in the present study. Similarly, a recent study across three northeastern states of Nigeria comprising Maiduguri, Damaturu and Gombe identified a total of 25 plants used in treating cancer. These included Balantine egyptica, Acacia nilotica and Azadiracta indica amongst others [17]. However, none of the plants identified in the study were cited in the present study. Likewise, a study across the northwestern states of Nigeria comprising Kano and Kaduna identified a total of 72 plants used for cancer treatment although only two of such plants X. aethiopica and H. indicum were cited in the present study [18]. The variations in herbal practices observed between northwestern and northeastern part of Nigeria in comparison to the present study conducted in the southwest could be attributed to the differences in culture and vegetation.

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On the other hand, recent studies have reported the types of medicinal plants used for cancer treatment in other parts of Africa. For instance, a total of 151 medicinal plants were reportedly used to treat various types of cancer such as breast, liver, prostate, stomach, and brain by traditional healers in the Ashanti region of Ghana [19]. This included M.charantia, B. pinnatum, X. aethiopica, H. indicum, Z. officinale, A. melegueta, A. comosus, E. heterophylla, M. indica, K. africana, A. muricata, E. guineensis, and P. guajava that were also identified in the present study [19]. Similarly, plants identified in the present study such as M. indica, A. muricata, X. aethiopica, E. chlorantha, V. amygdalina, O. basilicun, were also reportedly used to treat cancer and other related diseases in Woleu-Ntem province of Gabon [10]. Whereas, only Z. officinale and A. muricata identified herein were reportedly used to treat cancer in Morocco out of 63 identified medicinal plants [20]. M. indica that has reportedly been used to treat cancer in Ghana and Gabon was the least cited plant in the present study. In fact, pharmacological studies have reported the cytotoxic potency of extract and mangiferin isolated from M. indica [21,22]. However, M. indica was the least cited medicinal plant in the present study. Whereas, a similar study conducted in southwest Nigeria did not cite the plant [9,15] except for another study conducted in Ogun state [14]. This suggests the potential lack of knowledge by traditional healers on the cytotoxic potency of M. indica plant. 7

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Diagnosis of cancer by herbal practitioners can be a difficult task and sometimes can be misdiagnosed as duly admitted by some practitioners during oral interviews. Notwithstanding, the traditional practitioners diagnose cancer through the identification of external tumor growth and rashes that secrete liquid substances in various parts of the body such as breast, neck, throat, and head amongst others. Furthermore, herbal practitioners also admitted that cancer could also spread to other parts of the body. This method of diagnosis reported herein is similar to our recent unpublished findings in the northwestern part of Nigeria and previously published study [9]. Interestingly, breast (55.6%) and prostate (25%) cancers accounted for the most treated cancer by the traditional herbalist. This is consistent with a recent report that showed breast (37%) and prostate (29.1%) cancers accounted for the highest new cases in females and males in Nigeria, respectively [23]. The herbal concoctions are prepared as decoction, infusion or powder for oral or topical application. For decoctions, plant parts are boiled in a pot or soaked in the case of infusion, using a solvent and though the amount boiled or soaked is not accurately measured nonetheless a measured 1 - 1.5 teaspoon of the concoction is taken orally. Whereas, powdered parts of a plant are topically applied or mixed with a local ointment such as Shea butter and topically applied to the affected area. This is in agreement with a previous report [15]. Accordingly, the treatment period ranged for an average of 4 -5 months as indicated by the herbal practitioners that participated in the present study. Consequently, as shown in table 3, toxicity studies available in the literature on the medicinal plants cited in the present study reported mild or no toxic effect of the medicinal plants at therapeutic doses in vivo thereby, suggesting that the plants could be considered safe for cancer treatment. However, long term treatment and uncontrolled dosage could cause profound damage to vital organs such as the liver and kidney.

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A survey of literature revealed that some of the plants listed in the study possess antiproliferative and cytotoxic potencies. For instance, plumbagin isolated from Plumbago zeylanica has been shown to induce in vivo and potent in vitro antiproliferative and cytotoxic effect on a range of cancer cells such as Bowes cells, MCF-7, Hela cells, Raji, Calu-1 and glioma cells [24–27]. Similarly, methanol seed extract of Xylopia aethiopica induced potent antiproliferative and cytotoxic effect against drug sensitive and resistant human cancer cells (IC50 3.28µg/ml33.43µg/ml) mediated via loss of MMP without inducing similar toxicity to non-cancerous cells [28]. However, the methanol fruit extract of X. aethiopica induced weak antiproliferative effect on PC-3 (IC50 62.1µg/ml) and LNCaP (IC50 73.6 µg/ml) [29]. Furthermore, flavonoid and alkaloid compounds isolated from X. aethiopica induced cytotoxic effect against drug-sensitive and resistant cancer cells mediated via loss of MMP and ROS production [30]. Likewise, extracts of Petiveria alliacea L reportedly induced cytotoxic effect on breast adenocarcinoma cells (IC50 19.9µg/ml) mediated via modulation of glycolytic metabolism [31]. A recent in vivo study showed that P. alliacea extract caused decreased tumor growth and improved survival of BALB/c mice with murine breast cancer [32]. Contrarily, P. alliacea did not induce an antiproliferative effect on human hepatocellular carcinoma cells (Hep G2)[33]. Compounds isolated from Zingiber officinale have been shown to induce antiproliferative and cytotoxic effect on cancer cells [34,35]. In fact, a comprehensive report of the cytotoxic potency of Z. officinale has been reported [36,37]. Similarly, extracts from Ocimum basilicum have been shown to 8

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induce an antiproliferative and cytotoxic effects on Hep-2 (IC50 10.76 µg/ml) and NCI-H292 (IC50 6.85µg/ml), as well as breast cancer cells (MCF-7) mediated via mTOR/Akt/p70S6K pathway [38,39]. Whereas, the compound 3”-O-acetylvitexin isolated from the leaves of O. basilicum induced antiproliferative effect on human colon cancer cells (IC50 16.8µg/ml) [40]. In contrast, Saccharum officinarum has been scarcely investigated although, a previous study has reported a very weak antiproliferative activity (IC50 = 31.31 – 459.5 µg/ml) of a tricin acylated glycoside against a broad range of human cancer cell lines [41]. Whereas, a more potent antiproliferative activity has been reported for Triterpenes isolated from Euphorbia hirta on human colon carcinoma (IC50 = 4.8µg/ml) and non-small cell lung adenocarcinoma (IC50 = 4.5µg/ml) [42]. Similar in vitro potent effect has been reported for Magnifera indica peels against human hepatoma, lung, colon and breast cancer cells [22]. In fact, Mangiferin isolated from M. indica has been shown to induce in vivo antitumor growth against ascitic fibrosarcoma in Swiss mice [21]. A recent study demonstrated the cytotoxic potency of Kigelia africana seed oil against MDA-MB-231breast cancer cells [43]. Similarly, several studies have demonstrated the cytotoxic potency of different parts of Annona squamosa and Annona muricata including seed, seed oil, leaf, pericarp and fruit against a broad range of cancer cells by in vitro and in vivo antitumor growth inhibition [44–46]. Additionally, in vitro studies have also demonstrated the cytotoxic potencies of Enantia chlorantha, Nicotiana tabacum, Elaeis guineensis and Psidium guajava against cancer cells [47–50].

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In contrast, there are no reported antiproliferative or cytotoxic activity of some medicinal plants identified herein. Nevertheless, biological activities have been reported for these plants. This include in vivo antioxidant activity of Bryophyllum pinnatum, Pistia stratiotes, Nymphaea lotus, Gongronema latifolium, Musa sapientum, Momordica charantia, Aframomum melegueta and Piper guineense [51,52]. Similarly, in vivo anti-inflammatory effect was also reported for Bryophyllum pinnatum, Pistia stratiotes, Heliotropium indicum, Parquetina nigrescens, Alstonia boonei and Citrullus lanatus [53,54]. 5. Conclusion

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This study has provided further information on the relevance of medicinal plants in the management of cancer and cancer-related diseases in our society. It is a step forward towards exploring the medicinal plants diversity in Nigerian flora. Indeed, the study revealed plants that have been shown in vitro experiments to have cytotoxic potency are also currently used as traditional treatments for cancer. This necessitates future pharmacological and toxicological studies to determine the potency of potentially novel cytotoxic compounds from each plant as well as determine their safety. Funding

No external funding was received for this research Conflict of Interest The authors declare no conflict of interest 9

Author’s contribution IBA is the lead author and designed the study, protocols and co-wrote the manuscript. ANUK; Co-designed the study and co-developed the protocols. FSO, QON and MBF participated in the field study conducting oral interviews and filled out questionnaires. MBF and QON also reviewed the manuscript. IM and SJA analyzed the data from the questionnaire and conducted the statistical analysis. AM reviewed the protocols and co-wrote the manuscript.

Acknowledgement

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APPENDIX A

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The authors appreciate the contribution of Mr Bolu Ajayi towards identifying the medicinal plants

KEBBI STATE UNIVERSITY OF SCIENCE AND TECHNOLOGY, ALIERO

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FACULTY OF SCIENCE

DEPARTMENT OF BIOCHEMISTRY

Dear Respondent,

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Questionnaire on the plants commonly used for cancer physiotherapy in South West Nigeria.

Research topic: An inventory of medicinal plants used for cancer treatment in South-West Nigeria

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In respect to the aforementioned subject matter, this questionnaire is designed and partitioned into two phases. Phase 1: The Bio-data of the respondent would be collected. Phase 2: This section contains research questions on professionalism, traditional methods of cancer treatment including plants parts, mode of preparation, application and etc. Answer all the questions by filling the blank spaces or ticking where necessary. The purpose of this study is for potential anticancer drug development from medicinal plants. Information collected herein is for research purpose only and would be treated confidentially.

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GENERAL DATA

Name: _________________________________________ Family Name: ________________________ Age: __________________ Sex: Male ( ) Female ( ) Date of Birth: ___________________

Position in your village: ( ) 1, Priest 10

( ) 2, Family Head ( ) 3, Opinion Leader ( ) 4, Chieftaincy Title Holder ( ) 5, Others (Please specify) HOME ADDRESS

Village Name: _____________________________ Local Government: ___________________________

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State: _____________________________________Ethnicity/Tribe________________________________

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PHASE 1: RESPONDENTS’ PERSONAL INFORMATION ON ESTABLISHMENT

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State and region in which investigation is carried out: _______________________________ Name of herbal home/organization/establishment: ________________________________________________________________________ __ Years of operation _____________________ How long does it take you to learn the traditional medicine profession ___________________________ Do you have a basic/ tertiary education before practicing? (yes) or (No) If yes; Tick amongst the listed: ( ) 1, Primary School ( ) 2, Secondary School ( ) 3, Technical/ Teachers Colleges ( ) 4, Diploma ( ) 5, National Certificate of Education ( ) 6, First Degree ( ) 7, Higher Degree. Do you a professional certification for your profession trade? (Yes) or (No) If yes, State: _____________________________________________________ Do you belong to any registered trado- medical Association? (Yes) or (No) If yes, State: ________________________________________________________________ Are your bodies/ associations recognized by NAFDAC? (Yes) or (No)

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PHASE 2: RESEARCH QUESTION ON MEDICINAL PLANT IN RELATION TO CANCER treatment

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1. How long have you been in practice of herbal medicine and /or research? Tick () a. 1-5 years ( ) b. 5 – 10 years ( ) c. 10 -15 years ( ) d. 15- 20 years ( ) e. 20 years - above 2. What is your area of specialty/ specialization in the field? ( ) a. Teaching how to use medicinal plants ( ) b. Treating patient using medicinal plant ( ) c. Treating patients using incision 12

( ) d. Preparing drugs using medicinal plants. ( ) e. Treating patients by divination ( ) f. others (please specify). 3. What type of cancer or tumor do you treat_________________________________

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4. Can you differentiate between inflammation and cancer______________________

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5. To what extent can you describe the effect of cancer symptoms on patient? ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ _______________________

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6. How do you diagnose and determine if a patient has cancer or tumor _____________________________________________________________ _____________________________________________________________ ________________

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7. If a patient portrays the cancerous symptoms, what are the likely medicinal approach to seek and considered appropriate in treating the ailment? ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ________________________ 8. Could you please, itemize the plants you use for treating cancer i. ___________________________________________ ii. ___________________________________________ 13

___________________________________________ iv. ___________________________________________ v. ___________________________________________ 9. What part of the plant do you use? _____________________________________________________________ iii.

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10. What are the procedures/methods that are employed in the preparation of the anti-dot in treating the ailment?

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11. What measurement of the concoction/ dosage is to be taken by the patient?

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a) What are the effectiveness of the plant/ species used in the treating the ailment? ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ________________________ ___________________________________________________________ ________

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b) How long does it take in getting the patient suffering from the ailment (Tumours) treated?____________________________________________________ ________ c) How do you determine that a patient is responding to treatment? _____________________________________________________________ _______ d) Have you ever completely cured a patient from cancer or tumor?______________

Please provide any other additional useful information. You may use extra sheets for more recipe’s information.___________________________________________________________________________ 14

_____________________________________________________________________________________ ____

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Thank you with regard.

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Reference R.L. Siegel, K.D. Miller, Cancer Statistics , 2019, CA CANCER J CLIN. 69 (2019) 7–34. doi:10.3322/caac.21551.

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I.M. Akpanabiatu, D.N. Ekpo, F.U. Ufot, M.N. Udoh, J.E. Akpan, E.U. Etuk, Acute toxicity , biochemical and haematological study of Aframomum melegueta seed oil in male Wistar albino rats, J. Ethnopharmacol. 150 (2013) 590–594. doi:10.1016/j.jep.2013.09.006.

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I.A. Oyemitan, F. Kolawole, A.O. Oyedeji, Acute toxicity , antinociceptive and antiinflammatory activity of the essential oil of fresh fruits of Piper guineense Schum & Thonn ( Piperaceae ) in rodents, J. Med. Plant Res. 8 (2014) 1191–1197. doi:10.5897/JMPR2014.5639.

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A.S. Nalule, M. Afayoa, B. Mali, M. Majidu, Acute oral toxicity of Euphorbia heterophylla Linn . ethanolic extract in albino mice, African J. Pharm. Pharmacol. 11 (2017) 1–9. doi:10.5897/AJPP2014.4186.

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G.. . Mbaka, T.. Akala, Evaluation of the Histomorphological and Toxicological Changes in Rodents after treatment with Hydroethanolic Extract of the Secamone Afzelii Aerial Parts, J. Morphol. Sci. 35 (2018) 233–241.

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C.K. Murithi, D.S. Fidahusein, J.M. Nguta, C.W. Lukhoba, Antimalarial activity and in vivo toxicity of selected medicinal plants naturalised in Kenya, Int. J. Educ. Res. 2 (2014) 395–406.

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H.M. Farah, A.M. El Hussein, H.E. Khalid, H.M. Osman, Toxicity of Kigelia africana Fruit in Rats Toxicity of Kigelia africana Fruit in Rats, Adv. Res. 12. 12 (2017) 1–9. doi:10.9734/AIR/2017/38539.

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O.L. Olayinka, E. Awad, G. Khalil, S.A. Atunwa, A. Abdullaahi, M.K. Salawu, K.A.T. Ogunwale, F.D. Olalere, S.A. Lawal, A. Majeed, O.A. Olutunde, O.O. Afolabi, A.B. Nafiu, Safety and toxicity of aqueous leaf extracts of Camellia sinensis , Parquetina nigrescens and Telfairia occidentalis in mice, African J. Pharm. Pharmacol. 12 (2018) 208–220. doi:10.5897/AJPP2017.4879.

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Erythrophleum ivorense and Parquetina nigrescens, Toxicol. Reports. 1 (2014) 411–420. doi:10.1016/j.toxrep.2014.06.009. X. Feng, Z. Wang, D. Meng, X. Li, Cytotoxic and antioxidant constituents from the leaves of Psidium guajava, Bioorg. Med. Chem. Lett. 25 (2015) 2193–2198. doi:10.1016/j.bmcl.2015.03.058.

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H.T. Manekeng, A.T. Mbaveng, S.A.N. Mendo, A.D. Agokeng, V. Kuete, Evaluation of Acute and Subacute Toxicities of Psidium guajava Methanolic Bark Extract : A Botanical with In Vitro Antiproliferative Potential, Evidence-Based Complement. Altern. Med. (2019).

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L. Ya Nkono, Barnabé, S.D. Sokeng, D.D.D. Paul, L. Frida, P. Kamtchouing, Subchronic toxicity of aqueous extract of Alstonia boonei de wild . ( apocynaceae ) stem bark in normal rats, Int. J. Pharmacol. Toxicol. 3 (2015) 5–10. doi:10.14419/ijpt.v3i1.4625.

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L.E.A. Hassan, H.M. Sirat, S.S. Dahham, F.S.R. Al-suede, Y. Tabana, A.M.S. Abdulmajid, A.S. Abdulmajid, Phytochemical and Toxicity Studies of Citrullus lanatus var . citroides ( Wild melon ) on Brine Shrimps ( lethality test ), Aust. J. Basic Appl. Sci. 9 (2015) 60–65.

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[101] H.. Andjani, Y. Sentosa, K. Yati, A. Fauzantoro, M. Gozan, Y.. Yoo, Acute Oral Toxicity Test of Nicotiana tabacum L . Bio-Oil Against Female Winstar Rats Acute Oral Toxicity Test of Nicotiana tabacum L . Bio-Oil Against Female Winstar Rats, in: IOP Conf. Ser. Earth Environ. Sci., 2019. doi:10.1088/1755-1315/353/1/012047.

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[102] K.Y. Ping, I. Darah, Y. Chen, S. Sreeramanan, S. Sasidharan, Acute and Subchronic Toxicity Study of Euphorbia hirta L . Methanol Extract in Rats, Biomed Res. Int. 2013 (2013). [103] Y. Zhang, J. Li, Z. Wu, E. Liu, P. Shi, L. Han, L. Guo, X. Gao, T. Wang, Acute and LongTerm Toxicity of Mango Leaves Extract in Mice and Rats, Evidence-Based Complement. Altern. Med. 2014 (2014) 1–9.

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[104] R.A. Reddeman, R. Glávits, J.R. Endres, A.E. Clewell, G. Hirka, A. Vértesi, E. Béres, I.P. Szakonyiné, A Toxicological Evaluation of Mango Leaf Extract ( Mangifera indica ) Containing 60 % Mangiferin, J. Toxicol. 2019 (2019). [105] M. Niu, W. Cai, H. Liu, Y. Chong, W. Hu, S. Gao, Q. Shi, X. Zhou, X. Liu, R. Yu, Plumbagin inhibits growth of gliomas in vivo via suppression of FOXM1 expression, J. Pharmacol. Sci. 128 (2015) 131–136. doi:10.1016/j.jphs.2015.06.005. Figure and Table Captions Fig 1: Fig 1: Maps of study areas; a) Lagos metropolis b) Ilorin metropolis

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Table 1: An inventory of medicinal plants used to treat cancer by herbal practitioners in Lagos and Ilorin metropolis of Lagos and Kwara states Table 2: Demographic information of respondents Table 3: Medicinal plants and plants part used for treating various types of cancer Table 4: Informant consensus factor

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Table 5: Fidelity level (%)

27

Table 1: An inventory of medicinal plants used to treat cancer by herbal practitioners in Lagos and Ilorin metropolis of Lagos and Kwara states s/no

Local name

Common name

Botanical name

Family

1

Ewe ojuoro

Water lettuce

Pistia stratiotes L.

Araceae

2

Ewe abamoda

Miracle leave

Bryophyllum pinnatum (Lam). Oken

Crassulaceae

3

Awogbo ahun

Stool wood

Alstonia congensis Engl.

4

Ewe osibata

White lotus

Nymphaea lotus L.

5

Ewe inabiri

Ceylon leadwort

Plumbago zeylanica L.

6

Ewe awogba

Guinea-hen weed

Petiveria alliacea L.

7

Ewe arokeke

Bush buck

8

Apekan

9

NCL

FCL (%)

R (L)

NCI

FCI (%)

R (I)

UILH/1376

20

57.1

1

17

56.7

1

UILH/909

12

34.3

2

15

50

2

UILH/ 1200

10

28.6

3

15

50

3

Nymphaeaceae

UILH/551

10

28.6

3

7

23.3

5

Plumbaginaceae

UILH/1374

9

25.7

5

5

16.7

12

Phytolaccaceae

UILH/1100

8

22.9

6

7

23.3

5

Gongronema latifolium Benth.

Apocynaceae

UILH/1176

8

22.9

6

6

20

11

Sour Sop

Annona muricata L.

Annonaceae

UILH//1106

8

22.9

6

4

13.3

13

Ewe Efirin

Sweet Basil

Ocimum basilicum L.

Lamiaceae

UILH/954

8

22.9

6

3

10

23

10

Ewe ejirin

Bitter gourd

Momordica charantia L.

Cucurbitaceae

UILH/963

8

22.9

6

2

6.7

29

11

Ewe eru

African pepper

Xylopia aethiopica (Dunnal)A.Rich.

Annonaceae

UILH/1089

7

20

11

7

23.3

5

12

Ewe arunpale

Mexican tea

Chenopodium ambrosioides L.

Amaranthaceae

UILH/1375

7

20

11

14

46.7

4

13

Ewe

Bitter leaf

Vernonia amygdalina Delile

Compositae

UILH/972

7

20

11

4

13.3

13

ro

-p

lP

re

Apocynaceae

ur na

Jo

of

VN

28

Ewuro 14

Ogede wewe

Banana

Musa sapientum L.

Musaceae

15

Ebo

Sugar apple

Annona squamosa L.

Annonaceae

16

Awopa

African yellow wood

Enantia chlorantha Oliv.

Annonaceae

17

Ata ile

Ginger

Zingiber officinale Roscoe

18

Atare

Alligator pepper, Grains of Paradise

Aframomum melegueta K. Schum.

19

Ope oyinbo

Pineapple

Ananas comosus (L.) Merr.

20

Alubosa elewe

English Shallot

21

Epo Igi Ope

22

6

17.1

14

7

23.3

5

UILH/1158

6

17.1

14

4

13.3

13

UILH/1356

6

17.1

14

3

10

23

Zingiberaceae

UILH/1083

6

17.1

14

2

6.7

29

Zingiberaceae

UILH/1166

6

17.1

14

2

6.7

29

Bromeliaceae

UILH//1084

5

14.3

19

4

13.3

13

Allium ascalonicum L.

Liliaceae

UILH/1335

5

14.3

19

4

13.3

13

The African oil palm

Elaeis guineensis Jacq.

Arecaceae

UILH/880

5

14.3

19

4

13.3

13

Koro Iyere

Ashanti pepper

Piper guineense Schumach. & Thonn.

Piperaceae

UILH/203

5

14.3

19

2

6.7

29

23

Ewe lara

Fire plant

Euphorbia heterophylla L.

Euphorbiaceae

UILH/1198

5

14.3

19

2

6.7

29

24

Ewe Arilu

Secamone afzelii (Roem. & Schult.) K.Schum.

Asclepiadaceae

UILH/967

5

14.3

19

2

6.7

29

25

Ewe gbegi

Goose grass

Chloris pilosa Schumach. & Thonn.

Poaceae

UILH/609

4

11.4

25

7

23.3

5

26

Epo jebo

Sipo mahogany

Entandrophragma utile (Dawe & Sprague) Sprague

Meliaceae

UILH/1325

4

11.4

25

7

23.3

5

27

Ewe ogbeori

Indian

Heliotropium indicum L.

Boraginaceae

UILH/968

4

11.4

25

5

16.7

12

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ur na

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of

UILH/1380

29

akuko

heliotrope

28

Koro Egbesi

Guinea peach

Nauclea latifolia Sm.

Rubiaceae

29

Efirin odan

Bird goose berry

Hoslundia opposita Vahl

Lamiaceae

30

Ireke

Sugar cane

Saccharum officinarum L.

Poaceae

31

Pandoro leaves

The sussage tree

Kigelia africana (Lam.) Benth

32

Ewe ewidun

African parquetina

Parquetina nigrescens (Afzel.) Bullock

33

Bara

Watermelon

Citrullus lanatus (Thunb.) Matsum. & Nakai

34

Taba juku

Tobacco

35

Ewe ahara

36

Gurofa

37

4

11.4

25

4

13.3

13

UILH/1346

3

8.6

29

4

13.3

13

UILH/475

3

8.6

29

4

13.3

13

Bignoniaceae

UILH/958

3

8.6

29

3

10

23

Asclepiadaceae

UILH/003

3

8.6

29

2

6.7

29

Cucurbitaceae

UILH/1268

3

8.6

29

2

6.7

29

Nicotiana tabacum L.

Solanceae

UILH/722

3

8.6

29

2

6.7

29

Momordica cabraei (Cogn.) C.Jeffrey.

Cucurbitaceae

UILH/1330

2

5.7

35

3

10

23

Guava

Psidium guajava L.

Myrtaceae

UILH/973

2

5.7

35

3

10

23

Ahun

Stool wood

Alstonia boonei De Wild

Apocynaceae

UILH/1035

2

5.7

35

3

10

23

38

Oro alago

Asthma weeds

Euphorbia hirta L

Euphorbiaceae

UILH/187

2

5.7

35

2

6.7

29

39

Ewe elu

Indigo vine

Lonchocarpus cyanescens (Schum. & Thonn.) Benth.

Fabaceae

UILH/1242

2

5.7

35

2

6.7

29

40

Ewe egele

Asthma herb

Euphorbia convolvuloides Hochst. ex Benth

Euphorbiaceae

UILH/669

2

5.7

35

2

6.7

29

41

Ewe mangoro

Mango

Mangifera indica L.

Anacardiaceae

UILH/1080

1

2.9

41

2

6.7

29

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UILH/506

VN: Voucher number, NCL: Number of citation Lagos, FCL: Frequency of citation, Lagos, R (L): Ranking (Lagos), NCI: Number of citation Ilorin, FCI: Frequency of citation Ilorin, R (I): Ranking (Ilorin)

30

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Table 2: Demographic information of respondents

Ilorin 9.2 18.5 9.2 9.2 0.0 0.0

Lagos 12.3 26.2 15.4

Ilorin 9.2 21.5 15.4

Lagos 54.3 45.7

Ilorin 56.7 43.3

< 30 years 31-50 years > 50 years

Male Female

Jo

Gender (%)

ur na

Age (%)

re

Lagos 8.2 12.3 10.8 12.3 7.7 4.6

lP

Primary school Secondary school Technical/colleges Diploma National Certificate First Degree

-p

Parameters Education Status (%)

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Table 3: Medicinal plants and plants part used for treating various types of cancer Botanical name

Plant parts used

Types of cancer treated

Mode of preparation

Route of administration

Reported cytotoxic bioactivity/Phytochemicals

Toxicity

1

Pistia stratiotes L.

Leaves

Breast

Concoction

1½ teaspoon is taken orally 2-3 times daily

No study

Mild renal toxicity on rats [55]

2

Bryophyllum pinnatum (Lam). Oken

Leaves

Prostate, breast

1½ teaspoon is taken orally 2-3 times daily

No study

There was no toxicological effect in acute and sub-acute study [56]

3

Alstonia congensis Engl.

Leaves

Prostate, breast

Concoction

1½ teaspoon is taken orally 2-3 times daily

No study

No toxicity in acute study [57]

4

Chenopodium ambrosioides L.

Leaves

Prostate, breast

Concoction

1½ teaspoon is taken orally 2-3 times daily

No study

No toxicity at therapeutic dose [58]

5

Nymphaea lotus L.

Leaves

Prostate, breast

Concoction

1½ teaspoon is taken orally 2-3 times daily

No study

No toxic in acute and subacute toxicity [59]

6

Petiveria alliacea L.

Root

Prostate, breast, cervical

Concoction

1½ teaspoon is taken orally 2-3 times daily

In vivo and in vitro antiproliferative and cytotoxic activity by plant

No adverse toxic effect on Sprague Dawley rats [60]

lP

re

s/no

Jo

ur na

Concoction

33

extract [31,32] Seed

Prostate, breast, cervical

Concoction

1½ teaspoon is taken orally 2-3 times daily

8

Plumbago zeylanica L.

Root

Prostate, breast

Concoction

1½ teaspoon is taken orally 2-3 times daily

9

Gongronema latifolium Benth.

Leaves

Breast, cervical

Decoction

10

Musa sapientum L.

Tuber

Breast, prostate, cervical

11

Annona muricata L.

Leaves

Breast, cervical

In vitro cytotoxicity via disruption of MMP and ROS production/ 3,4',5trihydroxy-6'',6''dimethylpyrano[2,3g]flavone, Isotetrandrine [30]

of

Xylopia aethiopica (Dunnal) A.Rich.

No toxicity in acute study [57]

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Moderate irritation effect and toxic effect on liver and kidney [63,64]

1-teaspoon is taken orally 2 times daily

No study

Mild changes in biochemical and hematological parameters [65,66]

Concoction

1½ teaspoon is taken orally 2-3 times daily

No study

No observed toxic effect on rats [67]

Concoction

1-teaspoon is taken orally 2 times daily

In vitro antiproliferative activity against cancer cells/ Solalllin, Murisolin, Corossolone, Corossotin, Annonacinone, Annonacin, Muricin (J,K,L,M,N,), Annonamuricin (A, B, C,

No toxic effect was observed in acute and subchronic toxicity study [72]

Jo

ur na

lP

re

In vivo and In vitro cytotoxic activity against cancer cells via inhibition of FOXM1, BCL2, MMP-2/9 and PI3K/Akt/ β-sitosteryl3β-glucopyranoside-6'-Opalmitate, β-sitosterol, Plumbagin, 3β-Hydroxylup20(29)-ene-27,28-dioic acid dimethyl ester [24– 26,61,62]

34

D) [68–71] Chloris pilosa Schumach. & Thonn.

Leaves

Breast, skin

Powder

Topically applied to affected area

No study

No study

13

Entandrophragma utile (Dawe & Sprague) Sprague

Leaves

Breast

Concoction

1½ teaspoon is taken orally 2-3 times daily

No study

No study

14

Ocimum basilicum

Leaves

Breast, prostate

Decoction

1-teaspoon is taken orally 2 times daily

In vitro antiproliferative activity against colon cancer cells by extracts and active compound/ 3'-Oacetylvitexin [38–40]

No adverse toxic effect was observed in acute and subchronic study in wistar rats [73]

Decoction

1teaspoon is taken orally 2 times daily

No study

No observed toxic effect at dose administered to rats [74]

1½ teaspoon is taken orally 2-3 times daily

No study

No observed sub-chronic toxicity in rats [75]

1½ teaspoon is taken orally 2-3 times daily

In vitro antiproliferative activity against cancer cells/Squamotin A–D, Annosquatin IV–V, Muricin O, Squamosten B, Annosquacins A–D, Annosquatin A, Annosquatin B, (2,4-cis and trans)-Squamolinone, (2,4cis and trans)-9-oxoAsimicinone, Bullacin B, Squamocin-IV, SquamocinV, Squamoxinone-E[46,76– 78]

No toxic effect or significant changes to biochemical and hematological parameters at 1000mg/kg in mice [79]

Vernonia amygdalina Delile

Leaves

Prostate, breast

16

Momordica charantia L.

Leaves

Prostate, breast

17

Annona squamosa

Breast

ro

-p

Concoction

ur na Seed

Jo

L

lP

15

re

L.

of

12

Decoction

35

Ananas comosus (L.) Merr.

Leaves

Breast

Decoction

1-teaspoon is taken orally 2 times daily

No study

19

Allium ascalonicum L.

Bulb

Prostate, breast

Concoction

1½ teaspoon is taken orally 2-3 times daily

No study

20

Elaeis guineensis Jacq.

Bark

Breast

Concoction

A spoonful is taken once daily

In vitro antiproliferative activity against cancer cells [49]

No toxic effect in acute or brine shrimp lethality test [81]

21

Heliotropium indicum L.

Leaves

Prostate, breast

Concoction

1½ teaspoon is taken orally 2-3 times daily

No study

Mild toxicity observed in liver and spleen of rodents [82]

22

Enantia chlorantha

Root

Breast

Concoction

1-teaspoon is taken orally 2 times daily

In vitro antiproliferative activity of extract against cancer cell [83]

Toxic effect of stem bark extract was observed at high dose in rat [84]

Seed

Prostate, breast

1½ teaspoon is taken orally 2-3 times daily

No study

No observed toxicity in acute and sub-acute study in rats [85]

Nauclea latifolia Sm.

24

Zingiber officinale Roscoe

ro

-p

re

Decoction

ur na

23

lP

Oliv.

of

18

No toxic effect on rats [80]

No study

Seed/pod

Breast

Concoction

1½ teaspoon is taken orally 2-3 times daily

Caspase 3 mediated apoptosis and autophagy [34]

No observed toxicity in rats [86][87]

Seed

Breast

Decoction

A spoonful is taken once daily

No study

A mild toxicity with lower Hb and RBC levels were reported [88]

Aframomum melegueta K. Schum.

26

Piper guineense Schumach. & Thonn.

Seed

Breast

Powder

Topically applied to affected area

No study

Mild toxic effect was observed in rats [89]

27

Euphorbia heterophylla L.

Leaves

Breast, cervical

Decoction

1-teaspoon is taken orally 2 times daily

No study

Hemorrhage and necrosis observed in high doses (2000-4000mg/kg) [90]

Jo

25

36

Secamone afzelii (Roem. & Schult.) K.Schum.

Leaves

Breast, cervical

Decoction

1-teaspoon is taken orally 2 times daily

No study

29

Hoslundia opposita Vahl

Leaves

Breast, cervical

Decoction

1-teaspoon is taken orally 2 times daily

No study

30

Saccharum officinarum L

Juice

Prostate, cervical

Decoction

1½ teaspoon is taken orally 2-3 times daily

31

Kigelia africana (Lam.) Benth

Bark

Breast

Decoction

32

Momordica cabraei (Cogn.) C.Jeffrey.

Leaves

Breast, prostate

33

Parquetina nigrescens

Leaves

Leaves

Alstonia boonei

No toxicity at therapeutic dose but hepatorenal toxic effect at high dose [93]

Decoction

1½ teaspoon is taken orally 2-3 times daily

No study

No study

Breast

Concoction

1½ teaspoon is taken orally 2-3 times daily

No study

Mild renal fibrosis, hemorrhage and inflammation were observed in rats [94,95]

Breast

Powder

Topically applied to affected area

In vitro antiproliferative activity against cancer cells/ Guavinoside C, Guavinoside F, Quercetin [96]

Stem bark extract caused minor toxic effect including minor liver inflammation [97]

Bark

Breast, skin

Powder

Topically applied to affected area

No study

Mild hepatic and renal tissue injury [98]

Leaves

Breast, skin

Powder

Topically applied to affected area

No study

A study reported toxicity to brine shrimp larvae [99]

De Wild 36

Citrullus lanatus (Thunb.) Matsum. &

ro

In vitro antiproliferative activity of seed oil against cancer cells [43]

lP

re

-p

1½ teaspoon is taken orally 2-3 times daily

ur na

35

No observed toxicity at therapeutic dose in rat [92] No study

Jo

Psidium guajava L.

No observed toxic effect at therapeutic dose in rodents [91]

In vitro antiproliferative activity against cancer cells/ Tricin-7-O-β-(6''methoxycinnamic)glucoside [41]

(afzel.) Bullock 34

of

28

37

Nakai Leaves

Breast, ovarian

Powder

Topically applied to affected area

In vitro antiproliferative activity against cancer cells/ 6,7-dimethoxy-4'-hydroxy8-formylflavon, 8-formyl4',6,7-trimethoxyflavon, 4',7-dihydroxy-8-formyl-6methoxyflavon, Tababiphenyl G, Tababiphenyl H, Tababiphenyl I [48,100]

Bio-oil was not toxic against female wistar rats [101]

38

Euphorbia hirta L

Stem

Breast, prostate

Decoction

1½ teaspoon is taken orally 2-3 times daily

In vitro antiproliferative activity against cancer cells/ 24-hydroperoxycycloart-25en-3β-ol [42]

No sub-chronic toxicity after long term oral administration [102]

39

Lonchocarpus cyanescens (Schum. & Thonn.) Benth.

Leaves

Skin

Decoction

1½ teaspoon is taken orally 2-3 times daily

No study

No study

40

Euphorbia convolvuloides

Leaves

Breast, skin

Powder

Topically applied to affected area

No study

No study

Bark

Breast, prostate

Decoction

1½ teaspoon is taken orally 2-3 times daily

In vivo and in vitro cytotoxic activity/ Mangiferin [21,22]

No significant toxic effect over 90 days study period [103,104]

of

Nicotiana tabacum L.

ur na

lP

re

-p

ro

37

Hochst. ex Benth

Mangifera indica L.

Jo

41

38

of ro -p

Table 4: Informant consensus factor

Jo

ur na

lP

re

Category IFC (L) IFC (I) 0.804 0.803 Breast 0.676 0.701 Prostate 0.708 0.895 Cervical 0.600 0.625 Skin 0.00 0.00 Ovarian IFC (L): Informant consensus factor Lagos, IFC (I): Informant consensus factor Ilorin

39

of ro -p

Plant species

Breast

L 1

Pistia stratiotes L

54.3

2

Bryophyllum pinnatum (Lam). Oken

37.1

3

Alstonia congensis Engl.

17.1

4

Nymphaea lotus L

5

I

Prostate

L

lP

s/no

re

Table 5: Fidelity level (%)

I

63.3

Skin

Ovarian

L

I

L

I

L

I

-

-

-

-

-

-

22.9

40

-

-

-

-

-

-

30

11.4

20

-

-

-

-

-

-

25.7

26.7

17.1

16.7

-

-

-

-

-

-

Plumbago zeylanica L.

22.9

16.7

8.6

10

-

-

-

-

-

-

6

Petiveria alliacea L.

14.3

26.7

5.7

13.3

8.6

10

-

-

-

-

7

Gongronema latifolium Benth.

14.3

26.7

14.3

13.3

-

-

-

-

-

-

8

Annona muricata

17.1

13.3

-

-

11.4

6.7

-

-

-

-

9

Ocimum basilicum L.

25.7

6.7

11.4

3.3

-

-

-

-

-

-

10

Momordica charantia

14.3

10

11.4

-

-

-

-

-

-

-

Jo

ur na

53.3

Cervical

40

14.3

20

11.4

13.3

5.7

6.7

12

Chenopodium ambrosioides L.

17.1

43.3

11.4

26.7

-

-

13

Vernonia amygdalina Delile

11.4

13.3

8.6

-

-

14

Musa sapientium

20

20

14.3

13.3

11.4

15

Annona squamosal L.

17.1

13.3

-

-

-

16

Enantia chlorantha Oliv.

17.1

10

-

-

17

Zingiber officinale Roscoe

6.7

17.1

18

Aframomum melegueta K. Schum

17.1

13.3

-

19

Ananas Comosus (L) Merr

14.3

20

Allium ascalonicum L.

11.4

21

Elaeis guineensis Jacq.

14.3

22

Piper guineense Schumach & Thonn.

14.3

23

Euphorbia heterophylla L.

24

-

-

-

-

-

-

-

-

-

-

-

10

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

3.3

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-p

-

re

lP

-

of

Xylopia aethiopica (Dunnal)A.Rich

ro

11

13.3

5.7

10

-

-

-

-

-

-

16.7

-

-

-

-

-

-

-

-

10

-

-

-

-

-

-

-

-

14.3

6.7

-

-

17.1

-

-

-

-

-

Secamone afzelii (Schult.) K.Schum

8.6

6.7

-

-

5.7

6.7

-

-

-

-

25

Chloris pilosa

8.6

20

-

-

-

-

8.6

6.7

-

-

26

Entandrophragma utile

11.4

23.3

-

-

-

-

-

-

-

-

27

Heliotropium indicum

5.7

16.7

5.7

10

-

-

-

-

-

-

28

Nauclea latifolia Smith

11.4

6.7

8.6

6.7

-

-

-

-

-

-

29

Hoslundia opposite Vahl

8.6

10

-

8.6

6.7

-

-

-

-

Jo

ur na

16.7

41

-

2.9

6.7

-

-

-

-

16.7

-

-

-

-

-

-

-

-

32

Parquetina nigrescens (afzel.) Bullock

-

-

8.6

6.7

-

-

-

-

-

-

33

Citrullus lanatus (Thunb.) Matsum. & Nakai

8.6

6.7

-

-

-

2.9

-

-

-

34

Nicotiana tabacum L.

8.6

6.7

-

-

35

Momordica cabraei (Cogn.) C.Jeffrey.

8.6

16.7

2.9

6.7

36

Psidium guajava L.

5.7

10

-

37

Alstonia boonei De Wild

8.6

6.7

-

38

Euphorbia hirta L.

5.7

6.7

39

Lonchocarpus cyanescens (Schum. & Thonn.) Benth.

-

-

40

Euphorbia convolvuloides Hochst. ex Benth

-

41

Mangifera indica Linn

2.9

ro

8.6

-

-p

Kigelia africana (Lam.) Benth

-

-

-

-

2.9

3.3

-

-

-

-

-

-

re

31

of

5.7

-

-

-

-

-

-

-

-

-

-

8.6

3.3

-

-

-

6.7

-

-

-

-

-

-

-

-

-

-

5.7

13.3

-

-

-

-

-

-

-

5.7

6.7

-

-

6.7

2.9

6.7

-

-

-

-

-

-

lP

Saccharum officinarum L

ur na

30

Jo

L: Lagos metropolis, I: Ilorin metropolis

42

43

re

lP

ur na

Jo -p

ro

of