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Plantago Major

Writer's picture: Ulilang KaluluwaUlilang Kaluluwa

“Neurological uses

This plant has been used to cure epilepsy lonely, either exclusively, or with other herbs such as cooked lentils with plantain leaves, which in traditional Persian medicine, is called “Adasiyyat”. It also helps to improve nervous pains such as earache by using drops or massage of mucilage, or nasal inhalation

Ophthalmic effects

Plantago major is effective in the treatment of many eye diseases including eye choroid diseases, day blindness, conjunctivitis and eyes sores. Leaf juice has been used as drops with other herbs or independently, in addition to the oral form.

ENT effects

Plantago major is advised for toothache, earache, halitosis, oral lesions, mouth sores, epistaxis, hemoptysis, loose teeth, gingivitis and tonsillitis by gargling the juice of the leaves or its decoction, or dropping in the ear and applying semi hot dry leaves on the location.

Pulmonary effects

Plantago major can treat hemoptysis, asthma, tuberculosis, lung and plural lesions and it was used as decoction and incense. The leaf extract was suitable for treating lung and plural lesions. Taken orally with honey is the most desirable dosage form for treating pulmonary disorders

Gastrointestinal effects

Plantago major is effective in upper and lower gastrointestinal bleeding, hematemesis, dysentery, hemorrhoids, stomachache, intestinal ulcers, dyspepsia and constipation by eating the extract and baking leaves with salt and vinegar or enema of extract or its mucilage

Hepatic, splenic effects

Plantago major extract and seed or root has been extensively applied as liver tonic and advised in obstructive diseases of liver and spleen

Urogenital effects

Plantago major is prescribed in uterus wart, uterus ulcer, menometrorrhagia and polymenorrhea in the form of oral or vaginal. Due to diuretic effect of Plantago major, it is also advised for urinary retention, hematuria, and bladder and kidney pain. For this aim, it was used as plaster or oil on the skin, locally

Dermatologic effects

Plantago major is used in different kinds of wound and skin diseases in TPM such as deep wound, purulent wound, chronic and progressive wound, malignant wound, fire burn, erysipelas, progressive blister, pruritus, irritating urticarial and fistula, by sprinkling the plant powder on the wound or its plaster with salt or separately. It is also used for head and face skin ulcers in the same manner

Pharmacological effects

Immune Enhancing Effects

Methanol extracts of P. major leaves, increase creation of nitric oxide (NO), tumor necrosis factor-alpha (TNF-α) and stimulate lymphocyte proliferation, so activated macrophages are produced in a variety of cytotoxicity such as nitric oxide, TNF-α and lymphokines. As a result, it can prevent the development of tumors and infections. Plantago major shows immunomodulatory activity, increasing lymphocyte proliferation and secretion of interferon-γ at low concentrations (< 50 μg/ml), but at high concentrations, it can inhibit this property (< 50 μg/ml). The hot water extracts of Plantago major can help to improve leukemia, carcinoma and viral infections.

Hepatoprotective Effects

In recent years, hepatic disorders have been the main cause of deaths around the world (26). In one model of animal study, extract of Plantago major seed, exhibits the hepatoprotective activity by which the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) showed reduction.

Gastrointestinal effects

Due to the anti-inflammatory effect of Plantago major, it can be used to treat endoparasites and stomach problems in animals. The polyholozidic fraction separated from the leaves and seeds of some Plantago species (Plantago major, media, lanceolata) explains its gastro protective action, and a laxative effect was obtained with higher doses of Plantago major. The seeds of the plant have a high gastro protective effect in comparison to the leaves, which may be as a result of high content from mucilage. A water immersion-stress ulcer model was used on rats to test the plant extract’s ability to inhibit ulcers. Acidity and gastric fluid were significantly decreased by extract which may be due to inhibition of gastric acid secretion and increase of mucosal defensive factors. On the other hand, Plantago leaves extract decreased the motility of duodenum and also had antidiarrheal effect in oral administration. Plantago major seeds are recommended for inflammatory bowel disease (IBD). Although the oral administration of leaf extract can decrease gastric ulcers, the seed extract has no effect. But both seed and leaf extracts can decrease total acidity as well.

Pulmonary effects

Plantago major inhibits mast-cell degranulation and can be used for treating asthma and allergic disease. It protects against pneumococcal infection in mice and treatment of chronic bronchitis.

Urinary effects

Plantago major has diuretic effects and can also inhibit activity of angiotensin converting enzyme. Another study on extract of Plantago major showed that it is more efficient than allopurinol and potassium citrate in inhibiting the size of the calcium oxalate crystal in-vitro and it can be consumed to improve urolithiasis.

Dermatologic effects

Plantago major is an effective herb in the management of acute urticaria. Ursolic acid, oleanolic acid and α-linolenic acid are three Plantago major components that have shown inhibitory effects on COX-2 catalyzed prostaglandin production. Luteolin (one of the flavonoids) also has the ability to suppress leukocyte migration and inhibit mast cell degranulation which all together can be considered as anti urticaria treatment strategies

Anti-hypercholesteremia, Anti-atherosclerosis and Hypoglycemic effect

Plantago major leaves can inhibit progressions of atherosclerosis and hypercholesteremia in animals via the lecithin/cholesterol ratio. Plantago major seeds have hypoglycemic effect in mice. Plantagoside and its aglycone in Plantago major seeds inhibit protein cross-linking glycation and have potential beneficial applications in the prevention of diabetic complications.

Antinociceptive Effects

Methanolic extracts of leaves, seeds or aqueous extract of plant have shown anti-inflammatory and analgesic activities through inhibition of prostaglandins synthesis.

Antioxidant and Free Radical Scavenging Effects

Ethanolic hot and cold water extracts of Plantago major leaves and seeds have antioxidant activity. Plantago major contains flavonoids such as luteolin, apigenin, hispidulin and baicalein, which can induce carcinoma cell death. In addition, Plantago extracts have inhibitory and cytotoxic effects on breast adenocarcinoma and melanoma cell lines and these preliminary results could be justified by the cytotoxic activity of the flavone, luteolin-7-O-β-glucoside, the major flavonoid in Plantago species.

Anti-infective, Antibiotic, Antifungal, Antiviral, Antimalarial and Anti-giardiasic Effect

Some types of Plantago major extract were effective in the treatment of fungal, bacterial and viral infections. Anti-malarial and anti-Giardia effects of plant have been proven as well. However, the aqueous extract of Plantago major had a slight anti-herpes virus activity versus the caffeic acid, which exhibited the strongest activity against HSV-1, HSV-2 and ADV-3. However, chlorogenic acid possessed the strongest anti-ADV-11 activity. Ethyl alcohol extract showed antibacterial activity against E. coli and Bacillus cereus and acetone extract was effective on bacteria species (Bacillus cereus, Bacillus subtilis, Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Klebsiella pneumonia, Pseudomonas aeruginosa, Proteus mirabilis, Salmonella enteritidis) in different concentrations. Plantago major extract also showed acceptable potency against C. albicans comparable to synthetic antifungal agents.

Anticancer and Cytotoxic Activity Methanolic Plantago major extract was evaluated for cytotoxic activity against three human cancer cell lines including the human renal adenocarcinoma (TK-10), the human breast adenocarcinoma (MCF-7) and the human melanoma (UACC-62). Flavonoids, flavone and luteolin are the main factors in cytotoxic activity. Plantago major may be partially effective in preventing carcinogenesis. The cytotoxic activity of Plantago major methanol extract on human transformed cells: HCT-15 (colon carcinoma), SQC-UISO (cervical carcinoma), OVCAR (ovary carcinoma) and KB (nasopharynx carcinoma) has also been evaluated, in vitro. Aqueous and methanol extracts of Plantago major also stimulate cell proliferation in bone marrow and spleen cell cultures. Although the same number of cells was cultured in both types of tumor, cell population was significantly higher in spleen cultures than in bone marrow cultures. In fact, oleanolic acid and ursolic acid stimulated the proliferation of splenocytes and enhanced the recovery of hematopoietic system.

Wound Healing Effects

Plantago major was used in wound healing and the leaves were used as a remedy of wounds. Anti-inflammatory action is via a complex event linked to tissue damage whether by bacteria, physical trauma, chemical, heat or any other phenomenon. Also, inflammatory response is the critical protective reaction to these kinds of injures remarked by redness, fever, edema (swelling) and pain in involved tissue. In an animal study, water extract of Plantago major is recommended as a suitable substitute for silver sulfadiazine, especially when applied in 50% concentration in wound burn healing. Polyphenols especially plantamajoside are considered as the main significant compounds for wound healing.

Adverse reactions

Plantago major is a safe plant, but some adverse reactions such as: nausea, vomiting, diarrhea, anorexia, bloating, hyper-sensitivity and dermatitis may arise after treatment. Life threatening anaphylaxis may occur in more serious cases in over dose usage

Safety and toxicity

Daily dosage is 3–5 g of the powdered herb 1–3 times daily but the most common dose as infusion is 150 ml (one cupful) 3–4 times a day. The Plantago major may be prepared in either a dried state or as an extract before being packaged and distributed in a form suitable for oral administration, including capsules, pills, coated pills, tablets and dragee. Plantago major is not among the most toxic of plants. Analysis of the anti-nutritional and toxic components showed low content of oxalic acid (6736 mg) and erucic (3.45%) in Plantago major extract. Furthermore, LC50 and LD50 for Plantago major were determined as 4.74 (μg/mL) and 182.54 (mg/kg) and median effective dose (ED50) value of Plantago major was found to be 7.507 mg/kg. Plantago major also has phenol groups”

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