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ANALGESIC, ANTIPYRETIC AND ANTI-INFLAMMATORY

POTENTIAL OF DICHLOROMETHANOLIC ROOT EXTRACT OF


CLUTIA ABYSSINICA JAUB AND SPACH IN RATS AND MICE
MODELS

KOECH SAMSON CHERUIYOT (BSc Biochem)


I56/28505/2014

A Research Thesis Submitted in Partial Fulfillment of the Requirements


for the Award of the Degree of Master of Science (Biochemistry) in the
School of Pure and Applied Sciences of Kenyatta University

July, 2017
ii
iii

DEDICATION

I dedicate this thesis to my family for their immense support towards my

education.
iv

ACKNOWLEDGEMENT

I greatly acknowledge Kenyatta University for giving me an opportunity to

further my studies. Much of my appreciation goes to my supervisor‟s Prof Eliud

N.M Njagi and Dr Mathew Piero Ngugi for their inspiration, mentorship and

tireless effort in guiding me to complete my research study. May God bless them

abundantly.

I owe special thanks to the Department of Biochemistry and Biotechnology and

her staff for the close companionship and cooperation during the entire period of

carrying thank out my research study. The following people deserve to be

mentioned, Mrs Lel, James Adino, Daniel Gitonga and James Ngunjiri for their

technical support. To Veronica Sindani, Peter Nthiga, James Kimani, John

Mwonjoria, Jane Maoga, Wylcliffe Arika, Alex Cheruiyot, Herbet Cheruiyot and

Robert Ouko you for your motivation and encouragement.

I also owe a big thanks to my parents, brothers, sister and friends for the

encouragement, motivation and support throughout the entire period. Above all I

thank the almighty GOD for giving me good health and strength to complete this

project.
v

TABLE OF CONTENT
DECLARATION ............................................................................................. ii
DEDICATION ................................................................................................ iii
ACKNOWLEDGEMENT .............................................................................. iv
TABLE OF CONTENT ................................................................................... v
LIST OF FIGURES ...................................................................................... viii
LIST OF TABLES .......................................................................................... ix
LIST OF APPENDICES .................................................................................. x
ABBREVIATIONS AND ACRONYMS ....................................................... xi
ABSTRACT ................................................................................................... xii
CHAPTER ONE .............................................................................................. 1
INTRODUCTION ........................................................................................... 1
1.1 Background of the Study ........................................................................... 1
1.2 Problem Statement and Justification .......................................................... 7
1.3 Hypotheses ................................................................................................. 8
1.4 General Objective ...................................................................................... 9
1.4.1 Specific Objectives ................................................................................9
CHAPTER TWO ........................................................................................... 10
LITERATURE REVIEW .............................................................................. 10
2.1 Biochemical and Physiological Basis of Pain, Fever and
inflammation ............................................................................................ 10
2.2 Screening Models for Pain, Pyrexia and Inflammation ........................... 15
2.2.1 Screening Models for Pain ..................................................................15
2.2.1.1 Test Based on Thermal Stimuli..................................................15
2.2.1.1.1 Tail flick test using radiant heat ................................................15
2.2.1.1.2 Hot plate test ..............................................................................16
2.2.1.2 Test Based on Mechanical Stimuli ...............................................16
2.2.1.3 Test Based on Electrical Stimuli ..................................................16
2.2.1.3.1 Electrical stimulation of the tooth-pulp .....................................16
vi

2.2.1.3.2 Electrical stimulation of the tail.................................................17


2.2.1.4 Test Based on Chemical Stimuli ..................................................17
2.2.1.4.1 Formalin-Induced pain test ........................................................17
2.2.1.4.2 Acetic acid-Induced pain test ....................................................17
2.2.2 Screening Models for Pyrexia .............................................................18
2.2.2.1 Turpentine-Induced test ................................................................18
2.2.1.2 DNP-Induced test .........................................................................18
2.2.2.3 Brewer‟s Yeast-Induced test .........................................................19
2.3.3 Screening Models for Inflammation ...................................................19
2.3.3.1 Carragenaan-Induced Hind Paw Edema test ................................19
2.2.3.2 Xylene-Induced Ear Edema test ...................................................20
2.2.3.3 Formalin-Induced Paw Edema Test .............................................21
2.2.3.4 Cotton Pellet Granuloma Test ......................................................21
2.3 Conventional Management of Pain, Pyrexia and Inflammation .............. 21
2.4 Use of Medicinal Plants in Management of Diseases .............................. 25
2.5 Herbal Management of Pain, Fever and Inflammation ............................ 26
2.5.1 Pain ......................................................................................................26
2.5.2 Pyrexia .................................................................................................28
2.5.3 Anti-inflammatory...............................................................................29
2.6 Clutia abyssinica...................................................................................... 31
2.6.1 Description and Distribution ...............................................................31
2.6.2 Medicinal uses .....................................................................................32
CHAPTER THREE ....................................................................................... 34
MATERIALS AND METHODS ................................................................... 34
3.1 Collection and Preparation of Plant Materials ......................................... 34
3.2 Extraction ................................................................................................. 34
3.3 Experimental Design ................................................................................ 35
3.3.1 Laboratory Animals.............................................................................35
3.4 Determination of Analgesic Effect .......................................................... 35
vii

3.5 Evaluation of Antipyretic Effect .............................................................. 37


3.6 Determination of Anti-inflammatory Effect ............................................ 39
3.7 Qualitative Phytochemical Screening ...................................................... 41
3.7.1 Flavonoids ...........................................................................................41
3.7.2 Terpenoids (Salkowski test) ................................................................41
3.7.3 Steroids ................................................................................................42
3.7.4 Cardiac glycosides...............................................................................42
3.7.5 Phenolics .............................................................................................42
3.7.6 Alkaloids- Mayer‟s test .......................................................................42
3.7.7 Saponins (Frothing test) ......................................................................43
3.8 Data Management and Statistical Analysis.............................................. 43
CHAPTER FOUR .......................................................................................... 44
RESULTS ...................................................................................................... 44
4.1 Analgesic Activity of DCM Root Extracts of C. abyssinicaon acetic acid-
. induced pain in Swiss albino mice .......................................................... 44
4.2 Antipyretic Activity of DCM Root Extract of C. abyssinica on turpentine-
. Induced pyrexia in Wistar albino rats. ..................................................... 46
4.3 Anti-inflammatory Activity of DCM Root Extract of C. abyssinica....... 50
on Carrageenan-Induced Inflammation in Swiss Albino Mice................ 50
4.4 Qualitative Phytochemical Screening ...................................................... 55
CHAPTER FIVE ........................................................................................... 56
DISCUSSION, CONCLUSION, RECOMMENDATIONS AND
SUGGESTIONS FOR FURTHER STUDIES ............................................... 56
5.1 Discussion ................................................................................................ 56
5.2 Conclusion ............................................................................................... 67
5.3 Recommendations .................................................................................... 68
5.4 Suggestions for Further Studies ............................................................... 69
REFERENCES .............................................................................................. 70
viii

LIST OF FIGURES
Figure 2. 1: Clutia abyssinica…………………………………………………..32
Figure 4. 1: Percentage change in rectal temperature of DCM root
extract of Clutia abyssinica on turpentine-induced
pyrexia in Wistar albino rats..............................................................49

Figure 4. 2: Percentage change in hind paw diameter of DCM root


extract of Clutia abyssinica on carragenaan induced
inflammation in Swiss albino mice .................................................. 54
ix

LIST OF TABLES

Table 3. 1: Treatment protocol for assessment of analgesic activity of


DCM root extract of C. abyssinica in Swiss albino mice ................. 36
Table 3. 2: Treatment protocol for antipyretic activity of DCM root
extract of C. abyssinica in wistar albino rats..................................... 38
Table 3. 3: Treatment protocol for evaluation of anti-inflammatory
activity of DCM root extract of C. abyssinica in swiss
albino mice. ....................................................................................... 40
Table 4. 1: Analgesic activities of DCM root extracts of C. abyssinica
on acetic acid-induced pain in Swiss albino mice……..……………45

Table 4.2: Antipyretic activities of DCM root extracts of


C. abyssinica on Turpentine-induced pyrexia in Wistar
albino rats………………………………………………………….48

Table 4. 3: Anti-inflammatory activities of DCM root extracts of


C. abyssinica on carragenaan-induced inflammation in
Swiss albino mice .............................................................................. 53
Table 4. 4: Phytochemical composition of DCM root extract of
....................C. abyssinica ..................................................................................... 55
x

LIST OF APPENDICES

Appendix I: Mean percentage change in the number of abdominal


writhes after administration of DCM root extract in
Swiss.albino mice………………………………………………..87
Appendix II: Effects of DCM root extract of Clutia abyssinica on
turpentine-induced pyrexia in Wistar albino rats…………….88
Appendix III: Effects of DCM root extract of Cluta abyssinica on
carrageenan-induced inflammation in Swiss albino mice…….....89
Appendix IV: A map of the location where the plant was
collected Courtesy of Google Earth maps………………………90
Appendix V: Analysis of analgesic activity of DCM root extract of .
………………Clutia abyssinica in Swiss albino mice………………………….91
Appendix VI: Analysis of antipyretic activity of DCM root extract
of Clutia abyssinica in Wistar albino rats……………………….92
Appendix VII: Analysis of anti-inflammatory activity of DCM root
extract of Clutia abyssinica in Swiss albino mice……………...95
xi

ABBREVIATIONS AND ACRONYMS


5-HT Serotonin (5-hydroxytryptamine receptors)
Aδ A delta fibers
ANOVA Analysis of variance
Bw Body weight
CAM Complemetary and alternative medicine
COX 1 Cyco-oxygenase 1
COX 2 Cyclo-oxygenase 2
COX cyclo-oxygenase
DAMPs Damaged associated molecular patterns
DCM Dichloromethane
DMSO Dimethyl sulfoxide
DNP 2,4-Dinitrophenol
IASP International association for the study of pain
IL-1RA Interleukin 1 RA
IL-1α Interleukin 1α
IL-1β Interleukin 1β
IL-6 Interleukin 6
Ip Intraperitoneally
KG Kilograms
M Meters
M/L Milliliters
M/S Meters per second
MG Milligrams
Ms Microsoft
NFκB Nuclear factor kappa activated Bcells
NLRS Nord-like receptors
NSAIDs Non-steroidal anti-inflammatory drugs
OVLT Organum vasculum of the laminae terminalis
PGE2 Prostaglandin E2
PGs prostaglandins
SEM Standard error mean
TLR-4 Toll-like receptor 4
TLRs Toll like receptors
TNFα Tumour necrosis factor α
UL Microliters
WHO World health organization
xii

ABSTRACT
Various diseases and injuries are always presented with pain, fever and
inflammation. These are considered as symptoms associated with various
pathological processes in an animal body. Drugs that are used to alleviate pain,
fever and inflammation such as non-steroidal anti-inflammatory drugs exhibit
adverse effects for example cardiac abnormalities, peptic ulcers, liver toxicity and
kidney failure. Therefore, there is need to come up with alternative remedies.
Herbal medicines are deemed to be safe, have good efficacy and have fewer side
effects. Clutia abyssinica is a shrub that is found in East, Central, and South
Africa and it has been used traditionally to cure several ailments including
malaria, chest pain, gonorrhea, fever, infertility, pain, inflammation, skin diseases
and cancer. Roots of this medicinal plant have been used traditionally to prepare
decoctions. The aim of the project was to evaluate the analgesic, antipyretic and
anti-inflammatory potential of dichloromethanolic root extract of Clutia
abyssinica in animal models. Plant sample material was collected from Kaptebee
village, Turbo sub-county in Uasin Gishu County Kenya, and the active
components extracted using dichloromethane. Pain, fever and inflammation were
induced Swiss albino mice and Wistar albino rats using acetic acid, turpentine and
carrageenan respectively. Swiss albino mice and Wistar albino rats were grouped
into normal control, negative control, positive control and 3 experimental groups.
Extracted root extracts were administered intraperitoneally to Swiss albino mice
and Wistar albino rats at predetermined doses (50, 100, and 150 mg/kg body
weight). The analgesic and anti-inflammatory activities of the plant root extract
were compared to diclofenac the (reference drug) while the antipyretic activity
was compared to aspirin. The dichloromethanolic root extract of C. abyssinica
demonstrated significant analgesic, antipyretic and anti-inflammatory activities.
Number of abdominal writhing was reduced between 33.95-49.51% by
dichloromethanolic root extract while the diclofenac (reference drug) reduced
abdominal writhing by 46.51%. Reduction in number of abdominal writhings by
the extract indicates the plant posse‟s analgesic properties. The elevated
temperature was reduced between 0.68-3.34% by the dichloromethanolic root
extract while Aspirin the (reference drug) reduced elevated temperature between
3.32-4.96%. Edema was reduced between 0.88-5.34% by the plant extract while
diclofenac reduced edema between 2.21-5.35% respectively. Rectal temperature
and the size of the edema was reduced more in the third and fourth hours
signifying better blockage of mediators responsible for fever and inflammation.
Data was analyzed using one way analysis of variance followed by turkey‟s test.
Qualitative phytochemical analysis revealed the presence of alkaloids, flavonoids,
terpenoids, steroids, saponins and cardiac glycosides. The extract from Clutia
abyssinica may be used as an alternative bioresource in development of analgesic,
antipyretic and anti-inflammatory agent. The study therefore, confirms the
folklore use of the medicinal plant by Kalenjin community of Kenya to manage
pain, fever and inflammation.
1

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Pain is defined as multidimensional, subjective and unpleasant experience that is

allied to tissue damage comprising sensory experiences that include; time,

intensity, space, emotion, cognition and motivation (Maze et al., 2000). Pain

contains both sensory and psychological mechanisms. However, pain is beyond

sensation, it comprises of perception and subjective interpretation of the

discomfort (Maze et al., 2000). Major mediators of pain include; Bradykinin,

histamine, serotonin and prostaglandins. Pain in its real sense lack a way to

define it, but in general term, occurs whenever the body tissues are damaged

(Arome et al., 2016). Sensation of pain is a sign that something in the body is

wrong. Pain plays an important role in drawing attention to tissue injury from

harmful stimuli and reflexes are elicited to protect the injured part of the body

(Arome et al., 2016).

Damage caused by mechanical, thermal, chemical and electrical stimuli through

peripheral receptors triggers pain sensation to nociceptors in an organism (Guyton

and Hall, 2006). Perception of pain is a normal physiological response that is

mediated by nervous system and is used for diagnosing various diseases such as

diabetes, arthritis and cancer that are normally associated with chronic pain

(Apkarian et al., 2005).


2

Fever or pyrexia is a common clinical sign that is characterized by rise in body

temperature beyond the normal range of (36.5°C -37.5°C) (Axelrod and Diringer,

2008). Pyrexia depicts an increase in body temperature due to cytokine-induced

upward displacement of the set point in the hypothalamic thermoregulatory center

(Karakitsos and Karabinis, 2008). Fever is considered a normal reaction in a

number of health problems. It is even considered as an alarming sign when fever

itself is absent than when it is present. Symptoms of fever include; sweating,

chills, sensation of cold and other subjective sensations (Guyton and Hall, 2000).

High temperature with absence of these symptoms may indicate a sign of a

serious illness (Saper and Breder, 1994).

A number of different microorganisms and other substances can cause fever and

are collectively termed as pyrogens (Shalini and Donna, 2006). Pyrogens are

classified into either exogenous or endogenous pyrogens. Exogenous pyrogens are

those that originate outside the body for example bacteria toxins on the other hand

endogenous pyrogens are derived from immune cells in the body responding to

stimuli from an external environment (Shalini and Donna, 2006). Products

released by bacterial cell membranes such as lipopolysaccharide, toxins and

breakdown of protein products in an organism body can cause the set point of the

hypothalamic thermostat to increase (Guyton and Hall, 2000). Under normal

health conditions the range for oral temperature is between 33.2 – 38.2°C, for the

armpit 35.5 – 37.0°C, the rectal 34.4 – 37.8°C, while for tympanic membrane
3

35.4-37.8°C (Sund-Levander et al., 2002). Fever is associated with sickness

conditions, such as depression, anorexia, sleepiness, lethargy, inability to

concentrate and hyperalgesia (Kelly et al., 2003).

Inflammation on the other hand is a complex response in the vascularised

connective tissue that may be triggered by either exogenous or endogenous

stimuli (Rang et al., 2003). Inflammation is considered a normal process that

provide protective role to tissue injury brought about by microbiological agents,

physical trauma and noxious chemicals. Inflammation is utilized by the immune

system as a means of defence. During the process of inflammation, foreign

material responsible for inflammation are destroyed as a means of tissue repair

and regeneration (Rang et al., 2003).

Inflammation is characterised by a number of components that result from tissue

injury and this include; leukocyte infiltration, edema formation and granuloma

formation (Guyton and Hall, 2000; Mitchell and Cotran, 2000). For edema to be

formed, synergism between various inflammatory mediators are involved that

increase vascular permeability and blood flow into the damaged sides (Lalenti et

al., 1995). Inflammation can either be acute or chronic. Acute inflammation is

considered as that initial response to harmful stimuli by the body while chronic

inflammation on the hand is considered inflammatory response that is out of


4

proportion resulting in damage to the body tissue or organs (Palladino et al.,

2003).

Cardinal signs of inflammation include; redness, increased temperature, swelling,

pain, and loss of function (Craig and Stitzel, 2003). A diverse number of

substances can provoke inflammation for example toxins, infections, frostbite,

chemicals, noxious agents, physical injuries, foreign materials, pathogens,

antibodies, immune reaction and necrosis (Young et al., 2002).

Inflammation can also be triggered by a number of diverse inflammatory

mediators for example prostaglandins, leukotrienes, neuropeptides, eicosanoids,

histamine, serotonin, kinins and platelet activating factors (Burke et al., 2006).

Different immune cells like neutrophils, monocytes, lymphocytes, basophils, mast

cells, resident macrophages and eosinophils are also involved in pathogenesis of

inflammation (Richardson, 1971).

Pain, fever and inflammation are beneficial to the immune system. However, they

cause a lot of suffering and discomfort to the victims lowering the quality of life

and therefore need to be managed. Non-steroidal anti-inflammatory drugs

(NSAIDs) are commonly used to manage inflammation, fever and pain (Barar,

2009). Opoid analgesics are choice drugs for severe or chronic malignant pain

(Richard et al., 2008). Their mechanism of action involves inhibition of cyclo-


5

oxygenase (COX) enzyme which results in disruption of prostaglandins synthesis

(Burke et al., 2006). However, non-steroidal anti-inflammatory drugs and opioid

analgesics that are normally used to treat inflammation, fever and pain manifest a

great number of adverse effects (Beg et al., 2011).

Despite numerous progress in medical science and in the production of new

synthetic conventional drugs for management of pain, fever and inflammation,

there is still need for development of more cost-effective and improved remedies

with lesser side effects. Recent studies by world health organisation (WHO)

indicate that these compounds/drugs used in the management of pain,

inflammation and fever manifest a lot of side effects after long term use that

include gastric irritation, ulceration, prolonged bleeding, renal failure, interstitial

corrosion, and pruritis (Beg et al., 2011). Reduction in ligament formation,

tendon, cartilage healing and delay in muscle regeneration in many studies has

been associated with NSAIDs (Almekinders, 1999). Conventional drugs used to

manage pain, inflammation and fever only provide asymptomatic relief and the

greatest disadvantage lies in their toxicity to the liver, kidney and reappearance of

symptoms after discontinuation (Shah et al., 2006).

In this regard, herbal medicines have been employed in complementary and

alternative medicine (CAM) for treatment of pain, fever and inflammation as well

as diseases related to these conditions. Many traditionally used medicinal plants


6

are known to contain antipyretic, analgesic and anti-inflammatory properties but

only a small percentage are included in health care systems after clinical research

to manage these conditions (Singh et al., 2008).

In general, natural products and in particular, medicinal plants, are believed to be

an important source of novel chemical substances with potential therapeutic

capabilities. Considering that most of anti-inflammatory, analgesic, anti-malarial

and antipyretic synthetic drugs such as aspirin, morphine chloroquine and

artemisinin were derived from plant products, the search for plant species with

anti-inflammatory, antipyretic and analgesic properties should be viewed as a

fruitful strategy in search of new drugs (Gupta et al., 2006).

Clutia abyssinica has been used traditionally by the kalenjin community in

Kaptebee village, Turbo sub-county in Uasin Gishu County Kenya in

management of pain, malaria, kidney problem, fever and inflammation (Jeruto et

al., 2014). Though there are some ethnobotanical studies conducted on this

medicinal plant, there has been no scientifically evaluated data about its potential.

It is against this background that bioscreening of analgesic, antipyretic and anti-

inflammatory potential of dichloromethanolic (DCM) root extracts of C.

abyssinica in animal models was investigated. The study aimed at providing

preliminary information for production of plant derived analgesic, antipyretic and

anti-inflammatory drugs.
7

1.2 Problem Statement and Justification

Recently, there has been a remarkable development in medical science. However,

treatment and management of many serious indicators of ill health including pain,

fever and inflammation is still problematic and complex (Adedapo et al., 2009).

Pain, fever and inflammation cause suffering and discomfort among the victims

(Kariuki et al., 2012). Recent studies by WHO indicates that the NSAIDs used in

management of these conditions manifest a lot of side effects (Robotin, 2006; Beg

et al., 2011).

This is therefore, a challenge to the research sector to find alternative approaches

of managing pain, fever and inflammation. Herbal medicines are deemed to be

safe, have good efficacy, are culturally accepted and have lesser side effects than

the synthetic drugs (Sen et al., 2010).

Although C. abyssinica is widely used in Kaptebee village, Turbo sub-county in

Uasin Gishu County Kenya by the Kalenjin community to manage pain, fever,

inflammation, malaria and other ailments in the traditional system of medicine, an

extensive search on the literature reveals that no data has been documented about

the medicinal use of the plant against pain, fever and inflammation.
8

1.3 Hypotheses

i. The DCM root extracts of C. abyssinica do not have analgesic effects in

mice models.

ii. The DCM root extracts of C. abyssinica do not have antipyretic effects in

rat models.

iii. The DCM root extracts of C. abyssinica do not have anti-inflammatory

effects in mice models.

iv. The DCM root extracts of C.abyssinica do not have phytochemical

compounds associated with analgesic, antipyretic and anti-inflammatory

activities.
9

1.4 General Objective

To determine analgesic, antipyretic and anti-inflammatory potentials of DCM root

extracts of C. abyssinica in rats and mice models.

1.4.1 Specific Objectives

i. To determine effects of DCM root extracts of C. abyssinica on acetic acid

induced-pain in Swiss albino mice models.

ii. To determine the effects of DCM root extracts of C. abyssinica on

turpentine-induced pyrexia in Wistar albino rat models.

iii. To determine the effects of DCM root extracts of C. abyssinica on

carragenaan-induced inflammation in Swiss albino mice models.

iv. To determine the qualitative phytochemical composition of DCM root

extracts of C. abyssinica.
10

CHAPTER TWO

LITERATURE REVIEW

2.1 Biochemical and Physiological Basis of Pain, Fever and Inflammation

The international association for the study of pain (IASP) defines pain as

“unpleasant sensory and emotional experience that is caused by actual or potential

tissue damage”. The emotional component differ from one person to the other

and in the same individual from time to time and it can be classified in several

ways, but in therapeutic application into; nociceptive and neuropathic (Rajagopal,

2006). In the body, Sensory nerve endings are generally found in every part of the

body such as the blood vessels, internal organs, muscles, joints, and the skin.

Damage caused by the chemical, mechanical, and thermal stimuli sensitize

nociceptors. When cells are damaged a number of chemical mediators are

released which then activate and sensitize nociceptors to other mediators of pain

(Thorp, 2008). Sensation of pain due to mechanical, thermal and electrical

stimuli is initiated by peripheral receptors (Guyton and Hall, 2006). In the brain

pain stimulus are processed and generated impulses are send down the spinal cord

following the appropriate nerves and instructs the body to respond, for instance

withdrawing your hand from fire (Rang et al., 2006).

Peripheral nerves transmit pain stimulus to the spinal cord which then links to the

brain. Two types of nerve fibers are involved in this process; slow pain fibers and

Fast pain fibers. Transmission of fast pain is through the A delta fibers (Aδ fibers)
11

to the spinal cord. The activity of fast pain fibers is terminated at luminal in the

spinal cord. A second neuron is excited which follows the neospinothalamic

pathway and terminates its transmission in the brainstem (Arome et al., 2016).

Fast pain nerve endings secrete a neurotransmitter called glutamate, which

transmits fast pain impulses to the brain in the cortex. Therefore localization of

pain in certain part of the body becomes relatively precise (Rang et al., 2006).

Bradykinin, histamine, serotonins and prostaglandins are the major mediators of

pain (Craig and Stitzel, 2003). It is a sensory modality that is essential for survival

of an organism from harmful stimuli. It provides a warning signal to the nervous

system to initiate a response that would otherwise minimize injury to the tissues

(Arome et al., 2016).

Pain can also be classified into fast and slow pain. A second after application of

pain stimulus such as pricking of hand or touching a hot object fast pain is felt at

that moment. This kind of pain is shallow, felt within underneath of the skin but

not felt in most internal tissues of the body. Its transmission is through the A delta

fibers at a velocity of about 5-30 m/s and due to its high speed in conduction of

pain stimulus it allows the body to immediately withdraw from the stimuli

(Guyton and Hall, 2006). Slow pain on the other hand is throbbing and diffused.

It is felt immediately after pain stimulus is applied lasting for few minutes, weeks

or even months and if not properly processed by the body, may result in chronic
12

pain. Slow pain is felt in internal tissues of the body and its transmission is

through C-fibers at a speed of 0.5-2 m/s to the brain. Other types of pain include

the visceral, somatic and neuropathic pain (Guyton and Hall, 2006).

Fever means the body temperature is above normal and fever is a symptom, not a

disease. It is a mechanism used by the immune system to fight or defend against

infections. Fever turns on the body‟s immune system and helps fight infections

(Blatteis, 2007). Regulation of temperature is in the hypothalamus. Fever is

triggered by substances called „‟pyrogen‟‟ and this pyrogens causes release of

prostaglandin E2 (PGE2). Prostaglandin E2 acts on the hypothalamus and a

systemic response is generated which act on the rest of the body, causing heat-

creating effects to match the new temperature. The hypothalamus works like a

thermostat in many situations (Anochie and Philip, 2013).

In essence, endogenous pyrogens are cytokines which are associated with innate

immune system. Phagocytic cells produce this molecules that causes increase in

thermoregulatory set-point and this includes; interleukin 1α and interleukin 1β

(Walter, 2003). When the set-point is raised, the body develop‟s mechanism of

heat generation and retention. Vasoconstriction decreases loss of heat through the

skin and makes an individual to feel cold (Anochie and Philip, 2013). This differs

with hyperthermia, in which the body overheats due to undesirable retention of

heat or overproduction of heat under the normal conditions (Fauci, 2008).


13

Febrile response involves innate immune system activation via Toll-like receptor

4 (TLR-4) leading to production of pyrogenic cytokines such as; (IL)-1β, IL-6,

and tumor necrosis factor (TNF-α) that act on an area of the brain known as the

OVLT and eventually leading to the release of PGE2 via activation of COX-2

enzyme (Young and Sexana, 2014). In the hypothalamus, PGE2 binds to receptors

leading to an increase in heat generation mechanism and reduction in heat loss

until a new elevated set-point in the hypothalamus is reached (Young and Sexana,

2014).

Inflammation is defined as a biological response to a disrupted tissue homeostasis

(Medzhitov, 2008). Inflammation simply involves tissue-destroying process in

which blood-derived products such as plasma proteins, fluids and leukocytes are

recruited into perturbed tissues (Medzhitov, 2008). A number of processes are

involved in inflammation for example mediator release, cell migration, tissue

breakdown, enzyme activation, regeneration and repair (Vane and Bolting, 1995).

There are two kinds of inflammation, acute and chronic inflammation. Acute

inflammation begins immediately after the injury of tissues and is usually marked

by cardinal signs such as redness, heat, pain and loss of function. On the other

hand chronic inflammation is marked by continuation of acute inflammation, new

connective tissue formation, persistent and is prolonged (Bhagyasri et al., 2015).


14

Germ-line encoded receptors such as intracellular nucleotide binding domains

(NOD) and transmembrane toll-like receptors (TLRs) recognize damaged signals

(Lange et al., 2001; Proell et al., 2008). Once ligands are recognized, TLRs

activate ordinary signaling pathways and these results in the activation of NF-κB

(Ghosh et al., 1998). When the signal is transducted, NF-κB is released from IκB

and is translocated to the nucleus. In the nucleus transcription is upregulated by

binding to target genes (Friendman and Hughes, 2002). Increasing numbers of

damaged associated molecular patterns (DAMPs) trigger the intracellular nod-like

receptors that alert the immune system to cell injury and provide ways in which

possible exposure to toxins or pollutants in environment can be detected (Nathan,

2002). Transcription and translation of genes lead to expression of inducible

cytokines that promote inflammation that include TNF-α, IL- 1β, IL-6, and others.

Neutrophils create an environment in which the toxins or the micro-organism

cannot survivor by releasing noxious chemicals from cytoplasmic granules such

as reactive oxygen species and nitrogen species. Both oxygen and glucose are

consumed when these noxious chemicals are released from the cytoplasmic

granules a process termed as respiratory burst (Nathan, 2002).

Prostaglandins act as short-lived localized hormones that are released when any

cell in the body is exposed to traumatic injury or any other form harmful stimuli.

Once present in the intracellular space prostaglandins can induce fever, pain and
15

inflammation (Rehman and Sack, 1999). Thromboxane a hormone activator

responsible for generating inflammatory response plays an active role in

regulation of blood vessel tone, clot formation and platelet aggregation (Rehman

and Sack, 1999). The inflammatory process is considered a complex process in

which once stimulated by injury or harmful stimuli leads to production of pro-

inflammatory mediators in a sequential manner whose early effect is pain, tissue

destruction then followed by healing and recovery (Fitzgerald, 2004).

2.2 Screening Models for Pain, Pyrexia and Inflammation

2.2.1 Screening Models for Pain

Pain models have been classified into: Thermal, electrical, mechanical and

chemical stimuli according to the kind of stimuli applied. The neuronal basis of

this models is not clearly known, however they are used to predict analgesic

activity of new substances (Parle and Yadav, 2013).

2.2.1.1 Test Based on Thermal Stimuli

2.2.1.1.1 Tail flick test using radiant heat

It is a model used for screening analgesic agents response in animals. When

thermal radiation is applied to the tail/paw of the animal it triggers the animal to

withdraw its tail/paw from the thermal source (Smith et al., 1943). Tail

withdrawal from the heat source is referred to as “tail flick latency‟‟. Time taken

for the animal to withdraw its paw/tail from the heat source in this model is timed

and recorded.
16

2.2.1.1.2 Hot plate test

This involves placing an animal in an open-ended cylindrical space with the

surface consisting of hot metal or boiling liquid by a thermode. The time taken

during paw licking and jumping from the heat source is timed and recorded, this

is called reaction time. Both licking of the paw and jumping from heat source are

considered as supra-spinally integrated response. The model is used for assessing

new analgesics agents (Parle and Yadav, 2013).

2.2.1.2 Test Based on Mechanical Stimuli

The hind paw and the tail are ideal sites for applying nociceptive mechanical

stimuli. In this model the tail or paw is jammed between two plane surfaces and

the pressure of increasing intensity is applied until the animal begins a response

behavior of withdrawing its tail or hind paw from the two planes. The vocal

reaction taken by the animal to withdraw tail or hind paw from two the plane

surfaces is timed and recorded (Green et al., 1951).

2.2.1.3 Test Based on Electrical Stimuli

2.2.1.3.1 Electrical stimulation of the tooth-pulp

Electrical current is applied to the tooth-pulp of the laboratory animal in this

model. This produces behavioral characteristic reaction such as head flick, biting,

chewing, and licking of the tooth pulp due to induction of pain. Time taken for the

above observation is timed and recorded (Parle and Yadav, 2013).


17

2.2.1.3.2 Electrical stimulation of the tail

In this model electrical current of increasing intensity is applied to the tail of the

rat or mice. This will generate some observed reflex movement in the tail with

increasing electrical currents. Time taken for the animal to withdraw its tail from

electrical stimuli is timed and recorded. Morphine or drugs falling in the same

class as morphine are effective in this model (Parle and Yadav, 2013).

2.2.1.4 Test Based on Chemical Stimuli

2.2.1.4.1 Formalin-Induced pain test

This model is sensitive to peripherally acting analgesics agents. Nociceptive

effect of formalin is considered biphasic. The initial phase is mediated by

serotonin (5-HT), histamine and kinin. The second phase is mediated by

prostaglandins (Turner, 1965). When formalin is injected into the hind paw of the

animal it elicits a painful behavior such as licking of the paw, bitting and lifting.

The time taken by the animal to lick, lift and bit the paw is timed and recorded

(Parle and Yadav, 2013).

2.2.1.4.2 Acetic acid-Induced pain test

In this model acetic acid or phenylquinone is used to induce pain in mice or rats

by injecting these irritants into the peritoneal cavity. The animal responds by

characteristics such as stretching of hind paw, turning of trunk, abdominal

musculature contraction and stomach touching the floor. This model is sensitive

to peripherally acting analgesics. This agent irritates the serous membrane and
18

therefore eliciting a stereotype behavior. The number of abdominal writhes within

a given period is timed and recorded (Parle and Yadav, 2013).

2.2.2 Screening Models for Pyrexia

2.2.2.1 Turpentine-Induced test

Turpentine induces fever slowly reaching its peak at 11th hour after its injection.

Macrophages release protein signals such as interleukin-1 and interleukin-6 to

counteract the pyrogen (Leon, 2002). Interleukin acts on the temperature

regulating hypothalamus to increase body temperature. Stimulating the

hepatocystes to secrete acute phase proteins and increasing number of circulating

eosinophils and neutrophils begin to neutralize turpentine (Cartmell et al., 2000).

Turpentine injection into experimental animals induces a persistently high fever

pattern (Kuochung et al., 2006).

2.2.1.2 2,4-Dinitrophenol (DNP)-Induced test

2,4-Dinitrophenol (DNP) is known to induce febrile response through uncoupling

oxidative phosphorylation. This then would result in fast consumption of energy

without generating adenosine triphosphate causing the release of calcium from its

mitochondrial stores and subsequently prevent the uptake of calcium. This leads

to free intracellular calcium, muscle contraction and hyperthermia and Energy

proton gradient would then be lost as heat (Kumar et al., 2002).


19

2.2.2.3 Brewer’s Yeast-Induced test

Brewer‟s yeast induces pyrexia after injection subcutaneously into the

experimental animal. When subcutaneously injected into the experimental animal;

brewer‟s yeast binds to an immunological protein called lipopolysaccharide-

binding protein and these results to release of various endogeneous cytokine

factors such as phagocyte and interleukin-1; interleukin will act on T lymphocytes

and this will in turn result in hypothalamus producing prostaglandins (Dubey and

Maheswari, 2005). Brewer‟s yeast is also known to induce TNFα and

prostaglandins (Kluger, 1991).

2.3.3 Screening Models for Inflammation

2.3.3.1 Carragenaan-Induced Hind Paw Edema test

Carrageenan has widely been used as a harmful agent for inducing inflammation

in laboratory animals and for screening compounds possessing anti-inflammatory

activities. When injected into experimental animal this phlogistic agent produces

a severe inflammatory reaction (Marzouk et al., 2010). Freshly prepared solution

of carrageenan of between 1-3% is commonly used and is injected into

experimental animal at a dose of 50-150 ul (Naude et al., 2010). Carrageenan is

known to induce inflammation in two phases and is dependent upon age and

weight. It is known to induce edema in mice models in two phases and is

dependent on age and weight of the experimental animal (Vinegar et al., 1969).

The first phase (0-2 hours) is due to release of inflammatory mediators such as
20

serotonin and histamine, resulting in sensitization of central nociceptor neurons.

The lysosome, protease, prostaglandins and bradykinin are released majorly in the

second phase (D‟Amour et al., 1965). The second phase (2.5-5 hours) of edema is

sensitive to clinically used anti-inflammatory drugs. During the second phase

prostaglandins play a major role in inflammatory reaction and can stimulate the

nociceptors and thus induce pain (Dacie, 1958). The initial phase is due to release

of inflammatory mediators such as serotonin and histamine while the second

phase is mediated by lysosome, protease, bradykinin and prostaglandins (Vinegar

et al., 1969).

2.2.3.2 Xylene-Induced Ear Edema test

Application of xylene to the ear of laboratory animal induces a neurogeneous

edema that is partly related with substance P. Substance P is released from

neurons in the midbrain in response to stress and is an undecapeptide of central

and peripheral nervous system. When substance P is released from sensory

neurons in the periphery, it causes plasma extravasations and vasodilatation

resulting into inflammation (Kou et al., 2005).


21

2.2.3.3 Formalin-Induced Paw Edema Test

This technique is based on the ability of the drug to hinder inflammation produced

in the hind paw of the mice or rat after injection with formalin. Nociceptive effect

of formalin is biphasic, consisting of two phases. The first phase is mediated by

release of histamine, serotonin (5-HT), and kinin while the second phase is

majorly mediated by prostaglandins. The size of edema is measured using string

or a vernier caliper and recorded (Turner, 1965).

2.2.3.4 Cotton Pellet Granuloma Test

In this model, laboratory animal is subcutaneously implanted with cotton pellets

in the dorsal region to induce granulomas lesion. This model is used to asses

proliferative phase of inflammation. Inflammation involves the proliferation of

macrophages, neutrolphils and fibroblast which are responsible for granuloma

formation (Winter and Porter, 1957).

2.3 Conventional Management of Pain, Pyrexia and Inflammation

Non-steroidal anti-inflammatory drugs (NSAIDs) belong to an important class of

therapeutic agents that are prescribed all over the world for treatment of

orthopaedics conditions such as fractures, soft-tissue injuries and osteoarthritis

(Boursinos et al., 2009). The NSAIDs posses antipyretic, anti-inflammatory and

analgesic activities (Lascelles et al., 2007; Sparkes et al., 2010). These NSAIDs

for instant aspirin is known to acetylate the active site of COX enzyme called

Tyro 385 and Ser 530. Aspirin and arachidonic acid compete for the active
22

binding site in the COX enzyme. This competition result in displacement of

arachidonic acid from binding to the active site leading to inhibition of

prostaglandins synthesis (Rao and Knaus, 2008). Generally NSAIDs exhibit three

modes of inhibiting COX;

i. Competitive reversible inhibition that competes with arachidonic acid for

binding to the COX site for example ibuprofen and piroxicam.

ii. Competitive, reversible inhibitors, time dependent that bind COX active

site in the early phase to form a reversible enzyme inhibitor complex for

example diclofenac and flurbiprofen.

iii. Competitive, time independent irreversible inhibitors that form an enzyme

inhibitor complex for example aspirin.

During the early 18th century, salicin a compound responsible for the synthesis of

acetylsalicylclic acid was discovered and isolated. In the 1990s there was the

emergence of selective COX-2 inhibitors and development of small molecule

therapies to manage pain, pyrexia and inflammation (Marnett, 2009). NSAIDs for

example indomethacin, diclofenac, ibuprofen and aspirin that show non-selective

COX inhibition, represents various types of NSAIDs prescribed to relieve short

term fever, pain and inflammation (Inotai et al., 2010). Analgesic drugs such as

diclofenac relieve pain peripherally/centrally by inhibiting cyclooxygenase

enzyme (COX-1 and COX-2). Inhibition of cyclooxygenase enzyme reduces the

production of pain mediators such as prostaglandins, substance P, histamine,


23

serotonin, and Bradykinin. Pain sensation is eventually reduced in the nociceptors

(Davies et al., 1984).

Antipyretic drugs such as aspirin, exhibit their antipyretic activity by inhibiting

cyclooxygenase enzyme (COX). Inhibition of cyclooxygenase enzyme results in

blockage of synthesis of prostaglandins consequently the levels of PGE2 in the

hypothalamic region is also reduced. Hence fever is reduced to normal by

resetting the hypothalamic regulatory center (Paya and Katzung, 1995).

Acetylsalicylic acid is known for its ability to irreversibly disable COX enzymes

and therefore blocking formation of prostaglandins (Maroon et al., 2010). They

also act by suppressing the production of pyrogenic cytokines such as TNF-α and

IL-β (Aronoff and Neilson, 2001). Mechanism of action of NSAIDs is mainly

through interaction with pro-inflammatory cytokines and interleukin such as IL-

1b, IL-1a, TNF-α and IL-6 (Ghosh et al., 1998). New generation of NSAIDs

which are selective in the inhibition of cyclooxygenase enzyme exhibit analgesic

and anti-inflammatory activities greater than non-selective NSAIDs and have

reduced side effects (Boursinos et al., 2009). Ability of NSAIDS to disrupt the

synthesis of prostaglandins during the inflammatory process makes them have

anti-inflammatory activity (Talalay, 2001).

Glucocorticoid is an important class of drugs belonging to corticosteroids and

over a number of years its therapeutic application in the management of allergy,


24

inflammation and pain has spread (Hawkey and Rampton, 1985). Conventional

NSAIDs that work as analgesic, antipyretic and anti-inflammatory agents are non-

specific cyclooxygenase enzyme blockers on the other hand selective NSAIDs are

specific in their inhibition by inhibiting COX-2 only (Vane et al., 1998). Non-

selective conventional NSAIDs block both constitutive COX-1 and inducible

COX-2 (Vane et al., 1998). COX 1 enzyme plays an important role in renal and

gastrointestinal blood flow as well platelet aggregation while COX 2, on the hand

plays a key role in pain and inflammation process (Rao and Knaus, 2008).

Eventually disrupting the synthesis of PGs. Prostaglandins (PGs) generally acts in

an autocrine or paracrine manner (Hawkey and Rampton, 1985).

Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, indomethacin,

ibuprofen, and naproxen are usually used for management of pyrexia, pain and

inflammation (Paya and Katzung, 1995). NSAIDs represent a class of drugs that

are used to prevent and treat postoperative pain (Luna et al., 2007). However,

NSAIDs manifest adverse effects for example impairment in bone/fracture

healing, prolonged healing and causing deterioration in the quality of bone

formed. Its negative effects are linked to the inhibition of prostaglandin which has

an effect on oesteoblasts (Boursinos et al., 2009). It has been shown that long

term use of predinisolone in experimental rabbits caused delayed fracture healing

in ulnar osteotomy (Waters et al., 2000). Recent studies by WHO indicates that

these conventional drugs used in the management of pain, inflammation and fever
25

manifest a lot of side effects after long term use for example gastric irritation,

ulceration, prolonged bleeding, renal failure, interstitial corrosion, and pruritis

(Robotin, 2006; Beg et al., 2011). At typical doses acetaminophen is effective in

management of fever and pain. It is a weak anti-inflammatory drug but appears to

have fewer side effects (Burke et al., 2006).

2.4 Use of Medicinal Plants in Management of Diseases

Traditional medicinal herbs for over centuries have served as potential source for

alternative medicine and the knowledge of herbal medicine has been passed on

from generation to generation. From ancient time, Indian, Chinese, Egyptian,

Greek, Syrian, African and Roman medicinal practices documented the use herbal

medicine for curing different diseases (Komboj, 2000). Many communities all

over the world have utilized Phytopharmaceuticals for centuries in curing an array

of ailments (Semwal et al., 2010). Herbal medicines from medicinal plants have

been utilized by societies as the principal source of curing a number of diseases

(Shinwari, 2010).

Therefore, medicinal plants are an assuming important role in people‟s wellbeing

(Vasundra and divya, 2013). Nature is endowed with complete store of remedies

to cure all diseases affecting the human being (Kokate et al., 2002). Nature is

also endowed with natural remedies inform of herbs, animal products and algae

capable of curing diseases without any side effects (Trease and Evans 1983).
26

Herbal medicine is an important source of discovering new therapeutic agents

with potential therapeutic capabilities. Investigation into plants used traditionally

to relieve inflammation, pain and fever should be seen as a step towards discovery

of novel analgesic, antipyretic and anti-inflammatory agents (Gupta et al., 2006).

According to WHO, a world population of between 75-80% still depends on

herbal medicines (Gupta et al., 2006). Secondary active constituents from plant

sources are directly used as therapeutic agent and can serve as lead molecule in

discovery and synthesis of new drugs (Komboj, 2000). In a study conducted in

2002 by the National Center for complementary and alternative medicine (CAM)

surveyed a total of 31,044 adults (Barnes et al., 2004). Found out that during the

last 12 months, 36% of respondents used some form of complementary and

alternative medicine (CAM) therapy (Barnes et al., 2004).

2.5 Herbal Management of Pain, Fever and Inflammation

2.5.1 Pain

Throughout history man has used different forms of therapy to relief pain.

Morphine for example was isolated from a medicinal plant Papaver somniferium

(De souza, 2011). The search of herbal plants with analgesic activities, used as

pain relievers should be viewed as a successful search for new pain relieving

drugs (Elisabetskey et al., 1995). Considering that most of anti-inflammatory,

analgesic, anti-malarial and anti-pyretic synthetic drugs such as aspirin, morphine,


27

artemisinin, atrophine and chloroquine were derived from the plant products

(Gupta et al., 2006).

White Willow Bark (Salix alba) has been used traditionally in management of

inflammation, mild feverish colds, influenza, headache, arthritic conditions and

muscle spasm (Vadivelu et al., 2011). Its anti-inflammatory, antipyretic and

antiuricosuric activities have been attributed to flavonoids, tannins and salicylates.

Salicin extract when taken at a dose level of 120-240 mg on daily basis can

reduce back pain in some patients (Vadivelu et al., 2011). Harpagophytum

procumbens (devil's Claw) has traditionally been used to manage symptoms

associated with pain such as, low back pain, osteoarthritis, rheumatoid arthritis,

gastrointestinal upset gout, myalgia, chronic low back pain and lumbago.

Inhibition of both cyclooxygenase and lypoxygenase inflammatory pathways

according to current research have been linked to herpagoside (Chrubasik et al.,

2004; Vadivelu et al., 2011).

The analgesic activities of ginger and ibuprofen showed no significant difference

in management of pain indicating that herbal extract do have antinociceptive

activity (Bliddal et al., 2000). The antinociceptive activity of ginger is assumed to

be through inhibition of COX 2 and lipooxygenase (Srivastava and Mustafa,

1989). Likewise, Mworia et al.,(2015) demonstrated antinociceptive activities

of leaf extract of Carissa spinarum on acetic acid-induced pain test in Swiss


28

albino mice models. The extract showed dose dependent response with 100 mg/kg

body weight having the highest inhibition percentage compared to 50 mg/kg body

weight. A similar study conducted by Kariuki et al. (2012) on root extract of

Toddalia asiatica exhibited antinociceptive activity in adult Swiss albino mice

when pain was induced using acetic acid, hot plate and tail flick test in laboratory

animals.

2.5.2 Pyrexia

Though medicinal plants from time immemorial have been used as a source of

antipyretic agents to manage fever, emergence of synthetic drugs however,

resulted in neglect of their use. But due to its availability, low cost and fewer side

effects herbal medicine is gaining its popularity (Sharma et al., 2010). Treatment

of fever dates back to 400 B.C years ago when Greek Hippocrates prescribed an

extract from the willow bark and leaves (Rao and Knaus, 2008). Tumeric

(Curcuma longa) is an ancient spice that has been used traditionally as condiment,

medicine, and flavouring agent. Its medicinal properties is attributed to the

compound curcuminoid. Curcuminoids, a major phytochemical compound in the

plant is believed to exert it antipyretic activity by inhibiting both 5-lipooxygenase

and cyclooxygenase enzymes (Chandra and Gupta, 1972).

According to Vadivelu et al. (2011), white Willow Bark (Salix alba) contains

heavy concentration of salicin and glycoside a precursor for aspirin. The

therapeutic application of Salix alba in traditional system of medicine has


29

spanned over centuries in management of headache, mild feverish colds, arthritic

conditions, influenza and inflammation. The antipyretic activities of Salix alba

has been atributed to flavonoids, tannins and salicylates present in the extract

(Vadivelu et al., 2011).

In a study conducted by Lapah et al. (2014) on aqueous extract of phragmanthera

capitata, the extract exhibited antipyretic activity in sprague dawley rats. Dose

level of 100 mg/kg and 200 mg/kg body weight extract reduced body temperature

significantly when compared to refference drug. In a similar study conducted by

Mwonjoria et al. (2011) on antinociceptive and antipyretic activities of

methanolic root extract of Solanum incanum (linneaus) in animal model using

brewer‟s yeast induced-pyrexia demonstrated significant antipyretic activities.

The antipyretic activities of 50 mg/kg and 100mg/kg body weight were

comparable to reference drug (Mwonjoria et al., 2011).

2.5.3 Anti-inflammatory

For centuries, mankind has used herbal medicine for relieving inflammation and

pain (Sen et al., 2010). Boswellia serrata is among many herbal plants used in

ayurvedic medicine and it has been used traditionally in management of pain

associated conditions such as osteoarthritis, tendonitis and rheumatoid arthritis.

Boswellic acids in Boswelia serrata in a number of laboratory studies about its

anti-inflammatory activity have shown to exert its effects by inhibiting


30

leukotrienes an inflammatory mediator (Vadivelu et al., 2011). The principle

components that have been associated with anti-inflammatory activities are

boswellic acid, α-boswellic and β-boswellic (Vadivelu et al., 2011). Tumeric

(Curcuma longa) is an ancient spice and condiment that has been used as herbal

medicine in India and china. Its medicinal value is attributed to curcuminoid.

Curcuminoids exert is activity by inhibiting 5-lipooxygenase and cyclooxygenase

enzymes resulting in a well established anti-inflammatory activity (Chandra and

Gupta, 1972).

Camellia sinensis commonly known as tea plant is an important herbal plant. The

leaves and buds produce tea, the most consumed beverage in the world. The anti-

inflammatory activity of green tea has been attributed to high content of

polyphenols/catechins and mainly epigallocatechin-3-gallate. Potential of green

tea in management of arthritis on collagen type-II-induced arthritis in mice has

been reported (Curtis et al., 2004). Likewise, study carried out by Mwangi et al.

(2014) on leaf extract of Caesalpinia volkensii and Maytenus obscura exhibited

anti-inflammatory activities in animal models. In addition, a study by Onasanwo

et al. (2012) on methanolic, hexane, dichloromethane and chloroform leaf extracts

of Anacardium occidentalis demonstrated strong anti-inflammatory and analgesic

activity in animal models. Furthermore, a study conducted by Ravi et al. (2009)

on methanolic bark extract of solanum nigrum berries demonstrated a dose

dependent response in reducing the inflamed hind paws of rats.


31

2.6 Clutia abyssinica

2.6.1 Description and Distribution

Clutia abyssinica (Figure 2.1) belongs to the genus Clutia and family of

Euphorbiaceae. It is dioecious, erect, lax shrub that grows up to 4–5 m tall, with

brittle branches and glabrous to evenly hairy. Leaves alternate, simple and entire.

Stem is green tinged red-brown; leaves are green but turn red when old.

Inflorescence an auxiliary white-yellow flower, fruits are green. The plant is

usually harvested from the wild for its local medicinal use (Matu, 2008).

Clutia abyssinica (Figure 2.1) is found in Central Africa to Eritrea, Ethiopia and

through eastern Africa south to Zambia, Angola, Mozambique and South Africa.

The vernacular names used by the local communities include; Muhende

(shambaa), Turmanyat (Nandi), Kurbanyat (Kipsigis), Mrukuru (Pare),

Muthimamburi (Kikuyu) and Sambukwe by the Luhya (Kokwaro, 2009). Clutia

abyssinica is commonly found in dry forest, forest remnants, secondary forest and

wooded grassland on rocky hillsides, and riverine, evergreen thickets, at an

altitude level of between 700–3700 m above the sea level (Matu, 2008).
32

Figure 2. 1 Clutia abyssinica

Source: Turbo Subdivision in Uasin Gishu County

2.6.2 Medicinal uses

Methanolic leave extract of Clutia abyssinica contains saponins, anthraquinone,

phenolics, terpenoids, flavanoids and alkaloids (Jeruto et al., 2011). It is

extensively used as herbal medicine in South Nandi District Kenya and it has

been used traditionally to treat several ailments that include; malaria, colds, fever,

skin diseases, chest problems, cancer and infertility in humans (Jeruto et al.,

2011). The root and leaf extracts are drunk or rubbed on the head to treat

headache. Sap from the leafy twigs is used to treat chest pain, side pain and
33

shortness of breath. To cure malaria, influenza, colds, indigestion, intestinal

worms, and fever, root extract from the plant is drunk as a remedy (Matu, 2008).

The maceration of the crushed leaves of Clutia abyssinica given orally has been

traditionally used for the treatment of animal trypanosomosis (Mergia et al.,

2014). In Eastern Africa, soup from boiled roots is taken as a remedy for

headache, stomach-ache, enlarged spleen and kidney problems (Matu, 2008).

Clutia abyssinica is used to treat yellow fever, malaria and infections of the ear,

nose and throat (Njoroge and Bushman, 2006). In Marakwet community, boiled

root extract is used to treat erectile dysfunction and works synergistically with

other herbs (Kipkore et al., 2014).


34

CHAPTER THREE

MATERIALS AND METHODS

3.1 Collection and Preparation of Plant Materials

Fresh roots of Clutia abyssinica were collected randomly from Kaptebee village,

Turbo sub-county in Uasin Gishu county Kenya with the help of local herbalist

under accepted bio-conservation methods from its natural habitat (Appendix IV).

This process was conducted during the months of January-March 2016, a season

in which the local herbalist believed that the medicinal plant had its maximum

medicinal activity. A sample of fresh twigs with leaves was presented to a

taxonomist for botanical authentication and a sample voucher was deposited at the

National Museums of Kenya herbarium Nairobi. Sample roots were then cleaned

with tap water to remove any dirt and chopped into smaller pieces. The root

samples of Clutia abyssinica were completely air dried under shade for two

weeks. The samples were then packed into burlap sacks and transported to

Kenyatta University Biochemistry laboratory. The samples were then pulverized

into fine powder using laboratory electrical mill.

3.2 Extraction

A 400 g weight of powdered root sample was soaked in 1.3 litres of

dichloromethane (DCM) with regular agitation at an interval of 1 hour to

uniformly mix the sample within the first 10 hours and left to stand for 48 hours.

Filtration was performed using Whatman‟s filter paper No.1 (sigma-aldrich). The
35

filtrate was concentrated using rotary evaporator (Buchi India) at a temperature of

41°C under reduced pressure. The concentrate was kept in sealed containers at

low temperature 4°C until use in bioscreening experiments.

3.3 Experimental Design

3.3.1 Laboratory Animals

Swiss albino mice aged between 5-6 weeks, weighing between 18-25 g and

Wistar albino rats aged 8-9 weeks and weighing 120-140 g were used in this

study. All the experimental animals were housed in the animal house at Kenyatta

University in standard laboratory cages. The experimental animals were kept at

room temperature for 12 hours in darkness followed by 12 hours light cycles

throughout the entire experimental period. The animals were fed on rodent pellet

diet and water ad libitum. Wistar albino rats were utilized in testing for antipyretic

activity assay while for analgesic and anti-inflammatory activities assays, Swiss

albino mice were used. In this study ethical guidelines and procedures were

followed while handling the laboratory animals (Lapah et al., 2014).

3.4 Determination of Analgesic Effect

Analgesic activity of DCM root extract of Clutia abyssinica was determined

through acetic acid-induced pain in experimental animals following the procedure

described by Singh and Majumdar (1995) and Akuodor et al. (2011). The

experiment animals were grouped into 6 groups of five animals each. Prior to pain

induction and administration of the experimental doses, all the experimental


36

animals were fasted for 12 hours but were allowed access to water ad libitium.

Pain was induced by injecting 3% acetic acid solution at a dose of 20 ml/kg body

weight into the left side of the abdomen intraperitoneally. Immediately after

injection with acetic-acid, abdominal muscle constriction in the abdomen and

turning of body trunk of the laboratory animal was seen as an indication of pain.

The different groups were treated as follows; Group I (Normal control) was

administered with 10% dimethyl sulphoxide (DMSO) only but pain was not

induced. All the animals in group II (negative control) were induced with pain and

administered with 10% dimethyl sulphoxide (DMSO). Those in group III

(positive control) were induced with pain and administered with the reference

drug (diclofenac 15 mg/kg body weight). Group IV-VI were induced with pain

and administered with DCM root extract of C. abyssinica at dose levels of 50, 100

and 150 mg/kg body weight respectively. This design is summarized in table 3.1.

Table 3. 1: Treatment protocol for assessment of analgesic activity of


DCM root extract of C. abyssinica in Swiss albino mice

Group Treatment
I (Normal control) 10% DMSO only
II (Negative control) 3 % Acetic acid
III (Positive control) 3 % Acetic acid + diclofenac (15
mg/kg bw)
IV (Experimental group A) 3 % Acetic acid + C.abyssinica (50
mg/kg bw)
V (Experimental group B) 3 % Acetic acid + C.abyssinica (100
mg/kg bw)
VI (Experimental group C) 3 % Acetic acid + C.abyssinica (150
mg/kg bw)
37

Thirty minutes after different treatments were administered, each mouse in groups

II−VI was intraperitoneally (ip) injected with 3% acetic acid into the left side of

the abdomen at a dose of 20 ml/kg body weight to induce pain sensation except

those in group I, which were administered with the vehicle (10% DMSO) only.

Each mouse was then placed in a transparent observation box and the number of

abdominal constrictions (writhes) for each mouse was counted for 30 minutes

commencing 5minutes after intraperitoneal injection of acetic acid. The

percentage writhing inhibition was then calculated using the formula described by

Ezeja et al. (2011);

Where;

C- The vehicle- treated control group

T - Treated group value

3.5 Evaluation of Antipyretic Effect

Male Wistar albino rats were grouped into 6 groups of five rats each. Prior to

fever induction, rectal temperature of all the experimental animals were measured

using digital thermometer and recorded. All the experimental animals were fasted

for 12 hours before induction of fever and administration of the experimental

doses but were allowed access to water ad libitium. Turpentine solution was used

to induce fever and it was injected intraperitoneally at a dose of 20 ml/kg body


38

weight and the animals left for one hour (Kuochung et al., 2006). A raise in rectal

temperature of Wistar albino rats by 0.8°C after one hour was termed pyretic and

proceeded to be used in the assay.

One hour after fever induction, pyretic animals in groups IV-VI were

administered intraperitoneally with the three experimental doses of 50, 100 and

150 mg/kg body weight respectively. Pyretic animals in group III (Positive

control) were administered with aspirin (100 mg/kg body weight). Pyretic animals

in group II (negative control) were administered with 10% DMSO only.

Experimental animals in group I (normal control) were not induced with fever but

administered 10% DMSO only. This design is summarized in table 3.2.

Table 3. 2: Treatment protocol for antipyretic activity of DCM root extract


of C. abyssinica in wistar albino rats

Group Treatment
I (Normal control) DMSO (10%)
II (Negative control) Turpentine (20%)
III (Positive control) Turpentine (20%) + Aspirin (100 mg/kg
bw)
IV (Experimental group A) Turpentine (20%) + C.abyssinica (50
mg/kg bw)
V (Experimental group B) Turpentine (20%) + C.abyssinica (100
mg/kg bw)
VI (Experimental group C) Turpentine (20%) + C.abyssinica (150
mg/kg bw)

Plant extract doses were prepared on the same day of experiment. All the

treatments were administered intraperitoneally. The rectal temperatures of rats


39

were measured by inserting a well lubricated digital thermometer about 3cm into

the anus of the rats. The mean body temperature of Wistar albino rats was

recorded at 20 minutes intervals over 1 hour before turpentine injection and was

recorded as the baseline/initial temperature. Rectal temperature was measured and

recorded at an interval of one hour continuously for four hours after treatments.

Percentage inhibition of anal temperature was calculated by formula described by

Maria et al. (2014);

Where,

B - Rectal temperature at 1 hour after turpentine injection.

Cn - Rectal temperature after dose administration

3.6 Determination of Anti-inflammatory Effect

Edema was induced by injecting 0.05 ml of 1% (w/v) carragenaan solution into

the sub-plantar region of right hind paw of the Swiss albino mice according to

procedure described by Winter et al. (1962). Swiss albino mice (male) were

grouped into 6 groups of 5 animals (n=5) and treated as follows; each mouse in

group I (normal group) was administered with the vehicle (10% DMSO) only but

inflammation was not induced. All the mice in Group II (negative control) were

induced with inflammation and administered with the vehicle (10% DMSO) while
40

those in group III (positive control) were induced with inflammation and

administered with diclofenac (15 mg/kg body weight) one hour prior to

administration of 1% carragenaan solution into the sub-plantar region of right

hind paw of Swiss albino mice. Animals in groups IV-VI were induced with

inflammation and administered with the plant extract at 50 , 100 and 150 mg/kg

body weight respectively, one hour prior to administration of 1% carragenaan

solution. This design is summarized in table 3.3.

Table 3. 3: Treatment protocol for evaluation of anti-inflammatory activity


of DCM root extract of C. abyssinica in swiss albino mice.

Group Treatment
I (Normal control) DMSO (10%)
II (Negative control) Carragenaan (1%)
III (Positive control) Carrageenan (1%) + Diclofenac (15
mg/kg bw)
IV (Experimental group A) Carrageenan (1%) + C. abyssinica (50
mg/kg bw)
V (Experimental group B) Carrageenan (1%) + C.abyssinica (100
mg/kg bw)
VI (Experimental group C) Carrageenan (1%) + C.abyssinica (150
mg/kg bw)

Measurement of the hind paw diameter was carried out using a vernier calliper in

order to find out the diameter of right hind paw immediately before and after 1, 2,

3 and 4 hours following carragenaan injection. Percentage inflammation

inhibition was calculated according to the formula described by Jia et al. (2003);
41

Where;

Ct = Paw diameter at 1 hour after carrageenan administration (control)

Tt = Paw diameter after Treatment

3.7 Qualitative Phytochemical Screening

The dichloromethanolic (DCM) root extract of C. abyssinica was subjected to

qualitative phytochemical screening to determine the presence/absence of

different active secondary metabolites following the methodology described by

Trease and Evans (1983). The phytochemicals tested included flavonoids,

phenolics, saponins, alkaloids, cardiac glycosides, steroids and terpenoids. This

phytochemicals compounds are associated with analgesic, antipyretic and anti-

inflammatory activities.

3.7.1 Flavonoids

A quantity of 1 ml of the plant root extract was put in a test tube followed by

additional few drops of dilute NaOH solution. A golden intense yellow

precipitate indicated the presence of flavonoids.

3.7.2 Terpenoids (Salkowski test)

Dry crude extract of the plant (5 mg) was dissolved in 2 ml chloroform and 1 ml

of acetic acid added to it. Concentrated (1ml) sulphuric acid was carefully added
42

to the solution alongside the test tube. Formation of a reddish violet colour

indicated the presence of terpenoids.

3.7.3 Steroids

A volume of 2 ml of acetic anhydride was added to 5ml of the extract followed by

2 ml of concentrated sulphuric acid (H2SO4). A formation of violet to blue or

green confirmed the presence of steroids.

3.7.4 Cardiac glycosides

To 0.5g of the extract, 2ml of glacial acetic acid containing four drops of 10%

ferric chloride (FeCl3) solution was added and under-layered with 1ml of

concentrated sulphuric acid. The formation of a violet, greenish or a brown ring

indicated the presence of cardiac glycosides.

3.7.5 Phenolics

A solution of 2ml of the extract was put in a test tube and 1ml of ferric chloride

solution added carefully. Formation of blue to the green color indicated the

presence of phenolics.

3.7.6 Alkaloids- Mayer’s test

A volume of 1 ml of plant sample extract, two drops of Mayer‟s reagents were

added along the sides of test tube. Appearance of white creamy precipitate

indicated the presence of alkaloids.


43

3.7.7 Saponins (Frothing test)

A volume of 1 ml of the root extract was dissolved in 10 ml of distilled water and

shaken vigorously for 15 minutes. A foam layer was formed at the top of the

mixture indicated the presence of saponins.

3.8 Data Management and Statistical Analysis

In this study, quantitative and qualitative data was obtained and recorded.

Quantitative data on the number of abdominal constrictions, the paw edema

diameter and the rectal temperature were obtained from experimental animals,

recorded and tabulated on a broad sheet using Ms Excel program. Data obtained

was then exported to statistical software (Minitab version 17.0) for analysis. Data

was subjected to descriptive statistics and results were expressed as Mean ±

Standard Error of the Mean (SEM). Results among the groups was analysed for

statistical significance using one way ANOVA followed Tukey‟s post hoc test for

pairwise comparison and separation of means. Data on percentage inhibition on

the number of abdominal constrictions was presented in form of a table while

percentage inhibition on rectal temperature and edema paw diameter was

presented in form of tables and graphs. A value of P ≤0.05 was considered

significant.
44

CHAPTER FOUR

RESULTS

4.1 Analgesic Activity of DCM Root Extracts of C. abyssinicaon acetic


acid-induced pain in Swiss albino mice

The DCM root extract of C. abyssinica demonstrated an analgesic activity

in acetic acid-induced pain in Swiss albino male mice by reducing the

number of abdominal writhes 30 minutes after the administration of the

plant extract (Table 4.1). The intraperitoneal administration of DCM root

extracts of C. abyssinica into Swiss albino mice at all the three dose levels

(50, 100 and 150 mg/kg body weights), reduced the number of abdominal

writhing by 49.3%, 38.6% and 33.95% respectively (Table 4.1). However,

diclofenac (reference drug) reduced the number of abdominal writhes by

46.51% (Table 4.1).

The analgesic effects of DCM root extract of C. abyssinica showed no

significant difference at the three doses and were comparable to diclofenac

(P> 0.05; Table 4.1). The DCM root extract of C. abyssinica, at the three

dose levels (50, 100 and 150 mg/kg body weight), reduced the number of

abdominal writhings in a reverse dose dependent manner (Table 4.1).


45

Table 4. 1: Analgesic activities of DCM root extracts of C. abyssinica on acetic


Acid-Induced pain in Swiss albino mice

Group Treatment % inhibition

Normal Control 10% DMSO 100.00±0.0a

Negative Control Acetic acid + DMSO 0.00±0.0c

Positive Control Acetic acid + Diclofenac 46.51±4.22b


(15 mg/kg bw)
Experimental group Acetic acid + C.abyssinica 49.77±4.69b
A (50 mg/kg bw)
Experimental group Acetic acid + C.abyssinica 38.60±4.33b
B (100 mg/kg bw)
Experimental group Acetic acid + C.abyssinica 33.95±8.01b
C (150 mg/kg bw)
Values are expressed as Mean ± SEM for five animals per group. Values with the
same superscript letter are not significantly different (one way ANOVA followed
by Tukey‟s test) (P>0.05).
46

4.2 Antipyretic Activity of DCM Root Extract of C. abyssinica on turpentine-


. Induced pyrexia in Wistar albino rats.

The DCM root extract of C. abyssinica showed antipyretic effects against

turpentine-Induced pyrexia in rats, which was indicated by reduction in rectal

temperature (Table 4.2; Figure 4.1). In the first hour after treatment with the

experimental doses, all the three doses (50, 100 and 150 mg/kg body weight),

lowered the elevated anal temperature by 0.81%, 0.68% and 1.14% respectively

(Table 4.2; Figure 4.1). On the other hand, aspirin lowered the anal temperature

significantly by 3.32%, indicating a stronger antipyretic activity than the all the

three experimental doses (P˂ 0.05; Table 4.2; Figure 4.1). However, the

antipyretic effects of all the three doses of the DCM root extract of C.abyssinica

were not significantly different (P>0.05; Table 4.3).

In the 2nd hour, experimental animals administered with DCM root extract of C.

abyssinica at 50, 100 and 150 mg/kg body weight, reduced the anal temperature

by 2.54%, 1.84% and 2.48% respectively. The reference drug, at this hour,

reduced rectal temperature by 3.53% (Table 4.3; Figure 4.1). At this hour, a dose

of 50 mg/kg body weight demonstrated the highest fever reducing activity. Even

though the three experimental doses of C. abyssinica and the reference drug

reduced the rectal temperature at different percentages, their antipyretic effects

were not significantly different (P>0.05; Table 4.2; Figure 4.1).


47

In the third hour, the DCM root extract of C. abyssinica, at the three doses

exhibited antipyretic effects by reducing the elevated anal temperature by 2.38%,

2.88% and 3.34% respectively in a dose dependent manner. Reference drug

(aspirin) reduced elevated rectal temperature by 4.56% (Table 4.2; Figure 4.1).

The antipyretic effects of 150 mg/kg body weight and 100 mg/kg body weight

were comparable to the reference drug (aspirin) (P> 0.5; Table 4.2).

At the end of four hours of the test period, the DCM root extract of C. abyssinica

at all three dose levels, reduced the rectal temperature by 2.44%, 2.88% and

3.21% respectively in a dose dependent manner. The reference drug reduced

rectal temperature by 4.96% (Table 4.2; Figure 4.1). Administration of extract to

the experimental groups at all the three dose levels (50, 100 and 150 mg/kg body

weight), exhibited strong antipyretic activity but showed no significant difference

(P> 0.5; Table 4.2; Figure 4.1). The antipyretic effects of 100 mg/kg body weight

and 150 mg/kg body weight were comparable to the reference drug (aspirin) (P>

0.5; Table 4.2; Figure 4.1).


48

Table 4. 2: Antipyretic activities of DCM root extracts of C. abyssinica on Turpentine-Induced pyrexia in Wistar albino rats
Group Treatment % change in anal temperature in (°C) after dose
administration
0hr 1hr 2hr 3hr 4hr

Normal Control 10% DMSO 100.00±0.00 99.79±0.16bc 99.79±0.16bc 99.94±0.12c 99.95±0.31c


(0.00) (0.21) (0.21) (0.06) (0.05)
c c c
Negative Control Turpentine 100.00±0.00 101.08±0.51 101.39±0.5 100.82±0.2 100.61±0.4c
(0.00) (-1.08) (-1.39) (-0.82) (-0.61)
a a a
Positive Control Turpentine + Aspirin (100 100.00±0.00 96.68±0.19 96.47±0.12 95.44±0.29 95.04±0.23a
mg/kg bw) (0.00) (3.32) (3.53) (4.56) (4.96)
b a b
Experimental Turpentine + C.abyssinica 100.00±0.00 99.19±0.56 97.46±0.48 97.62±0.53 97.56±0.46b
group A (50 mg/kg bw) (0.00) (0.81) (2.54) (2.38) (2.44)
b ab ab
Experimental Turpentine + C.abyssinica 100.00±0.00 99.32±0.54 98.17±0.68 97.12±0.80 97.12±0.79ab
group B (100 mg/kg bw) (0.00) (0.68) (1.83) (2.88) (2.88)
b a ab
Experimental Turpentine + C.abyssinica 100.00±0.00 98.86±0.16 97.52±0.34 96.64±0.33 96.79±0.45ab
group C (150 mg/kg bw) (0.00) (1.14) (2.48) (3.34) (3.21)
Values are expressed as Mean ± SEM for five animals per group. Values with the same superscript letter are not significantly
different (one way ANOVA followed by Tukey‟s test) (p>0.05). Percentage reduction in rectal temperature is within parenthesis.
49

Figure 4. 1: Percentage change in rectal temperature of C. abyssinica on


.....................turpentine-Induced pyrexia in Wistar albino rats
50

4.3 Anti-inflammatory Activity of DCM Root Extract of C. abyssinica


on Carrageenan-Induced Inflammation in Swiss Albino Mice

Generally, the DCM root extract, at the three doses demonstrated an anti-

inflammatory activity on carragenaan-induced paw edema in Swiss albino

mice. This was indicated by reduction in the diameter of the hind paw

after administration of the three extract doses (Table 4.3 and Figure 4.2).

In the first hour, the DCM root extract of C. abyssinica, at 50, 100 and 150

mg/kg body weight, reduced the inflamed hind paw diameter by 0.88%,

1.88% and 3.30% respectively while diclofenac reduced by 2.21% (Table

4.3; Figure 4.2).

At this hour, the anti-inflammatory activities of DCM root extract of C.

abyssinica, at all the three extract doses, were significantly different

(P<0.05; Table 4.3). However, the anti-inflammatory activities of DCM

root extract of C. abyssinica, at 100 mg/kg body weight and diclofenac

were not significantly difference (P>0.05; Table 4.3). The anti-

inflammatory effects of 50, 150 mg/kg body weight and diclofenac were

statistically significant (P<0.05; Table 4.3).

In the 2nd hour, the DCM root extract of C. abyssinica, at 50, 100 and 150

mg/kg body weight and diclofenac reduced the inflamed hind paw

diameter by 1.47%, 3.04%, 3.76% and 3.57% respectively thereby


51

demonstrating anti-inflammatory activities (Table 4.3; Figure 4.2). The

anti-inflammatory effects of 100 mg/kg and 150 mg/kg body weight were

not significantly different (P>0.05; Table 4.3). However, the anti-

inflammatory activity of DCM root extract of C. abysssinica at 50 mg/kg

body weight was significantly different from the anti-inflammatory

activities of the other two dose levels (100 mg/kg body weight and 150

mg/kg body weight) and diclofenac (P< 0.05; Table 4.3).

In the 3rd hour, the DCM root extract at 50, 100 and 150 mg/kg body

weight and diclofenac reduced the inflamed hind paw diameter by 1.61%,

3.59%, 4.64% and 5.01% respectively (Table 4.3; Figure 4.2). The anti-

inflammatory effects of 100 mg/kg body weight and 150 mg/kg body

weight were not significantly different (P>0.05; Table 4.3; Figure 4.2).

The anti-inflammatory effects of 50 mg/kg body weight was significantly

different from diclofenac (P<0.05; Table 4.3). The anti-inflammatory

activity of 150 mg/kg body weight and diclofenac showed no significant

differences (P>0.05; Table 4.3; Figure 4.2).

In the fourth hour, the DCM root extract at 50, 100 and 150 mg/kg body

weight reduced inflamed hind paw diameter by 1.84%, 4.30% and 5.34%

respectively while diclofenac (reference drug) reduced inflamed hind paw

edema diameter by 5.35% (Table 4.3; Figure 4.2). The anti-inflammatory


52

activities of 150 mg/kg body weight and 100 mg/kg body weight were not

significantly different and were comparable to diclofenac (P> 0.05; Table

4.3; Figure 4.2). However, the anti-inflammatory effect of 50 mg/kg body

weight was significantly different from the other two doses and diclofenac

(P< 0.05; Table 4.3; Figure 4.2).


53

Table 4. 3: Anti-inflammatory activities of DCM root extracts of C. abyssinica on carragenaan-induced inflammation in Swiss albino
mice

Group Treatment % change in paw diameter in (mm) after dose administration


0hr 1hr 2hr 3hr 4hr

Normal Control 10% DMSO 100.00±0.00 99.92±0.08d 99.92±0.08c 99.84±0.16d 99.92±0.08c


(0.00) (0.08) (0.08) (0.09) (0.08)
e d e
Negative Control Carrageenan 100.00±0.00 102.40±0.24 103.46±0.42 104.34±0.34 104.73±0.32d
(0.00) (-2.4) (-3.46) (-4.35) (-4.74)
b a a
Positive Control Carrageenan + Diclofenac (15 100.00±0.00 97.79±0.09 96.43±0.24 94.98±0.30 94.64±0.35a
mg/kg bw) (0.00) (2.21) (3.57) (5.01) (5.35)
c b c
Experimental Carrageenan + C.abyssinica 100.00±0.00 99.12±0.18 98.41±0.28 98.39±0.56 98.16±0.6b
group A (50 mg/kg bw) (0.00) (0.88) (1.47) (1.61) (1.84)
b a b
Experrimental Carrageenan+ C. abyssinica 100.00±0.00 98.12±0.05 96.96±0.22 96.41±0.23 95.70±0.22a
group B (100 mg/kg bw) (0.00) (1.88) (3.04) (3.59) (4.30)
a a ab
Experimental Carrageenan + C.abyssinica 100.00±0.00 96.70±0.14 96.24±0.29 95.35±0.21 94.64±0.18a
group C (150 mg/kg bw) (0.00) (3.30) (3.76) (4.64) (5.34)
Values are expressed as Mean ± SEM for five animals per group. Values with the same superscript letter are not significantly different
(one way ANOVA followed by Tukey‟s test) (p>0.05). Percentage reduction in the size of the edema is given within parenthesis.
54

Figure 4. 2: Percentage change in hind paw diameter of C. abyssinica on


…………….carragenaan induced inflammation in Swiss albino mice
55

4.4 Qualitative Phytochemical Screening

The DCM root extract of C. abyssinica upon phytochemicals test revealed the

presence of the following compounds; terpenoids, alkaloids, flavonoids, steroids,

cardiac glycosides and saponins. However, Phenolics compounds were absent

(Table 4.4).

Table 4. 4: Phytochemical composition of DCM root extract of C. abyssinica

Phytochemicals DCM root extract of C. abyssinica


Alkaloids +
Flavonoids +
Steroids +
Saponins +
Cardiac glycosides +
Phenolics -
Terpenoids +
Present phytochemicals denoted by (+), absent phytochemicals denoted by (-)
56

CHAPTER FIVE

DISCUSSION, CONCLUSION AND RECOMMENDATIONS

5.1 Discussion

Various injuries and diseases are most often presented with fever, pain and

inflammation among other clinical signs. Although during the past years there has

been remarkable progress in medical science in management of pain, fever and

inflammation using conventional methods (Adedapo et al., 2009), there is need to

seek alternative methods to manage these indicators of ill health. Conventionally

used analgesic, antipyretic and anti-inflammatory drugs such as NSAIDs, opiods

analgesics and glucocorticoids pose a lot of side effects after long term use like

cardiac abnormalities, peptic ulcers, prolonged bleeding, hepatic failure and renal

failure among others effects leading to their limited use in clinical settings

(Castellsague et al., 2012).

Therefore, due to these limitations and other associated problems of these

conventional drugs, search for newer drugs from medicinal plants with analgesic,

antipyretic and anti-inflammatory activities in traditional system of medicine is

essential. In this regard, alternative medicines from natural sources such as

medicinal plants are an important option into discovery of novel drugs because

currently available conventional drugs are derived from traditionally used

medicinal plants (Robinon and Zhang, 2011).


57

The present study was designed to evaluate the analgesic, antipyretic and anti-

inflammatory potential of DCM root extract of C. abyssinica in animal models.

To evaluate the analgesic activity of the DCM root extract, acetic acid-induced

pain test was used to induce abdominal writhings in Swiss albino mice. Acetic

acid-induced pain test has widely been used for screening new analgesic agents

and it majorly involves cholinergic, histaminic peritoneal receptors, acetylcholine

and histamine mediators. It is also used to asses peripherally acting analgesics

(Collier et al., 1968; Fujiyoshi et al., 1989).

The DCM root extract of C. abyssinica in this study, exhibited analgesic activities

by reducing the number of abdominal writhes in acetic acid-induced pain in male

Swiss albino mice after treatment with the extract. After thirty minutes of test

period, the DCM root extract at 50 mg/kg body weight demonstrated the highest

analgesic activity by reducing the number of writhes by 49.77%, while 100 mg/kg

body weight decreased the number of writhes by 38.6% and the dose of 150

mg/kg body weight decreased the number of writhes by 33.95% in a reverse dose

dependent manner (Table 4.1).

These findings strongly suggest that the DCM root extract of C. abyssinica posses

peripherally or centrally analgesic property. Perhaps acting in a similar manner as

conventionally used therapeutic drugs that reduce the pain perception in

nociceptors by inhibiting production of prostaglandins. These results concur with


58

other research studies on the evaluation of analgesic activity of herbal plant

extracts using Swiss albino mice. Reduction in the number of abdominal

writhings in this study is in agreement with a study carried out by Mworia et al.

(2015) on analgesic properties of acetone leaf extracts of Carissa spinarum in

mice. The findings are also in line with studies by Kariuki et al. (2012) on

antinociceptive activity of Toddalia asiatica (L) Lam in models of central and

peripheral pain. The same effect in reduction of number of abdominal writhes was

observed by Elson et al. (2007) while examining the analgesic and anti-

inflammatory effects of DCM root bark extract of Cheiloclinium cognanum in

mice models.

The non-dose dependent analgesic activities of DCM root extract of C.

abyssinica, are in agreement with a study carried out by Gitahi et al. (2015) on

analgesic activities of root and leaf extract of Carissa edulis in Wistar albino rats.

The higher analgesic activity of a dose level of 50 mg/kg body weight than 150

mg/kg body weight (Table 4.1) might be attributed to the fact that when certain

limits in dose ranges are exceeded, the activity of that particular agent is reduced.

Also, high dose concentration of the extract could be taking longer time to diffuse

across peritoneum cavity in that compounds that are more concentrated takes

longer period to diffuse while those with lower concentration takes a shorter time.

Analgesic effects produced by a lower dose were comparable to the reference


59

drug, suggesting that the lower dose was more effective in managing pain induced

by acetic acid.

The dose range of (50, 100 and 150 mg/kg body weight) applied in bioscreening

of analgesic, anti-inflammatory and antipyretic activities of DCM root extract in

the assays were comparable to dose ranges used by Tayyaba et al. (2015) while

evaluating the antipyretic, anti-inflammatory and analgesic activity of methanolic

leaf extract of Acacia hydaspica (R) parker in laboratory animals. Similarly,

Kamau et al. (2016a) used these doses while evaluating anti-inflammatory

activity of methanolic leaf extract of Kigelia africana (lam) benth and stem bark

extract of Acacia hockii de wild in Swiss albino mice. Likewise, Elson et al.

(2007) used a similar dose range while studying the analgesic and anti-

inflammatory effects of DCM root bark extract of Cheiloclinium cognanum using

acetic acid-induced test, tail flick test and croton oil-induced ear edema test.

The analgesic activities of DCM root extract of C.abyssinica could be attributed

to one or more of phytochemical compounds present in the extract (Table 4.4).

Studies conducted on herbal plants by many researchers have linked presence of

secondary active metabolites such as flavonoids, saponins and alkaloids to

analgesic, antipyretic and anti-inflammatory activities among other properties

(Asfar et al., 2015; Kumar et al., 2015). An agent that lowers the number of

abdominal writhes is considered analgesic by inhibiting prostaglandin synthesis


60

(Alam et al., 2009), a peripheral mechanism of pain inhibition (Alam et al.,

2009). Flavonoids have the ability to disrupt synthesis of eicosanoids (Robak and

Gryglewski, 1996). Flavonoids also have the ability to reduce production of

arachidonic acid through inhibition of neutrophils degranulation (Tordera et al.,

1994). Besides flavonoids, alkaloids also have been associated with the ability to

inhibit pain perception (Uche et al., 2008). Alkaloids, for example berberine from

berberies in a skeletal based pyridine ring have shown strong anti-inflammatory

and antinociceptive activities (Kupeli et al., 2002). These mentioned

phytochemicals were confirmed in preliminary phytochemical screening of DCM

root extract of C. abyssinica (Table 4.4). Therefore, the phytochemicals found in

the extract might have antagonized peripheral mediators of pain and thereby

blocking transmission of pain.

Evaluation of antipyretic potential of DCM root extract of C. abyssinica was

tested using turpentine-induced pyrexia in Wistar albino rats. Fever can be

induced in laboratory animals using several agents collectively termed as

pyrogens such as lipopolysacharides (LPS), E-coli, amphetamines, sulphur,

brewer‟s yeast and turpentine. These agents are considered exogenous pyrogens

(Petrova et al., 1978; Vasundra and Divya, 2013). Turpentine is a clear flammable

liquid with pungent odour and bitter taste, refined from resin pine. Turpentine

causes tissue damage and induces acute phase response as well as fever (Wieslaw

et al., 1998). Turpentine injection into experimental animals induces a persistently


61

high fever pattern (Kuochung et al., 2006). Based on this information, turpentine

in the present study was chosen as an appropriate pyrogen.

The DCM root extract of C. abyssinica, in this study demonstrated antipyretic

activities against turpentine-induced pyrexia in Wistar albino rats (Table 4.2;

Figure 4.1). Findings from this study were comparable to other earlier research

studies on evaluation of antipyretic effects of extracts of herbal plants using

animal models. Similar study carried out by Nthiga et al. (2016) showed that the

methanolic stem extracts of Harrisonia abyssinica and Ladolphia buchananiii

staphf posses antipyretic activities against turpentine-induced pyrexia in Wistar

albino rats. Likewise, a study carried out by Kamau et al. (2016b) on antipyretic

properties methanolic leaf extracts of Kigelia africana (Lam) and Acacia hockii

de wild showed significant antipyretic activities in Wistar albino rats. In addition,

a study by Vasundra and Divya. (2013) observed similar trend in reduction of

elevated temperature while examining the antipyretic effects of ethanolic extract

of Asparagus racemosus using laboratory animals.

The DCM root extract of C. abyssinica, lowered the elevated rectal temperature

more in the fourth hour than (in the third hour, the second and the first hour)

(Table 4.2; Figure 4.1). This might be attributed to the fact that most of the

bioactive compounds may have not been completely absorbed across the

peritoneum cavity while in the third and fourth hours most of the bioactive
62

compounds may have been absorbed across the peritoneum cavity thereby causing

higher antipyretic activities. Lower percentage inhibition in first and the second

hours could also be attributed to the fact that the drug needed time to be

biotransformed into an antipyretic agent for example zidovudine used as an

antiviral drug (Jarko et al., 2008) . Another factor is that at certain dose ranges,

the active antipyretic phytochemical compounds in the extract were not sufficient

enough to lower the rectal temperature. However, the plant extract at 50 mg/kg

body weight lowered the rectal temperature in the second hour, then reducing

antipyretic activity in the third and fourth hours respectively (Table 4.2; Figure

4.1). This scenario could be ascribed to the fact that most of the bioactive

compounds might have been quickly metabolized and excreted because of the

small concentrations of active phytochemical compounds in the extract.

In the fourth and the third hours, the DCM root extract of C. abyssinica, showed a

dose dependent response in reducing the elevated rectal temperature in turpentine-

induced pyrexia in Wistar albino rats (Table 4.2; Figure 4.1). The dose dependent

response observed in this study are in agreement with studies by Mbiri et al.

(2016b), who observed a similar trend while examining antipyretic activities of

methanolic bark extract of T. brownii in rats. Likewise, Nthiga et al. (2016)

observed similar dose dependent response while evaluating the antipyretic

properties of methanolic stem bark extracts of H. abyssinica oliv and L.

buchananiii staphf against turpentine-induced pyrexia in Wistar albino rats. In


63

another related study carried out by Tosan et al. (2014) on antipyretic activities of

ethanolic roots extract of Abultilon mauritianum (jacq) on brewer‟s yeast-induced

pyrexia and lipopolysaccharide-induced pyrexia in Wistar albino rats, a similar

trend was observed.

From the data obtained in this study (table 2), the DCM root extract of C.

abyssinica reduced the rectal temperature significantly when compared to the

reference drug. The extract might have inhibited cyclooxygenase enzyme, a key

enzyme necessary for synthesis of prostaglandins, thereby reducing fever.

Moreover, the extract may have reduced the concentration of PGE2 in the

hypothalamus through its action on cyclooxygenase enzyme or by enhancing of

body‟s own antipyretic substances like vasopressin, IL 10 and arginine (Okokon

and Nwafor, 2010). However, other mechanism for blocking fever for example

blockage of voltage-independent sodium channels cannot be ignored.

Qualitative phytochemical screening of the extract revealed the presences of

bioactive compounds such as terpenoids, alkaloids, flavonoids, steroids, cardiac

glycosides and saponins (Table 4.4). Flavonoids have been found to inhibit

prostaglandin E synthase production and its transcription, resulting in blockage of

prostaglandin synthesis (Hamalainen et al., 2011). Flavonoids such as baicalin

have been shown to exert antipyretic activity by inhibiting TNF-α (Adesokan et

al., 2008). This study correlates with a study by Gitahi et al. (2015), that bioactive
64

compounds such as alkaloids, saponins and flavonoids could act synergistically to

produce an observed pharmacogical activity. Therefore alkaloids, flavonoids and

saponins present in the extract might have contributed to antipyretic activities.

The anti-inflammatory activity of DCM root extract of C. abyssinica was

evaluated using carragenaan induced-inflammation in male Swiss albino mice. It

is the most used primary test for screening new anti-inflammatory agents and

constitute a simple and routine animal model for evaluation of inflammation (Jain

et al., 2001; Paschapur et al., 2009). Carragenaan is obtained from a sea weed

known as carrageen moss. It is a sulphated polysaccharide (Necas and

Bartosikova, 2013). Carragenaan induces severe inflammatory reaction when

injected into the hind paw leg of the rat/mice (John and Nodine, 1999). It is also

used to access anti-inflammatory effect of natural product (Dirosa et al., 1971).

The DCM root extract of C. abyssinica in this study demonstrated strong anti-

inflammatory activities against carragenaan-induced edema in Swiss albino mice

by reducing the diameter of the edema (Table 4.3; Figure 4.2). There are some

correlations, between results obtained from this study and other studies on

evaluation of anti-inflammatory activity of medicinal plants using animal models.

Similar study conducted by Tukappa et al. (2015), on in vitro and in vivo anti-

inflammatory and toxicity studies of methanolic bark extract of Rumex vesicarius

linn using carragenaan-induced edema in Wistar albino rats exhibited anti-


65

inflammatory activities. In addition, a study conducted by Mwangi et al. (2015),

on anti-inflammatory properties of dichloromethane:methanolic leaf extract of

Caesalpinia volkensi and mytenus obscura in animal models demonstrated strong

anti-inflammatory activities. Therefore, it is possible that DCM root extract of C.

abyssinica inhibited production of prostaglandins that are responsible for

initiating inflammation, signifying that the extract may have acted on cyclo-

oxygenase enzyme, a key enzyme required for catalyzing production of

prostaglandins from arachidonic acid.

The DCM root extract of C. abyssinica, demonstrated a dose dependent response

on carragenaan-induced inflammation (Table 4.3; Figure 4.2). The dose

dependent response was observed from the first hour to the fourth hour.

Reduction in the size of the hind paw edema was more in the fourth hour than in

the third, second and the first hours respectively. These differences in percentage

inhibition in the fourth hour and the first hour might be attributed to the fact that

absorption within first hour was slow but consistent. In the third and fourth there

were sufficient quantity of active phytochemical compounds necessary to reduce

inflammation more than in the first and the second hours. Lower percentage

inhibition in the first and the second hours might be ascribed to the fact that the

plant extract needed time to be biotransformed into an anti-inflammatory agent

for example 5-flurouracil a conventional drug used as an anticancer agent (Jarko

et al., 2008). The plant extract at 150 mg/kg body weight exhibited higher anti-
66

inflammatory effects than the other two dose levels in the entire experimental

period. This can be explained in terms of sufficient quantity of bioactive

compounds in the dose level than the other two doses. Another factor is small

concentration of active phytochemicals in the other two doses might have been

quickly metabolized and excreted.

This observed anti-inflammatory activity, is in concurrence with a study carried

out by Mwangi et al. (2015), while evaluating anti-inflammatory properties of

dichloromethane:methanolic leaf extracts of Caesalpinia volkensi and Mytenus

obscura in animal models. Likewise, a study carried out by Mbiri et al. (2016a)

on anti-inflammatory activities of methanolic stem bark extract of T. brownii in

rats observed similar dose dependent response.

Preliminary phytochemical screening, of the DCM root extract of C. abyssinica,

showed the presence of phytochemical compounds such as terpenoids, alkaloids,

flavonoids, steroids and saponins (Table 4.4). Alkaloids, flavonoids, cardiac

glycosides and sterols have been reported to inhibit prostaglandin pathway

(Kumar et al., 2013). Moreover, flavonoids can inhibit cyclo-oxygenase,

phospholipase, TNF α and lipo-oxygenase enzyme of arachidonic acid

metabolism (Chi et al., 2001; Jang et al., 2002). According to Vasudevan et al.

(2007), saponins have been shown to inhibit inflammation and therefore acting as

an anti-inflammatory agent. Therefore flavonoids, alkaloids, terpenoids and


67

saponins present in the extract might have acted synergistically to bring forth anti-

inflammatory activities.

5.2 Conclusions

The following conclusions can be made from the study;

i. The DCM root extracts of C. abyssinica posse‟s analgesic activities.

Significant reduction in the number of abdominal writhings after treatment

with the extract and the reference drug indicates that extract inhibited pain

mediators.

ii. The DCM root extracts of C. abyssinica posse‟s antipyretic properties.

Reduction in elevated rectal temperature after treatment with the extract

and the reference drug indicates that the extract reduced fever.

iii. The DCM root extract of C.abyssinica posses anti-inflammatory

activities. Reduction in the diameter of the inflamed hind paw after

treatment with the extract and the reference drug indicates that the extract

disrupted synthesis of pro-inflammatory mediators.

iv. Phytochemical compounds that were confirmed in preliminary

screening of the DCM root extract of C.abyssinica have previously been

reported to posses analgesic, antipyretic and anti-inflammatory properties.

The DCM root extract of C. abyssinica, might prove useful in obtaining

agents capable of managing condition related to pain, fever and inflammation.


68

However, there is still need of identification of molecular targets of the

extract. Therefore, the present study scientifically confirmed the traditional

uses of C. abyssinica in management of pain, fever and inflammation hence

the null hypothesis was rejected.

5.3 Recommendations

i. The extract of Clutia abyssinica may be used as an alternative bio-

resource in development of analgesic, antipyretic and anti-inflammatory

agent.
69

5.4 Recommendations for Further Studies

i. Isolation and characterization of the bioactive constituent responsible

for the activity which may lead to discovery of compounds that might be

used as lead compounds in discovery of analgesic, antipyretic and anti-

inflammatory agents.

ii. Use of a different route in administration of the extract other than

intraperitoneally. The data from both routes of administration can be

compared in management of pan, fever and inflammation.

iii. Determining the expression levels of biomarkers cytokines for pain,

fever and inflammation. This will ensure that biomarkers responsible for

pain, fever and inflammation that are released during this process of pain,

fever and inflammation are quantified.

iv. Evaluation of acute and chronic toxicity to determine the safety of the

extract in animal models.


70

REFERENCES

Adedapo, A.A., Sofidiya, MO., Afolayan, A.J. (2009). Anti-inflammatory and


analgesic activities of the aqueous extracts of Margaritaria Discoidea
(Euphorbiaceae) stem bark in experimental animal models. Revista de Biologia
Tropical. 57: 1193–1200.

Adesokan, A.A., Yakubu M.T., Owoyele, B.V., Akanji, M.A., Soladoye, A.O.,
and Lawal, O. (2008).Effect of administration of aqueous and ethanol extracts of
Enantia chlorantha stem bark on brewer‟s yeast induced pyresis in rats. African
Journal of Biochemistry. 2: 165-169.

Afsar, T., Khan, M., Razak, S., Ullah, S., and Mirza, B. (2015). Antipyretic,
anti-inflammatory and analgesic activity of Acacia hydaspica R. Parker and its
phytochemical analysis. BMC Complementary and Alternative Medicine.15: 136-
145.

Akuodor, G.C., Anyalewechi, N.A., Udoh, F.V., Ikoro, N.C., Akpan, J.L.,
Gwotmut, M.D., Iwuanyanwu, T.C., and Osunkwo, U.A. (2011).
Pharmacological evaluation of Verbena hastate leaf extract in the relief of pain
and fever. Advances in Pharmacology and Toxicology. 3: 1–8.

Alam, M.A., Subhan, N.A., Awal, M., Alam, M.S., Sarder, M.L., and Sarker,
S.D. (2009). Antinociceptive and anti-inflammatory properties of Ruellia
tuberosa. Pharmaceutical Biology. 47, 209-214.

Almekinders, L.C. (1999). Anti-inflammatory treatment of muscular injuries in


sport. An update of recent studies. Sports Medicine. 28: 383-388.

Axelrod, Y.K., and Diringer, M.N. (2008). Temperature management in acute


neurologic disorders. Neurologic Clinics. 26: 585-603.

Apkarian, A.V., Bushnell, M.C., Treede, R.D., and Zubieta, J.K. (2005).
Human brain mechanisms of pain perception and regulation in health and disease.
European Journal of Pain. 9: 463-484.

Anochie, and Philips. (2013). Mechanism of fever in humans. Apex Journal


International. 2: 37-43.

Aronoff, D.M., and Neilson, E.G. (2000). Antipyret-ics: Mechanism of action


and clinical use in fever suppression. American Journal of Medicine. 111: 304-
315.
71

Arome, D., Akapabio, I.S., Onalike, E.I., and Agbafor, A. (2016). Pain and
inflammation: Management by conventional and herbal therapy. Indian Journal of
Pain. 28: 5-12.

Barar, F.K. (2009). Essentials of Pharmacotherapeutics. Non-narcotic analgesics


and antipyretics, anti-inflammatory agents, drugs for gout, rheumatoid arthritis
and migraine. 5th ed., S. Chand & company Ltd, New Delhi. pp. 117-137.

Barnes, P., Powell-Griner, E., McFann, K., and Nahin, R. (2004).


Complementary and alternative medicine use among adults: United States.
Advanced Data Analysis and Classification. 343: 1-20.

Beg, S., Swain, S., and Hasan, H. (2011). Systematic review of herbals as
potential anti-inflammatory agents: Recent advances, current clinical status and
future perspectives. Pharmacognosy Reviews. 5: 120–137.

Bhagyasri, Y., Lavakumar, V., Diva M., and Ashok, C. (2015). An overview
of anti-inflammatory activity of Indian medicinal plants: International Journal of
Research Pharmaceutical and Nano Science. 4: 1-9.

Blatteis, C.M. (2007). The onset of fever: new insights into its mechanism.
Progress in Brain Research. 162: 3–14.

Bliddal, H., RosetzskyT., and Schlichting, A. (2000). A randomized, placebo-


controlled, cross-over study of ginger extracts and ibuprofen in osteoarthritis.
Osteoarthritis Cartilage Journal. 8 : 9-12.

Boursinos, L.A., Karachalios T., Poultisides L., and malizos, T.K. (2009). Do
steroids, conventional non-steroidal anti-inflammatory drugs and selective Cox-2
inhibitors adversely affect fracture healing. Journal of Musculoskelet Neuronal
Interact. 9: 44-52.

Burke, A., Smith, E., and Fitz-Gerald, G.A. (2006). Analgesic-antipyretic


agents; Pharmacotherapy of gout. In: Brunton LL, Lazo JS, Parker KL (edition):
Goodman & Gilman‟s. The Pharmacological Basis of Therapeutics. McGraw-
Hill, New York, Eleventh edition. pp 540.

Cartmell, T., Poole, S., Turnbull, A.V., Rothwell, N. J., and Luheshi, G. N.
(2000). Circulating interleukin-6 mediates the febrile response to localized
inflammation in rats. Journal of Physiology. 525: 653-661.
72

Castellsague, J., Riera-Guardia, N., Calingaert, B., Varas-Lorenzo, C.,


Fourrier-Reglat, A., and Nicotra, F. (2012). Individual NSAIDs and upper
gastrointestinal complications: a systematic review and meta-analysis of
observational studies (the SOS project). Drug Safety. 35: 1127-1146.

Chandra, D., and Gupta, S. (1972). Anti-inflammatory and anti-arthritic activity


of volatile oil of Curcuma longa (Haldi). Indian Journal of Medical Research. 60:
138-142.

Chi, Y., Jong, H., Son, K., Chang, H., Kang, S., and Kim, H. (2001). Effects of
naturally occurring prenylated flavnoids on enzymes metabolizing arachdonic
acid: cyclooxygenases and lipooxygenases. Biochemical Pharmacology. 62:1185-
1191.

Chrubasik, S. (2004). Devil's claw extract as an example of the effectiveness of


herbal analgesics. American Journal of Medicine. 33: 804–809.
Collier, H.J., Dinneen, L.C., Johnson, C.A., and Schneider, C. (1968). The
abdominal constriction response and its suppression by analgesics drugs in the
mouse. British Journal of Pharmacology. 32: 295-310.

Craig, C.R., and Stitzel, R.E. (2003). Modern Pharmacology with Clinical
Applications. Lippincott Williams & Wilkins, Philadelphia, 5th edition. pp 832.

Curtis, C.L., Harwood, JL., Dent, CM., and Caterson, B. (2004). Drug
Discovery Today. Journal of Drug Discovery and Therapeutics. 9: 165-174.

Dacie, J.V. (1958). Practical Hematology, 2nd edition. A Churchill Ltd., London.
pp. 38-48.

D'Armour, F.E., Blad, F.R., and Belden, D.A. (1965). Manual for Laboratory
work in Physiology, 3rd edition. The University of Chicago Press, Chicago.
Illinois. pp.4-6.

Davies, P., Bailey, P.J., Goldenberg, M.M., and Ford-Hutchinson, A.W.


(1984). The role of arachidonic acid oxygenation products in pain and
inflammation. Annual Review of Immunology. 2: 35-54.

De Sousa, D.P. (2011). Analgesic-like Activity of Essential Oils Constituents


Molecules. Phytopharmacology. 16: 223-225.
73

Dirosa, M., Giroud J.P., And Willoughby, D.A. (1971): Studies of the acute
inflammatory response induced in rats in different sites by carrageenan and
turpentine. Journal of Pathology. 104: 15-29.

Dubey, R.C., and Maheswari, D.K. (2005). A text book of Microbiology by and
5th edition published by S.Chand. New delhi pp 67.

Elisabetskey, E.A., Ahmador, RR., Nunse, D.S., and Carvallo, A.T. (1995).
Analgesic activity of Phshotua Colorata Muell. Journal of Ethnopharmacology.
48: 77–83.

Elson. A., Lucio, R., Itamar, S., Lecia, G., Gilmar., A and Luciano, M.
(2007). Anagesic and anti-inflammatory effects of cheiloclinium cognatum root
barks. Brazillian Journal of Pharmacognosy. 17: 508-513.

Ezeja, M.I., Ezeigbo, I.I., and Madubuike, K.G. ( 2011). Analgesic activity of
the methanolic seed extract of Buchholzia coriacea. Research Journal of
Pharmaceutical, Biological and Chemical Sciences. 2: 182-187.

Fauci, A. (2008). Harrison‟s Principles of Internal Medicine (17th edition)


McGraw –Hill Professional. New York. pp. 117-121.

Fitzgerald, G.A. (2004). Coxibs and cardiovascular disease. The New England
Journal of Medicine. 351: 1709–1711.

Friedman, R., and Hughes, A.L. (2002). Molecular evolution of the NF-κβ
signaling system. Immunogenetics. 53: 964–974.

Fujiyoshi, T., Hayashi, I., Ohishi, S., Kuwashima, M., Iida, H., Dozen, M.,
Taniguchi, N., Ikeda, K., and Ohnishi, H. (1989). Kaolin-induced writhing in
mice, a new model of possible bradykinin-induced pain for assessment of
analgesic agents. Agent and Actions. 27: 332-334.

Ghosh, S., May, M.J., and Kopp, E.B. (1998). NF-κβand Rel proteins:
evolutionarily conserved mediators of immune responses. Annual Review of
Immunology. 16: 225–231.

Gitahi, S.M., Maina, M.W., Njagi, J.M., Mworia, J.K., Juma, K.K., Umar,
A., Mwonjoria, K.J., Njoroge, W.A., Ngugi, M.P., and Mburu N.D. (2015).
Antipyretic Properties of Dichloromethane: Methanolic Leaf and Root Bark
74

Extracts of Carissa edulis in Rats. Asian Journal of Biomedical and


Pharmaceutical Sciences. 5: 12-20.

Green, A.F., Young, P.A., and Godfrey, E.L. (1951). A comparison of heat and
pressure analgesimetric methods in rats. Britain pharmacology. 6: 572-585.

Gupta. M., Mazumder, U.K., Gomathi, P., and Selvan, V.T. (2006). Anti-
inflammatory activity of extract of Vernonia amygdalina. Complementary and
Alternative Medicine. 6: 36-43.

Guyton, A.C., and Hall, J.E. (2006). Textbook of Medical Physiology. 11th
edition. Elsevier Saunders, Philadelphia. pp 429-434.

Guyton, A.C., and Hall., J.E. (2000). Textbook of medical physiology. 10th
edition: Saunders Philadelphia. pp 822–823.

Hamalainen, M., Nieminen, R., Asmawi, M.Z., Vuorela, P., Vapaatalo, H.,
and Moilanen, E. (2011). Effects of flavonoids on prostaglandin E2 production.
Planta Medicina. 77: 1504-1511.

Hawkey, C.J., and Rampton, D.S. (1985). Prostaglandins and the


gastrointestinal mucosa: are they important in its function, disease, or treatment.
Gastroenterology. 89: 1162–1188.

Inotai, A., Hanko, B., and Meszaro, A. (2010). Trends in the non-steroidal anti-
inflammatory drug market in six central-eastern European countries based on
retail information. Pharmacoepidemiology and Drug Safety. 19: 183–190.

Jain, N.K., Patil, C.S., Singh, A., and Kulkarni, S.K. (2001). A simple
technique to evaluate inflammatory pain along with anti-inflammatory studies in
carrageenan-induced paw edema. Indian Journal of Pharmacology. 33: 114-115.

Jang, D., Cuendet, M., Hawthorne ,M., Kardono, L., Kawanishi, K., and
Fong, H. (2002). Prenylated flavnoids of the leaves of Mucaranga conifera with
inhibitory activity against cyclooxygenase-2. Phytomedicine. 61: 867-872.

Jarko, R., Hanna, K., Tycho, H., Dooman, O., Tomi, J., and Jauko, S. (2008).
Prodrugs: Designs and Clinical Application. Nature Reviews Drug Discovery. 7:
255-270.

Jeruto, P., Charles, M., Lukhoba, C., and George, O. (2011). Phytochemical
constituents of some medicinal plants used by the Nandis of South Nandi district,
Kenya; Journal of Animal and Plant Sciences. 9: 1201–1210.
75

Jia, w., Gao, W.Y., Cui, N., and Xiao, P.G. (2003). Anti-inflammatory effects of
an herbal medicine (xuan-ju agent) on carragenaan and adjuvant-induced paw
edema in rats. Journal of Ethnopharmacology. 89: 139-141.

John, H., and Nodine, M.D. (1999). Year Book Medical. Publishers Inc;
Chicago. pp.492.

Kamau, J.K., Nthiga, P.M., Safari, V.C., Njagi, S.M., Mwonjoria, J.K.,
Ngerenwa, J.N., and Ngugi, M.P. (2016a) Anti-inflammatory activity of
methanolic leaf extract of Kigelia africana (Lam) benth and Acacia hockii de wild
in mice. Journal of Developing Drugs. 5: 158-166.

Kamau, J.K., Nthiga, P.M., Safari, V.C., Njagi, S.M., Mwonjoria, J.K.,
Ngugi, M.P., and Ngerenwa, J.N. (2016b). Antipyretic properties of methanol
stem bark extracts of Acacia hockii de wild and Kigelia africana (Lam) benth in
Wistar rats. Journal of Pharmacognosy and Natural Products. 2: 118-124.

Karakitsos, D., and Karabinis, A. (2008). Hyerthermia therapy after traumatic


brain injury in children. New England Journal of Medicine. 359: 1179-1182.

Kariuki, H.N., Kanui, T.I., Yenesew, A., Patel, N.B., and Mbugua, M.P.
(2012). Antinociceptive activity of Toddalia asiatica (L) Lam in models of central
and pheripheral pain. Phytopharmacology. 3: 122-129.

Kelly, K.W., Bluthe, R.M., Dantzer, R., Zhou, J.H., Shen, W.H., Johnson,
R.W., and Broussard, S.R. (2003). Cytokine induced sickness behaviour . Brain
Behaviour and Immunology. 1: 2-8.

Kipkore, W., Benard, W., Hillary, R., and Gabriel, K. (2014). A study of
medicinal plants used by the Marakwet community in Kenya. Journal of
Ethnobiology and Etnomedicine. 10: 32–37.

Kluger, M.J. (1991). Fever: role of pyrogens and cryogens. Physiology Review.
71: 93–127.

Kokate, C.K., Purohit, A.P., and Gothale, S.B. (2002). Text book of
pharmacognosy 18th edition Nirali prakasan Ltd. Pune India.

Kokwaro, J.O. (2009). Medicinal plants of East Africa. 3rd edition. Kenya
literature bureau limited. Nairobi. pp 130.

Komboj, V.P. (2000). Herbal medicine. Current Science. 78: 35-39.


76

Kou. J., Ni, Y., Li, N., Wang, J., Liu, L., and Jiang, Z.H. (2005). Analgesic and
anti-inflammatory activities of total extract and individual fractions of Chinese
medicinal ants Polyrhachis lamellidens. Biological and Pharmaceutical Bulletin.
28; 176–180

Kumar, A., Agarwal, K., Maurya, K.A., Shanker, K., Bushra, U., and
Tandon, S. (2015). Pharmacological and phytochemical evaluation of Ocimum
sanctum root extracts for its antiinflammatory, analgesic and antipyretic activities.
Pharmacognosy Magazine. 11: 17-24.

Kumar, S., Bajwa, B.S., Singh, K., and Kalia, A.N. (2013). Anti-inflammatory
activity of herbal plants. International Journal of Advances in Pharmacy, Biology
and Chemistry. 2: 77-88.

Kumar, S., Baker, K., and Seger, D. (2002). Dinitrophenol-induced


Hyperthermia Resolving With Dantrolene Administration.Abstract of North
American Congress of Clinical Toxicology. Clinical Toxicology. 40 : 599 - 673.

Kuochung, T., Haruko, F., Yasuo, Y., and Yuzo, T. (2006). Effects of
turpentine induced fever during the enamel formation of rat incisor. Archives of
oral biology. 51: 464-470.

Kupeli, E., Kosar, M., Yesilada, E., and Baser, K. (2002). A comparative study
on the antiinflammatory, antinociceptive and antipyretic effects of isoquinoline
alkaloids from roots of Turkish Berberis species. Life Sciences. 72: 645-652.

Lalenti, A., Ianaro, A., Moncada, S., and Di Rosa, M. (1995). Modulation of
acute Inflammation by endogenous nitric oxide. Europium Journal
Pharmacology. 211: 177-182.

Lange, C., Hemmrich, G., Klostermeier, U.C., Lopez, J.A., and Miller, D.J.
(2001). Defining the origins of the NOD-like receptor system at the base of
animal evolution. Journal of Molecular Biology and Evolution. 28: 687–702.

Lapah, P.T., Noa, P.A., and Ogbonna, O.J. (2014). Anti-Pyretic and Analgesic
Potentials of Aqueous Extract of Phragmanthera capitata S. Balle in Albino Rats.
American Journal of Pharmacy and Pharmaceutical Sciences.1: 37-43.
Lascelles, B.D., Court, M., Hardie, E.M., and Robertson, S.A. (2007).
Nonsteroidal anti-inflammatory drugs in cats: a review. Veterinary Anaesthesia
and Analgesia.34 :228–250
77

Leon, L.R. (2002). Molecular biology of thermoregulation (Invited Review):


cytokine regulation of fever: studies using gene knockout mice. Journal of
Applied Physiology, 92: 2648-2655.

Luna, S.P., Basilio, A.C., Steagall, V.M., Machado, L.P., Moutinho, F.Q.,
Takahira, R.K., and Brandao, C.V. (2007). Evaluation of adverse effects of
long-term oral administration of carprofen, etodolac, flunixin meglumine,
ketoprofen, and meloxicam in dogs. American Journal of Veterinary Research.
2007; 68: 258-264.

Maria, F., Jeffrey, B.N., Natarajan, P., and Mehalingam, P. (2014).


Pharmacological screening of leaf extracts of ethnomedicinal plant Vitex altissima
for its traditional claims. Asian Journal of Pharmaceutical and Clinical
References. 7: 22-28.

Marnett, L.J. (2009). The COXIB experience. Annual Review Pharmacology


and Toxicology. 49: 265–290.

Maroon, J.C, Bost, J.W., and Adara., M. (2010). Natural anti-inflammatory


agents for pain relief. Surgical Neurology International. 1: 74-80.

Marzouk, B., Marzouk, Z., Haloui, E., Fenina, N., Bouraoui, A., and Aouni,
M. (2010). Screening of analgesic and anti-inflammatory activities of Citrullus
colocynthisfrom southern Tunisia. Jounal of Ethnopharmacology. 128: 15-19.

Matu, E.N. (2008). Clutia abyssinica Jaub and Spach. In: Schmelzer GH, Gurib-
Fakim A, Editors. Prota11 (1): Medicinal plants/Plantes médicinales PROTA,
Wageningen, Netherlands.

Maze, M., Hunter, J.C., and Gaeta, R.R. (2000). Conscious sedation and pain.
In Carruthers SG, Hoffman BB, Melmon KL, Nierenberg DW (eds.): Melmon
and Morrelli's Clinical Pharmacology. McGraw-Hill, NewYork, Fourth edition pp
200.

Mbiri , J.W., Sichangi, K., Kisangau, P., Wilton, M., and Ngugi, M.P.
(2016a). Anti-inflammatory properties of methanolic bark extract of Terminalia
brownii in Wistar albino rats. International Journal of Current Pharmaceutical
Research. 8: 1-5.

Mbiri, J.W., Sichangi, K., Kisangau, P., Wilton, M., and Ngugi, M.P. (2016b).
Anti-pyretic properties of methanolic bark extracts of Terminalia brownii in
Wistar albino rats. Journal of Pharmacognosy and Natural Products. 2: 121-126.
78

Medzhitov, R. (2008). Origin and physiological roles of inflammation. Nature.


454: 28–35.

Mergia, E., Terefe, G., Teklehaymanot, T., and Shibeshi, W. (2014)


Evaluation of in vivo Antitrypanosomal activity of aqueous and methanol leaf
extracts of Clutia Abyssinica against Trypanosoma Congolense. Austin Journal
of Pharmacology and Therapeutics. 2: 5–9.
Mitchell, R.N., and Cotran, R.S. (2000). In: Robinsons Basic Pathology. 7th
edition. Harcourt (India) Pvt Ltd. New Delhi. pp. 33.

Mwangi, B.M., Gitahi, S.M., Njagi, J.M., Mworia, J.K., Aliyu, U., Njoroge,
W.A., Mwonjoria, K.J., Ngugi, M.P., and Mburu, N.D. (2015). Anti-
inflammatory properties of dichloromethane:methanolic leaf extracts of
Caesalpina volkensii and Maytenus obscura in animal models. International
journal of current pharmaceutical research. 7: 83-87.

Mwonjoria, J.K., Kariuki, H., and Waweru, F.N. (2011). The antinociceptive
antipyretic effects of Solanum incanum (Lin.) in animal models, International
Journal of Phytopharmaceuticals. 2: 22-26.

Mworia, J.K., Gitahi, S.M., Juma, K.K., Njagi, J.M., Mwangi, B.M., Aliyu,
U., Njoroge, W.A., Mwonjoria, K.J., Mawia, A.M., Nyamai, D.W., Ngugi,
M.P., and Ngeranwa, J.N. (2015) Antinociceptive Activities of Acetone Leaves
Extracts of Carissa Spinarum in Mice. Medicinal and Aromatic Plants. 10: 1- 4.

Nathan, C. (2002). Points of control in inflammation. Nature. 420: 846–852.

Naude, P.J., Cromarty, A.D., and Rensburg, C.E. (2010). Potassium humate
inhibits carrageenan-induced paw oedema and a graft-versus-host reaction in rats.
Inflammopharmacology. 18: 33–39.

Necas, J., and Bartosikov, K. (2013). Carragenaan a review. Veterinani


medicina; 58: 187-205.

Njoroge, G.N., and Bussmann, R.W. (2006). Traditional management of ear,


nose and throat (ENT) diseases in Central Kenya. Journal of Ethnobiology and
Ethnomedicine. 2: 54–58.
79

Nthiga, P.M., Kamau, J.K., Safari, V.Z., Mwonjoria, J.K., Mburu, D.N., and
Ngugi, M.P (2016). Antipyretic Potential of Methanolic Stem Bark Extracts of
Harrisonia abyssinica Oliv and Landolphia buchananii (Hallier F.) Stapf in
Wistar Rats. Journal of Applied Pharmacy. 8: 227-233.

Okokon, J.E., and Nwafor, P. (2010). Antiinflammatory, analgesic and


antipyretic activities of ethanol root extract of Croton zambesicus. Journal of
Pharmaceutical Science. 23: 385-392.

Onasanwo, S.A., Fabiyi, T.D., Oluwole L.K., and Olaleye, S.B. (2012).
Analgesic and anti-inflammatory properties of the leaf extracts of Anacardium
occidentalis in the laboratory rodents. Nigerian Journal of Physiological
Sciences. 27: 65-71.

Palladino, M.A., Bahjat, F.R., Theodorakis, E.A., and Moldawer, L.L. (2003).
Anti-TNF-α therapies: The next generation. Nature Reviews Drug Discovery. 2:
736-746.

Parle, M., and Yadav, M. (2013). Laboratory models for screening analgesics.
International Research Journal of Pharmacy. 4: 15-19.

Paschapur, M.S., Patil, M.B., Kumar, R., and Patil, S.R. (2009). Evaluation of
anti-inflammatory activity of ethanolic extract of Borassus flabellifer L. male
flowers (inflorescences) in experimental animals. Journal of Medicinal Plants
Research. 2: 49–54.

Paya, D.G., and Katzung, B.G. (1995). Non-steroidal anti-inflammatory drugs;


nonopoid analgesics; drugs used in gout. Basic and Clinical Pharmacology. 6:
536–559.

Petrova, L., Nikolova, M., Nikolov, R., and Stefanova, D. (1978). Dipyrone
and acetylsalicylic acid comparative pharmacological research. Antipyretic, anti-
inflammatory and analgesic action. In: Ovtcharov R, Pola W (eds) Proceedings
Dipyrone. Moscow Symposium, Schattauer-Verlag, Stuttgart New York, pp 99-
107

Proell, M., Riedel, S.J., Fritz, J.H., Rojas, A.M., and Schwarzenbacher, R.
(2008). The Nod-like receptor (NLR) family: A tale of similarities and
differences. PLoS One Journal Impact. 3: 2199-2208.
80

Rajagopal. (2006). Pain - Basic Considerations: Indian Journal of Anaesthetic. 5:


331–334.

Rang, H.P., Dale, M.M., Ritter, J.M., and Flower, M.C. (2006). Pharmacology,
7th edition, Churchill Livingstone. pp. 202-210.

Rang, H.P., Dale, M.M., Ritter, J.M., and Moore, P.K. (2003). Pharmacology.
Churchill Livingstone, Edinburgh, 5th edition . pp. 797.

Ravi, V., Saleem, T.S., Patel, S.S., Raamamurthy, J., and Gauthamam, K.
(2009). Anti-Inflammatory Effect of Methanolic Extract of Solanum nigrum Linn
Berries. International Journal of Applied Research in Natural Products. 2: 33-36.

Rao, P.N., and Knaus, E.E. (2008). Evaluation of Nonsteroidial anti-


inflammatory drugs cyclooxygenase inhibition and beyond. Journal of
Pharmaceutical Sciences. 11: 81-110.

Rehman, Q., and Sack, K.E. (1999). When to try COX-2-specific inhibitors:
Safer than standard NSAIDS in some situations. Postgraduate Medical Journal.
106: 95–106.

Richard, F., Michelle, A.C., and Luigi, X.C. (2008). Lippincott's Illustrated
Reviews. Pharmacology. Lippincott Williams & Wilkins. Philadelphia, Fourth
edition. 564.

Richardson, K.T. (1971). Pharmacology and pathophysiology of inflammation.


Archives of Ophthalmology. 86: 706–724.
Robak, J., and Gryglewski, R.J. (1996). Bioactivity of flavonoids. Polish
Journal of Pharmacology. 48: 555-564.

Robinon, M.R., and Zhang, X. (2011). The World Medicine Situation


(Traditional Medicines: Global Situation, Issues and Challenges). Geneva," World
Health Organization”.

Robotin, M.C., and Penman, A.G. (2006). Integrating complementary therapies


into mainstream cancer care: which way forward. Medical Journal of Australia.
185: 377–379.

Saper, C.B., and Breder, C.D. (1994). The neurologic basis of fever. New
England Journal of Medicine. 330: 1880–1886.
81

Semwal, D.K., Badoni, R., Semwal, R., Kothiyal, S.K., Singh, G.J., and
Rawat, U. (2010). The genus Stephania (Menispermaceae): Chemical and
pharmacological perspectives. Journal of Ethnopharmacology. 132: 369-383.

Sen, S., Chakraborty, R., and De, B. (2010). Analgesic and anti-inflammatory
herbs: A potential source of modern medicine. International Journal of
Pharmaceutical Sciences and Research. 11: 32–44.

Shah, B.S., Nayak, B.S., Seth, A.K., Jalalpure, S.S., Patel, K.N, Patel, M.A.,
and Mishra, A.D. (2006). Search for medicinal plants as a source of anti-
inflammatory and anti-arthritic agents. Pharmacognosy Magazine. 2: 77–86.

Shalini, M.D., and Dona, S.Z. (2006). Pathopysiology and Management of


Fever. Journal of Supportive Oncology. 4: 9-16.
Sharma, U.S., Umesh, K.S., Abhishek, S., Niranjan, S., and Puspak, J.S.
(2010). Screening of Terminalia bellirica Fruits Extracts for its Analgesic and
Antipyretic Activities. Jordan Journal of Biological Sciences. 3: 45-53.
Shinwari, Z.K. (2010). Medicinal plants research in Pakistan. Journal of
Medicinal Plants Research. 4: 161-176.

Singh, A., Malhotra, S., and Subban, R. (2008). Anti-inflammatory and


analgesic agents from Indian medicinal plants. International Journal of
Integrative Biology. 1: 57–72.

Singh, S.D., and Majumbar, K. (1995). Analysis of activity of Ocimum sanctum


and its possible mechanism of action. International Journal of Pharmacology. 3:
188–192.

Smith, D.L., D’amour, M.C., and D’amour, F.E. (1943). The analgesic
properties of certain drugs and drug combinations. Journal Pharmacology
Experimental Therapeutics. 77: 184-193.

Sparkes, A., Heiene, R., Lascelles, B.D., Malik, R., Sampietro, L.R.,
Robertson. S., Scherk, M., and Taylor, P. (2010). NSAIDs and cats- it‟s been a
long journey. Journal of Feline Medicine and Surgery. 12 :519–538

Srivastava, K.C., and Mustafa, T. (1989). Ginger (Zingiber officinale) and


rheumatic disorders. Medical Hypotheses. 29: 25-28.
82

Sund- Levander, M., Forsberg, C., and Wahren, L.K. (2002). Normal oral,
rectal, tympanic and axillary body temperature in adult men and women: a
systematic literature review. Journal of Caring Science. 16: 122- 129.

Talalay, P. (2001). The importance of using scientific principles in the


development of medicinal agents from plants. Academic Medicine. 76: 38–47

Tayyaba, A., Muhamed, R.K., Suhail, R., Shafi, U., and Bushra, M. (2015).
Antipyretic, anti-inflammatory and analgesic of Acacia hydaspica r parker and its
phytochemicals analysis. Complementary and Alternative Medicine. 15: 136-147.

Thorp, C.M. (2008). Pharmacology for the Health Care Professions. A John
Wiley & Sons, Ltd. Lodon; pp 243.

Tordera, M., Ferrandiz, M.L., and Alcaraz, M.J. (1994). Influence of anti-
inflammatory flavonoids on degranulation and arachidonic acid release in rat
neutrophils. Journal of Biosciences. 49: 235-240.

Tosan, C.A., Adeoti, O.K., Ojewuyi, O.B., and Olayemi, J. (2014). Antipyretic
activity of Abutilon mauritianum (jacq) roots in Wistar rats. International Journal
of Pharma Sciences and Research. 5: 75-81.

Tukappa, N.K., Ramesh, L.J., Sanjeev, C.B., and Hanumantapa, B.N. (2015).
Evaluation of in vitro and in vitro anti-inflammatory and toxicity studies of
methanolic extract of Rumex vesicarius Linn. Orient Pharmaceuticals Experiment
Medicine. 9: 35-43.

Turner, R. (1965). Screening Method in Pharmacology. Anti-Inflammatory


Agent. Academic Press, New York, NY, USA. 13; pp 245.

Trease, G.E., and Evans, M.C. (1983). Text book of Pharmacognosy. 12th
edition. Balliere, Tindall: London. Pp. 343-383.

Uche, F.I., and Aprioku, J.S. (2008).The phytochemical constituents, analgesic


and anti-inflammatory effects of methanol extract of Jatropha curcas leaves in
mice and wistar albino rats. Journal of Apllied Sciences and Enviromental
Management. 4: 990-102.

Vadivelu, N., Urman, R.D., and Hines, R.L. (2011).Essentials of Pain


Management. Springer Science. 157: 167–169.
83

Vane, J.R., and Bolting, R.M. (1995). New insights into the mode of action of
anti-inflammatory drugs. Journal Inflammation Research. 44: 1-10

Vane, J.R., Bakhle, Y.S. and Bolting, R.M. (1998). Cyclooxygenase-1 and 2.
Annual Review of Pharmacology and Toxicology. 38: 97-120.

Vasudevan, M., Gunnam, K.K., and Parle, M. (2007). Antinociceptive and


anti-inflammatory effects of Thespesia populnea bark extract. Journal of
Ethnopharmacology. 109: 264-270.

Vasundra, D.P., and Divya, P.S. (2013). Antipyretic Activity of Ethanol and
Aqueous Extract of Root of Asparagus racemosus in Yeast Induced Pyrexia.
Asian Journal of Pharmaceutical Clinical Researh. 6; 190-19

Vinegar, R., Schreiber, W., and Hugo, R. (1969). Biphasic development of


carrageenan oedema in rats. Journal of Pharmacology and Experimental
Therapeutics. 166: 96-103.

Walter, F.B. (2003). Medical Physiology: A Cellular and Molecular Approach.


Elsevier. Saunders limited. Philadelphia. pp 1300.

Waters R.V., Gamradt, S.C., and Asnis, P. (2000). Systemic corticosteroids


inhibit bone healing in a rabbit ulnar osteotomy model. Acta Orthopaedica
Scandinavica. 71 :316-21.

Winter, C.A., and Poter, C.C. (1957). Effect of alterations in the side chain
upon anti-iflammatory and liver glycogen activities of hydrocortisone esters.
Journal of American Pharmaceutical Association Science. 46: 343-383.

Winter, C.A, Risley, E.A and Nuss, G.W. (1962). Carrageenan-induced oedema
in the hind paw of rats as an assay for anti-inflammatory activity. Proceeding of
Society for Experimental Biology and Medicine.111: 544-547.

Wieslaw, K., Mathew, J.K., Dariusz, S., Carole, C., Karin, R., Lisa, T., and
Hui, Z. (1998). IL-6 and IL-1β in fever. Studies using cytokine-deficient
(knockout) mice. Annals of the New York Academy of Sciences. 856: 33-47.

Young, A., Jordan, F., Ledingham, M., Thomson, A., Norman, J., and Greer,
I. (2002). Quantification of pro-inflammatory cytokines in myometrium, cervix
and fetal membranes during human parturition. Journal of the Society of
Gynecologic Investigation. 9: 133–137.
84

Young, P., and Saxena, M. (2014). Fever management in intensive care patients
with infections: Intensive Care. 18: 206–213.
85

APPENDICES

APPENDIX I: Mean percentage change in the number of abdominal writhes


. after administration of DCM root extract in Swiss albino mice

Doses Mean abdominal


withings
C. abyssinica root 50 mg/kg bw 21.6±2.01
extract 100 mg/kg bw 26.4±1.86
150 mg/kg bw 28.4±3.44
86

APPENDIX II: Effects of DCM root extract of C. abyssinica on turpentine-Induced pyrexia in Wistar albino rats

Group Treatment % change in rectal temperature in (°C) after dose


administration
0hr 1hr 2hr 3hr 4hr

Normal Control 10% DMSO 37.18±0.03b 37.1±0.29b 37.1±0.32b 37.18±0.35b 37.16±0.35b

Negative Control Turpentine 38.94±0.26a 39.36±0.34a 39.48±0.27a 39.26±0.24a 39.18±0.39a

Positive Control Turpentine + Aspirin (100 mg/kg 39.14±0.35a 37.84±0.34b 37.76±0.34b 37.36±0.41b 37.2±0.42b
bw)
Experimental Turpentine + C.abyssinica (50 38.52±0.48ab 38.2±0.37ab 37.54±0.34b 37.6±0.49b 37.58±0.48ab
group A mg/kg bw)
Experimental Turpentine + C.abyssinica (100 38.08±0.48ab 37.82±0.32b 37.38±0.29b 36.98±0.31b 36.98±0.33b
group B mg/kg bw)
Experimental Turpentine + C.abyssinica (150 38.72±0.08a 38.28±0.11ab 37.76±0.16b 37.42±0.18b 37.48±0.20b
group C mg/kg bw)
87

APPENDIX III: Effects of DCM root extract of C. abyssinica on carrageenan-Induced inflammation in Swiss albino
………………….mice

Group Treatment % change in rectal temperature in (°C) after dose


administration
0hr 1hr 2hr 3hr 4hr

Normal Control 10% DMSO 2.49±0.03b 2.47±0.03b 2.49±0.3c 2.48±0.03c 99.95±0.03c

Negative Control Turpentine 3.60±0.03a 3.69±0.05a 3.73±0.04a 3.76±0.05a 3.77±0.04a

Positive Control Turpentine + Diclofenac 3.53±0.09a 3.45±0.09ab 3.40±0.08b 3.35±0.09b 3.34±0.09b


(15 mg/kg)
Experimental Turpentine + C.abyssinica 3.47±0.08a 3.43±0.08ab 3.40±0.09b 3.40±0.09b 3.39±0.09b
group A (50 mg/kg bw)
Experimental Turpentine + C.abyssinica 3.62±0.04a 3.55±00.04ab 3.51±0.04ab 3.49±0.03ab 3.47±0.04ab
group B (100 mg/kg bw)
Experimental Turpentine + C.abyssinica 3.44±0.13a 3.33±0.12b 3.31±0.12b 3.28±0.12b 3.26±0.12b
group C (150 mg/kg bw)
88

APPENDIX IV: Source of the plant Turbo division. Courtesy of Google Earth maps
89

APPENDIX V: Analysis of analgesic activity of DCM root extract of .


. C.abyssinica in Swiss albino mice

Descriptive Statistics: pain

Variable C1 Mean SE Mean StDev


% inhibition 100 mg/kg 38.60 4.33 9.67
150 mg/kg 33.95 8.01 17.91
50 mg/kg 49.77 4.69 10.48
Negative control 0.000000 0.000000 0.000000
Normal control 100.00 0.000000 0.000000
Positive control 46.51 4.22 9.45

One-way ANOVA: writhings versus treatments


Analysis of Variance

Source DF Adj SS Adj MS F-Value P-Value


C1 5 26189 5237.7 51.24 0.000
Error 24 2453 102.2
Total 29 28642

Model Summary

S R-sq R-sq(adj) R-sq(pred)


10.1103 91.43% 89.65% 86.62%

Means

C1 N Mean StDev 95% CI


100 mg/kg 5 38.60 9.67 ( 29.27, 47.94)
150 mg/kg 5 33.95 17.91 ( 24.62, 43.29)
50 mg/kg 5 49.77 10.48 ( 40.44, 59.10)
Negative control 5 0.000000 0.000000 (-9.331808, 9.331808)
Normal control 5 100.0 0.0 ( 90.7, 109.3)
Positive control 5 46.51 9.45 ( 37.18, 55.84)

Pooled StDev = 10.1103

Tukey Pairwise Comparisons

Grouping Information Using the Tukey Method and 95% Confidence

C1 N Mean Grouping
Normal control 5 100.0 A
50 mg/kg 5 49.77 B
Positive control 5 46.51 B
100 mg/kg 5 38.60 B
150 mg/kg 5 33.95 B
Negative control 5 0.000000 C
90

Means that do not share a letter are significantly different.

APPENDIX VI: Analysis of antipyretic activity of DCM root extract of C.


………………….abyssinica in Wistar albino rats

Descriptive Statistics: 0 hour, 1 hour, 2 hour, 3 hour, 4 hour

Variable C1 Mean SE Mean StDev


0 hour 100 mg/kg 0.000000 0.000000 0.000000
150 mg/kg 0.000000 0.000000 0.000000
50 mg/kg 0.000000 0.000000 0.000000
Negative control 0.000000 0.000000 0.000000
Normal control 0.000000 0.000000 0.000000
Positive control 0.000000 0.000000 0.000000

1 hour 100 mg/kg 0.680 0.539 1.206


150 mg/kg 1.137 0.156 0.348
50 mg/kg 0.812 0.561 1.254
Negative control -1.077 0.513 1.146
Normal control 0.211 0.157 0.351
Positive control 3.320 0.193 0.431

2 hour 100 mg/kg 1.829 0.676 1.512


150 mg/kg 2.480 0.343 0.768
50 mg/kg 2.525 0.476 1.065
Negative control -1.392 0.523 1.170
Normal control 0.215 0.155 0.347
Positive control 3.526 0.121 0.271

3 hour 100 mg/kg 2.876 0.799 1.786


150 mg/kg 3.359 0.331 0.740
50 mg/kg 2.384 0.532 1.190
Negative control -0.824 0.265 0.592
Normal control 0.002 0.121 0.270
Positive control 4.553 0.289 0.647

4 hour 100 mg/kg 2.879 0.788 1.761


150 mg/kg 3.203 0.446 0.997
50 mg/kg 2.436 0.463 1.036
Negative control -0.610 0.485 1.084
Normal control 0.054 0.309 0.690
Positive control 4.964 0.228 0.511

One-way ANOVA: 1 hour versus C1


Analysis of Variance

Source DF Adj SS Adj MS F-Value P-Value


C1 5 51.69 10.3373 13.00 0.000
Error 24 19.09 0.7954
Total 29 70.78
91

Model Summary

S R-sq R-sq(adj) R-sq(pred)


0.891872 73.03% 67.41% 57.86%

Means

C1 N Mean StDev 95% CI


100 mg/kg 5 0.680 1.206 (-0.144, 1.503)
150 mg/kg 5 1.137 0.348 ( 0.313, 1.960)
50 mg/kg 5 0.812 1.254 (-0.011, 1.635)
Negative control 5 -1.077 1.146 (-1.901, -0.254)
Normal control 5 0.211 0.351 (-0.612, 1.035)
Positive control 5 3.320 0.431 ( 2.497, 4.143)

Pooled StDev = 0.891872

Tukey Pairwise Comparisons

Grouping Information Using the Tukey Method and 95% Confidence

C1 N Mean Grouping
Positive control 5 3.320 A
150 mg/kg 5 1.137 B
50 mg/kg 5 0.812 B
100 mg/kg 5 0.680 B
Normal control 5 0.211 B C
Negative control 5 -1.077 C

Means that do not share a letter are significantly different.

One-way ANOVA: 2 hour versus C1

Analysis of Variance

Source DF Adj SS Adj MS F-Value P-Value


C1 5 81.16 16.2313 17.47 0.000
Error 24 22.30 0.9290
Total 29 103.45

Model Summary

S R-sq R-sq(adj) R-sq(pred)


0.963863 78.45% 73.96% 66.32%

Means

C1 N Mean StDev 95% CI


100 mg/kg 5 1.829 1.512 ( 0.940, 2.719)
150 mg/kg 5 2.480 0.768 ( 1.590, 3.369)
92

50 mg/kg 5 2.525 1.065 ( 1.635, 3.415)


Negative control 5 -1.392 1.170 (-2.281, -0.502)
Normal control 5 0.215 0.347 (-0.675, 1.104)
Positive control 5 3.526 0.271 ( 2.636, 4.416)

Pooled StDev = 0.963863

Tukey Pairwise Comparisons

Grouping Information Using the Tukey Method and 95% Confidence

C1 N Mean Grouping
Positive control 5 3.526 A
50 mg/kg 5 2.525 A
150 mg/kg 5 2.480 A
100 mg/kg 5 1.829 A B
Normal control 5 0.215 B C
Negative control 5 -1.392 C

Means that do not share a letter are significantly different.

One-way ANOVA: 3 hour versus C1


Analysis of Variance

Source DF Adj SS Adj MS F-Value P-Value


C1 5 106.15 21.2295 21.25 0.000
Error 24 23.97 0.9989
Total 29 130.12

Model Summary

S R-sq R-sq(adj) R-sq(pred)


0.999464 81.58% 77.74% 71.21%

Means

C1 N Mean StDev 95% CI


100 mg/kg 5 2.876 1.786 ( 1.954, 3.799)
150 mg/kg 5 3.359 0.740 ( 2.437, 4.282)
50 mg/kg 5 2.384 1.190 ( 1.461, 3.306)
Negative control 5 -0.824 0.592 (-1.747, 0.098)
Normal control 5 0.002 0.270 (-0.920, 0.925)
Positive control 5 4.553 0.647 ( 3.631, 5.476)

Pooled StDev = 0.999464

Tukey Pairwise Comparisons

Grouping Information Using the Tukey Method and 95% Confidence

C1 N Mean Grouping
Positive control 5 4.553 A
93

150 mg/kg 5 3.359 A B


100 mg/kg 5 2.876 A B
50 mg/kg 5 2.384 B
Normal control 5 0.002 C
Negative control 5 -0.824 C

Means that do not share a letter are significantly different.

One-way ANOVA: 4 hour versus C1


Analysis of Variance

Source DF Adj SS Adj MS F-Value P-Value


C1 5 108.24 21.647 18.34 0.000
Error 24 28.32 1.180
Total 29 136.56

Model Summary

S R-sq R-sq(adj) R-sq(pred)


1.08637 79.26% 74.94% 67.59%

Means

C1 N Mean StDev 95% CI


100 mg/kg 5 2.879 1.761 ( 1.876, 3.881)
150 mg/kg 5 3.203 0.997 ( 2.200, 4.206)
50 mg/kg 5 2.436 1.036 ( 1.433, 3.439)
Negative control 5 -0.610 1.084 (-1.613, 0.393)
Normal control 5 0.054 0.690 (-0.948, 1.057)
Positive control 5 4.964 0.511 ( 3.961, 5.966)

Pooled StDev = 1.08637


Tukey Pairwise Comparisons

Grouping Information Using the Tukey Method and 95% Confidence

C1 N Mean Grouping
Positive control 5 4.964 A
150 mg/kg 5 3.203 A B
100 mg/kg 5 2.879 A B
50 mg/kg 5 2.436 B
Normal control 5 0.054 C
Negative control 5 -0.610 C

Means that do not share a letter are significantly different.

APPENDIX VII: Analysis of anti-inflammatory activity of DCM root


……………………extract of C.abyssinica in Swiss albino mice

Descriptive Statistics: 0 hour, 1 hour, 2 hour, 3 hour, 4 hour


Variable C1 Mean SE Mean StDev
0 hour 100 mg/kg 0.000000 0.000000 0.000000
150 mg/kg 0.000000 0.000000 0.000000
50 mg/kg 0.000000 0.000000 0.000000
Negative control 0.000000 0.000000 0.000000
Normal control 0.000000 0.000000 0.000000
94

Positive control 0.000000 0.000000 0.000000

1 hour 100 mg/kg 1.8774 0.0518 0.1159


150 mg/kg 3.300 0.143 0.320
50 mg/kg 0.884 0.184 0.412
Negative control -2.401 0.240 0.537
Normal control 0.0816 0.0816 0.1825
Positive control 2.2090 0.0851 0.1903

2 hour 100 mg/kg 3.036 0.223 0.498


150 mg/kg 3.761 0.287 0.641
50 mg/kg 1.470 0.276 0.616
Negative control -3.464 0.424 0.949
Normal control 0.0778 0.0778 0.1740
Positive control 3.567 0.243 0.544

3 hour 100 mg/kg 3.586 0.232 0.519


150 mg/kg 4.642 0.206 0.460
50 mg/kg 1.608 0.560 1.252
Negative control -4.348 0.343 0.767
Normal control 0.1621 0.0993 0.2221
Positive control 5.011 0.301 0.674

4 hour 100 mg/kg 4.305 0.221 0.494


150 mg/kg 5.359 0.182 0.408
50 mg/kg 1.839 0.602 1.347
Negative control -4.735 0.320 0.717
Normal control 0.0806 0.0806 0.1803
Positive control 5.356 0.352 0.788
One-way ANOVA: 1 hour versus C1

Method

Null hypothesis All means are equal


Alternative hypothesis At least one mean is different
Significance level α = 0.05

Equal variances were assumed for the analysis.

Factor Information

Factor Levels Values


C1 6 100 mg/kg, 150 mg/kg, 50 mg/kg, Negative control, Normal
control, Positive
control

Analysis of Variance

Source DF Adj SS Adj MS F-Value P-Value


C1 5 99.726 19.9452 186.10 0.000
Error 24 2.572 0.1072
Total 29 102.298

Model Summary
95

S R-sq R-sq(adj) R-sq(pred)


0.327375 97.49% 96.96% 96.07%

Means

C1 N Mean StDev 95% CI


100 mg/kg 5 1.8774 0.1159 ( 1.5752, 2.1796)
150 mg/kg 5 3.300 0.320 ( 2.997, 3.602)
50 mg/kg 5 0.884 0.412 ( 0.582, 1.186)
Negative control 5 -2.401 0.537 ( -2.704, -2.099)
Normal control 5 0.0816 0.1825 (-0.2205, 0.3838)
Positive control 5 2.2090 0.1903 ( 1.9069, 2.5112)

Pooled StDev = 0.327375

Tukey Pairwise Comparisons

Grouping Information Using the Tukey Method and 95% Confidence

C1 N Mean Grouping
150 mg/kg 5 3.300 A
Positive control 5 2.2090 B
100 mg/kg 5 1.8774 B
50 mg/kg 5 0.884 C
Normal control 5 0.0816 D
Negative control 5 -2.401 E

Means that do not share a letter are significantly different


One-way ANOVA: 2 hour versus C1
Analysis of Variance

Source DF Adj SS Adj MS F-Value P-Value


C1 5 191.784 38.3568 101.56 0.000
Error 24 9.064 0.3777
Total 29 200.848

Model Summary

S R-sq R-sq(adj) R-sq(pred)


0.614545 95.49% 94.55% 92.95%

Means

C1 N Mean StDev 95% CI


100 mg/kg 5 3.036 0.498 ( 2.468, 3.603)
150 mg/kg 5 3.761 0.641 ( 3.194, 4.328)
50 mg/kg 5 1.470 0.616 ( 0.902, 2.037)
Negative control 5 -3.464 0.949 ( -4.031, -2.897)
Normal control 5 0.0778 0.1740 (-0.4894, 0.6450)
Positive control 5 3.567 0.544 ( 3.000, 4.134)

Pooled StDev = 0.614545


96

Tukey Pairwise Comparisons

Grouping Information Using the Tukey Method and 95% Confidence

C1 N Mean Grouping
150 mg/kg 5 3.761 A
Positive control 5 3.567 A
100 mg/kg 5 3.036 A
50 mg/kg 5 1.470 B
Normal control 5 0.0778 C
Negative control 5 -3.464 D

Means that do not share a letter are significantly different

One-way ANOVA: 3 hour versus C1


Analysis of Variance

Source DF Adj SS Adj MS F-Value P-Value


C1 5 310.45 62.0897 118.64 0.000
Error 24 12.56 0.5234
Total 29 323.01

Model Summary

S R-sq R-sq(adj) R-sq(pred)


0.723431 96.11% 95.30% 93.92%

Means

C1 N Mean StDev 95% CI


100 mg/kg 5 3.586 0.519 ( 2.919, 4.254)
150 mg/kg 5 4.642 0.460 ( 3.975, 5.310)
50 mg/kg 5 1.608 1.252 ( 0.940, 2.276)
Negative control 5 -4.348 0.767 ( -5.015, -3.680)
Normal control 5 0.1621 0.2221 (-0.5057, 0.8298)
Positive control 5 5.011 0.674 ( 4.343, 5.679)

Pooled StDev = 0.723431

Tukey Pairwise Comparisons

Grouping Information Using the Tukey Method and 95% Confidence

C1 N Mean Grouping
Positive control 5 5.011 A
150 mg/kg 5 4.642 A B
100 mg/kg 5 3.586 B
50 mg/kg 5 1.608 C
Normal control 5 0.1621 D
Negative control 5 -4.348 E
97

Means that do not share a letter are significantly different

One-way ANOVA: 4 hour versus C1


Analysis of Variance

Source DF Adj SS Adj MS F-Value P-Value


C1 5 384.61 76.9215 136.11 0.000
Error 24 13.56 0.5652
Total 29 398.17

Model Summary

S R-sq R-sq(adj) R-sq(pred)


0.751771 96.59% 95.88% 94.68%

Means

C1 N Mean StDev 95% CI


100 mg/kg 5 4.305 0.494 ( 3.611, 4.998)
150 mg/kg 5 5.359 0.408 ( 4.665, 6.052)
50 mg/kg 5 1.839 1.347 ( 1.145, 2.533)
Negative control 5 -4.735 0.717 ( -5.429, -4.041)
Normal control 5 0.0806 0.1803 (-0.6132, 0.7745)
Positive control 5 5.356 0.788 ( 4.662, 6.050)

Pooled StDev = 0.751771

Tukey Pairwise Comparisons

Grouping Information Using the Tukey Method and 95% Confidence

C1 N Mean Grouping
150 mg/kg 5 5.359 A
Positive control 5 5.356 A
100 mg/kg 5 4.305 A
50 mg/kg 5 1.839 B
Normal control 5 0.0806 C
Negative control 5 -4.735 D

Means that do not share a letter are significantly different

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