Dried whole-plant Artemisia annua slows evolution of malaria drug resistance and overcomes resistance to artemisinin

Elfawal, Mostafa A.; Towler, Melissa J.; Reich, Nicholas G.; Weathers, Pamela J.; Rich, Stephen M.

doi:10.1073/pnas.1413127112

Cited by 124Malaria Research and ControlPhytochemical compounds biological activitiesSesquiterpenes and Asteraceae Studies

Dried whole-plant Artemisia annua slows evolution of malaria drug resistance and overcomes resistance to artemisinin

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Elfawal, Mostafa A., Towler, Melissa J., Reich, Nicholas G., Weathers, Pamela J., Rich, Stephen M.·2015·Proceedings of the National Academy of Sciences

DOI 10.1073/pnas.1413127112PMC PMC4311864

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Abstract

Significance: Evolution of malaria parasite drug resistance has thwarted efforts to control this deadly disease. Use of drug combinations has been proposed to slow that evolution. Artemisinin is a favorite drug in the global war on malaria and is frequently used in combination therapies. Here we show that using the whole plant ( Artemisia annua ) from which artemisinin is derived can overcome parasite resistance and is actually more resilient to evolution of parasite resistance; i.e., parasites take longer to evolve resistance, thus increasing the effective life span of the therapy.

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Dry leaf consumption seems resilient against the evolution of artemisinin drug resistance as shown in humans and in Plasmodium yoelii-infected mice.
“Another reason for increasing the in planta artemisinin content is that dry leaf consumption of A. annua is showing efficacy in human trials (Daddy et al. 2017; Munyangi et al. 2019) and seems resilient against the evolution of artemisinin drug resistance as maybe shown in humans (Daddy et al. 2017) and in Plasmodium yoelii -infected mice (Elfawal et al. 2015).”
From Enhancing artemisinin content in and delivery from Artemisia annua: a review of alternative, classical, and transgenic approaches (2021) · cites this paper as Elfawal et al. 2015
The Results and Discussion (page not available in our copy) report that dried whole-plant Artemisia annua was more resilient than pure artemisinin during experimental selection for resistance. But that evolution experiment used P. chabaudi-infected mice; the P. yoelii experiments tested treatment of an already artemisinin-resistant strain, not the evolution of resistance in that species. (LLM, conf=0.91)
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Botanical Medicines Cryptolepis sanguinolenta, Artemisia annua, Scutellaria baicalensis, Polygonum cuspidatum, and Alchornea cordifolia Demonstrate Inhibitory Activity Against Babesia duncani
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Artemisia annua and artemisinins are ineffective against human Babesia microti and six Candida sp
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Transcriptome analysis and connectivity mapping of Cissampelos pareira L. provides molecular links of ESR1 modulation to viral inhibitionPreprint
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The Role of Ayurveda in Prostate Cancer Management
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Analysis for Science Librarians of the 2015 Nobel Prize in Physiology or Medicine: The Life and Work of William C. Campbell, Satoshi Ōmura, and Youyou Tu
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Polymorphisms in the K13-Propeller Gene in Artemisinin-Resistant Plasmodium in Mice
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Current Antimalarial Treatments: Focus on Artemisia annua Dry Leaf
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WITHDRAWN: RESPONSE to Gillibert et al. 2019
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Factors Influencing Clinical Trials of Herbal Medicinal Products – Using Ginger as Example
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Rethinking the basic action modes of herbal medicine and pondering classical standardization
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Preventive Effects of Psoraleae Semen Extracts on Cognitive Dysfunction in Alzheimer’s Disease Model AppNL-P-F Mice
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Dried Whole Plant Artemisia annua as an Antimalarial Therapy
Elfawal, M. A., Towler, M. J., Reich, N. G., Golenbock, D. T., Weathers, P. J., & Rich, S. M. (2012) · PLoS ONE · doi:10.1371/journal.pone.0052746 · Cited by 128 · see citing works
Self-citation
Assembly and Deformation of Amphiphilic Copolymers and Networks at Fluid Interfaces
Bae, J. (2021) · Scholarworks (University of Massachusetts Amherst) · doi:10.7275/6836159.0
Use of whole plant Artemisia annua L. as an antimalarial therapy
Elfawal, M. A., Towler, M. J., Gazzinelli, R. T., Golenbock, D. T., Weathers, P. J., & Rich, S. M. (2020) · The Journal of the American Medical Association (JAMA) Network (American Medical Association) · doi:10.13028/9whb-b153
Self-citation
Using the whole plant to treat malaria
Harrington, M. (2015) · Lab Animal · doi:10.1038/laban.721
Phytochemical synergy in artemisia annua herbal tea against malaria: a systematic review of its efficacy and safety in the context of emerging Pfkelch13 resistance
Munyangi, J., Zalagile, P. A., Mbutshu, H. L., Munyemo, S. K., Ramazani, B.-E. I., & Camara, A. (2026) · Infectious Diseases of Poverty · doi:10.1186/s40249-026-01486-x

Authors: Elfawal, M. A., Towler, M. J., Reich, N. G., Weathers, P. J., & Rich, S. M.
Affiliations: University of Massachusetts Amherst (US)
Worcester Polytechnic Institute (US)
ORCID: Reich, Nicholas G.
Weathers, Pamela J.
Rich, Stephen M.
Venue: Proceedings of the National Academy of Sciences
Publisher: National Academy of Sciences
Published: 2015-01-05
Volume: 112
Issue: 3
Pages: 821-826
ISSN: 0027-8424 (ISSN-L)
1091-6490
DOI: 10.1073/pnas.1413127112
PMC: PMC4311864
OpenAlex: W2088835649
Cited by: 124
References: 65
Citations by year: 2026: 9 · 2025: 14 · 2024: 6 · 2023: 11 · 2022: 11 · 2021: 10 · 2020: 11 · 2019: 10 · 2018: 9 · 2017: 7 · 2016: 17 · 2015: 9
FWCI: 15.01
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.pnas.org/site/misc/userlicense.xhtml (vor)
Locations: Proceedings of the National Academy of Sciences (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: Center for Clinical and Translational Sciences (na)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Phytochemical compounds biological activities
Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Sesquiterpenes and Asteraceae Studies
Keywords: Artemisia annua, artemisinin, antimalarial drug resistance, Plasmodium yoelii, Plasmodium chabaudi, whole plant extract, malaria treatment, resistance evolution, secondary metabolites, plant defense, combination therapy, rodent malaria model
MeSH terms: Animals, Antimalarials, Drug Resistance, Artemisia annua, Artemisinins, Mice

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Dried whole-plant Artemisia annua slows evolution of malaria drug resistance and overcomes resistance to artemisinin

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