A Reverse Pharmacology approach for evaluating traditional medicines
A Reverse Pharmacology approach for evaluating traditional
in the Republic of Palau
to improve the management of obesity-linked diabetes
Jolle Houriet1, Christopher Kitalong2, Renata Campos Nogueira3, Carla Rudigier4, Jeanne Benichou5, Victor Yano2, Vanessa
Espangel2, Pearl L. Marumoto 2, Josepha Tiobech2, Christian Wolfrum4, Jean-Luc Wolfender1, Bertrand Graz2, 3
School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Rue Michel-Servet 1, 1206 Geneva,
Pacific Academic Institute for Research, 822 Ernguul Rd., Koror, Palau
Antenna Foundation, Avenue de la Grenade 24, 1207 Geneva, Switzerland
Institute of Food, Nutrition and Health, ETH Zurich, Schorenstrasse 16, CH-8603 Schwerzenbach, Switzerland .
ENSAT-National Institute of Agronomy and Environment of Toulouse, Avenue de lAgrobiopole, BP 32607 AuzevilleTolosane, France
An important recommendation of the World
Health Organization is the evaluation of
ethnopharmacological methodology which aims
precisely to evaluate traditional practices .
It includes three main stages:
1. Selection of medicinal herbs
2. Clinical evaluation
3. Laboratory studies
implemented in the Republic of Palau to improve
overweight and obese
adults of around 80 %,
according to WHO data.
Declaration of State of Emergency on
Non-Communicable Diseases in 2011
(obesity-linked diseases, i.e. diabetes and
1. Selection of medicinal herbs
Selection by a Retrospective Treatment
statistically identified the remedies
correlating with the best clinical
The drink of the leaves of Phaleria
correlated with the lower blood sugar
This drink is also called by the Palauan
population Delal A Kar, the Mother of
2. Clinical evaluation
This first clinical study ever organized
in Palau was designed as a pilot
randomized, double-blind, crossover
The drink of Phaleria nisidai was
evaluated as an an adjuvant therapy
for patients with insufficient diabetes
Patients with insufficient diabetes
control improved their glycemia during
the clinical study (reduction of HbA1C).
Decreased blood pressure and weight
reduction were also observed .
established between the
Pacific Academic Institute of
Research (PAIR) and both
Clinical study on nontreated diabetic patients,
compared to the
Identification of the
bioactive components to
select markers for
Mice fed a high fat diet with
Higher insulin secretion
The freeze-dried drink is
characterized by a high
amount of the C-glycoside
xanthone mangiferin and
Advantages of the Reverse
This study succeeded in identifying a promising herbal
medicine to improve diabetes control.
Valorization of traditional medicine made by the
Prioritization of the clinical evaluation of the selected
medicinal herb at the beginning of the drug development
Highly valuable post-clinical laboratory studies thanks to
the preliminary clinical evaluation.
Low cost compared to the
classic drug development
1.Willcox M., et al., A "reverse pharmacology" approach for developing an anti-malarial phytomedicine. Malar J, 2011. 10 Suppl 1: p.
2.Graz B., et al., Screening of traditional herbal medicine: First, do a retrospective study, with correlation between diverse treatments
used and reported patient outcome. J Ethnopharmacol, 2005. 101(13): p. 338-339.
3.Graz B., et al., Traditional local medicines in the republic of Palau and non-communicable diseases (NCD), signs of effectiveness. J
Ethnopharmacol, 2015. 161: p. 233-7.
4.Kitalong C., et al., "DAK", a traditional decoction in Palau, as adjuvant for patients with insufficient control of diabetes mellitus type
II. J Ethnopharmacol, 2017. 205: p. 116-122.
5.Kitalong C., et al., Phenolics from Phaleria nisidai with Estrogenic Activity. Records of Natural Products, 2012. 6(3): p. 296-300.
Icons from Noun Project:
Gan Khoon Lay (overweight humans), Corpus
delicti (Choose pharmacy), Eucalyp (diabetes),
Wilson Joseph (population), Juan Manueal Corredor
(human), Dinosoft Labs (agreement), Alina Oleynik
(mouse), Juraj Sedlka (molecule), Meaghan
Hendricks (future), Gan Khoon Lay (advantages).
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