Analysis of floristic composition and species diversity of vascular plants native to the State of Palestine (West Bank and Gaza Strip).

This study aims at providing an updated checklist of the native vascular flora of the Palestinian West Bank and Gaza Strip (State of Palestine, SP), serving as a taxonomic and nomenclatural basis for botanical research and encouraging new floristic surveys and biosystematic studies. The study provides an up-to-date checklist of native vascular taxa of the SP and their distribution within the plant districts in the country. This is the very first annotated checklist for the native vascular plants of the SP which incorporates recent name changes, new distribution records, habitat, herbarium specimens catalouge, Red List criteria, wild edible plants, endemism and use in Traditional Palestinian Herbal Medicine. The quantitative analysis of the flora has shown that the SP hosts 1826 taxa, distributed in 686 genera and 108 families; five taxa are gymnosperms, nine taxa are Pteridophytes and 1812 taxa are angiosperms. The most represented families are Leguminosae (222 taxa, 12.2%), Asteraceae (197, 10.2%) and Poaceae (196, 10.7%), while the most represented genera are Trifolium (38, Leguminosae), Silene (32, Caryophyllaceae), Astragalus (27, Leguminosae), Medicago (26, Leguminosae), Allium (25, Amaryllidaceae) and Euphorbia (25, Euphorbiaceae). Annuals (52.4%), Hemicryptophytes (20.2%) and Chamaephytes (12.2%) are the most represented life-forms amongst the SP flora. The richest plant districts in the SP vascular plant taxa are Gaza Strip (GS) (1216 taxa), Jerusalem and Hebron Mountains (JHM) (1235) and Nablus Mountains (NM) (1126). Agglomerative hierarchical clustering (AHC) permitted the division of SP into two main regions, based on the existence of vascular plant taxa: Region 1 (western plant districts with 1128-1237 taxa) with higher water availability and temperate Mediterranean climate which permit the establishment of more than 65% of the total SP flora in these districts and Region 2 (eastern plant districts with 571-698 taxa), characterised by desert and semi-desert conditions, as well as the presence of alluvial and co-alluvial soils, which allow the survival of lower numbers of plant taxa. One hundred and sixty-five taxa of the SP flora are endemic and near-endemic. However, in comparison with some countries of the Mediterranean Basin, this number is below the average endemism concentration, along with other southern arid countries, such as Tunisia and Egypt. In total, there are 102 threatened plant taxa, belonging to 39 families and 83 genera representing 5.6% of the total plants in the SP. IUCN and the Conservation Measures Partnership (CMP) unified classification of direct threats for SP Red-Listed plants has shown a high extinction risk to the Palestinian threatened wild flora, with 76.5% of the threatened species being either critically endangered (CR) or endangered (EN); only 23.5% were vulnerable (VU). However, several taxa are threatened by numerous factors including small population size, human activities, for example, conversion of traditional to intensive agriculture accompanied by deep ploughing and the application of pesticides, urban development and construction, global climatic change, drying of marshes and wetlands, quarrying, fires and pollution. This checklist can help focus conservation efforts and provide a framework for research, protection and policy applications for the SP flora, especially for the endemic and threatened plants.

Isolation, identification, and antimycotic activity of plumbagin from Plumbago europaea L. roots, leaves and stems.

Plumbago europaea L. is a plant utilized in Palestinian ethnomedicine for the treatment of various dermatological diseases. The current investigation was designed to isolate plumbagin from P. europaea leaves, roots and for the first time from the stems. Moreover, it aimed to evaluate the antimycotic activity against three human fungal pathogens causing dermatophytosis, also against an animal fungal pathogen. The qualitative analysis of plumbagin from the leaves, stems, and roots was conducted using HPLC and spectrophotometer techniques, while the structure of plumbagin was established utilizing Proton and Carbon-13 Nuclear Magnetic Resonance (NMR) and Infrared (IR) techniques. The entire plant constituents were determined by GC-MS. Moreover, the antimycotic activity against Ascosphaera apis, Microsporum canis, Trichophyton rubrum, and Trichophyton mentagrophytes was assessed utilizing the poison food technique method. The percentage of plumbagin recorded in the leaves, stems, and roots was found to be 0.51±0.001%, 0.16±0.001%, and 1.65±0.015%, respectively. The GC-MS examination declared the presence of 59 molecules in the plant extract. The plant extract and pure plumbagin exhibited complete inhibition against all tested dermatophytes at 6.0mg/mL for the extracts and 0.2mg/mL for plumbagin. P. europaea root is the best source of plumbagin and the plant extract could represent a potential drug candidate for the treatment of dermatophytosis infections. Further studies required to design suitable dosage forms from the natural P. europaea root extracts or plumbagin alone, to be utilized for the treatment of dermatological and veterinary ailments.

Detection and Phylogenetic Analysis of Viruses Linked with Fig Mosaic Disease in Seventeen Fig Cultivars in Palestine.

Fig mosaic is a viral disease (FMD) that spreads in Palestinian common fig ( Ficus carica L.) orchards. Recognizing the economic value of fig plants and the harmful nature of FMD, the disease poses a significant threat to the economy of the fig production in Palestine. We applied the reverse transcription and amplification (RT-PCR) and PCR technique to leaf samples of 77 trees and 14 seedlings of 17 fig cultivars. The samples were collected from orchards in the main fig-growing provinces of the Palestinian West Bank, to assess the prevalence of viruses associated with FMD, and confirm a possible link of symptoms with viruses detected. Four viruses were detected: Fig mosaic virus (FMV), Fig badnavirus-1 (FBV-1), Fig leaf mottle-associated virus 2 (FLMaV-2), and Fig fleck-associated virus (FFkaV). FMV and FBV-1 were found in all tested fig plants (100%), while FLMaV-2 and FFkaV were detected in 61.5% and 33% of the fig samples, respectively. The high incidence of FBV-1 in the newly propagated symptomatic and symptomless seedlings from different cultivars may be an indication that FBV-1 is integrated into the genome of the fig in a cultivar nondiscriminatory manner. Very weak or no association was detected between FMD symptoms severity in the 17 Palestinian fig cultivars with the various viruses' combinations observed (i.e., number of the viruses infecting the plant). These results support the notion that FMD symptom severity expression is likely to be controlled by a combination of FMV infection, cultivars, and environmental factors, rather than the number of viruses infecting the plant.

Effects of selected Palestinian plants on the in vitro exsheathment of the third stage larvae of gastrointestinal nematodes.

BACKGROUND: Gastrointestinal parasites are one of the main restrictions to small ruminant production. Their pathological importance is primarily related to the major production losses, in quantity or quality, induced by the direct action of worms. Control of these parasites is based exclusively on the frequent use of anthelmintic drugs. However, the resistance to anthelmintics in worm populations after commercialisation of chemical drugs is now widespread. Therefore, there is a need to find new natural resources to ensure sustainable and effective treatment and control of these parasites. The aim of this study was to evaluate the anthelmintic activity, as minimum inhibitory concentration (IC 50 mg/mL), of different plant extracts using larval exsheathment inhibition assay using a two-species but steady population of parasitic nematodes (ca. 20% Teladorsagia circumcinta and 80% Trichostrongylus colubriformis). RESULTS: The study showed that the ethanolic extracts of 22 out of the 48 plant extracts, obtained from 46 plant species, have an inhibitory effect >50% (at concentrations of 100 mg/mL) on the third stage larvae (L3) of the nematodes exhibited the strongest inhibition activity (94%) with IC 50 of 0.02 mg/mL, where other members of the Rhamnaceae family have shown to possess strong anthelmintic activity (70-89%). CONCLUSIONS: Plant extracts are potential rich resources of anthelmintics to combat helminthic diseases. Our results suggest that extracts from Rhamnus elaternus, Epilobium hirsutum, Leucaena leucocephala and Rhamnus palaestinus have promising anthelmintic activity, with potential applications in animal therapeutics and feed.

Exploring an herbal "wonder cure" for cancer: a multidisciplinary approach.

CONTEXT AND OBJECTIVES: The unmonitored use of herbal medicinal remedies by patients with cancer presents a significant challenge to oncology healthcare professionals. We describe an increasingly popular herbal "wonder drug," Ephedra foeminea (Alanda in Arabic), whose use has spread from the Palestinian patient population throughout the Middle East. We conducted a multicentered and multidisciplinary collaborative research effort in order to understand the potential benefits and harms of this popular herbal remedy. METHODS: We conducted an in-depth search of the medical literature, both traditional and modern, for any mention of the clinical use of Alanda for the treatment of cancer. We then tested the remedy, first for toxic ephedra alkaloid components and then for anticancer effects, as well as effects on the cytotoxic activity of chemotherapy agents (cisplatin and carboplatin) on breast cancer cell cultures. RESULTS: We found no mention in the literature, both conventional and traditional, on the use of Alanda for the treatment of cancer. Laboratory testing did not find any toxic components (i.e., ephedra alkaloids) in the preparation. However, in vitro exposure to Alanda led to a reduced cytotoxic effect of chemotherapy on breast cancer cell cultures. CONCLUSIONS: The use of an integrative ethnobotanical, laboratory and clinical research-based approach can be extremely helpful when providing nonjudgmental and evidence-based guidance to patients with cancer, especially on the use of traditional herbal medicine. The effectiveness and safety of these products need to be examined by integrative physicians who are dually trained in both complementary medicine and supportive cancer care.

Compared perspectives of Arab patients in Palestine and Israel on the role of complementary medicine in cancer care.

CONTEXT: Complementary medicine (CM) is extensively used by patients with cancer across the Middle East. OBJECTIVES: We aimed to compare the perspectives of two Arab populations residing in diverse socioeconomic-cultural settings in Palestine and Israel regarding the role of CM in supportive cancer care. METHODS: A 27-item questionnaire was constructed and administered to a convenience sample of Arab patients receiving cancer care in four oncology centers in northern Israel and Palestine. RESULTS: Each of the two groups had 324 respondents and was equally distributed by age and marital status. Compared with the Israeli-Arab group, Palestinian participants reported significantly higher CM use for cancer-related outcomes (63.5% vs. 39.6%, P < 0.001), which included more herbal use (97.6% vs. 87.9%, P = 0.001) and significantly lower use of dietary supplements, acupuncture, mind-body and manual therapies, and homeopathy. Most respondents in both groups stated that they would consult CM providers if CM was integrated in oncology departments. Related to this theoretical integrative scenario, Palestinian respondents expressed fewer expectations from their oncologists to actively participate in building their CM treatment plan. Treatment expectations in both groups focused on improving quality of life (QOL), whereas Palestinian respondents had fewer expectations for CM to improve fatigue, emotional concerns, sleep, and daily functioning. CONCLUSION: Arab patients with cancer from Palestine and Israel highly support CM integration within their oncology institutions aiming to improve QOL. Nevertheless, respondents differed in their perceived model of CM integration, its treatment objectives, and their oncologists' role in CM integration.

In vitro antioxidant and antitumor activities of six selected plants used in the Traditional Arabic Palestinian herbal medicine.

CONTEXT: Despite several pharmacological applications of the medicinal plants in the Traditional Arabic Palestinian Herbal Medicine in Palestine (TAPHM), studies on their antioxidant properties are still scarce. OBJECTIVE: This work evaluates the antioxidant and antitumor activities of the ethanol extracts from different parts of six plants: [Arum palaestinum Boiss (Araceae), Urtica pilulifera L. (Urticaceae), Coridothymus capitatus (L.) Reichb (Lamiaceae), Majorana syriaca (L.) Rafin. (Lamiaceae), Teucrium creticum L. (Lamiaceae), and Teucrium capitatum L. (Lamiaceae)] used in the TAPHM. MATERIALS AND METHODS: The antioxidant activity was evaluated for the ethanol extracts by DPPH and ß-carotene-linoleic acid assays together with total contents of phenols and flavonoids. For the anti-carcinogenic evaluation, the extracts were tested for the ability to inhibit the proliferation of breast cancer cells (MCF-7) using the MTT reduction assay. RESULTS: Among the extracts, the U. pilulifera had the highest amount of total phenolics, possessing the second highest total flavonoids. It also showed a maximum cytotoxic activity (IC50 = 63 µg/ml), followed by C. capitatus, and A. palaestinum. Otherwise, the extract of T. creticum was demonstrated to be an efficient scavenger of O2 (IC50 = 83 µg/ml), followed by M. syriaca, C. capitatus, T. capitatum, A. palaestinum, and U. pilulifera. DISCUSSION AND CONCLUSION: The results suggest that the investigated plants have shown varied antioxidant capacities which were strongly correlated with their contents of phenolics. Accordingly, this study proposes that the therapeutic benefit of these plants can be, at least in part, attributed to its potential inhibition of oxidative processes.

Integrative oncology research in the Middle East: weaving traditional and complementary medicine in supportive care.

INTRODUCTION: Complementary and alternative medicine (CAM) has an important role in supportive cancer care in the Middle East and is often used in association with traditional medicine. This article provides a comprehensive review of published data on CAM research in supportive cancer care in the Middle East. METHODS AND RESULTS: A multi-disciplinary Middle-Eastern Research Group in Integrative Oncology (MERGIO) was established in six countries. Authors independently searched Medline database for articles in Arabic, Hebrew, French, and Turkish using oncology and CAM-related keywords. Articles were recorded according to the first author's affiliation with an academic or clinical institution in the Middle East. RESULTS: We identified 143 articles on CAM and cancer care that had been published in 12 Middle-Eastern countries. Eighty-five articles were directly related to cancer supportive care. The latter included studies on the prevalence of CAM use by patients with cancer, aspects related to of doctor-patient communication, ethics and regulation, psychosocial aspects of CAM, CAM safety and quality assurance, studies of CAM education for health care providers, and ethno-botanical studies and reviews. Twenty-eight articles referred to clinical research on supportive care, and the use of specific CAM modalities that included acupuncture, anthroposophic medicine, dietary and nutritional therapies herbal medicine, homeopathy, mind-body medicine, shiatsu, therapeutic touch, and yoga. CONCLUSIONS: CAM-related supportive care research is prevalent in the Middle East, a fact that may serve as a basis for future multinational-multidisciplinary research work in supportive care in oncology.