Antimalarial Phytochemicals: Delineation of the Triterpene Asiatic Acid Malarial Anti-Disease and Pathophysiological Remedial Activities - Part I

Malaria is a composite condition of the Plasmodium parasite infection and accompanying pathologies. Parasite induced red blood cell perturbations and immunological response to infection drive various organ-specific syndromes accounting for a huge percentage of deaths amongst children <5 years and pregnant women. The multi-factorial pathophysiology includes acute renal failure, hypoglycaemia, severe malaria anaemia, acute respiratory distress syndrome/ acute lung injury and cerebral malaria as some of the prominent presentations of the disease. Current malaria treatment has largely remained “anti-parasite” or “anti-infection” necessitating discovery of “anti-disease” drugs that will ameliorate immunological aberrations, inflammation and metabolic disturbances which are ultimately the cause of high morbidity and mortality. Asiatic acid, a phytochemical, has well known curative properties on other conditions which share disease manifestations with malaria. However, the influence of Asiatic acid on malaria has not yet been reported. This review unravels the different facets of Asiatic acid and their possible remedial effects on molecular and biological changes introduced by the disease with emphasis on how this relates to glucose metabolism, acute renal failure, severe malaria anaemia, acute respiratory distress syndrome/ acute lung injury and cerebral malaria.