Dr. Wiwied Ekasari, M.Si., Apt, Universitas Airlangga pharmaceutical expert, develops of antimalarial drugs. (Photo by courtesy)
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UNAIR NEWS – Malaria disease carried by vector Anopheles sp. females infect many residents in the tropics including Indonesia. Diseases caused by this type of Plasmodium parasite has been widely treated. However, this parasite has developed resistance to certain drugs.

Dr. Wiwied Ekasari, M.Si., Apt, Universitas Airlangga pharmaceutical expert  developed an antimalarial drug by extracting the ingredients contained in the Johar plant ( Cassia siamea lamk ). Her research journey began when one of his seniors told about the efficacy of Johar leaves which is often used by Indonesian independence combatants to avoid malaria during guerrilla war in the jungle.

“The soldier was ordered by his commander to drink the juice of Johar leaves. Water juice is often used to reduce heat and malaria. It is evident as when they drank the juice of leaf, they are not infected by malaria, “said the lecturer of the Faculty of Pharmacy.

Even before 2000, Wiwied examined the benefits of Johar’s plant to complete her thesis. There are many compounds contained in Johar plants, but the lecturer of Anatomic Practice of Plant Morphology chose to use a fraction containing the compound of cassiarin A to stop the infection caused by female Anopheles sp mosquitoes.

The reason, the compound cassiarin A is the most active compound in crippling  malaria.

In the course of her research, the lecturer of Department of Pharmacognosy and Phytochemistry compared the effectiveness of cassiarin A compounds with chloroquine. Chloroquine is a drug commonly used as an antimalarial. However, the malaria-causing parasite has been resistant to chloroquine. As a replacement, malaria patients now consume artemisinin as a standard drug.

Using the regulations set by the World Health Organization (WHO), Wiwied combines two active ingredients to treat malaria. Lecturer of Pharmacognosy and Phytochemistry Department combined fractions containing active compound cassiarin A with artemesinin.

“The combination with artemesinin is better than just artemesinin alone. So there are many opportunities for Johar to be a combination of drugs. WHO recommends, antimalarial drugs do not stand alone in order to avoid resistance, “said Wiwied.

Wiwied mentioned, there are three working mechanisms produced by the combination of both active ingredients. First, the combination of these two active ingredients inhibit the endocytosis of red blood cells into vacuoles to nourish the parasite. Second, it inhibits the degradation of globin into amino acid proteins. Third, it inhibits the change from the detoxification of heme to hemozoin.

“Of course, in the end, the parasite causes malaria to die with a combination of two active ingredients,” explained the author of TOGA Indonesia, published in 2016.

Currently, together with the Health Research and Development Agency (Balitbangkes) of Ministry of Health of Republic Indonesia, Wiwied is researching the maximum dose of the compound fraction of cassiarin A which can kill the parasite causing malaria.

“We are adjusting the dose so it won’t exceed the safe limit,” she added.

To Achieve Independence

According to Wiwied, one of the advantage of antimalarial herbal medicine being studied is the availability of Johar plants. The raw materials can be found in all parts of Indonesia. However, it does the opposite to the availability of raw artemisinin materials. Raw artemisinin material cannot be found in Indonesia.

“Artemesinin is not from our plants. It’s from China. Hence, we (Indonesia) continue to import it. By using Johar, it is hoped the medicine is original from us. We make our own medicine from our own plants. Natural resources are available and supported by qualified human resources, “said Wiwied.

In addition, Wiwied research may also be an alternative if the malaria vector are resistant to standard drugs currently used by WHO. Wiwied said, although the case of resistance to drug artemisinin has not occurred in Indonesia, but this case has occurred in Asia. One of them is Thailand.

The case of drug resistance is due to deregulation of the drug distribution program to the public. In addition, the government needs to be aware of the case on resistance due to the high mobility of the population.

“But, the transmission by mosquitoes happens so fast because they breed and infect travelers. They can spread anywhere while the artemesinin has not found the replacement. Especially in Indonesia there are still people who need medicine. Hence, we studied antimalarial from Johar because almost all regions have this plant, “said the researcher born in Surabaya, January 22, 1969.

Wiwied added that after the maximum dose of research is found, in 2018 it will hold the domestic industry to conduct a series of clinical trials in humans. Over the next three years, Wiwied hopes that the anti-malaria drug she developed can be distributed and used by people living in the endemic area of malaria, including Indonesia.

Author: Defrina Sukma S

Editor: Nuri Hermawan

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