Artemisia annua, also known as sweet wormwood, is a plant with a long history of use in traditional Chinese medicine. Here's what it's primarily been used for:

• Malaria: Artemisinin, a potent compound extracted from Artemisia annua, is a key component in the most effective antimalarial treatments available. Traditionally, the plant was used as a tea or pressed for its juice to combat malaria.

  

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  Artemisia annua plant

• Fever: Its antipyretic (fever-reducing) properties made it a traditional remedy for various types of fevers.
• Inflammation: The plant was used to address inflammatory conditions.
•  

Other Traditional Uses:

• Headaches
• Bleeding
• Jaundice
• Bacterial dysentery
• Tuberculosis
•  

Important Notes:

• Modern Medicine: The discovery of artemisinin revolutionized malaria treatment. While traditional use focused on the whole plant, modern treatments rely on the isolated, active compound.
• Research: Ongoing research explores the potential of Artemisia annua and its derivatives for other conditions, including cancer.

As always, consult a healthcare provider before using Artemisia annua for medicinal purposes.

Artemisia Afra

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Chinese wormwood

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Artemisia annuaArtemisia annua

Summary

• 1Plant Name
• 2International Latin denomination
• 3Botanical family
• 4Description and habitat
• 5History and tradition
• 6Parts used
• 7Dosage forms available
• 8Usual dosages
• 9Composition
  • 9.1Main components of the plant
  • 9.2Main components of buds or young shoots
  • 9.3Main components of essential oil
• 10Properties
  • 10.1Properties of the plant
  • 10.2Properties of the bud
  • 10.3Properties of essential oil
• 11Indications
  • 11.1Indications for the whole plant (phytotherapy)
  • 11.2Bud indications (gemmotherapy)
  • 11.3Specific indications for essential oil (aromatherapy)
• 12Known or suspected mode of action
• 13Usual formulations
• 14Regulation
• 15Possible side effects and precautions for use
• 16Bibliographic references

Plant Name

Chinese wormwood, Quinghao , Chinese mugwort

International Latin denomination

Artemisia annua L.

Botanical family

Asteraceae

Description and habitat

• Fragrant annual herbaceous plant, with palmate leaves covered with fine bristles, small globular flower heads measuring 2 to 3 mm with a whitish involucre
• The fruits are small achenes (12,000 seeds per gram)
• Native to Asia, present in Mediterranean regions

History and tradition

• Traditional Chinese medicine used it to treat fevers and malaria
• Chinese researcher Youyou Tu, research director at the Academy of Traditional Chinese Medicine, received the Nobel Prize in Medicine in 2015 for her work on artemisinin in malaria, since the 1960s [1] , [2] , [3] , [4] , [5] , [6]

Parts used

• Leaves

Dosage forms available

Usual dosages

• Dosage of three to ten grams of dry plant in the form of decoction, fresh juice or even fresh plants, according to the Jardins du Monde association
  • Other sources advise the dosage of five to ten grams per day

Composition

Main components of the plant

• Sesquiterpene lactone  : artemisinin (0.01 to 0.5%)
  • Selected plants can produce 1.3% artemisinin
• Essential oil  : artemisia-ketone , 1,8-cineole , alpha-pinene and beta-pinene , ( abrotamine , beta-bourbonene  ?)
• Flavonoids  : apigenin , luteolin , rhamnetin , isorhamnetin , quercetin and derivatives, kaempferol , casticin , axillarin , eupatin , astragalin , mikanin , chrysoplenol , eupatorin , chrysoeriol , cynaroside , chrysin , retusine , laricitrin , gossypetin , myricetin , tamarixetine , artemetine , cirsimaritin , cirsilineol , acacetin
• Polyines , coumarins

Main components of buds or young shoots

Main components of essential oil

• Camphor (44%), germacrene D (16%), trans-pinocarveol (11%), beta-selinene (9%), beta-caryophyllene (9%), artemisia ketone (3%)

Properties

Properties of the plant

• Artemisinin is antimalarial, schizonticidal (curative and not prophylactic) [7] , although it seems very active in prevention [8]
  • Artemisinin rapidly penetrates erythrocytes and acts on the early stages of schizont maturation by accumulating in the parasite wall which then becomes inactive
• Inhibits the growth of Plasmodium falciparum at 10 power -7
• The concentration of artemisinin is low in the plant (0.18 ±0.02) but the effectiveness of Chinese mugwort infusion in malaria is due to synergies [9]
  • Synergistic effect of artemisinin with various flavonoids which suppress the enzymatic activity of cytochromes P450 responsible for disturbances in its metabolism ( apigenin , luteolin , rhamnetin , isorhamnetin , quercetin and derivatives, kaempferol , casticin , axillarin , eupatin , astragalin , mikanin , chrysoplenol [ 10 ] _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
• Total extracts have greater activity than isolated compounds [11] , and other synergies can be sought (such as artemisinin + curcumin + piperine ) or combinations of medicinal plants (such as Artemisia annua leaves + root of Curcuma longa + Piper nigrum seeds ), which can improve the effectiveness of herbal remedies and is the basis of traditional medicine [12]
• The arguments in favor of a superiority of action of the traditional preparation of totum plant compared to the purified drug are not yet validated, although the activity is present, despite a low content and bioavailability of artemisinin. in traditional formulations of Artemisia annua [13]
• Artemisinin is relatively poorly soluble in water and lipids .
• Antifungal [14]
• Anti-allergic [15]
• Anticancer potentials of artemisinin and its derivatives ( dihydroartemisinin , artesunate , artemether , arteether ): reduction of oxidative stress by reactive oxygen species and nitric oxide, DNA repair, apoptosis, autophagy, inhibition of angiogenesis and tumor-related signal transduction pathways [16] , and especially artesunate [17] , [18] , see bibliography of artemisinin
• Anti-tumor synergies with casticin (see the bibliography)
• Artesunate improves short-term memory in chronic Lyme borreliosis [19]
• Antiviral:
  • Potential for HIV ( dicaféylquinic acid and synergies) [20]
  • Antiherpetic ( Herpes Simplex virus type l HSV1) [21]
  • Potential for SARS-CoV-2 [22] , [23] , [24]
  • Potential in Lyme disease (activity against Borrelia burgdorferi ), as well as Cryptolepis sanguineolenta , Juglans nigra , Polygonum cuspidatum , Uncaria tomentosa , Cistus incanus , Scutellaria baicalensis [25]
• Species of the Artemisia genus are thought to have properties mainly on the central nervous system and the cardiovascular system [26]
• Artemisia vulgaris appears to possess the same antimalarial activity as Artemisia annua , in areas where this is not available (e.g. Sri Lanka) [27] , [28] , [29]

Properties of the bud

Properties of essential oil

• Antibacterial (Gram-positive germs) and antifungal [30] , [31]

Indications

Indications for the whole plant (phytotherapy)

• Malaria: artemisinin derivatives such as arteether , artemether
• Used in China and India, could be used as first-line treatment in malarious countries [32]
  • The powder at a dose of 1 g/day seems likely to cure malaria resistant to combined therapies and artesunate [33].
  • A randomized, double-blind clinical study on 957 patients suffering from malaria in the DRC (Democratic Republic of Congo) shows that under Artemisia annua or Artemisia afra , the cure rate is higher than that obtained with an artesunate-amodiaquine combination [34] , although that Artemisia afra does not contain artemisinin
• Schistosomiasis (with Artemisia afra ) [35]

Bud indications (gemmotherapy)

Specific indications for essential oil (aromatherapy)

Known or suspected mode of action

Usual formulations

• Use as an antimalarial Aassociation Artemisia annua, a plant against malaria  :
  • Artemisia annua has proven to be effective as a curative and not preventive measure against serious forms of malaria (in particular against Plasmodium falciparum which has become resistant to conventional drugs in many places). It is therefore a simple alternative within the reach of populations subject to this scourge.
  • Good results are obtained with cures in the form of herbal teas:
    • When to use it?
      • At the time of fever
    • How to use it ?
      • As a herbal tea: Boil 1 liter of water then add 10 g of dried leaves, drink during the day. It is recommended to drink 1 liter of this herbal tea per day for 5 days.
      • In capsules: The administration of Artemisia annua powder in capsules is significantly simpler and apparently more effective than administration in herbal tea. However, administration in capsules comes up against their manufacturing and distribution costs and in our eyes it remains imperfectly adapted for the large-scale use of Artemisia annua. The promotion of local production of Artemisia annua and its use in herbal tea therefore remains for us currently the best method of prevention and treatment of malaria and to be disseminated in the poorest countries.

Regulation

• The WHO has issued a statement of principles in which it does not justify the promotion of Artemisia plant materials or their use in any form for the prevention or treatment of malaria [36].

Possible side effects and precautions for use

• Little toxicity of artemisinin and its derivatives, which manifests itself in humans at very high doses: neurotoxicity and reproductive toxicity (which depend on the nature of the compound, the route of administration and the formulation )
• An isolated case of liver toxicity [37]

Bibliographic references

1. ↑ Youyou T, Muyun N, Yurong Z, Lanna L, Shulian G, Muqun Z, Xiuzhen W, Xiaotian L. [STUDIES ON THE CONSTITUENTS OF ARTEMISIA ANNUAL L]. Yao Xue Xue Bao. 2015 Oct;50(10):366-70. Chinese. PMID 26837162 .
2. ↑ Chang-xiao Liu. Discovery and Development of Artemisinin and Related Compounds. Chinese Herbal Medicines, Volume 9, Issue 2, 2017, Pages 101-114, ISSN 1674-6384, https://doi.org/10.1016/S1674-6384(17)60084-4 .
3. ↑ Kong LY, Tan RX. Artemisinin, a miracle of traditional Chinese medicine. Nat Prod Rep. 2015 Dec 19;32(12):1617-21. doi:10.1039/c5np00133a. PMID 26561737 .
4. ↑ Su XZ, Miller LH. The discovery of artemisinin and the Nobel Prize in Physiology or Medicine. Sci China Life Sci. 2015 Nov;58(11):1175-9. doi:10.1007/s11427-015-4948-7. PMID 26481135 ; PMCID: PMC4966551.
5. ↑ Efferth T, Zacchino S, Georgiev MI, Liu L, Wagner H, Panossian A. Nobel Prize for artemisinin brings phytotherapy into the spotlight. Phytomedicine. 2015 Dec 1;22(13):A1-3. doi: 10.1016/j.phymed.2015.10.003. Epub 2015 Oct 16. PMID 26563851 .
6. ↑ Youyou Tu, from Mao Zedong to the Nobel Prize - 2015 Nobel Prize in Medicine: William C. Campbell, Satoshi Ōmura and Youyou Tu: Dominique Mazier and Marc Thellier. Med Sci (Paris), 32 1 (2016) 106-109, DOI: https://doi.org/10.1051/medsci/20163201017
7. ↑ Liu C, Zhao Y, Wang Y. Artemisinin: current state and perspectives for biotechnological production of an antimalarial drug. Appl Microbiol Biotechnol. 2006 Aug;72(1):11-20. PMID 16773335
8. ↑ Michel Onimus, Sophie Carteron, Pierre Lutgen. The Surprising Efficiency of Artemisia annua Powder Capsules. Medicinal & Aromatic Plants Volume 2 • Issue 3 • 1000125 http://dx.doi.org/10.4172/2167-0412.1000125
9. ↑ De Donno A, Grassi T, Idolo A, Guido M, Papadia P, Caccioppola A, Villanova L, Merendino A, Bagordo F, Fanizzi FP. First-time comparison of the in vitro antimalarial activity of Artemisia annua herbal tea and artemisinin. Trans R Soc Trop Med Hyg. 2012 Nov;106(11):696-700. doi: 10.1016/j.trstmh.2012.07.008. PMID 22986092
10. ↑ Ferreira JF, Luthria DL, Sasaki T, Heyerick A. Flavonoids from Artemisia annua L. as antioxidants and their potential synergism with artemisinin against malaria and cancer. Molecules. 2010 Apr 29;15(5):3135-70. doi:10.3390/molecules15053135. PMID 20657468
11. ↑ Elfawal MA, Towler MJ, Reich NG, Weathers PJ, Rich SM. Dried whole-plant Artemisia annua slows evolution of malaria drug resistance and overcomes resistance to artemisinin. Proc Natl Acad Sci US A. 2015 Jan 20;112(3):821-6. doi:10.1073/pnas.1413127112. PMID 25561559
12. ↑ Rasoanaivo P, Wright CW, Willcox ML, Gilbert B. Whole plant extracts versus single compounds for the treatment of malaria: synergy and positive interactions. Malar J. 2011 Mar 15;10 Suppl 1:S4. doi:10.1186/1475-2875-10-S1-S4. PMID 21411015
13. ↑ van der Kooy F, Sullivan SE. The complexity of medicinal plants: the traditional Artemisia annua formulation, current status and future perspectives. J Ethnopharmacol. 2013 Oct 28;150(1):1-13. doi: 10.1016/j.jep.2013.08.021. PMID 23973523
14. ↑ Liu CH, Zou WX, Lu H, Tan RX. Antifungal activity of Artemisia annua endophyte cultures against phytopathogenic fungi. J Biotechnol. 2001 Jul 12;88(3):277-82. PMID 11434973
15. ↑ Deng Y, Liu Z, Geng Y. Anti-allergic effect of Artemisia extract in rats. Exp Ther Med. 2016 Aug;12(2):1130-1134. doi: 10.3892/etm.2016.3361. PMID 27446332 ; PMCID: PMC4950231.
16. ↑ Efferth T. From ancient herb to modern drug: Artemisia annua and artemisinin for cancer therapy. Semin Cancer Biol. 2017 Oct;46:65-83. doi: 10.1016/j.semcancer.2017.02.009. PMID 28254675
17. ↑ Efferth T, Dunstan H, Sauerbrey A, Miyachi H, Chitambar CR. The anti-malarial artesunate is also active against cancer. Int J Oncol. 2001 Apr;18(4):767-73. PMID 11251172
18. ↑ Ferreira JF, Luthria DL, Sasaki T, Heyerick A. Flavonoids from Artemisia annua L. as antioxidants and their potential synergism with artemisinin against malaria and cancer. Molecules. 2010 Apr 29;15(5):3135-70. doi:10.3390/molecules15053135. PMID 20657468
19. ↑ Puri BK, Hakkarainen-Smith JS, Monro JA. The effect of artesunate on short-term memory in Lyme borreliosis.Med Hypotheses. 2017 Aug;105:4-5. doi: 10.1016/j.mehy.2017.06.015. PMID 28735651
20. ↑ Lubbe A, Seibert I, Klimkait T, van der Kooy F. Ethnopharmacology in overdrive: the remarkable anti-HIV activity of Artemisia annua. J Ethnopharmacol. 2012 Jun 14;141(3):854-9. doi: 10.1016/j.jep.2012.03.024. PMID 22465592
21. ↑ Karamoddini, Mehrangiz & Emami, Seyed Ahmad & Sabouri Ghannad, Masoud & Sani, Esmaeel & D, Amirhossein. (2011). Amirhossein S. Antiviral Activities of aerial subsets of Artemisia species against Herpes Simplex virus typel (HSV1) in vitro. Asian biomedicine. 5. 63-68. 10.5372/1905-7415.0501.007.
22. ↑ Chuanxiong Nie, Jakob Trimpert, Sooyeon Moon, Rainer Haag, Kerry Gilmore, Benedikt B. Kaufer, Peter H. Seeberger. 2021. In vitro efficacy of Artemisia extracts against SARS-CoV-2. BioRxiv. doi: https://doi.org/10.1101/2021.02.14.431122 , https://www.biorxiv.org/content/10.1101/2021.02.14.431122v1
23. ↑ MS Nair, Y. Huang, DA Fidock, SJ Polyak, J. Wagoner, MJ Towler, PJ Weathers. Artemisia annua L. extracts prevent in vitro replication of SARS-CoV-2. bioRxiv 2021.01.08.425825; doi: https://doi.org/10.1101/2021.01.08.425825
24. ↑ Kapepula PM, Kabengele JK, Kingombe M, Van Bambeke F, Tulkens PM, Sadiki Kishabongo A, Decloedt E, Zumla A, Tiberi S, Suleman F, Tshilolo L, Muyembe-TamFum JJ, Zumla A, Nachega JB. Artemisia Spp. Derivatives for COVID-19 Treatment: Anecdotal Use, Political Hype, Treatment Potential, Challenges, and Road Map to Randomized Clinical Trials. Am J Trop Med Hyg. 2020 Sep;103(3):960-964. doi: 10.4269/ajtmh.20-0820. PMID 32705976
25. ↑ Feng J, Leone J, Schweig S, Zhang Y. Evaluation of Natural and Botanical Medicines for Activity Against Growing and Non-growing Forms of B. burgdorferi. Front Med (Lausanne). 2020 Feb 21;7:6. doi: 10.3389/fmed.2020.00006. PMID 32154254 ; PMCID: PMC7050641.
26. ↑ Bora KS, Sharma A. The genus Artemisia: a comprehensive review. Pharm Biol. 2011 Jan;49(1):101-9. doi:10.3109/13880209.2010.497815. PMID 20681755
27. ↑ Udagama, Preethi & Ratnasooriya, WanigasekeraDaya & Kodippili, Kasun & Premakumara, Sirimal. (2011). An investigation of the antimalarial activity of Artemisia vulgaris leaf extract in a rodent malaria model. International Journal of Green Pharmacy. 5.276.10.4103/0973-8258.94347.
28. ↑ Bamunuarachchi, Gayan & Ratnasooriya, Wanigasekara & Premakumara, Sirimal & Udagama, Preethi. (2011). Study of Anti-malarial Activity of Artemisia vulgaris Leaf Extract, using the Plasmodium berghei murine model.
29. ↑ Bamunuarachchi, Gayan & Ratnasooriya, Wanigasekara & Premakumara, Sirimal & Udagama, Preethi. (2013). Antimalarial properties of Artemisia vulgaris L. ethanolic leaf extract in a Plasmodium berghei murine malaria model. Journal of vector borne diseases. 50. 278-84.
30. ↑ Fabien Juteau, Veronique Masotti, Jean Marie Bessière, Michel Dherbomez, Josette Viano. Antibacterial and antioxidant activities of Artemisia annua essential oil. Fitoterapia, Volume 73, Issue 6, October 2002, Pages 532–535
31. ↑ Bilia AR, Santomauro F, Sacco C, Bergonzi MC, Donato R. Essential Oil of Artemisia annua L.: An Extraordinary Component with Numerous Antimicrobial Properties. Evid Based Complement Alternat Med. 2014;2014:159819. [1] full text
32. ↑ Mueller MS, Karhagomba IB, Hirt HM, Wemakor E. The potential of Artemisia annua L. as a locally produced remedy for malaria in the tropics: agricultural, chemical and clinical aspects. J Ethnopharmacol. 2000 Dec;73(3):487-93. PMID 11091003
33. ↑ Worcester Polytechnic Institute. "Patients with drug-resistant malaria cured by plant leaves: Tablets made from dried of the Artemisia annua plant cured 18 critically ill patients in a Congo clinic. The results suggest a new and inexpensive treatment option for the mosquito-borne disease that affects 212 million people worldwide." ScienceDaily. ScienceDaily, April 24, 2017. <www.sciencedaily.com/releases/2017/04/170424141222.htm>.
34. ↑ Munyangi J, Cornet-Vernet L, Idumbo M, Lu C, Lutgen P, Perronne C, Ngombe N, Bianga J, Mupenda B, Lalukala P, Mergeai G, Mumba D, Towler M, Weathers P. Artemisia annua and Artemisia afra tea infusions vs. artesunate-amodiaquine (ASAQ) in treating Plasmodium falciparum malaria in a large scale, double blind, randomized clinical trial. Phytomedicine. 2019 Apr;57:49-56. doi: 10.1016/j.phymed.2018.12.002. PMID 30668322
35. ↑ Munyangi J, Cornet-Vernet L, Idumbo M, Lu C, Lutgen P, Perronne C, Ngombe N, Bianga J, Mupenda B, Lalukala P, Mergeai G, Mumba D, Towler M, Weathers P. Effect of Artemisia annua and Artemisia afra tea infusions on schistosomiasis in a large clinical trial. Phytomedicine. 2018 Dec 1;51:233-240. doi: 10.1016/j.phymed.2018.10.014. PMID 30466622
36. ↑ World Health Organization. Use of non-pharmaceutical forms of Artemisia. No. WHO/CDS/GMP/2019.14. World Health Organization, 2019. pdf
37. ↑ Ruperti-Repilado FJ, Haefliger S, Rehm S, et al. Danger of Herbal Tea: A Case of Acute Cholestatic Hepatitis Due to Artemisia annua Tea. Front Med (Lausanne). 2019;6:221. PMID 31681778 Published 2019 Oct 11. doi:10.3389/fmed.2019.00221

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Store in a cool, dry place, away from light. Keep tightly closed, away from the reach of Children and pets.

Do not exceed the daily dose.

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