Artemisia annua, also known as sweet wormwood, sweet annie, sweet sagewort, annual mugwort[or annual wormwood, is a common type of wormwood native to temperate Asia, but naturalized in many countries including scattered parts of North America.
Research to develop antimalarial drugs led to the discovery of artemisinin, a compound which is extracted from Artemisia annua, in the 1970s by Chinese scientist Tu Youyou, for which she shared the 2015 Nobel Prize in Physiology or Medicine.
While most TCM herbs are boiled at high temperature that can damage the active ingredient in Artemisia annua, one traditional source says that this herb is to be steeped in cold water; knowing this, scientists found that a better extract was obtained by using a low-temperature ether-based extraction method.
Purification processes were used to isolate the active molecule, and clinical trials showed the active ingredient to be an effective drug.
Artemisinin is a sesquiterpene lactone with an endoperoxide bridge and has been produced semisynthetically as an antimalarial drug. The efficacy of tea made from A. annua in the treatment of malaria is dubious.
Research has found that artemesinin is not soluble in water and the concentrations in these infusions are considered insufficient to treat malaria. In 2004, the Ethiopian Ministry of Health changed Ethiopia’s first line antimalaria drug from sulfadoxine/pyrimethamine (Fansidar), which has an average 36% treatment failure rate, to artemether/lumefantrine (Coartem), a drug therapy containing artemesinin which is 100% effective when used correctly, despite a worldwide shortage at the time of the needed derivative from A. annua.
A 2012 review said that artemisinin-based remedies are the most effective drugs for the treatment of malaria.
A 2013 review suggested that although Artemisia annua may not cause hepatotoxicity, haematotoxicity, or hyperlipidemia, it should be used cautiously during pregnancy due to a potential risk of embryotoxicity at a high dose.
Despite global efforts in combating malaria, it remains a large burden for the population, particularly in tropical and subtropical regions. Although WHOrecommends artemisinin-based remedies for treating uncomplicated malaria, artemisinin resistance can no longer be ignored.
The causes that affected the emergence of artemisinin resistance include, for example, the use of artemisinin-based remedies. Encouraging herbal alternatives are in the pipeline, but the only indelible solution for the eradication of malaria would be for the creation of an effective vaccination.
Emergence of artemisinin resistance has been identified in Cambodia and the border of Thailand.It will likely spread to other endemic areas across the world in the impending future.As of 2013, it seems that the pathogenic agent of malaria is becoming resistant to artemisinin-based drugs.