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  • Review
  • Open Access

Traditional medicinal plants used for respiratory disorders in Pakistan: a review of the ethno-medicinal and pharmacological evidence

  • 1Email author,
  • 1,
  • 1,
  • 1,
  • 2,
  • 3 and
  • 4
Chinese Medicine201813:48

https://doi.org/10.1186/s13020-018-0204-y

  • Received: 9 June 2018
  • Accepted: 30 August 2018
  • Published:

Abstract

Respiratory disorders are a common cause of malady and demise in Pakistan due to its remoteness, cold and harsh climatic conditions as well as scarce health care facilities. The people rely upon the indigenous plant resources to cure various respiratory disorders. The primary objective of this review was to assemble all available ethno-medicinal data of plants used for respiratory disorders in Pakistan. Pharmacological activity of these plants (based upon published scientific research), distribution, diversity, use, preparation methods, economical value, conservation status and various available herbal products of some plants have also been explored. This study scrutinized various electronic databases for the literature on medicinal plants used in Pakistan to treat respiratory disorders. A total of 384 species belonging to 85 families used to treat respiratory disorders in Pakistan has been documented. Cough was the disorder treated by the highest number of species (214) followed by asthma (150), cold (57) and bronchitis (56). Most of the plants belongs to Asteraceae (32) and Solanaceae family (32) followed by moraceae (17), Poaceae (13), and Amaranthaceae (13) with their habit mostly of herb (219) followed by Shrub (112) and tree (69). Traditional healers in the region mostly prepare ethno medicinal recipes from leaves (24%) and roots (11%) in the form of decoction. Among the reported conservation status of 51 plant species, 5 were endangered, 1 critically endangered, 11 vulnerable, 14 rare, 16 least concern, 3 infrequent and 1 near threatened. We found only 53 plants on which pharmacological studies were conducted and 17 plants being used in herbal products available commercially for respiratory disorders. We showed the diversity and importance of medicinal plants used to treat respiratory disorders in the traditional health care system of Pakistan. As such disorders are still causing several deaths each year, it is of the utmost importance to conduct phytochemical and pharmacological studies on the most promising species. It is also crucial to increase access to traditional medicine, especially in rural areas. Threatened species need special attention for traditional herbal medicine to be exploited sustainably.

Keywords

  • Respiratory disorders
  • Medicinal flora of Pakistan
  • Pharmacological evaluation

Background

Respiratory disease is a common and significant cause of illness and death around the world. In 2012, respiratory conditions were the most frequent reasons for hospital stays among children. In Pakistan acute respiratory infections constitute 30–60% of outdoor patients in hospital including 80% upper respiratory tract infections and 20% lower respiratory tract infections. The most common problems of the respiratory system are: asthma, bronchitis, common cold, cough and whooping cough [1]. Asthma affect about 300 million people worldwide and it has been estimated that a further 100 million will be affected by 2025 [24]. The prevalence of asthma in Pakistan is increasing day-by-day with an annual increase of 5% of which 20–30% are children. Nearly 20 million people (12%) of Pakistani adult population are already suffering from asthma while chronic bronchitis occurring in the population over 65 years of age was 14% in females and 6% in males. An estimated seven million cases of pneumonia occur every year in Pakistan and out of these, as many as 92,000 children die before their fifth birthday due to the infection.

Respiratory disorders are common in Pakistan due to its remoteness, cold and harsh climatic conditions as well as limited health care facilities. The people depend on the indigenous plant resources to treat various respiratory disorders. Herbal remedies for the treatment of respiratory disorders are common practice in many parts of the world.

Phyto-therapeutic agents are in use since ancient times for disease control but there use is greatly increased in last decade. By the end of twentieth century, 170 herbal drugs got official recognition. According to the WHO, 80% world population satisfy their primary health related needs by the use of phyto-therapeutic agents and 11% drugs are of plant origin among the essential drugs [5]. Approximately 70–95% populations of developing countries use herbal drugs for basic health care [6]. Pakistan is a rich producer of medicinal plants with more than 6000 species due to its climatic zones including high altitudes of Hindu-Kush Himalayas and Karakorum. About 600–700 (12%) species from the above mentioned figure are extensively used for medicinal purposes and various plants are also exported to foreign countries [7, 8]. From villages of Pakistan, 60% population use medicinal plants to fulfill their basic drug related needs [9].

During the previous few decades there has been an increase in the study of remedial plants and their folk usage in various parts of Pakistan. In the recent years numbers of information are documented on the use of plants in indigenous healing system either by ethnic people or rural communities around the world and Pakistanis increasing. The knowledge of ethno pharmacology and its holistic approach supported by experience can serve as a fuel for the discovery of safe, new and affordable medicines. Drugs development on the basis of natural products had an extensive history in the US, and in 1991, almost half of the drugs with maximum sale were natural products or their derivatives. With the passage of time, the emphasis on plant research is increasing day by day and stronger evidences are collected that proved the extensive use of medicinal plants in TM. Approximately 13,000 plants are investigated in previous 5 years [10].

The present study aimed at documenting the traditional uses of medicinal plants used to treat different respiratory disorders in Pakistan and to evaluate the efficacy of plant species based on the review of literature.

Specifically we sought to answer the following questions
  • What is the distribution and geographical patterns of medicinal plants used for respiratory disorders across the Pakistan?

  • Which plant species are most often used for treating respiratory disorders?

  • Which plant parts are most commonly used in ethno preparations?

  • Which preparation modes are commonly used to prepare the medicinal recipes?

  • Which respiratory conditions are most commonly treated with medicinal plant species?

  • Have pharmacological studies been conducted to confirm the traditional use of the medicinal plants against respiratory disorders?

  • Which plant species are used in herbal preparations for the treatment of respiratory disorders?

  • What is the economical and conservation status of the plant species used for respiratory disorders?

We believe that answering these questions will help to identify the plant species that have the potential to be explored in future lab trails. We also hope to highlight eventual under investigated areas.

Materials and methods

Data collection

Published papers up till June 2015 were retrieved from the online bibliographical databases: PubMed, Google, Google scholar, Science direct, Springer link, IUCN redlist and drug Infosys. These databases were searched by using keywords like, traditional use of plants, medicinal uses of plants, indigenous use of plants, ethno botanical surveys and ethno-pharmacological studies of different areas of Pakistan (Provinces and districts). A total of 230 scientific papers based on ethno-botanical surveys of different areas of Pakistan were reviewed for this study (Punjab = 85, KPK = 58, Sindh = 15, Baluchistan = 8, Gilgit = 22, Kashmir = 42). Plants with the reported traditional usage against respiratory diseases were screened from the data gathered. A master list was generated enlisting all the medicinal plants used in Pakistan for the treatment of respiratory disorders (Table 1). Above-mentioned databases were also searched for pharmacological studies providing supporting evidence of medicinal uses for each species. Because of the massive number of studies been consulted only reference(s) were provided and complete information on pharmacological properties can be retrieved from the original studies. All the data has been summarized in six tables and six figures.
Table 1

Medicinal plants use for respiratory disorders

Scientific name

Family

Part used

Traditional use

Abelmoschus esculentus

Solanaceae

Fruit

Throat, cough and bronchitis infections [43]

Abies pindrow Royle

Amaranthaceae

Fresh leaves

Cough, asthma and other chest infection [44]

Abrus precatorius

Fabaceae

Root and leaves

Asthma, cough [45]

Acacia arabica

Apiaceae

Leaves and fruits

Cough [46]

Acacia jacquemontii

Myrsinaceae

Flower, seeds, leaves, stem, bark

Asthma [47]

Acacia modesta Wall

Acanthaceae

Gum

Respiratory tract problems [47]

Acacia nilotica

Apocynaceae

Flowers

Asthma [48]

Achillea millefolium

Asteraceae

Leaves

Cold, flu [49]

Achyranthes aspera Linn.

Amaranthaceae

Leaves

Pneumonia and asthma [50]

Aconitum chasmanthum

Ranunculaceae

Root

Cough, and asthma [51]

Aconitum hetrophyllum

Ranunculaceae

Root

Cough, asthma [51]

Aconitum violaceum

Ranunculaceae

Root

Asthma, cough [51]

Adhatoda vasica nees

Capparidaceae

Whole plant

Cough, bronchitis, asthma [52]

Adhatoda zelyanica Medic

Apocynaceae

Whole plant

Cough, asthma [53]

Adiantum capillus veneris

Liliaceae

Whole plant

Coughs, bronchitis [54]

Adiantum incisum Forssk

Liliaceae

Fronds

Cough and cold [55]

Adiantum venustum

Liliaceae

Rhizome and whole plant

Cough [40]

Aesculus indica

Liliaceae

Fruits

Cough [40]

Ageratum conyzoides L.

Asteraceae

Leaves

Cold and coughs [51]

Albizia lebbeck

Moraceae

Bark

Flu, cough, lung problems [49]

Alhagi maurorum Medic

Fabaceae

Whole plant

Respiratory diseases [54]

Allium cepa

Apiaceae

Stem, leaves

Cough [56]

Allium humile Kunth

Alliaceae

Bulb infusion

Asthma/breathing, problem, cough, cold [40]

Allium sativum L.

Euphorbiaceae

Bulb

Respiratory tract infection [40]

Aloe barbadensis

Liliaceae

Whole plant

Cough, asthma [52]

Aloe vera

Solanaceae

Arieal parts

Cough Suppressant [55]

Alstonia scholaris

Fabaceae

Bark, Leaves

Asthma [57]

Althaea officinalis L.

Lythraceae

Flowers, leaves, roots, fruits and seeds

Asthma and bronchitis [56]

Amaranthus viridis L.

Caeselpiniaceae

Leaves, stem

Cough [58]

Amaranthus albus

Amaranthacea

Flower, stem, leaves, seeds

Asthma [56]

Amaranthus caudatus

Asteraceae

Shoots

Cough and asthma [59]

Amaranthus spinosus L.

Astraceae

Whole plant

Bronchitis [56]

Ammi visnaga [L.] Lam

Amaranthaceae

Fruit and flower

Bronchial asthma/breathing problems, whooping coug [56]

Anagalis arvensis

Poaceae

Fruit, seeds, leaves, stem, flower

Flu [60]

Anaphalis nepalensis

Asteraceae

Flower and leaves

Asthma, cough [61]

Andrachne aspera

Leguminosae

Herb

Cough, bronchitis [62]

Anethum graveolens L.

Solanaceae

Seeds

Bronchitis [63]

Angelica glauaca Edgew

Asteraceae

Ariel parts

Asthma, cold [64]

Angelica glauca

Umbelliferae/apiaceae

Roots

Cough [64]

Apium Graveolens L.

Pinaceae

Seed and root

Bronchitis, asthma [65]

Aremisia scoparia

Asteraceae

Whole plant

Fever cough [66]

Arisaema flavum Forssk.

Berberidaceae

Rhizome, fruit

Cough, cold [66]

Arisaema jacquemonti

Asclepiadaceae

Stem, flower

Asthma [67]

Aristida adcensionis L.

Poaceae

Stem, leaves

Cold [68]

Arnebia benthamii

Boraginaceae

Stem and leaves

Asthma, cough [69]

Artemisia maritima L.

Asteraceae

Aerial parts

Cough [70]

Artemisia fragrans Willd.

Boraginaceae

Leaves

Asthma [71]

Artemisia macrocephala

Euphorbiaceae

 

Cold, cough, flu, asthma [70]

Artemisia scoparia

Asteraceae

Whole plant

Cough chest problems [70]

Artemisia vulgaris

Asclepiadaceae

Leaves

Asthma [71]

Asphodelus tenuifolius

Apocynaceae

Stem, leaves, seeds

Cold [67]

Astragalus psilocentros

Leguminosae

Roots and thorny branches

Flue [42]

Astragulus tragacantha

Asteraceae

Leaves

Respiratory infection [72]

Atropa acuminate Royle

Ranunculaceae

Leaves, flower

Cold, flu [73]

Avena sativa

Poaceae

Fruit, seeds, leaves, stem

Asthma [74]

Ayapana triplinervis

Caryophyllaceae

Leaves

Cough [75]

Azadirachta indica

Solanaceae

Leaves

Cough [70]

Bambusa bambos [L.]

Solanaceae

Leaves herb

Expectorant [76]

Barleria cristata L.

Lamiaceae

Whole plant

Cold and flu [77]

Bauhinia variegata

Mimosaceae

Bark, root, buds

Asthma [78]

Berberis balochistanica

Berberidaceae

Wholeplant

Cough [79]

Berberis lyceum

Adiantaceae

Root, bark

Cough [78]

Bergenia stracheyi

Saxifragaceae

Leaves and root

Cough, asthma, lungh cancer, respiratory problem [80]

Bergenia ciliate

Apiaceae

Root, flowers and leaves

Coughs and colds, asthma [81]

Bistorta amplexicaulis

Polygonaceae

Leaves

Flu [70]

Bistorta vivipara

Polygonaceae

Root and stem

Chronic bronchitis [68]

Boerhavia procumbens

Rutaceae

Roots

Cough, asthma [70]

Boerhavia procumbens

Nyctaginaceae

Roots

Flue [70]

Brassica campestris

Chenopodiaceae

Flower, fruit, seeds, leaves, stem, pod

Cold [82]

Broussonetia papyrifer

Moraceae

Fruit

Cough [70]

Bambusa arundinacea

Solanaceae

Leaves

Cold, flu [83]

Bunium persicum

Apiaceae

Seeds

Cold, cough [84]

Cadaba farinose

Umbelliferae

Roots, leaves

Cold and cough [85]

Calotropis gigantean

Convolvulaceae

All parts

Cough and asthma [86]

Calotropis procera

Asclepiadaceae

Roots, flowers, latex

Cough [70]

Cannabis sativa

Cannabiaceae

Whole plant

Cough [70]

Capparis aphylla Roth

Euphorbiaceae

Bark

Cough and asthma [87]

Capparis decidua

Solanaceae

All parts

Asthma, cough [70]

Capparis spinosa L.

Capparidaceae

Flower and seeds

Asthma, cough [88]

Capsella bursapastoris L.

Brassicaceae

Seeds

Cough, respiratory diseases [88]

Capsicum annum L.

Asteraceae

Fruit

Bronchitis [70]

Caragana brevifolia

Papillionacea

Roots

Cough [80]

Cardia myxa

Chenopodiaceae

Flower, leaves, seed, bark

Respiratory tract infection [89]

Carissa opaca Stapf

Myrtaceae

Leaves, root and fruit

Cold and flu [70]

Carthamus tinctorius L.

Asteraceae

Flower

Cough, respiratory problems [70]

Carum bulbocastanum Koch.

Apiaceae

Seeds

Fiue [90]

Carum capticum L.

Violaceae

Seeds, leaves and flowers

Cough bronchitis and diarrhea [91]

Carum carvi L.

Asteraceae

Stem and leaves

Bronchitis, cough [92]

Carum copticum Benth

Solanaceae

Whole plant

Whooping cough [22]

Cassia Occidentalis

Mimosaceae

Leaves

Cough [22]

Cassia fistula L.

Moraceae

Fruit

Cough and flue [93]

Catharanthus roseus

Mimosaceae

Whole plant

Cold, flue, bronchitis [70]

Celtis australis L.

Ulmaceae

Leaves

Cough [94]

Chenopodium album

Fabaceae

Flower, fruit, seeds, leaves, stem

Cold [74]

Chenopodium botrys L.

Chenopodiaceae

Stem and leaves

Asthma [67]

Chenopodium morale

Fabaceae

Flower, fruit, seeds, leaves, stem

Flu [62]

Cicer arietinum L.

Moraceae

Fruit

Flu, cough [62]

Cichorium intybus L.

Asteraceae

Whole plants

Asthma and breathing problems [70]

Cichorium endivia Linn.

Asteraceae

Seeds

Cough [94]

Cistanche tubulosa

Poaceae

Whole plant

Cough [95]

Citrullus colocynthis

Cucurbitaceae

Leaves, fruits

Bronchial asthma [93]

Citrus medica

Solanaceae

Leaves, seeds and latex

Cough, cold, asthma [70]

Colchicum luteum

Colchicaceae

Coms

Bronchial diseases [86]

Convolvulus arvensis Linn.

Astraceae

Whole plant

Cough, flu [67]

Conyza bonariensis

Brassicaceae

Whole plants, oil

Bronchial complaints [96]

Conyza canadenisis

Chenopodiaceae

Whole plant

Bronchial catarrh [52]

Cordia dichotoma

Moraceae

Whole plant and fruit

Dry cough [97]

Cordia gharaf Ehrenb.

Oleaceae

Tree fruit

Dry cough [98]

Cordia obliqua Willd.

Anacaediaceae

Fruits

Throat infection, common cold [93]

Cordial dichotoma

Boraginaceae

Leaves

Asthma [99]

Coriandrum sativum

Brassicaceae

Flower, fruit, seeds, leaves, stem

Respiratory tract infection [70]

Coronopus didymus

Brassicaceae

Leaves and tender parts

Asthma, bronchitis [67]

Corydalis ramose

Fumariaceae

Leaves

Cough [100]

Cousinia stocksii C. Winkler

Asteraceae

Gum and roots

Asthma [101]

Cucurbita maxima

Polygonaceae

Seeds

Cough [38]

Cupressus sempervirens

Asteraceae

Fruit and seed

Flu and cold [70]

Cuscuta reflexa

Fabaceae

Whole plant

Cough [70]

Cydonia oblonga Mill

Violaceae

Fruit

Cough [102]

Cymbopogon jawaracusa

Salvadoracea

Whole plant

Respiratory diseases [103]

Cymbopogon jwarancusa

Poaceae

Leaves, flowers and roots

Flu, and cough [82]

Cynodon dactylon

Ranunculaceae

Leaves

Asthma [94]

Cynoglossum lanceolatum

Solanaceae

Whole plant

Bronchitis, Cough [67]

Datura stramonium

Solanaceae

Seeds, flowers, leaf, fruit

Whooping cough [93]

Datura alba

Zygophyllaceae

Leaves and seeds

Asthma [103]

Datura fastuosa L.

Solanaceae

Whole plant

Asthma [70]

Datura innoxia Mill

Euphorbiaceae

Dried leaves, seeds and fruit

Asthma [70]

Datura metel Linn.

Solanaceae

Whole plant

Asthma [70]

Daucus carota

Moraceae

Stem, root, carrot

Asthma, bronchitis [99]

Delphinium brunonianum Royle

Ranunculaceae

Leaves, flower

Cough, asthma [88]

Dendrocalamus strictus

Scrophulariaceae

Leaves

Cough and cold [82]

Desmodium gangeticum

Caesalpiniaceae

Roots

Asthma and cough [45]

Desmostachya bipinnata

Nyctaginaceae

Leaves, root

Asthma [70]

Diospyros lotus L.

Punicaceae

Flower

Cough [104] ]

Dipterygium glaucum

Euphobiaceae

Areal part

Asthma [93]

Dodonaea viscosa

Spaindaceae

Leaves, flowers and seeds

Chest infection [74]

Duchesnea indica

Rosaceae

Aerial parts, fruits

Cough [80]

Echinops echinatus

Capparidaceae

Roots

Cough [78]

Eclipta prostata Linn.

Boraginaceae

Whole plant

Flu [70]

Elaeagnus angustifolia L.

Elaeagnaceae

Fruits

Respiratory problems [70]

Elaeagnus parvifolia

Fabaceae

Shrub

Cough [105]

Emblica officinale Gaerth

Euphorbiaceae

Tree

Cold, cough [44]

Ephedra gerardiana

Ephedraceae

Stem

Respiratory disorders, asthma/breathing problem [84]

Ephedra intermedia

Ephedraceae

Whole plant

Asthma and tuberculosis [70]

Ephedra procera

  

Cough and asthma [70]

Ephedra ciliata

Ephedraceae

Wholeplant

Chest problems, cough, asthma [84]

Eucalyptus citirodora

Solanaceae

Leaves

Cold, flue, and cough [93]

Eucalyptus globulus Labill

Moraceae

Tree

Flue [70]

Eugenia jambolana

Solanaceae

Bark

Bronchitis, asthma [87]

Euphorbia helioscopia Linn.

Fabaceae

Whole plant

Asthma, bronchitis, cough [60]

Euphorbia tircucalli

Mimosaceae

Juice

Cough, asthma [60]

Euphorbia hirta

Labiatae

Whole plant

Asthma, chronic bronchial [93]

Euphorbia prostate

Fabaceae

Whole plan

Asthma [87]

Euphorbia thymifolia

Salvadoraceae

Whole plant

Bronchial affection, cough and asthma [70]

Evolvulus alsinoides

Euphorbiaceae

Whole plant

Bronchitis [87]

Fagonia bruguieri DC

Zygophyllaceae

Whole plant

Asthma [106]

Fagonia cretica L.

Solanaceae

Whole plant

Antiasthematic, cough [94]

Fagonia indica Burm. F

Amaranthaceae

Whole plant

Asthma [70]

Ferula assa-foetida

Apiaceae

Root, stem and gum resin

Cough, asthma [70]

Ferula narthex Boiss.

Malvaceae

Whole plant

Cough and asthma [70]

Ferula oopoda [Boiss. and Buhse]

Apiaceae

Seeds, leaves and sap

Cough [107]

Ficus benghalensis

Moraceae

Milk of leaves, bark, root

Asthma [70]

Ficus religiosa L.

Papilionaceae

Fruit, leaves

Asthma [78]

Ficus carica L.

Moraceae

Fruit and leaves

Cough [93]

Ficus elastic

Moraceae

Bark, fruits and leaves

Cough, asthma [93]

Ficus lyrata

Molluginaceae

Whole plant

Asthma, cough [70]

Ficus palmate

Moraceae

Fruit, latex

Asthma, cough [70]

Foenicullum vulgare Miller

Papilionaceae

Seed and leaves

Cough, pneumonia [108]

Foeniculum capillacerm

Asteraceae

Seed, root, leaves

Cough, and asthma [45]

Fragaria nubicola

Rosaceae

Root and fruit

Asthma [81]

Fritillaria roylei Hook.

Asteraceae

Herb

Broncho-asthma [103]

Fumaria indica

Fumariaceae

Whole plant

Cough [109]

Gentiana kurrooroyle

Gentianaceae

Flower

Cough [110]

Gentianodes olivieri

Gentianaceae

Whole plant

Cough, chest problems [81]

Gentianodes tianschanica

Gentianaceae

Leaves

Cough [81]

Glossonema varians

 

Fruit

Cough [111]

Glycyrrhiza glabra

Adiantaceae

Roots

Cough [70]

Grewia optiva

Ranunculacea

Leaves

Cough [59]

Hackelia uncinatum

Ranunculaceae

Flowers

Coughs [103]

Helianthus annuus

Papilionaceae

Flower, root, seed, leaves

Asthma, bronchial [81]

Helianthus tuberosus

Acanthaceae

Tubers

Cough and bronchitis and flu, respiratory diseases [83]

Heliotropium europaeum

Malvaceae

Whole plant

Cough [86]

Heracleum candicans

Apiaceae

Root

Asthma, cough [112]

Hippophae rhamnoides

Elaeagnaceae

Fruit juice

Cough [70]

Hyoscyamus niger Linn.

Zygophyllaceae

Whole plant

Asthma, whooping cough [70]

Hyoscyamus insanus Stocks

Caesalpiniaceae

Whole plant

Anti asthmatic [45]

Inula grantioides

Asteraceae

Whole plant

Asthma [107]

Inula racemosa Hook

Violaceae

Root

Asthma and bronchitis [100]

Ipomea carnea

Malvaceae

Leaves, stem

Asthma [113]

Iris hookeriana

Iriddaceae

Flower

Asthma, cough and bronchitis [68]

Jatropha curcas L.

Malvaceae

 

Bronchitis [94]

Juglans regia

Euphorbiaceae

Fruits

Asthma [70]

Juniperus excelsa M. B.

Cupressaceae

Seeds and leaves

Chest infection [84]

Justicia adhatoda L.

Alliaceae

Cold

Cough, cold, flu [70]

Lactuca serriola L.

Asteraceae

Whole plant

Whooping cough and asthma [70]

Laepus nigricollis

Bouidugs

 

Bronchial diseases [62]

Lantana camara

Amaranthaceae

Leaves, root and flowers

Respiratory diseases [48]

Lasiurus scindicus

Poaceae

Stem, leaves

Cough [74]

Lathyrus aphaca L.

Moraceae

Shoot

Hiccough [95]

Launea procumbus

Euphorbiaceae

Whole plant

Cold, flu, cough [57]

Lawsomia alba Lam

Meliaceae

Leaves

Bronchitis [114]

Lawsonia inermis alba

Punicaceae

Powdered leaves, seeds, bark and flowers

Cough, bronchitis [57]

Lemna minor

Convolvulaceae

Whole plant

Cough [115]

Lepidium sativum L.

Fabaceae

Shoot

Cough and cold [95]

Leptadenia pyrotechnica

Brassicaceae

Root, bark and leaves

Asthma [76]

Limeum indicum

Nyctaginaceae

Leaf and stem

Cold [95]

Linum usitatissimum

Papaveraceae

Seed, bark, leaves, flower and Oil

Cough, asthma [52]

Lonicera periclymenum L.

Caprifoliaceae

Leaves and flower

Cough [116]

Lychnis coronaria Lamak

Anacaediaceae

Roots and flowers

Lung troubles [117]

Malva neglecta

Solanaceae

Leaves and stem

Bronchitis, cough [8]

Malva parviflora

Cruciferae

Whole plant

Cough [118]

Malva sylvestris

Myrtaceae

Whole plant

Chronic bronchitis [84]

Malvastrum coromendelianum

Oxalidaceae

Flowers

Coughs [109]

Mangifera indica

Capparaceae

Flowers, leaves, kernel, bark, fruits

Asthma, cough [93]

Marrubium vulgare L.

Umbelliferae

Leaves

Cough [51]

Medicago denticulate

Poaceae

Seeds

Respiratory diseases [119]

Melia azodirachta L.

Salvadoraceae

Root

Lung complaints [120]

Melilotus indica L.

Verbenaceae

Annual herb

Bronchial disorder [109]

Melilotus parviflora

Lamiaceae

Whole plant, seeds

Cold [53]

Mentha longifolia

Labiateae

Leaves

Cough [52]

Mentha royleana Benth.

Lamiaceae

Leaves

Cough and cold [57]

Micromeria biflora

Fabaceae

 

Colds and coughs [121]

Mimosa pudica L.

Lamiaceae

Roots and leaves

Asthma [122]

Mollugo cerviana

Oxalidaceae

Fruit, stem, leaves

Asthma [75]

Momordica balsamica L.

Moraceae

Fruits

Asthma [103]

Momordica charantia L.

Poaceae

Fruit

Treat cough, bronchitis [123]

Morus alba L.

Solanaceae

Flower, leaves, root, bulb

Cough [120]

Morus nigra L.

Poaceae

Leaves, roots, fruits

Cough [46]

Mukia moderaspatana

Fabaceae

Flower, seeds, stem, leaves

Cough [118]

Murraya koenigii

Rosaceae

Leaves

Asthma [122]

Musa paradisica L.

Amaranthaceae/Chenopodiaceae

Leaves, flower

Whooping cough [103]

Nasturtium officinale R.Br.

Rosaceae

Leaves

Chest troubles [124]

Nepeta praetervisa Rech. F.

Lamiaceae

Leaves

Cold, chest problems [84]

Nigella sativa

Ranunculacea

Seeds

Whooping cough [43]

Nonea edgeworthii

Cucurbitaceae

Leaves

Cough [103]

Nyctanthes arbor-tristis L.

Asclepidiaceae

Shrub flowers

Cough [73]

Ocimum basilicum

Solanaceae

Leaves and seeds

Bronchitis, cough, cold [52]

Oenothera rosea L.

Lamiaceae

 

Whooping cough [70]

Olea ferruginea

 

Leaves

Cough, cold, flue [103]

Onosma hispida

Boraginaceae

Leaves, flower

Cough, respiratory diseases [81]

Onosma bracteatum Wall

Moraceae

Whole plant

Asthma and bronchitis [125]

Opuntia dillenii

Lythraceae

Fruits

Asthma, whooping cough [83]

Opuntia monacantha Haw

Caesalpinaceae

Whole plant

Bronchitis and asthma [126]

Origanum vulgare

Violaceae

Perennial herb

Respiratory problems, colds, flu, asthma [53]

Oryza sativa

Salicaceae

Fruit, leaves, stem

Cold [103]

Oxalis corniculata L.

Ranunculaceae

Leaves

Respiratory disorders like bronchitis, asthma [103]

Oxystelma esculentum

Asclepiadaceae

Fruits

Expectorant, cough [93]

Panicum antidotale Retz

Polygonaceae

Stem, leaves

Cough [103]

Papaver hybridum

Solanaceae

Petals

Flu and cough [86]

Papaver nudicaule L.

Papaveraceae

Herb

Cough [120]

Papaver somniferum L.

Papaveraceae

Seed, fruit

Cough [107]

Peganum harmala

Solanaceae

Seeds, leaves

Asthma [52]

Pennisetum typhoides Burm.

Poaceae

Seeds

Flu and cough [78]

Periploca aphylla

Rhamnaceae

Whole plant

Nasal decongestant [54]

Phalaris minor Retz

Solanaceae

Leaves, stem

Cold, cough [103]

Phoenix dactylifera

Capparaceae

Fruit, gum and seeds

Colds, bronchial catarrh [109]

Phyla nodiflora

Verbenaceae

Whole plant

Cold [93]

Phyllanthus emblica

Liliaceae

Fresh, fruits, seeds, flowers, leaves, bark

Asthma, bronchitis [70]

Picrorhiza kurroa

Scrophulariaceae

Root

Asthma [68]

Pimpinella diversifolia

Asteraceae

Fruit

Cough, cold [103]

Pinus roxburghii

Solanaceae

Areal part

Coughs, cold [44]

Pistacia atlantica

Anacardiaceae

Gum

Cough, Chestproblems [70]

Pistacia integerrima

Rosaceae

Leaf galls

Cough, asthma [70]

Pistacia khinjuk

Anacardiaceae

Fruits

Cough [84]

Plantago lanceolata L.

Plantaginaceae

Leaves and seeds

Cough and chest diseases [70]

Plantago major L.

Punicaceae

Leaves, stem

Asthma, cough [70]

Plantago ovata Forssk

Brassicaceae

Seeds and husk

Cough and cold [101]

Plantago lanceolata

Plantaginaceae

Fresh or dried leaves

Relieving coughs [70]

Polygonum affine

Polygonaceae

Root

Lung disorder [110]

Polygonum hydropiper L.

Polygonaceae

Aerial parts

Respiratory [90]

Populus tremula

Xanthorhoeaceae

Leaves, bark

Cough [74]

Portulaca oleracea

Asteraceae

Aerial part of plant

Asthma [86]

Portulaca quadrifida

Tamaricaceae

Leaves

Cold, flu, Respiratory problems [70]

Potentilla bifurca L.

Rosaceae

Aerial part

Cough [57]

Potentilla salesoviana

Rosaceae

Flower

Cough, cold [57]

Primula veris L.

Primulaceae

Flower

Bronchitis [127]

Prosopis cineraria

Moraceae

Fruit, pods

Asthma [70]

Prosopis juliflora

Asclepidaceae

Xerophytic shrub

Asthma, cough [70]

Prosopis spicigera

Cactaceae

Bark, leaves, flowers

Asthma [109]

Prunella vulgaris L.

Asteraceae

 

Difficult breathing [70]

Prunus cornuta L.

Elaeagnaceae

Fruit

Asthma [92]

Psammogeton biternatum

  

Cough [101]

Pseudognaphalium luteoalbum

Asteraceae

Leaves

Asthma/breathing problem [110]

Psidium guajava

Malvaceae

Fruit

Old cough, bronchitis and chronic whooping cough [70]

Punica granatum

Punicaceae

Roots, fruit, rinds

Cough [70]

Pyrus communis L.

Rosaceae

Fruits

Cough [89]

Quercus incana Bartram

Podophyllaceae

Bark and fruits

Asthma/breathing problems [89]

Quercus leucotrichophora

Plantaginaceae

Banafsha

Asthma, cough [128]

Quercus floribunda

Rhamnaceae

Seeds

Asthma [70]

Ranunculus arvensis L.

Acanthaceae

Whole plant

Asthma [22]

Ranunculus muricatus L.

Solanaceae

 

Asthma [103]

Raphanus sativus L.

Brassicaceae

Whole plant

Asthma [81]

Rheum australe D. Don

Polygonaceae

Roots, rhizomes, stem, leaves

Cough [70]

Rhazya stricta

Asclepiadaceae

Whole plant

Asthma [70, 129]

Rheum emodi

Rosaceae

Floral scape

Cough and flu [38]

Rheum spiciforma Royle

Polygonaceae

Roots

Chronic bronchitis, asthama [70]

Rhodiola imbricate Edgew

Crassulaceae

Root

Cough [110]

Rhus coriaria L.

Apocynaceae

Leaves, flower, root

Cough, asthma [130]

Rhynchosia minima

Mimosaceae

Leaves

Asthma [93]

Ricinus communis

Leporidae

Leaves

Asthma and cough [49]

Rosa damascene

Amaranthaceae

 

Bronchitis, cough [76]

Rosa indica L.

Solanaceae

Flowers

Asthma [131]

Rosa webbiana

Umbelliferae

Fruits

Asthma [51]

Rubus fruiticosus Hook.

Violaceae

 

Whooping cough [128]

Rubus ulmifolius

Rosaceae

Leaves

Cough [59]

Rumex crispus L.

Solanaceae

 

Cough [103]

Rumex dentatus L.

Tamaricaceae

Fruit, stem, leaves

Cold [70]

Rumex hastatus D. Don

Fagaceae

Whole plant

Asthma, cough [130]

Rumex nepalensis Spreng

Polygonaceae

Leaves, roots

Lungs diseases [103]

Saccharum bengalense

Violaceae

Stem

Cough [56]

Salsola baryosma

Amarylliadaceae

Stem, leaves

Cough [74]

Salvadora oleoidesdecne

Apiaceae

Stem, root, oil, seed, leaves, bark

Cough [46]

Salvadora persica L.

Salvadoraceae

Seeds, roots

Cough [107]

Salvia nubicola

Labiateae

Leaves

Cough, asthma and other respiratory issues [81]

Salvia moorcroftiana

Malvaceae

Root

Cough [52]

Salvia officinalis Linn.

Liliaceae

Cough and asthma

Cough, cold [132]

Saussurea atkinsonii

Asteraceae

Aerial parts

Respiratory diseases like asthma, cough [133]

Saussurea ceratocarpa

Asteraceae

Whole plant

Asthma, bronchitis [68]

Scorzonera tortuosissima

Asteraceae

Roots, gum, flower, leaves

Cough and chest problems [107]

Sema alexandriana Miller

Asclepiadaceae

Dried leaves and pods

Asthma [52]

Silybum marianum

Sapindaceae

Leaves

Flu [35]

Sisymbrium irio L.

Brassicaceae

Leaves

Cough [52]

Skimmia laureola

Solanaceae

Leaves

Asthma [128]

Solanum melongena

Adiantaceae

Fruit, leaf, root

Asthma, bronchitis [56]

Solanum surratense

Solanaceae

Berries, root, fruit

Cough, asthma [134]

Solanum tuberosum

Solanaceae

Leaf, flower and tuber

Cough [134]

Solanum nigrum L.

Solanaceae

Leaf, berries, flowers, root

Cough, bronchitis [70]

Solanum incanum L.

Acanthaceae

Leaves, seeds

Bronchitis [52]

Sonchus asper

Leguminosae

Whole plant

Cough, asthma [70]

Spinacia oleraceal

Amarylliadaceae

Leaves

Cough [103]

Sporobolus ioclados

Solanaceae

Stem, leaves

Cough [103]

Stacia integerrima

Scrophulariaceae

Bark and fruit

Bronchial disorder [103]

Stellaria media

Caryophylaceae

Herb

Cough [103]

Suaeda fruiticosa

Fabaceae

Flower, fruit, stem, leaves

Cough [103]

Sussurea lappa

Compositae

Root

Cough with cold [94]

Swertia cordata

Gentianaceae

Flower

Cough [110]

Swertia petiolata

Violaceae

 

Asthma, bronchitis [70]

Tamarix aphylla

Amaranthaceae

Whole plant

Cough [135]

Tamarix dioica

Acanthaceae

Bark

Cough [136]

Tamarix gallica

Zygophyllacaea

Flower, fruit, stem, leaves

Asthma [58]

Tanacetum senecionis

Asteraceae

Floral parts

Asthma [57]

Taverniera persica

Myrsinaceae

Fruit, seeds, leaves, stem

Cough [74]

Taxus baccata Linn.

Moraceae

Bark

Asthma and bronchitis [100]

Taxus wallichiana Zuce

Scrophulariaceae

Leaves and fruits

Pneumonia, bronchitis, whooping cough, asthma [128]

Tephrosia lupinifolia

Myrtaceae

Roots, leaf, stem bark

Asthma [70]

Thymus linearis

Labiateae

Arial parts

Cough, asthma [128]

Thymus serpyllum L.

Lamiaceae

Dried leaves

Whooping cough, asth ma and respiratory inflammation [70]

Trachyspermum ammi

Malvaceae

Seeds and oil

Bronchitis, asthma and colds, cough [52]

Trianthema portulacastrum L.

Amaranthaceae

Roots

Asthma [70]

Trianthema triquetra

Chenopodiaceae

Flower, fruit, leaves, stem

Asthma [74]

Tribulus longipetalus L.

Amaranthaceae

Stem, leaves, fruit, seeds

Flu [51]

Tribulus terrestris L.

Amaranthacea

Root and fruit

Cough, asthma [70]

Trichodesma africanum

Boraginaceae

Leaves and fruits

Cough and chest problems [107]

Trichodesma indicum

Boraginaceae

Leaves and flowers

Flue and cough [70]

Trifolium resupinatum

Malvaceae

Whole plant

Whooping cough [70]

Trifolium alexandrium

Poaceae

Stem, leaves

Respiratory tract [74]

Trifolium pratense L.

Fabaceae

Dried flowers

Whooping cough, bronchitis and asthma [70]

Trifolium repens

Lamiaceae

Perennial herb

Coughs, colds [70]

Trigonella foenumgraecum

Acanthaceae

 

Cough [70]

Tussilago farfara L.

Asteraceae

Leaves

Cough, respiratory problems [70]

Tylophora hirsuta L.

Poaceae

Root, leaves

Asthma and whooping cough [70]

Verbascum thapsus L.

Scrophulariaceae

Flowers and leaves

Cough [128]

Vernonia anthelmentica

Asteraceae

Seeds

Cough, chest infection, Pneumonia [76]

Vicia sativa

Primulaceae

Whole plant

Respiratory diseases [70]

Viola serpens

Violaceae

Whole plant

Cold, cough and flu [70]

Viola betonicifolia Sm

Asclepiadaceae

Whole herb and flowers

Lung troubles, cough and colds, bronchitis [70]

Viola biflora L.

Pteridaceae

Flower

Cold and flu [22]

Viola canescens Wall. ex

Violaceae

Floral part

Cough [70]

Viola fedtschenkoana

Violaceae

Whole plant

Cough [22]

Viola odorata L.

Berberidaceae

Whole Plant

Flu and cold [22]

Viola stacksii

Acanthaceae

Whole plant

Cold, cough [70]

Viola sylvatica Fries

Acanthaceae

Dried plant

Cough, and cold [70]

Vitex negundo

Verbenaceae

Leaves

Flu [50]

Vitis vinifera L.

Rhamnaceae

Flowers

Bronchitis [133]

Wattakaka volubilis

Phasianidae

Leaves

Cough, cold and other respiratory problems [70]

Withania coagulans

Meliaceae

Fruit

Cough, asthma [74]

Withania somnifera

Zingerberaceae

Fruit, seeds, leaves, stem, flower

Flu [52]

Zataria multiflora Boiss.

Lamiaceae

Stem and leaves

Cough and chest problems [101]

Zea mays L.

Poaceae

 

Cough problems [44]

Zaleya pentandra

Aizoaceae

Root

Cough, phlegmatic cough and flue [70]

Zingiber officinalis

Asclepiadaceae

Stem, leaves

Flu [70]

Ziziphus jujube Mill.

Liliaceae

Fruits

Bronchitis [93]

Zizyphus nummularia

Solanaceae

Fruit

Bronchitis [40]

Zizyphus sativa G

Rhamnaceae

Fruit and leaves

Bronchitis [104]

Data analysis

Respiratory disorders have been divided into 12 categories depending upon the diseases enlisted in published research articles on ethno botanical survey of Pakistan. Diseases or categories consisting of similar disorders or pharmacological effects have been grouped as single category. The plant list was prepared on the Pakistan level as a whole by enlisting each plant only once that is being reported in different provinces for the same respiratory disease.

The conservation status of plant species was determined following the IUCN red list categories and criteria version 3.1 (IUCN red list categories and criteria, 2001) and economical value of plant species were determined using scientific literature based on the commercial value of medicinal plants in Pakistan.

Results and discussion

Diversity of plants remains essential for human beings, providing numerous modern and traditional remedies to the healthcare system. It can be precisely assumed that the present day ethno-botanical pharmacology is as old as man himself. Different medicinal plants have been in use since the ancient time. Even in the present age of science and technology, people in the developed countries still rely on traditional system of healthcare not only because of its low price, but also due to very less side effects, as compared to the modern allopathic medicines. Pakistan is rich in natural sources including medicnal plants and most of inhabitants are in remote areas and have limited economical sources so they rely on the plants for their health care needs.

Ethno botanical surveys and distribution of medicinal plants

Pakistan has been bestowed with distinctive biodiversity, consisting of a variety of climates, topographical regions, and ecological zones and holds rich diversity of medicinal plants used against various ailments [11]. The present review reported 385 plants of 85 families from different regions of Pakistan being ethno-medicinally used for treating different types of respiratory problems. Majority of 228 plants of 80 families were reported from Punjab followed by 148 plants of 60 families from Gilgit, 115 plants of 57 families from Kashmir, 95 plants of 48 families from KPK, 30 plants of 22 families from Baluchistan and 23 plants of 16 families from Sindh. Many of the plants were used in more than one region; those plants were counted just one time while enlisting. Literature review elucidates that majority of plant species being used for respiratory disorders in Pakistan belongs to Punjab. This botanical diversity from Punjab might be owing to its varied climate and soil types [12]. The distribution of plants in different regions of Pakistan is shown in Fig. 1.
Fig. 1
Fig. 1

Distribution of medicinal plants in different regions of Pakistan

A large portion of Ethno botanical overview have been accounted for from 30 districts of Punjab followed by 18 districts of Khyber Pakhtunkhwa, 12 districts of Baluchistan, 9 districts of Sindh, 7 districts of Gilgit Batistan, 10 districts of Kashmir. Still there are number of under-investigated districts that need to be surveyed for ethno botanical studies including 6 districts of Punjab, 8 districts of Khyber Pakhtunkhwa, 20 districts of Baluchistan, 20 districts of Sindh and 1 district of Gilgit Batistan. Another reason for majorty of the plants from Punjab might be that ethnobotanical surveys have been reported from maximum areas of Punjab except a few, while some regions of Northern areas and many areas of Balochistan and Sindh have not so far been explored concerning ethnobotanical knowledge. A list of investigated and under-investigated districts has been mentioned in Table 2.
Table 2

Investigated and under-investigated districts for ethno-botanical studies

Province

Investigated districts for ethno-botanical studies

Under-investigated districts for ethno-botanical studies

Punjab

30

6

Attock, Bahawalnaga, Bahawalpur, Bhakkar, Chakwal, Dera Ghazi Khan, Faisalabad, Gujranwala, Gujrat, Jhang, Jhelum, Kasur, Khushab, Mianwali, Multan, Muzaffargarh, Narowal, Nankana Sahib, Pakpattan, Rajanpur, Rawalpindi, Sahiwal, Sargodha, Sialkot, Toba Tek Singh, Vehari

Chiniot, Hfizabad, Khanewal, Okara, Rahim Yar Khan, Sheikhupura

Khyber Pakhtunkhwa

18

8

Abbottabad, Bannu, Battagram, Buner, Chitral, Dera Ismail Khan, Haripur, Karak, Kohat, Upper Kohistan, LakkiMarwat, Lower Dir, Malakand, Mansehra, Peshawar, Swat, Upper Dir, Lower Kohstan

Charsadda, Hangu, Mardan, Nowshera, Shangla, Swabi, Tank, Tor Ghar

Sindh

9

20

Ghotki, Jamshoro, Karachi, Kairpur, Sanghar, Sukkur, Tharparkar, Thatta, Karachi West

Badin, Dadu, Hyderabad, Jacobabad, Kashmore, Larkana, Matiari, Mirpurkhas, NaushahroFiroze, ShaheedBenazirabad. Kambar, Shahadkot, Shikarpur, TandoAllahyar, Tando Muhammad Khan, Umerkot, Sujawal, Karachi Central, Karachi East, Karachi South, Korangi, Malir

Gilgit Baltistan

7

1

Ghanche, Skardu, Astore, Diamer, Ghizer, Gilgit, Hunzanagar

Kharmang

Kashmir

10

 

Muzaffarabad, Hattian, Neelum, Mirpur, Bhimber, Kotli, Poonch, Bagh, Haveli, Sudhnati

Baluchistan

12

20

Awaran, Barkhan, Kachhi (Bolan), Chagai, Gwadar, Kalat, Khuzdar, Lasbela, Mastung, Musakhel, Quetta, Ziarat

Dera Bugti, Harnai, Jafarabad, Jhal Magsi, Kech (Turbat), Kharan, Kohlu, Killa Abdullah, Killa Saifullah, Loralai, Nasirabad, Nushki, Panjgur, Pishin, Sherani, Sibi, Washuk, Zhob, Lehri, Sohbatpur

Diversity, habit, and part used of medicinal plants

A total of 384 medicinal plants of 85 families were found in the literature that are being employed for the treatment of respiratory diseases in Pakistan. The most commonly used plants were member of Asteraceae family (32) followed by solanaceae (32), moraceae (17), Poaceae (13), Fabaceae (13), Amaranthaceae (13), Lamiaceae (12), rosaceae (11), Violaceae (10), ranunculaceae (10), Asclepiadaceae (10), Euphorbiaceae (9), apiaceae (9), polygonaceae (9), Malvaceae (8), Acanthacea (8), brassicaceae (8), Boraginaceae (7), liliaceae (6), Capparaceae (5), Labiatae (5), Mimosaceae (5), Papilionaceae (5), Myrtiaceae (5) and 10 families contain 4 plants, 9 families containg 3 plant species, 12 families consisting of 2 plant species and 28 families contain 1 plant species. The results, in terms of percentage, of plants in each family are represented in Fig. 2. Asteraceae holds the top position among the families used in ethno-medicines which indicates the presence of effective bioactive ingredients in the members of this family [13]. This predominance could be explained by worldwide highest number of species (23,000 species and 1535 genera) of this diverse family found in almost every habitat of all countries except Antarctica [14, 15]. Various secondary metabolites have been reported to be present in the members of this family especially sesquiterpene lactones, in addition to volatile oils and terpenoids [16, 17]. Perhaps these secondary metabolite profiles, together with the large number of species, are primarily responsible for the relevance of this family in traditional medicine. The prevalence of asteraceae family in medicinal use is not a new finding as studies from various other countries also reported similar results [18, 19]. Many species of asteraceae family are typically identified as weeds occurring in anthropogenic environments and are among the first species to emerge in the field after the soil is prepared for planting. This may contribute to the high rate of citations of species of this family in rural communities where the home gardens are the main source of medicinal plants [20].
Fig. 2
Fig. 2

Most commonly found families

Most of the medicinal plants used in ethno medicine for treating the respiratory disorders are herbs (219) followed by Shrub (112), tree (69) and only three (3) plant species are being documented as grass. Habit of plants in different regions of Pakistan is shown in Fig. 3. This predominance of herbs as a source of herbal therapies is often attributed to the fact that their high ethno botanical studies could be an indication of their abundance easy availability and the traditional knowledge [21]. Whilst shrubs and trees seem to be preferred because of their availability round the year and they are resistant to drought and seasonal variations [22]. Majority of herbal recipes include trees and shrubs due to their easy accessibility round the year, followed by utilization of herbs which might be related to their easy collection methods, higher abundance and efficacy in curing ailments as compared to other life forms [23, 24]. Thus variation in the use of medicinal plants growth form might be associated with the difference in socio-cultural believes, ecological status and variations in the practices of traditional healers.
Fig. 3
Fig. 3

Habit of medicinal plant species

It has also been revealed after literature review that leaves (131) are most commonly used in ethno medicine for the treatment of respiratory disorders. While other plant parts use frequencies are as follows, fruit (74), root (62), seeds (53), whole plant (70), stem (44), flowers (63), bark (23), and latex (6), and gum (6). Frequency of use of different plant parts are shown in Fig. 4. Preference of leaves over the other plant parts is commonly thought to be due to the reason that leaves are the photosynthetic organs containing the photosynthates which might be accountable for their medicinal values [25, 26]. It is may be due to the reason that the collection of leaves does not affect the life cycle of plant so it is preferred to use the leaves in ethno-preparations [27]. Fruit was the second most commonly used plant part according to the literature of Pakistan. It has also been reported in different studies that Fruit is being commonly used by Americans as well [28]. Roots were the third frequent used plant parts which may be due to the reason that active constituents are rich in roots [29, 30] but the collection of underground parts of the plant is not viable as it affects the plants life and such plants are considerd as highly threatened [31, 32]. The overview of ethno-botanical literature of whole country reveals that different plant parts are being used of the same plant in different areas which is may be due to the availability, ease of collection or ethnic believes of local people.
Fig. 4
Fig. 4

Plant parts used as medicine

Use and mode of preparation

The reported plants were used in 12 different respiratory disorders. The highest number of medicinal plants documented are being employed in the treatment of cough (214) followed by asthma (150), cold (57), bronchitis (56), flu (42), respiratory tract infections (27), whopping cough (16) and breathing problems (16). Percentage of plants used in ethno-medicine for the treatment of different respiratory conditions is shown in Fig. 5.
Fig. 5
Fig. 5

Common respiratory diseases treated traditionally

Different recipes are being used by local peoples for the use of medicinal plants but most common mode of preparations of phytomedicines are decoction (110), powder (14), juice (18), infusion (30), paste (8), tea (8) and oil (4). Different mode of preparation of the plants is shown in Fig. 6. Decoctions are prepared by boiling the plant in water until the volume of water is reduced to half. Previously studies reported that decoction and infusion predominates [33] because these preparations are rapid to prepare, inexpensive and easy to consume. In addition, high usage of decoction might be related to their proven efficacy over many years’ trial and indigenous knowledge accumulated on effectiveness of such preparations.
Fig. 6
Fig. 6

Mode of preparation of plant

Even though the literature was scrutinized exhaustively, there was missing information regarding the mode of preparation of ethno medicine. Many ethno-botanical studies published include raw lists of plants used medicinally, only indicating which parts are used for what ailments. Detailed preparation and application are rarely mentioned. These types of studies do not reveal the ideas underlying the use of the cited medicines nor do they explain why certain plants were selected. It is necessary to include precise medicinal indication for each species in future ethno-botanical studies in order to be able to reproduce the traditional preparations and understand their modes of actions. For example, individuals of the same species collected at different localities, in different seasons, even various times of the day and night or at different stages of growth might have strikingly different levels of active compounds [34]. Comprehensive information about both the collection and handling of each plant remedy needs to be meticulously recorded.

Pharmacological evaluation and herbal preparations

An attempt has been made to investigate the pharmacological activity of the enlisted plants from available literature to confirm their traditional use against respiratory conditions. Only 53 plants out of 384 have been found on which pharmacological studies were conducted to evaluate their anti-inflammatory, immunomodulatory, smooth-muscle relaxants, anti-allergic, anti-histaminic, mast cell stabilizing, bronchodilator and antioxidant properties as these properties are useful for the treatment of respiratory conditions [35]. Remaining 331 species mentioned in the table still needs to be pharmacologically evaluated in order to confirm their folkloric claim. Medicinal plants evaluated for pharmacological effects have been mentioned in Table 3.
Table 3

Pharmacological evaluation of medicinal plants

Scientific name

Family

Part used

Traditional use

Pharmacological effect

Refs.

Abies pindrow

Amaranthaceae

Leaves

Cough, asthma and other chest infection

Brochoprotective against histamine-induced bronchospasm, cromoglycate-like action on the mast cells and inhibition of sensitization and synthesis of reaginic-type antibodies

[40]

Abrus precatorius

Leguminosae

Root and leaves

Asthma, cough

Anti-allergic and Mast cell stabilizing effect in egg albumin induced degranulation of mast cells

[137, 138]

Achyranthes aspera Linn.

Amaranthaceae

Leaves

Pneumonia and asthma

Antihistaminic, anti-inflammatory, mast cell stabilizer and bronchoprotective effect. Inhibits action of histamine, acetylcholine and 5-HT

[139, 140]

Albizia lebbeck Benth

Moraceae

Bark

Flu, cough, lung problems

Bronchodialator, Anti-allergic, Mast cell stabilizing property due to histamine release and cytokine expression of antigen –ige activated mast cells

[141, 142]

Alstonia scholaris

Fabaceae

Bark, Leaves

Asthma

Bronchodialator, anti-tussive effect against sulfur dioxide induced mice coughing and citric acid induced guinea pigs coughing. Anti-asthmatic activity against histamine induced bronchoconstriction

[143, 144]

Althaea officinalis L.

Lythraceae

Flowers, leaves, roots, fruits

Asthma and bronchitis

Cough suppressant activity in citric acid-induced cough reflex

[145]

Artemisia vulgaris

Asclepiadaceae

Leaves

Asthma

Bronchodilator due to anticholinergic and Ca2+ antagonist mechanisms

[146]

Artemisia maritime

Asteraceae

Aerial parts

Cough

Bronchodilator activities mediated possibly through dual blockade of calcium channels and phosphodiesterase

[102]

Adhatoda vasica

Capparidaceae

Whole plant

Cough, bronchitis, asthma

Antiallergic, anti-anaphylactic, anti-inflammatory, antitussive, bronchodilator and bronchoprotective activity

[147149]

Allium cepa

Apiaceae

Stem, leaves

Cough

Mast cell membrane stabilizing activity through inhibitor of mast cell secretion and decrease in the release of tryptase, MCP-1 and IL-6

[150]

Bauhinia variegata

Mimosaceae

Bark, root, buds

Asthma

Mast cell membrane stabilizing effect

[151]

Boerhavia procumbens

Rutaceae

Roots

Cough, asthma

Anti-asthmatic and anti-inflammatory properties in Toluene diisocyanate (TDI) allergic model in rat

[152]

Cynodon dactylon

Ranunculaceae

Leaves

Asthma

Anti-anaphylactic activity and mast cell stabilizing activity

[153]

Emblica officinalis

Euphorbiaceae

Tree

Cold, cough

Anti-tussive activity

[37]

Broussonetia papyrifera (L.) Vent.

Moraceae

Fruit

Cough

Protective effect in lung inflammation and bronchitis

[154]

Bunium persicum

Apiaceae

Seeds

Cold, cough

Anti-histaminic effect

[155]

Calotropis gigantean

Convolvulaceae

All parts

Cough and asthma

Protective effect in anaphylaxis and allergic disorders due to antihistaminic and mast cell stabilizing effect

[156]

Cannabis sativa

Cannabiaceae

Whole plant

Cough

Bronchodilator

[157]

Capparis spinosa L.

Capparidaceae

Flowerl, seeds

Asthma, cough

Antiallergic and antihistaminic effect

Bronchorelaxant effects in histamine-induced bronchospasm

[158]

Capsicum annum L.

Asteraceae

Fruit

Bronchitis

Bronchodilator

[159]

Carum capticum L.

Violaceae

Seeds, leaves and flowers

Cough bronchitis and diarrhea

Bronchodilatory and anti-cholinergic effect, anti-histamine effect

[160162]

Carum carvi L.

Asteraceae

Stem and leaves

Bronchitis, cough

Bronchodilatory and anti-cholinergic effect

[163]

Ephedra gerardiana

Ephedraceae

Stem

Asthma/breathing problem

Anti-asthmatic activity in ovalbumin induced mice model

[164]

Euphorbia hirta

Labiatae

Whole plant

Asthma

Antihistaminic, antiallergic activity and mast cell from degranulation

[165]

Ficus religiosa L.

Papilionaceae

Fruit, leaves

Asthma

Mast cell stabilizing effect in histamine and acetylcholine induced bronchospasm model

[166]

Inula racemosa

Violaceae

Root

Asthma andbronchitis

Anti-histaminic, anti-serotonergic and Mast cell membrane stabilizing activity

[167]

Lepidium sativum

Fabaceae

Shoot

Cough and cold

Bronchodilator activity in histamine and acetylcholine induced bronchospasm model

[168]

Mimosa pudica Linn.

Lamiaceae

Roots, leaves

Asthma

Bronchodilator in histamine induced bronchospasm model

[169]

Nyctanthes arbortristis

Asclepidiaceae

Shrub flowers

Cough

Antihistaminic activity

[170]

Glycyrrhiza glabra

Adiantaceae

Roots

Cough

Demulscent, anti-tussive and anti-asthmatic effects via modulation of th1/th2 cytokines and enhancement of cd4+ cd25+ foxp3+ regulatory t cells in ovalbumin-sensitized mice

[35, 171]

Helianthus annuus

Papilionaceae

Flower, root, seed, leaves

Asthma, bronchial

Anti-asthmatic effect in Ovalbumin-induced mice

[172]

Hyoscyamus niger Linn.

Zygophyllaceae

Whole plant

Asthma, whooping cough

Bronchodilator effect through dual blockade of muscarinic receptors and Ca2+ channels

[173]

Trachyspermum ammi

Malvaceae

Seeds and oil

Bronchitis, asthma and colds, cough

Antiallergic, bronchodilator and spasmolytic effect (calcium antagonist)

[173]

Mangifera indica

Capparaceae

Flowers, leaves, bark and fruits

Asthma, cough

Anti-allergic, anti-asthmatic anti-cholinergic and anti-histamine effect

[174, 175]

Murraya koenigii

Rosaceae

Leaves

Asthma

Mast cell membrane stabilizing activity, anti-histaminic and anti-cholinergic effect

[3, 176]

Nigella sativa

Ranunculacea

Seeds

Whooping cough

Anti-histamine, bronchodilator and anti-asthmatic effect in asthmatic patients

[177179]

Ocimum basilicum

Solanaceae

Leaves and seeds

Bronchitis, cough, cold

Bronchodilator and vasodilator activities through dual blockade of muscarinic receptors and Ca2+ channels

[180]

Onosma bracteatum

Moraceae

Whole plant

Asthma and bronchitis

Anti-allergic and anti-inflammatory action in bronchial hyperreactivity

[181, 182]

Oryza sativa

Salicaceae

Fruit, leaves, stem

Cold

Antianaphylactic effect, anti-inflammatory action by inhibition of histamine release from mast cells

[183, 184]

Papaver nudicaule L.

Papaveraceae

Herb

Cough

Cough and asthma-relieving effects in histamine phosphate induced asthma in guinea pigs

[185]

Portula caoleracea

Asteraceae

Aerial parts

Asthma

Bronchodilator, anti-tussive and anti-asthmatic effect in histamiin induced asthmatic model bronchodilator effect, anti-tussive and anti-asthmatic effect

[156, 186, 187]

Ricinus communis

Leporidae

Leaves

Asthma and cough

Antiasthmatic activity in milk induced leukocytosis and eosinophilic mice

[188]

Salvia officinalis Linn.

Liliaceae

Leaves

Cough, cold

Bronchodilator effect via activation of voltage-dependent K+ channels and inhibition of phosphodiesterase enzyme

[129]

Solanum nigrum L.

Solanaceae

Leaf, berries, flowers, root and stem

Cough, bronchitis

Mast cell stabilizing effect in milk-induced leucocytosis and eosinophilic mice

[189]

Spinacia oleracea L.

Amarylliadaceae

Leaves

Cough

Anti-asthmatic effect in ovalbumin-induced asthmatic model

[190]

Taxus baccata Linn.

Moraceae

Bark

Asthma and bronchitis

Protective effect against bronchoconstriction and bronchial hyperreactivity in e histamine and acetylcholine aerosol induced bronchospasm

[191]

Viola odorata L.

Berberidaceae

Whole Plant

Flu and cold

Anti-asthmatic effect and Bronchodilator

[192, 193]

Artemisia scoparia Waldst. and Kit.

Asteraceae

Whole plant

Cough, chest problems

Anti-asthmatic effect

[194]

Vitexnegundo Linn.

Verbenaceae

Leaves

Flu

Anti-asthmatic, anti-inflammatory, and anti-allergic mast cell stabilizing and bronchodilatory activity

[182]

Cistanche tubulosa

Poaceae

Whole plant

Cough

Mast cell membrane stabilizing activity, anti-allergic effect

[165, 190]

Zingiber officinalis

Asclepiadaceae

Stem, leaves

Flu

Anti-asthmatic anti-inflammatory and protection against LPS induced airway hyperreactivity

[195, 196]

Ziziphus jujuba Mill

Liliaceae

Fruits

Bronchitis

Anti-allergic and anti-anaphylactic activity, anti-histamine action in milk induced eosinophilia and leukocytosis

[197, 198]

Herbal formulations are the finished labeled products containing active ingredients or plant material or combination of medicinal plants [36]. With the increase in demand of traditional medicine, worth of herbal industry is also increasing day by day [37]. Local healers from different areas use different plants in various combinations to treat respiratory conditions. Some plants mentioned by tribal healers for the treatment of respiratory conditions are known to be used in the preparation of popular herbal medicines. Among such plants are Achyranthes aspera, Adhatoda vasica, Glycyrrhiza glabra, Viola odorata and Onosma bracteatum. The major domestic manufacturers like Hamdard, Qarshi, Ajmal and others produce 300–400 herbal products. A list of 17 commercially available herbal medicines used for respiratory conditions with their composition is mentioned in a Table 4. In recent time it is important to collect the valuable knowledge from local folklore regarding medicinal use of plants to treat respiratory conditions and give more focus on the useful pharmacological evaluation of medicinal plants for their protection, usefulness and effectiveness of this disease.
Table 4

Herbal products used for respiratory disorders

Sr. no.

Brand (manu-facturer)

Use /dose

Composition

Ephedra gerardiana

Papaver somniferum

Achyranthes aspera

Glycyrrhiza glabra

Menthe arvensis

Valeriana officinalis

Mentha piperita

Hyssopus parvifloria

Zizphus vulgaris

1.

Corezcol [1]

Expectorant/10 ml 6 times/day

    

2.

Hoopinil [1]

Cough/10 ml 6 times/day

 

  

  

3.

Asthimna [1]

Asthma/10 ml TID

  

     

4.

Expectum [1]

Expectorant/10 ml 6 times/day

  

  

5.

Joshabasadar [2]

Cough/10 ml OD

   

   

6.

Linkus [3]

Cough/10 ml TID

   

 

   

7.

Shaafijoshanda [3]

Cough/1 sachet flu/BID

   

 

  

8.

Sualin [2]

Cough, flu/1–2 tablets TID

   

     

9.

Suduri [2]

Bronchitis/10 ml 6 times/day

   

     

10.

Joharjoshanda [1]

Cough/1 sachet flu/BID

   

     

11.

Tiryaq e nazla [2]

Cough, flu/6 gm OD

 

 

  

  

12.

Infuza [2]

Asthma/10 ml OD

   

     

13.

Joshina [2]

Bronchitis/1 sachet BID

   

     

14.

Sharbatsadar [1]

Bronchitis/10 ml TID

  

     

15.

Surfali [4]

Cough/10 ml TID

   

     

16.

Joshanda [2]

Cough and flu/1 sacet TID

   

     

17.

Sharbat e banafsha [1]

Cough/30 ml BID

         

Sr. no.

Brand (manu-facturer)

Use /dose

Composition

Mentha arvensis

Ocimum basilicum

Adhatoda vasica

Onosma bracteatum

Viola odorata

Acacia arabica

Zizphus sativa

Foeniculum vulgare

1.

Corezcol [1]

Expectorant/10 ml 6 times/day

 

     

2.

Hoopinil [1]

Cough/10 ml 6 times/day

  

     

3.

Asthimna [1]

Asthma/10 ml TID

  

     

4.

Expectum [1]

Expectorant/10 ml 6 times/day

  

     

5.

Joshabasadar [2]

Cough/10 ml OD

   

6.

Linkus [3]

Cough/10 ml TID

  

 

   

7.

Shaafijoshanda [3]

Cough/1 sachet flu/BID

  

 

  

8.

Sualin [2]

Cough, flu/1–2 tablets TID

 

     

9.

Suduri [2]

Bronchitis/10 ml 6 times/day

 

     

10.

Joharjoshanda [1]

Cough/1 sachet flu/BID

 

  

   

11.

Tiryaq e nazla [2]

Cough, flu/6 gm OD

   

 

  

12.

Infuza [2]

Asthma/10 ml OD

        

13.

Joshina [2]

Bronchitis/1 sachet BID

    

 

 

14.

Sharbatsadar [1]

Bronchitis/10 ml TID

  

     

15.

Surfali [4]

Cough/10 ml TID

     

  

16.

Joshanda [2]

Cough and flu/1 sacet TID

 

 

 

 

17.

Sharbat e banafsha [1]

Cough/30 ml BID

    

   

(1) Qarshi industries [pvt] Ltd, (2) Hamdard laboratories Waqf Pakistan, (3) Herbion Pakistan Pvt Ltd, (4) Ashraf labs

Conservation status

During the investigation of conservation status of medicinal plants used against respiratory conditions in Pakistan 51 plant species were evaluated through IUCN Red list categories and criteria. Among these species 5 were endangered, 1 critically endangered, 11 vulnerable, 14 rare, 16 least concern, 3 infrequent and 1 near threatened. Conservation status of 51 medicinal plants is mentioned in Table 5. Non-scientific and indiscriminate collection of medicinal plants in various parts of the area has led to the severe pressure on the availability of medicinal plants. Using the part like roots, rhizomes, bulbs could also be a severe threat for reproducing medicinal plants of the area. Unplanned collection, loss of habitat, increased exploitation and unsustainable harvesting, intensive grazing, and land leveling for agriculture, deforestation and erosion attack of pathogens were the major threats to the medicinal plants. According to IUCN threatened plant data base, about 32,000 species of plants are threatened with extinction. This figure represent 13% of estimated 250,000 of plants It is stated that rate of plant extinction has reached to one specie per day as a result of mentioned threats and it is considered 1000–10,000 time faster than that would occur naturally. If the trend remains constant, 60,000 and 100,000 plant species may disappear in the near future [38, 39]. So in order to save these medicinal plants some important measures should be taken. Government should distribute saplings each year among the villagers to plant them. Media should be used to save nature and its importance. Establishment of nurseries and botanical garden as well as local community awareness and involvement to protect these national assets will be the best conservation measure.
Table 5

Conservation status of plants

Scientific name

Family

Medicinal use

Conservation status

Population trend

Refs.

Abies pindrow Royle

Amaranthaceae

Cough, asthma

Least concern

Stable

[199]

Acacia modesta Wall

Acanthaceae

Cough, asthma

Endangerd

Persistent

[38]

Aconitum chasmanthum

Ranunculaceae

Cough, and asthma

Critically endangered

Decreasing

[200]

Aconitum violaceum

Ranunculaceae

Asthma, cough

Vulnerable

Decreasing

[200]

Alstonia scholaris

Fabaceae

Asthma

Least concern

[201]

Arisaema flavum

Berberidaceae

Cough, cold

Rare

Increased

[38]

Arisaema jacquemontii

Asclepiadaceae

Asthma

Rare

Increased

[38]

Artemisia scoparia

Asteraceae

Cough chest problems

Rare

Increased

[38]

Avena sativa

Poaceae

Asthma

Infrequent

Decreasing

[202]

Berberis lyceum

Adiantaceae

Cough

Vulnerable

Increased

[82]

Bergenia ciliate

Apiaceae

Coughs and colds, asthma

Engangerd

Increased

[82]

Bistorta amplexicaulis

Polygonaceae

Flue.

Endangerd

Persistent

[82]

Bunium persicum

Apiaceae

Cold, cough

Rare

Increased

[82]

Celtis australis L.

Ulmaceae

Cough

Engangerd

Persistent

[38]

Cichorium intybus L.

Asteraceae

Asthma and breathing problems

Rare

Increased

[38]

Cupressus sempervirens

Asteraceae

Flu and cold

Least concern

Unknown

[203]

Daucus carota

Moraceae

Asthma, bronchitis

Infrequent

Decreasing

[204]

Desmostachya bipinnata

Nyctaginaceae

Asthma

Least concern

Unknown

[205]

Ephedra gerardiana

Ephedraceae

Asthma/breathing problem

Vulnerable

Increased

[82]

Ephedra intermedia

Rosaceae

Asthma and tuberculosis.

Least concern

Stable

[206]

Ficus carica L.

Moraceae

Cough

Least concern

[207]

Ficus elastic

Moraceae

Cough, asthma

Rare

Increased

[38]

Ficus palmata

Myrtaceae

Expectorant

Rare

Increase

[38]

Inula grantioides

Asteraceae

Asthma

Rare

Increased

[38]

Juglans regia

Euphorbiaceae

Asthma

Near threatened

Decreasing

[207]

Juniperus excelsa

Cupressaceae

Chest infection

Least concern

Stable

[203]

Lemna minor

Convolvulaceae

Cold

Least concern

Unknown

[208]

Mangifera indica

Capparaceae

Asthma, cough

Infrequent

[201]

Mentha longifolia

Labiateae

Cough

Rare

Increased

[82]

Mimosa pudica L.

Lamiaceae

Asthma

Least concern

Stable

[209]

Morus alba L.

Solanaceae

Cough

Vulnerable

Persistent

[38]

Morus nigra L.

Poaceae

Cough

Vulnerable

Persistent

[38]

Olea ferruginea

Cough, cold, flue

Endangerd

Persistent

[38]

Opuntia dillenii

Lythraceae

Asthma, whooping cough

Least concern

Stable

[210]

Opuntia monacantha

Caesalpinaceae

Bronchitis and asthma

Least concern

Stable

[211]

Phyla nodiflora

Verbenaceae

Cold

Least concern

Stable

[212]

Pinus roxburghii

Solanaceae

Coughs, cold

Least concern

Stable

[38]

Pistacia integerrima

Rosaceae

Cough, asthma

Vulnerable

Increased

[82]

Plantago lanceolata

Plantaginaceae

Cough and chest diseases

Rare

Increased

[82]

Punica granatum

Punicaceae

Cough

Least concern

[207]

Pyrus communis L.

Rosaceae

Cough

Vulnerable

Persistent

[38]

Rhynchosia minima

Mimosaceae

Asthma

Least concern

Stable

[207]

Rubus fruiticosus

Violaceae

Whooping cough

Vulnerable

Persistent

[38]

Salvia nubicola

Labiateae

Cough, asthma

Vulnerable

Persistent

[38]

Thymus linearis

Labiateae

Cough, asthma

Rare

Increased

[82]

Thymus serpyllum L.

Lamiaceae

Whooping cough, asthma

Vulnerable

Persistent

[38]

Verbascum thapsus L.

Scrophulariaceae

Cough

Rare

Persistent

[38]

Viola serpens

Lamiaceae

Lung trouble

Vulnerable

Persistent

[38]

Viola biflora L.

Pteridaceae

Cold and flu

Rare

Increased

[82]

Viola canescens

Violaceae

Cough

Rare

Increased

[82]

Vitis vinifera L.

Rhamnaceae

Bronchitis

Least concern

[213]

Commercially available important plants

Among the 384 plants used against respiratory diseases 58 plants belonging to 32 families were commercially important and are a source of income for the local community. These plants are used as drugs for treating respiratory diseases in traditional system of medicine. The detailed list of local uses, part used price and commercial status for each plant is mentioned in the Table 6. The prices of each species vary from year to year and also depend on demand and supply. There was an increase of three to fivefolds in prices from collectors to the national market [40].
Table 6

Economical value of plants

Scientific name

Local name

Family

Part exported

Traditional use

Price/kg

Commercial status/exported to

Refs.

Acacia nilotica

Kikar

Apocynaceae

Flowers

Asthma

40

Increased

[214]

Achyranthes aspera Linn.

Puthkanda

Amaranthaceae

Rhizome/fruit

Pneumonia and asthma

Increased

[55]

Aconitum chasmanthum

Baroboma

Ranunculaceae

Roots

Cough, and asthma

25

Increased

[215]

Aconitum heterophyllum

Shaowboma

Ranunculaceae

Roots

Cough, asthma

400

Increased

[82, 215 ]

Aconitum violaceum

Bezhumolo

Ranunculaceae

Rhizome

Asthma, cough

250

Persistent

[55, 82]

Adhatoda vasica

Bansa

Capparidaceae

Leaves

Cough, bronchitis, asthma

5

Persistent

[215]

Adiantum capillus-veneris

Hansraal

Liliaceae

Whole plant

Coughs, bronchitis

250

Increased/Germany, Scotland, Iran and India

[82, 215 ]

Adiantum incisum Forssk

Pershoofa

Liliaceae

Fronds

Cough and cold

Increased/Germany, Scotland, Iran and India

[55]

Adiantum venustum

Sumbal

Liliaceae

Whole plant

Cough

5

Increased

[82]

Allium sativum

Thoom

Euphorbiaceae

Bulbs/leaves

Respiratory tract infection

 

Increased

[55]

Ammi visnaga

Chalveray

Amaranthaceae

Fruit

Bronchial asthma, breathing problems

40

Increased

[82]

Artemisia vulgaris

Baniru

Asclepiadaceae

Leaves/shoot, root

Asthma

12

Increased

[49, 55]

Atropa acuminataroyle

Lubbhar

Ranunculaceae

Whole plant

Cold, flu

12

Increased

[215]

Berberis lyceum

Kashmal

Papilionaceae

Wood roots

Cough

25

Increased

[82, 215 ]

Bergenia ciliate

Shaphus

Apiaceae

Leaves, rhizome, roots

Coughs and colds, asthma

300

Increased/China

[55]

Bistorta amplexicaulis

Saag

Polygonaceae

Rhizome

Flu

300

Persistent/Europe and India

[55, 82]

Bunium persicum

Zeera

Apiaceae

Fruit

Cold, cough

1000

Increased

[40, 55]

Calotropis procera

Akk

Asclepiadaceae

Roots, flowers

Cough

1000

Increased

[214]

Cannabis sativa

Bung

Cannabiaceae

Whole plant

Cough

10

Increased

[70]

Capsicum annum

Subzmirch

Asteraceae

Fruits

Bronchitis

Increased

[55]

Carum carvi

Sounjmik

Asteraceae

Seeds

Bronchitis, cough

160–180

Increased

[134]

Carum copticum

Ajwaindesi

Violaceae

Seed

Whooping, cough

15

Increased

[215]

Cassia fistula

Amaltas

Moraceae

Poods

Cough and flue

15

Increased

[215]

Cicer arietinum

Cholay

Myrtaceae

Fruit

Flu

40

Increased

[214]

Cichorium intybus

Qarali

Asteraceae

Leaves

Asthma and breathing problems

13

Increased

[49, 82]

Citrullus colocynthis

Bitter apple

Cucurbitaceae

Fruit

Bronchial asthma

50

Increased

[214, 215]

Colchicum luteum

Suranjaan-e-talkh

Colchicaceae

Coms

Bronchial diseases

500

Increased/Germany, South Africa, France and Bulgaria

[40, 215]

Coriandrum sativum

Dhaniya

Brassicaceae

Leaves/fruit

Respiratory tract infection

25

Increased

[55, 82]

Diospyros lotus

Amlok

Punicaceae

Fruits/leaves

Cough

300

Increased

[40]

Ephedra gerardiana

Soom

Ephedraceae

Fruit/leaves

Asthma/breathing problem

Increased

[55]

Ephedra intermedia

Somani

Ephedraceae

Bark/leaves

Asthma and tuberculosis

8

Increased

[82]

Eucalyptus globulus

Safaida

Moraceae

Bark/leaves

Flue

110

Increased

[214]

Foeniculum vulgare

Sonf

Papilionaceae

Leaves/seeds

Cough, pneumonia

20

Increased

[55, 214]

Fumaria indica

Pithpapadah

Fumariaceae

Shoot

Cough

Increased

[55]

Hyoscyamus niger

Khoobkalan

Zygophyllaceae

Seeds

Asthma, whooping cough

20

Increased

[215]

Juglans regia

Akhrot

Euphorbiaceae

Bark/fruit

Asthma

30

Increased

[55, 82]

Mentha longifolia

Jangli Podina

Labiateae

Whole plant

Cough

Increased

[55]

Origanum vulgare

Ganeyar

Violaceae

Root

Colds, flu, asthma

7

Increased

[82]

Peganum harmala

Harmal

Solanaceae

Seeds, leaves

Asthma

50

Increased

[214]

Pistacia integerrima

Kangar

Rosaceae

Leaves

Cough, asthma

Increased

[55]

Plantago lanceolata

Smanharswa

Plantaginaceae

Leaves/seeds

Cough and chest diseases

Increased

[55]

Punica granatum

Anar

Punicaceae

Fruit/bark/leaves

Cough

Increased

[55]

Portulaca oleracea

Asteraceae

Seeds/leaves

Asthma

Increased

[55]

Rheum australe

Chontal

Polygonaceae

Rhizome/leaves

Cough

10

Increased

[55, 82]

Salvia moorcroftiana

Gadakan

Malvaceae

Leaves/seeds

Cough

Increased

[55]

Sisymbrium irio

Khubkalan

Brassicaceae

Seeds

Cough

50

Increased

[214, 215]

Skimmia laureola

Nyra

Solanaceae

Leaves

Asthma

12

Increased

[82]

Solanum surratense

Kundiyara

Solanaceae

Fruits

Cough, asthma

Increased

[55]

Tamarix dioica

Rukh

Acanthaceae

Bark

Cough

100

Increased

[214]

Thymus linearis

Tumburu

Labiateae

Fruits

Cough, asthma

Increased

[55]

Trachyspermum ammi

Ajwain

Malvaceae

Fruits

Asthma and colds, cough

550

Increased

[40]

Viola biflora

Lilio

Pteridaceae

Flower

Cold and flu

16

Increased

[55, 82]

Viola canescens

Banafsha

Violaceae

Whole plant

Cough

16

Increased

[55]

Viola serpens

Banafsha

Violaceae

Flowers leave

Lung trouble

100–240

Increased/India, Germany and Scotland

[82, 215 ]

Withania coagulans

Akri

Meliaceae

Fruit

Cough, asthma

5

Increased

[215]

Withania somnifera

Asgand

Zingerberacee

Roots

Flu

35

Increased

[55, 215]

Zizyphus nummularia

Solanaceae

Fruit

Bronchitis

30

Increased

[214]

Zizyphus sativa

Mark Hany

Rhamnaceae

Fruit

Bronchitis

30

Increased

[55, 214]

In 2006 global trade of medicinal plants reached US$ 60 billion. Europe alone annually imports about US$ 1 billion from Africa and Asia. Such trade is expected to expand substantially by the year 2050 because of the increasing popularity of herbal medicines. Pakistan exports of high value plants generate over US$ 10.5 million annually in 2012, with a substantial percentage of the supply coming from Swat District [41]. Approximately 300 plant species are being traded in Pakistan of these were 22 medicinal plant species worth 14.733 million Rs were traded in 1990 while it was increased by 8.5 folds (122 million Rs). The geographical location of Swat District provides an ideal physical environment for the growth and nourishment of many high value medicinal and aromatic plants. These medicinal plants can make a contribution to the economic development of the area in particular and the country in general [41].

Market share of Pakistan has been declining due to unreliable and often poor quality of the material supplied, length of the supply chain, and poor marketing strategies. The availability of medicinal plants drastically decreased due to increased marketing pressure on medicinal plants, lack of job opportunities in the area, non-sustainable harvesting methods like digging of whole plant and increased population of the area. So to maximize the exports and benefits of medicinal plants, trade monitoring, equitable sharing of benefits of wild resources, improved control on harvesting and trade for the conservation of resources, enhancement of cultivation efforts, future research into trade in wild harvested plants, community participation in natural resource management and value addition in the herbal products are recommended [42].

Future recommendations

In this review, we described the medicinal plants used in Pakistan to treat respiratory disorders. Local people are using plants without any scientific base. There is a gap between traditional use of plants and pharmacological evaluation as well as very limited number of phytochemical studies has been documented. In recent time it is important to collect the valuable knowledge from local folklore regarding medicinal use of plants to treat respiratory conditions and give more focus on the useful pharmacological and phytochemical evaluation of medicinal plants for the isolation of novel compounds as well as for their protection, usefulness and effectiveness of this disease. We examined investigated areas across Pakistan in relation to medicinal plants richness and based on this we provide recommendations for the areas that should be targeted in future ethno-botanical surveys. From the review of literature it is deduced that proper documentation of data was lacking in several research articles studied. There were many spelling mistakes in the plant names and families. Life form, part used and mode of preparation for herbal remedies were also not stated in many published ethno-medicinal surveys. So in future ethno-pharmacological research with comprehensive information should be carried out in the under investigated areas to save the traditional knowledge and to take it to the light of science. Appropriate measures should be taken to increase the market share of Pakistan as well as to maximize the exports and benefits of medicinal plants. Properly monitored trade and marketing for stability in product supply, unbiased sharing of profits of wild resources, improved control on harvesting and trade for the conservation of resources, enhancement of cultivation efforts, creation of new markets for various products so as to profit the public, implementing rules and regulations at public level to facilitate attaining goals of economic development and ecosystem conservation, community participation in natural resource management and value addition in the herbal products are recommended.

The problems of biodiversity loss can be solved by underlying recommendations
  • Government should distribute saplings each year among the villagers to plant them.

  • Media should be used to save nature and its importance.

  • Initiating afforestation projects and controlling over grazing.

  • Reducing biotic pressure by supplying gas and electricity.

  • Establishment of nurseries and botanical garden as well as local community awareness and involvement to protect these national assets will be the best conservation measure.

  • Commercial exploitation of medicinal plants should make sure to safeguard the intellectual property rights of local people.

  • Providing educational material in native languages to update collectors about occurrence of medicinal flora, their therapeutic significance, and market values.

  • It is important to identify valuable species, precisely map their distribution, document their status, study their life cycle, and formulates guidelines for their conservation and management.

Conclusions

In essence, the current investigation identified that people from Pakistan discern and make use of 384 therapeutic plants, belonging to 85 families for respiratory disorders. Keeping in view the results, Asteraceae family contains more plants and herbs are the dominant life form, whereas among the parts, leaves have been maximally used in decoction form for the treatment of respiratory disorders. Moreover, 17 plant species are being frequently used by the manufacturers in different herbal products for the treatment of respiratory disorders and only 53 plants have been pharmacologically evaluated while 51 plants are in the IUCN threatened list as well as 58 plant species have reasonable commercial significance. This review will not only provide a baseline data for initial screening of promising plants used in respiratory disorders but also will be helpful for conducting phytochemical studies by the application of ethno botanical indices. The study also provides recommendations for the areas that should be targeted in future ethno-botanical surveys. The need of hour is to implement productive policies for the careful use of valuable ethno botanical inheritance of Pakistan and to fill the gap between ethno-medicine and pharmacological research, to fully elucidate promising significances of plant-derived medicines on public health.

Declarations

Authors’ contributions

All the authors have contributed equally in conducting research work and in writing research paper. All authors read and approved the final manuscript.

Acknowledgements

The authors acknowledge the financial support of Prince Abdullah Ben Khalid Celiac Disease Research Chair, Vice Deanship of Research Chairs, King Saud University, Riyadh, Saudi Arabia.

Competing interests

The authors declare that they have no competing interests.

Availability of data and materials

All the data collected is presented in the paper.

Consent for publication

Not applicable.

Ethics approval and consent to participate

Not applicable.

Funding

Not applicable.

Publisher’s Note

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Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Authors’ Affiliations

(1)
Laboratory of Cardiovascular Research and Integrative Pharmacology, College of Pharmacy, University of Sargodha, Sargodha, Pakistan
(2)
Rashid Latif College of Pharmacy, Lahore, Pakistan
(3)
Department of Pharmacology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
(4)
Prince Abdullah Ben Khaled Celiac Disease Research Chair, Department of Pediatrics, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia

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