Khan, Mohammed Tariq; (2004) Phytochemical and biological studies of thuja occidentalis and its clinical evaluation in the treatment of verruca pedis. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

This study undertakes a botanical investigation, phytochemical analysis, biological testing and chemical evaluation of Thuja occidentalis in the treatment of verruca pedis. Clinical observation over 10 years in dermatology and podiatric clinics revealed a high incidence of verruca pedis. Most medical and surgical intervention can cause a great deal of discomfort, as well as post-operative complications, investigation of medicinal plants for the treatment of podiatric disorders led to clinical pilot studies and a double-blind controlled trial of tagetes species in the treatment of verruca pedis (Khan, 1994). In the present study, the clinical features of verruca pedis, aetiology and pathology are described and advantages and limitations of traditional treatments are discussed. In the phytochemical study of Thuja occidentalis, a flavonoid, and a lignan deoxypodophyllotoxin, were isolated and identified by chromatographic techniques and spectral analysis. In the clinical study, the effect of Thuja occidentalis crude extracts and sub fractions in different organic solvents were tested in an open study and doubleblind study over a period of 12 weeks. Ethical approval was obtained from the Clinical Lead of Dermatology Department at the Royal London Hospital and the Director of Research at the Royal London Homoeopathic Hospital. Ninety volunteers were chosen, using inclusion and exclusion criteria and were admitted to the study from a population awaiting podiatric treatment at the Royal London Hospital and the Royal London Homoeopathic Hospital. These were then systematically allocated to 3 groups of 30 in each group. Test samples were prepared on the basis of the effective dose established in pilot clinical studies of Thuja occidentalis at 300mg/ml-dose/day for crude extract and 60mg/ml- dose/day for fractions. The results of the clinical study show that ethanolic crude extract of Thuja occidentalis was effective in reduction of verruca size and clearance, with a level of significance at p<0.001. The chlorofonn fraction of Thuja occidentalis was shown to be the most effective in reduction of size and clearance with a level of significance at p<0.01. In biological tests, Thuja occidentalis crude extract at 1iag/ml and the chloroform fraction at 0.021μg/ml showed no toxicity to human keratinocytes, but at concentrations of 1μg/ml to 1 mg/ml and 0.21μ/ml to 0.21 mg/ml was toxic to cell growth respectively. These findings concurred with earlier results from a clinical study that activity of Thuja occidentalis was located in the chloroform fraction as other fractions did not affect growth rate of cells. The results of the clinical study and biological tests show a close correlation in terms of safety and efficacy in the treatment of verruca pedis. These encouraging results need further investigation using a larger number of patients over a longer period of time.

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