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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Nat. Prod.</journal-id>
<journal-title>Frontiers in Natural Products</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Nat. Prod.</abbrev-journal-title>
<issn pub-type="epub">2813-2602</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="publisher-id">1602899</article-id>
<article-id pub-id-type="doi">10.3389/fntpr.2025.1602899</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Natural Products</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Anti-plasmodial and toxicological effects of BEEMAR - a natural formulation of harnessed honeycomb bioactive compounds suspended in enhanced marine plasma</article-title>
<alt-title alt-title-type="left-running-head">Adjei et al.</alt-title>
<alt-title alt-title-type="right-running-head">
<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fntpr.2025.1602899">10.3389/fntpr.2025.1602899</ext-link>
</alt-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Adjei</surname>
<given-names>Samuel</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
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<contrib contrib-type="author">
<name>
<surname>Obeng-Kyeremeh</surname>
<given-names>Richard</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/2142403/overview"/>
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<contrib contrib-type="author">
<name>
<surname>Ackah</surname>
<given-names>Isaac</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
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<contrib contrib-type="author">
<name>
<surname>Agbemelo-Tsomafo</surname>
<given-names>Constance</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
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<contrib contrib-type="author">
<name>
<surname>Amoah</surname>
<given-names>Daniel</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
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<contrib contrib-type="author">
<name>
<surname>Obeng</surname>
<given-names>Stephen Asante</given-names>
</name>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<role content-type="https://credit.niso.org/contributor-roles/formal-analysis/"/>
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<contrib contrib-type="author">
<name>
<surname>Asamoah</surname>
<given-names>Frederick</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
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<contrib contrib-type="author">
<name>
<surname>Damanka</surname>
<given-names>Susan</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/2805827/overview"/>
<role content-type="https://credit.niso.org/contributor-roles/data-curation/"/>
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<contrib contrib-type="author">
<name>
<surname>Danquah</surname>
<given-names>Kwabena Owusu</given-names>
</name>
<xref ref-type="aff" rid="aff4">
<sup>4</sup>
</xref>
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<contrib contrib-type="author">
<name>
<surname>Ntiri</surname>
<given-names>Michael Preko</given-names>
</name>
<xref ref-type="aff" rid="aff5">
<sup>5</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/2815728/overview"/>
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<contrib contrib-type="author">
<name>
<surname>Honyo</surname>
<given-names>Monia Enyonam</given-names>
</name>
<xref ref-type="aff" rid="aff6">
<sup>6</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/2804468/overview"/>
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<contrib contrib-type="author">
<name>
<surname>Erskine</surname>
<given-names>Isaac Joe</given-names>
</name>
<xref ref-type="aff" rid="aff7">
<sup>7</sup>
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<contrib contrib-type="author">
<name>
<surname>Kojo Acquah</surname>
<given-names>Festus</given-names>
</name>
<xref ref-type="aff" rid="aff6">
<sup>6</sup>
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<contrib contrib-type="author">
<name>
<surname>Amoah</surname>
<given-names>Linda Eva</given-names>
</name>
<xref ref-type="aff" rid="aff6">
<sup>6</sup>
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<contrib contrib-type="author" corresp="yes">
<name>
<surname>Kusi</surname>
<given-names>Kwadwo Asamoah</given-names>
</name>
<xref ref-type="aff" rid="aff6">
<sup>6</sup>
</xref>
<xref ref-type="corresp" rid="c001">&#x2a;</xref>
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<aff id="aff1">
<sup>1</sup>
<institution>Department of Animal Experimentation</institution>, <institution>Noguchi Memorial Institute for Medical Research (NMIMR)</institution>, <institution>College of Health Sciences</institution>, <institution>University of Ghana</institution>, <addr-line>Accra</addr-line>, <country>Ghana</country>
</aff>
<aff id="aff2">
<sup>2</sup>
<institution>Department of Anatomy</institution>, <institution>University of Ghana Medical School</institution>, <institution>College of Health Sciences</institution>, <institution>University of Ghana</institution>, <institution>Korle-Bu Campus</institution>, <addr-line>Accra</addr-line>, <country>Ghana</country>
</aff>
<aff id="aff3">
<sup>3</sup>
<institution>Department of Electron Microscopy and Histopathology</institution>, <institution>Noguchi Memorial Institute for Medical Research (NMIMR)</institution>, <institution>College of Health Sciences</institution>, <institution>University of Ghana</institution>, <addr-line>Accra</addr-line>, <country>Ghana</country>
</aff>
<aff id="aff4">
<sup>4</sup>
<institution>Department of Clinical Pathology</institution>, <institution>Noguchi Memorial Institute for Medical Research (NMIMR)</institution>, <institution>College of Health Sciences</institution>, <institution>University of Ghana</institution>, <addr-line>Accra</addr-line>, <country>Ghana</country>
</aff>
<aff id="aff5">
<sup>5</sup>
<institution>Department of Epidemiology</institution>, <institution>Noguchi Memorial Institute for Medical Research (NMIMR)</institution>, <institution>College of Health Sciences</institution>, <institution>University of Ghana</institution>, <addr-line>Accra</addr-line>, <country>Ghana</country>
</aff>
<aff id="aff6">
<sup>6</sup>
<institution>Department of Immunology</institution>, <institution>Noguchi Memorial Institute for Medical Research (NMIMR)</institution>, <institution>College of Health Sciences</institution>, <institution>University of Ghana</institution>, <addr-line>Accra</addr-line>, <country>Ghana</country>
</aff>
<aff id="aff7">
<sup>7</sup>
<institution>Department of Pathology</institution>, <institution>Korle-Bu Teaching Hospital</institution>, <addr-line>Accra</addr-line>, <country>Ghana</country>
</aff>
<author-notes>
<fn fn-type="edited-by">
<p>
<bold>Edited by:</bold> <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/1402125/overview">Abdel Nasser B. Singab</ext-link>, Ain Shams University, Egypt</p>
</fn>
<fn fn-type="edited-by">
<p>
<bold>Reviewed by:</bold> <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/1760741/overview">Mariana Guadalupe Vallejo</ext-link>, Universidad Nacional de C&#xf3;rdoba, Argentina</p>
<p>
<ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/2232001/overview">Himanshi Tanwar</ext-link>, University of Maryland, United States</p>
</fn>
<corresp id="c001">&#x2a;Correspondence: Kwadwo Asamoah Kusi, <email>akusi@noguchi.ug.edu.gh</email>
</corresp>
</author-notes>
<pub-date pub-type="epub">
<day>27</day>
<month>05</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="collection">
<year>2025</year>
</pub-date>
<volume>4</volume>
<elocation-id>1602899</elocation-id>
<history>
<date date-type="received">
<day>30</day>
<month>03</month>
<year>2025</year>
</date>
<date date-type="accepted">
<day>24</day>
<month>04</month>
<year>2025</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2025 Adjei, Obeng-Kyeremeh, Ackah, Agbemelo-Tsomafo, Amoah, Obeng, Asamoah, Damanka, Danquah, Ntiri, Honyo, Erskine, Kojo Acquah, Amoah and Kusi.</copyright-statement>
<copyright-year>2025</copyright-year>
<copyright-holder>Adjei, Obeng-Kyeremeh, Ackah, Agbemelo-Tsomafo, Amoah, Obeng, Asamoah, Damanka, Danquah, Ntiri, Honyo, Erskine, Kojo Acquah, Amoah and Kusi</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p>
</license>
</permissions>
<abstract>
<sec>
<title>Introduction</title>
<p> Increasing levels of anti-malarial drug resistance makes the development of novel drugs against malaria a necessity. Honeybee products, such as propolis, venom and honey, have been employed in traditional medicine to prevent and treat many diseases since ancient times. In theory, extracting the biologically active components of such natural products could result in the development of non-toxic and highly potent antimicrobial agents. The objectives of this study were to evaluate the pre-clinical anti-plasmodial activity and safety of BEEMAR, a patented formulation extracted from specific parts of the honeybee colony frames and suspended in-enhanced marine plasma.</p>
</sec>
<sec>
<title>Methods</title>
<p>Different concentrations of the BEEMAR were tested against <italic>Plasmodium falciparum</italic> (3D7 strain) <italic>in vitro</italic> using Sybr green growth inhibitory assay and <italic>Plasmodium berghei</italic> (NK65 strain) in vivo using Rane&#x2019;s test. Acute and sub-acute oral toxicity tests, based on Organization for Economic Cooperation and Development (OECD) guidelines, were used to assess the safety profile of the product.</p>
</sec>
<sec>
<title>Results</title>
<p>The product demonstrated significant (p&#x3c;0.05) dose-dependent inhibition of the growth of 3D7 <italic>P. falciparum strain, in vitro</italic>, with IC<sub>50</sub> of 0.55 mg/ml. In Rane&#x2019;s <italic>in vivo</italic> test, a maximum suppression of 69% was obtained at the highest dose of 1% (w/v) of the product compared to that of the standard drug, Artemether-Lumefantrine (64% at a concentration of 4mg/kg body weight) in ICR mice. Administration of the product did not result in any clinical signs of haematological or biochemical toxidromes in treated SD rats compared to the control SD rats.</p>
</sec>
<sec>
<title>Discussion</title>
<p>This study suggests that the BEEMAR product displays promising anti-plasmodial activity that is dose dependent. BEEMAR also exhibits an appreciable safety profile that requires further investigation.</p>
</sec>
</abstract>
<kwd-group>
<kwd>anti-plasmodial</kwd>
<kwd>
<italic>Plasmodium falciparum</italic>
</kwd>
<kwd>
<italic>Plasmodium berghei</italic>
</kwd>
<kwd>BEEMAR</kwd>
<kwd>malaria</kwd>
<kwd>acute toxicity</kwd>
<kwd>subacute toxicity</kwd>
</kwd-group>
<custom-meta-wrap>
<custom-meta>
<meta-name>section-at-acceptance</meta-name>
<meta-value>Biological Activities of Natural Products</meta-value>
</custom-meta>
</custom-meta-wrap>
</article-meta>
</front>
<body>
<sec id="s1">
<title>Introduction</title>
<p>Malaria is one of the most significant infectious diseases globally, resulting in an estimated 247 million cases and approximately 619,000 deaths in 2021 (<xref ref-type="bibr" rid="B33">World malaria report, 2022</xref>). According to the World Health Organization, nearly half of the world&#x2019;s population still lives in areas where the disease is transmitted. <italic>Plasmodium falciparum</italic> is responsible for most of these cases and deaths, particularly in sub-Saharan Africa, where the disease burden is highest (<xref ref-type="bibr" rid="B17">Liu et al., 2021</xref>). Current treatments for malaria are combination therapies that include artemisinin products as one major component but there is increasing evidence of the development of parasite resistance to these drugs, especially in South-East Asia (<xref ref-type="bibr" rid="B19">Lyu et al., 2021</xref>). The emergence of drug-resistant strains of <italic>P. falciparum</italic> has hampered efforts to control malaria, necessitating the development of alternative therapies. Natural products, especially those derived from plants and fungi have shown promise as anti-malarial agents (<xref ref-type="bibr" rid="B30">Seabrooks and Hu, 2017</xref>; <xref ref-type="bibr" rid="B1">Adnani et al., 2017</xref>). There is a growing interest in expanding the sources of antimicrobial and antimalarial drugs by using unprecedented multi-species resources to discover new therapies. In this context, the exploitation of honeybee products by humans for medicine and therapy has been going on for centuries.</p>
<p>Honeybees are known to produce honey, propolis, royal jelly, and bee venom, which have been reported to possess antimicrobial, anti-inflammatory, antioxidant, and immunomodulatory properties (<xref ref-type="bibr" rid="B15">Kocot et al., 2018</xref>; <xref ref-type="bibr" rid="B2">Alvarez-Suarez et al., 2014</xref>; <xref ref-type="bibr" rid="B26">Pharmaceutical Prospects of bee products, 2025</xref>). Bees forage over large distances to provide food for the hive, and in the process encounter a myriad and ever-changing array of bacteria, spores, parasites and viruses on the plants, and foliage they interact with (<xref ref-type="bibr" rid="B29">Santorelli et al., 2023</xref>). Despite their social interactions in the populated hive environment and the potential for any pathogens they carry to spread, bees are quite resilient and may benefit from some type of &#x201c;herd&#x201d; immunity (<xref ref-type="bibr" rid="B4">Chan et al., 2009</xref>). The hive has evolved highly effective nanomaterials to deal with the daily multitude of returning pathogens. Central to the honeybee immunological strategy is lysozyme, which is known to have direct antimicrobial properties but also modulates the host immune response to infection. Lysozymes generally are highly active antimicrobial agents of the innate immune system of animals and plants and are active against bacteria, viruses and fungi (<xref ref-type="bibr" rid="B7">Ferraboschi et al., 2021</xref>). In parallel to honeybee bioactive compounds, marine organisms&#x2019; resources are limitless and consistently prove efficacious at combatting viruses, bacteria, cancers, and other pathogens. Their unique chemical structures and diversity introduce novel modes of action, making them especially valuable against drug-resistant pathogens (<xref ref-type="bibr" rid="B8">Geahchan et al., 2021</xref>).</p>
<p>BEEMAR is a proprietary natural formulation that contains extracts from specific parts of the colony frames that are rich in lysozymes and other immune derivatives, suspended in Enhanced Marine Plasma, a modified ion and vitamin-rich seawater obtained from the depths of the ocean vortex where phytoplankton and zooplankton interact (<xref ref-type="bibr" rid="B27">Plasma Marino, 2025</xref>). The formulation is owned by the Irish biotech company CellNUA It is believed that BEEMAR could be effective against a wide range of pathogens, including viruses, bacteria, protozoan parasites, and fungi. The anti-<italic>Plasmodium</italic> efficacy and toxicological effects of BEEMAR have not been investigated. Vertebrate animals are used as models in medical testing because their genetic, biological and behaviour characteristics closely resemble those of humans, and many symptoms of human conditions can be replicated in several of these organisms. Rats and mice are mammals that share many processes with humans and are appropriate for use to answer many research questions. Mice and rat models of many human diseases have also been developed to advance the studies of disease pathogenesis, and to evaluate the effectiveness and toxicities of various candidate drugs. Their result can easily be extrapolated in humans. In this study, we aimed to assess the anti-plasmodial activities and toxicological effects of BEEMAR using both <italic>in vitro</italic> and <italic>in vivo</italic> approaches to generate data on BEEMAR&#x2019;s potential as an alternative anti-malarial product. We demonstrate significant anti-malarial activity against both human and murine malaria parasites and show a generally safe profile at the acute and sub-acute oral toxicity levels. There were however some few exceptions such as increased ALT levels and moderate interstitial inflammation in the lungs, as well as decreased monocyte and platelet counts in treated animals compared to control animals.</p>
</sec>
<sec sec-type="materials|methods" id="s2">
<title>Materials and methods</title>
<sec sec-type="ethics-statement" id="s2-1">
<title>Ethics statement</title>
<p>This study protocol was approved by the NMIMR Scientific and technical committee with reference number 8(4) 2021-22 and the animal study was reviewed and approved by the University of Ghana Institutional Animal Care and Use Committee (Certified Protocol Number: UG-IACUC 009/21-22). All procedures and techniques used on animals in this study were in accordance with the ARRIVE guidelines (<xref ref-type="sec" rid="s12">Supplementary Material</xref>). These animals were originally obtained from Harlan and were bred and maintained in the specific pathogen-free (SPF) barrier suite of the Animal Facility at the Noguchi Memorial Institute for Medical Research, University of Ghana. All animals used in this experiment were transferred from the breeding suit and allowed to acclimatize for seven (<xref ref-type="bibr" rid="B2">Alvarez-Suarez et al., 2014</xref>) days before commencement of experiment. Grouping of animals was based on weight-matching. Animals were humanely euthanised prior to necrotic assessment and, tissue and organ harvesting, by injecting sodium pentobarbital at a dose of 100&#xa0;mg/kg intraperitoneally. Quality assurance was maintained in accordance with good laboratory practice.</p>
</sec>
<sec id="s2-2">
<title>Preparation of BEEMAR doses</title>
<p>An admixture of lysozyme and other bioactive molecules were extracted from specific parts of the colony frames by weighing 20&#xa0;g of the caps or crushed honeycombs and mixing with 330&#xa0;mL of distilled water. This was then homogenized into a suspension using a mixer at 35,000&#xa0;rpm for 5&#xa0;min. The suspension formed is centrifuged at 11,650 &#xd7; g for 10&#xa0;min. The supernatant was collected, and the sediment further homogenized in 160&#xa0;mL of demineralised water and centrifuged at 11,650 &#xd7; g for 5&#xa0;min. The supernatant from the second centrifugation was added to the first. The supernatant was collected and filtered using the membrane filter (pore size of 0.2&#x2013;0.45&#xa0;&#xb5;m). The resulting solution was collected and dried using a vacuum evaporator at 180&#x2013;200&#xa0;rpm in a water bath set to between 38&#xb0;C and 41&#xb0;C and a vacuum pressure of 0.15&#x2013;0.20 Bar. The extract was subsequently resuspended in enhanced marine plasma and a 5% solution prepared as stock for <italic>in vitro</italic> and <italic>in vivo</italic> testing.</p>
</sec>
<sec id="s2-3">
<title>
<italic>In vitro</italic> anti-plasmodial assessment of BEEMAR</title>
<p>The <italic>in vitro</italic> sybr green growth inhibitory assay was used to determine the activity of BEEMAR against the 3D7 laboratory strain of <italic>P. falciparum</italic>. Briefly, a 1% solution of BEEMAR was serially diluted from 0.25% to 0.00195% (2-fold serial dilutions) in complete parasite culture medium (CPM) which consists of Incomplete Parasite Medium (IPM) (RPMI-1640 media containing 50&#xa0;&#x3bc;g/mL Hypoxanthine, 25&#xa0;mM HEPES, 2&#xa0;mg/mL NaHCO<sub>3</sub>, 5&#xa0;&#x3bc;g/mL gentamicin and 0.3&#xa0;mg/ml L-glutamine) supplemented with 0.5% Albumax II and 2% O-positive normal human serum. An aliquot of 50&#xa0;&#xb5;L of every test concentration was added in triplicates to a 96-well plate. Chloroquine and CPM were also added to the plates as positive and negative controls respectively for activity. This was followed by the addition of 50&#xa0;&#xb5;L of synchronized 3D7 test parasite culture at 4% haematocrit and 1% parasitaemia. The plates were then placed in a modular incubation chamber, gassed with a gas mixture containing 5% CO<sub>2</sub>, 5% O<sub>2</sub>, and 90% N<sub>2,</sub> and the chamber incubated at 37&#xb0;C for 72&#xa0;h. The plates were then frozen at &#x2212;20&#xb0;C overnight, after which they were thawed and each well incubated with 100&#xa0;&#xb5;L of lysis buffer containing 1X sybr green 1 at room temperature for 1.5&#xa0;h. Afterwards, fluorescence in the plates were read in a Varioskan Lux fluorometer at an excitation of 497&#xa0;nm and emission of 530&#xa0;nm wavelength. The IC<sub>50</sub> for each compound was determined using GraphPad Prism software and the data used to fit a dose-response curve. Three independent experiments were carried out to determine the IC<sub>50</sub> of BEEMAR.</p>
</sec>
<sec id="s2-4">
<title>
<italic>In vivo</italic> anti-plasmodial evaluation of BEEMAR</title>
<sec id="s2-4-1">
<title>Animals</title>
<p>A total of 40 female Institute of Cancer Research (ICR) mice (Hsd:ICR) aged 6&#x2013;8&#xa0;weeks old were used in this study. They were housed in normal rodent cages with dimensions 425&#xa0;mm &#xd7; 276&#xa0;mm &#xd7; 153&#xa0;mm (Techniplast S.p.A, Italy) with sterilized soft wood shavings as bedding and were provided with rodent feed pellets from AGRIFEEDS (AGRICARE LTD., Kumasi, Ghana), as well as clean water <italic>ad libitum</italic>. The animals were kept under controlled laboratory conditions, which included a temperature of 23&#xb0;C &#xb1; 2&#xb0;C, relative humidity of 60%&#x2013;70%, and a 12-h light-dark cycle.</p>
</sec>
<sec id="s2-4-2">
<title>Preparation of inoculum</title>
<p>The study used chloroquine-sensitive <italic>Plasmodium berghei</italic> (NK65 strain) that had been frozen at 5% parasitized red blood cells. The frozen cells were thawed and injected into donor ICR mice via the intraperitoneal route using a 200&#xa0;&#x3bc;L volume per mouse. The mice were then observed daily to detect the development of parasitaemia, which was determined by counting the number of infected red blood cells relative to the total number of red blood cells. When parasitaemia levels reached 5%, the donor mice were humanely euthanatized by injecting sodium pentobarbital at a dose of 100&#xa0;mg/kg intraperitoneally, and blood was collected through cardiac puncture using a sterile syringe and placed in a heparinized tube. The blood was diluted with 0.9% saline to achieve a concentration of 1 &#xd7; 10<sup>7</sup>&#xa0;<italic>P. berghei-infected</italic> red blood cells. Finally, 0.2&#xa0;mL of the infected blood was administered to each of the test mice via intraperitoneal injection.</p>
</sec>
<sec id="s2-4-3">
<title>Curative test (Rane&#x2019;s test)</title>
<p>Evaluation of the curative potential of the BEEMAR product was carried out according to a previously described method (<xref ref-type="bibr" rid="B28">Ryley and Peters, 1970</xref>; <xref ref-type="bibr" rid="B32">Uzor et al., 2021</xref>). On day 0, the standard inocula of 1 &#xd7; 10<sup>7</sup>&#xa0;<italic>P. berghei-infected</italic> red blood cells (0.2&#xa0;mL) were injected intraperitoneally (n &#x3d; 40) and the mice were observed for the establishment of infection. Seventy-two hours later, the mice were randomly grouped into 8 (n &#x3d; 5/cage) and were dosed orally from day 3 to day 7, once daily. Test groups (groups 2&#x2013;7) orally received varying doses (10<sup>0</sup>&#x2013;10<sup>&#x2212;5</sup>) (w/v) of BEEMAR diluted with distilled water. The highest dose of 1% (w/v) was equivalent to 98.7&#xa0;mg/kg, and this was serially diluted 10-fold to obtain the other five doses. The positive control group (group 1) was given 4&#xa0;mg/kg of artemether/lumefantrine (AL) as a control drug, and the negative control group (group 8) was given 10&#xa0;mL/kg of distilled water. A summary of the various animal treatments is provided in <xref ref-type="table" rid="T1">Table 1</xref>.</p>
<table-wrap id="T1" position="float">
<label>TABLE 1</label>
<caption>
<p>Dosages administered for Ranes&#x2019;s test in mice.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="left">Treatment group</th>
<th align="left">Dilution</th>
<th align="left">Average vol. (mL)</th>
<th align="left">Average b.wt (g)</th>
<th align="left">Dose (ml/kg b.wt)</th>
<th align="left">Dose (mg/kg b.wt)<xref ref-type="table-fn" rid="Tfn1">
<sup>a</sup>
</xref>
</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td align="left">1 (AL)</td>
<td align="left"/>
<td align="left">0.24</td>
<td align="left">23.6</td>
<td align="left">10.17</td>
<td align="left">4.0</td>
</tr>
<tr>
<td align="left">2/</td>
<td align="left">10<sup>0</sup>
</td>
<td align="left">0.23</td>
<td align="left">23.3</td>
<td align="left">9.87</td>
<td align="left">98.7</td>
</tr>
<tr>
<td align="left">3/</td>
<td align="left">10<sup>&#x2212;1</sup>
</td>
<td align="left">0.24</td>
<td align="left">23.5</td>
<td align="left">0.987</td>
<td align="left">0.987</td>
</tr>
<tr>
<td align="left">4/</td>
<td align="left">10<sup>&#x2212;2</sup>
</td>
<td align="left">0.24</td>
<td align="left">23.5</td>
<td align="left">0.0987</td>
<td align="left">9.87 <inline-formula id="inf1">
<mml:math id="m1">
<mml:mrow>
<mml:mo>&#xd7;</mml:mo>
</mml:mrow>
</mml:math>
</inline-formula> 10<sup>&#x2212;3</sup>
</td>
</tr>
<tr>
<td align="left">5/</td>
<td align="left">10<sup>&#x2212;3</sup>
</td>
<td align="left">0.23</td>
<td align="left">22.7</td>
<td align="left">0.00987</td>
<td align="left">9.87 <inline-formula id="inf2">
<mml:math id="m2">
<mml:mrow>
<mml:mo>&#xd7;</mml:mo>
</mml:mrow>
</mml:math>
</inline-formula> 10<sup>&#x2212;5</sup>
</td>
</tr>
<tr>
<td align="left">6/</td>
<td align="left">10<sup>&#x2212;4</sup>
</td>
<td align="left">0.24</td>
<td align="left">23.8</td>
<td align="left">0.000987</td>
<td align="left">9.87 <inline-formula id="inf3">
<mml:math id="m3">
<mml:mrow>
<mml:mo>&#xd7;</mml:mo>
</mml:mrow>
</mml:math>
</inline-formula> 10<sup>&#x2212;7</sup>
</td>
</tr>
<tr>
<td align="left">7/</td>
<td align="left">10<sup>&#x2212;5</sup>
</td>
<td align="left">0.23</td>
<td align="left">23.3</td>
<td align="left">0.0000987</td>
<td align="left">9.87 <inline-formula id="inf4">
<mml:math id="m4">
<mml:mrow>
<mml:mo>&#xd7;</mml:mo>
</mml:mrow>
</mml:math>
</inline-formula> 10<sup>&#x2212;9</sup>
</td>
</tr>
<tr>
<td align="left">8 (water)</td>
<td align="left"/>
<td align="left">0.23</td>
<td align="left">23.0</td>
<td align="left">10</td>
<td align="left">&#x2014;</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn id="Tfn1">
<label>
<sup>a</sup>
</label>
<p>mg/kg &#x3d; mL/kg x concentration of stock x dilution; b.wt &#x3d; body weight.</p>
</fn>
<fn>
<p>[1% stock &#x3d; 10&#xa0;mg/mL].</p>
</fn>
</table-wrap-foot>
</table-wrap>
</sec>
<sec id="s2-4-4">
<title>Parasitaemia measurement</title>
<p>Parasitaemia was monitored daily, beginning on day 3, by preparing a thin blood film from the tail of each mouse. The smears were prepared on microscope slides (76 &#xd7; 26&#xa0;mm) (Menzel-Glaser, Germany), air-dried, fixed with absolute methanol for 1&#x2013;3&#xa0;min, air dried and stained with 10% Giemsa at pH 7.2 for 15&#xa0;min. The stained slides were then washed gently using distilled water and air-dried at room temperature.</p>
<p>Two stained slides for each mouse were examined under a light microscope (Olympus with an oil immersion nosepiece of &#xd7;100 magnification). Three different fields on each slide were examined to calculate the average parasitaemia as previously described (<xref ref-type="bibr" rid="B3">Bantie et al., 2014</xref>) and shown below;<disp-formula id="equ1">
<mml:math id="m5">
<mml:mrow>
<mml:mo>%</mml:mo>
<mml:mtext>&#x2009;</mml:mtext>
<mml:mi>p</mml:mi>
<mml:mi>a</mml:mi>
<mml:mi>r</mml:mi>
<mml:mi>a</mml:mi>
<mml:mo>&#x3d;</mml:mo>
<mml:mfrac>
<mml:mrow>
<mml:mrow>
<mml:mfenced open="(" close=")" separators="|">
<mml:mrow>
<mml:mi>m</mml:mi>
<mml:mi>e</mml:mi>
<mml:mi>a</mml:mi>
<mml:mi>n</mml:mi>
<mml:mtext>&#x2009;</mml:mtext>
<mml:mi>p</mml:mi>
<mml:mi>a</mml:mi>
<mml:mi>r</mml:mi>
<mml:mi>a</mml:mi>
<mml:mtext>&#x2009;</mml:mtext>
<mml:mi>o</mml:mi>
<mml:mi>f</mml:mi>
<mml:mtext>&#x2009;</mml:mtext>
<mml:mi>n</mml:mi>
<mml:mi>e</mml:mi>
<mml:mi>g</mml:mi>
<mml:mi>a</mml:mi>
<mml:mi>t</mml:mi>
<mml:mi>i</mml:mi>
<mml:mi>v</mml:mi>
<mml:mi>e</mml:mi>
<mml:mtext>&#x2009;</mml:mtext>
<mml:mi>c</mml:mi>
<mml:mi>o</mml:mi>
<mml:mi>n</mml:mi>
<mml:mi>t</mml:mi>
<mml:mi>r</mml:mi>
<mml:mi>o</mml:mi>
<mml:mi>l</mml:mi>
<mml:mo>&#x2212;</mml:mo>
<mml:mi>m</mml:mi>
<mml:mi>e</mml:mi>
<mml:mi>a</mml:mi>
<mml:mi>n</mml:mi>
<mml:mtext>&#x2009;</mml:mtext>
<mml:mi>p</mml:mi>
<mml:mi>a</mml:mi>
<mml:mi>r</mml:mi>
<mml:mi>a</mml:mi>
<mml:mtext>&#x2009;</mml:mtext>
<mml:mi>o</mml:mi>
<mml:mi>f</mml:mi>
<mml:mtext>&#x2009;</mml:mtext>
<mml:mi>t</mml:mi>
<mml:mi>r</mml:mi>
<mml:mi>e</mml:mi>
<mml:mi>a</mml:mi>
<mml:mi>t</mml:mi>
<mml:mi>e</mml:mi>
<mml:mi>d</mml:mi>
<mml:mtext>&#x2009;</mml:mtext>
<mml:mi>g</mml:mi>
<mml:mi>r</mml:mi>
<mml:mi>o</mml:mi>
<mml:mi>u</mml:mi>
<mml:mi>p</mml:mi>
</mml:mrow>
</mml:mfenced>
</mml:mrow>
<mml:mi>x</mml:mi>
<mml:mn>100</mml:mn>
</mml:mrow>
<mml:mrow>
<mml:mi>m</mml:mi>
<mml:mi>e</mml:mi>
<mml:mi>a</mml:mi>
<mml:mi>n</mml:mi>
<mml:mtext>&#x2009;</mml:mtext>
<mml:mi>p</mml:mi>
<mml:mi>a</mml:mi>
<mml:mi>r</mml:mi>
<mml:mi>a</mml:mi>
<mml:mtext>&#x2009;</mml:mtext>
<mml:mi>o</mml:mi>
<mml:mi>f</mml:mi>
<mml:mtext>&#x2009;</mml:mtext>
<mml:mi>n</mml:mi>
<mml:mi>e</mml:mi>
<mml:mi>g</mml:mi>
<mml:mi>a</mml:mi>
<mml:mi>t</mml:mi>
<mml:mi>i</mml:mi>
<mml:mi>v</mml:mi>
<mml:mi>e</mml:mi>
<mml:mtext>&#x2009;</mml:mtext>
<mml:mi>c</mml:mi>
<mml:mi>o</mml:mi>
<mml:mi>n</mml:mi>
<mml:mi>t</mml:mi>
<mml:mi>r</mml:mi>
<mml:mi>o</mml:mi>
<mml:mi>l</mml:mi>
</mml:mrow>
</mml:mfrac>
</mml:mrow>
</mml:math>
</disp-formula>where &#x201c;para&#x201d; means parasitaemia.</p>
<p>Additionally, the percent parasitaemia suppression of the product was compared to the controls, and parasitaemia suppression was calculated as described previously (<xref ref-type="bibr" rid="B12">Kalra et al., 2006</xref>).</p>
</sec>
</sec>
<sec id="s2-5">
<title>Toxicological assessment of BEEMAR</title>
<sec id="s2-5-1">
<title>Acute toxicity study</title>
<p>The single-dose acute oral toxicity study following the recommendations by OECD Guidelines (425) (<xref ref-type="bibr" rid="B25">OECD, 2022</xref>) was used to evaluate the acute oral toxicity of BEEMAR in young, nulliparous, and nonpregnant female Sprague Dawley (SD) rats (Hsd:SD). The rats were kept in polycarbonate cages dimensions 480&#xa0;mm &#xd7; 265&#xa0;mm &#xd7; 210&#xa0;mm (Techniplast S.p.A, Italy) with sterilized soft wood shavings as bedding and were provided with rodent feed pellets from AGRIFEEDS (AGRICARE LTD., Kumasi, Ghana), as well as clean water <italic>ad libitum</italic>. The animals were kept under controlled laboratory conditions, which included a temperature of 23&#xb0;C &#xb1; 2&#xb0;C, relative humidity of 60%&#x2013;70%, and a 12-h light-dark cycle. A one-time oral administration of treatments and control was given to the experimental animals. 10 female SD rats were randomly divided into two (<xref ref-type="bibr" rid="B17">Liu et al., 2021</xref>) groups of five (<xref ref-type="bibr" rid="B1">Adnani et al., 2017</xref>) per cage, with one group receiving an undiluted dose (5%) of BEEMAR and the other group serving as a control and receiving distilled water. The rats were observed for clinical signs of toxic effects such as piloerection, draping, tremors, excitability, miosis, mydriasis, twitching, salivation, morbidity and mortality. This observation was conducted on the day of administration and daily for the next 14&#xa0;days. Body weight was measured before administration, on the day of administration, and weekly thereafter. On day 15, the animals were euthanized by injecting sodium pentobarbital at a dose of 100&#xa0;mg/kg intraperitoneally, blood was collected via cardiac puncture for haematological and serum biochemical analysis and a <italic>postmortem</italic> examination was performed on the major organs.</p>
</sec>
<sec id="s2-5-2">
<title>28-day repeated dose oral toxicity study</title>
<p>A repeated 28-day oral toxicity study was conducted using the OECD Guideline 407 (<xref ref-type="bibr" rid="B24">OECD, 2008</xref>). A total of 20 SD rats were randomly divided into four groups (n &#x3d; 5/cage) and were housed as described previously. The control group was given distilled water (10&#xa0;mL/kg), while the other three groups were orally administered BEEMAR daily through gavage at low (1%), medium (2.5%), and high (5%) doses for 28&#xa0;days. Throughout the 28-day treatments, the animals were observed daily for general health and clinical signs of toxicity, whereas body weight changes were recorded on days 0, 7, 14, 21, and 28 of the experiment, with the euthanasia criteria being 15% weight loss. On day 29, the animals were euthanized using isoflurane. Following euthanasia, blood was collected via cardiac puncture for haematological and serum biochemical analysis. Organs were then harvested and processed for histopathological analyses.</p>
</sec>
<sec id="s2-5-3">
<title>Haematological and biochemical analyses</title>
<p>Blood samples were collected into two different types of tubes for both the acute (day 15) and subacute (day 29): EDTA tubes and serum separator tubes. The blood in EDTA tubes was immediately analysed using the SYSMEX haematology autoanalyzer (Kobe, Japan). This analysis included determining the leukocyte count, erythrocyte count, haemoglobin concentration, haematocrit, mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC), reticulocyte ratio, platelet count, and differential leukocyte counts. The clotted blood in serum separator tubes was centrifuged at 4,000 <italic>g</italic> for 15&#xa0;min to separate the serum. The resulting serum samples were then transferred into cryovials for immediate analysis. The biochemical assays were performed using the SELECTRA JUNIOR Version 04 autoanalyzer (Vital Scientific, Spankeren, Netherlands) and included determining the levels of total bilirubin (TBIL), direct bilirubin (DBIL), aspartate aminotransferase (AST), alanine aminotransferase (ALT), total protein (TP), albumin (ALB), globulin (GB), alkaline phosphatase (ALP), &#x263;-glutamyl transpeptidase (&#x263;-GT), urea (URE), and creatinine (CR).</p>
</sec>
</sec>
<sec id="s2-6">
<title>Histopathological tissue processing and examination</title>
<p>For each of the test groups of rats used in the toxicological assessment of the product, four (<xref ref-type="bibr" rid="B30">Seabrooks and Hu, 2017</xref>) out of the five rats were randomly selected for histological processing of the six (<xref ref-type="bibr" rid="B15">Kocot et al., 2018</xref>) major organs. The kidneys, liver, lung, spleen, brain and heart of treated and control animals that were randomly selected, were harvested, and wet organ weights were measured following gross necropsy. The organs were then fixed using 10% neutral buffered formalin. Histological processing and examinations were done as previously described (<xref ref-type="bibr" rid="B20">Mahama et al., 2022</xref>). Micrographs were obtained from images taken from an average of three (<xref ref-type="bibr" rid="B19">Lyu et al., 2021</xref>) different fields.</p>
</sec>
<sec id="s2-7">
<title>Data and statistical analyses</title>
<p>GraphPad v8.0 was used to conduct all statistical analyses. All animals used in the experiments were included in the data analysis. The Student&#x2019;s t-test and one-way ANOVA (analysis of Variance) were used to compare the mean variations in data from animal/organ weights, haematological and biochemical tests. A <italic>post hoc</italic> Tukey test was performed at a 95% confidence interval for multiple comparisons where appropriate. The results were expressed as mean &#xb1; S.D. Histology scores were compared between treated animals and controls using the Mann-Whitney U test. Statistical significance in all cases was considered at p &#x3c; 0.05.</p>
</sec>
</sec>
<sec sec-type="results" id="s3">
<title>Results</title>
<sec id="s3-1">
<title>
<italic>In vitro</italic> anti-plasmodial activity of BEEMAR against <italic>Plasmodium falciparum</italic>
</title>
<p>To assess the potency of BEEMAR against the human malaria parasite, the product was tested at - 1% (w/v) against the 3D7 laboratory strain of <italic>P. falciparum in vitro</italic>. There was a dose-dependent inhibition of the growth of the parasite (<xref ref-type="table" rid="T2">Table 2</xref>; <xref ref-type="sec" rid="s12">Supplementary Material</xref>) with an average IC<sub>50</sub> of 0.055% (0.55&#xa0;mg/mL) from three repeat assays.</p>
<table-wrap id="T2" position="float">
<label>TABLE 2</label>
<caption>
<p>IC<sub>50</sub> of BEEMAR against 3D7 strain of <italic>Plasmodium falciparum</italic>.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="center">Measured Parameter</th>
<th align="center">Replicate 1</th>
<th align="center">Replicate 2</th>
<th align="center">Replicate 3</th>
<th align="center">Average (std)</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td align="left">
<bold>LogIC</bold>
<sub>
<bold>50</bold>
</sub>
</td>
<td align="center">&#x2212;1.361</td>
<td align="center">&#x2212;1.168</td>
<td align="center">&#x2212;1.266</td>
<td align="left"/>
</tr>
<tr>
<td align="left">
<bold>IC</bold>
<sub>
<bold>50</bold>
</sub> <bold>(%)</bold>
</td>
<td align="center">0.044</td>
<td align="center">0.068</td>
<td align="center">0.054</td>
<td align="center">0.055 (0.012)</td>
</tr>
<tr>
<td align="left">
<bold>R</bold>
<sup>
<bold>2</bold>
</sup>
</td>
<td align="center">0.928</td>
<td align="center">0.985</td>
<td align="center">0.965</td>
<td align="left"/>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>The sybr green I growth inhibitory assay was used to assess the efficacy of BEEMAR, against the asexual stages of the 3D7 strain of P. falciparum. A 1% solution of BEEMAR, was serially diluted over 8 concentrations and each tested in triplicate for each assay repeat. Three technical repeats were done to determine an average IC<sub>50</sub>. Std&#x2013;standard deviation.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</sec>
<sec id="s3-2">
<title>
<italic>In vivo</italic> anti-plasmodial activity against <italic>Plasmodium berghei</italic>
</title>
<p>The BEEMAR product was further tested <italic>in vivo</italic> using ICR mice and the mouse malaria parasite <italic>P. berghei</italic>. The results of the antimalarial test, based on Rane&#x2019;s curative model, showed a dose-dependent inhibition of parasitaemia by BEEMAR, compared to the control group. The lowest dose of BEEMAR (10<sup>&#x2212;5</sup>) inhibited parasite multiplication by 34.63% while the highest dose (10<sup>0</sup>) produced an inhibition of 69.04%. The highest dose of BEEMAR gave a slightly higher inhibition than the standard drug, AL (64.76% inhibition at a concentration of 4&#xa0;mg/kg body weight). While the longest survival time of the untreated mice (control group) was about 22&#xa0;days, the higher concentrations of the BEEMAR product prolonged the survival time of mice up to 29&#xa0;days (<xref ref-type="fig" rid="F1">Figure 1</xref>).</p>
<fig id="F1" position="float">
<label>FIGURE 1</label>
<caption>
<p>Survival times of mice treated with different concentrations of BEEMAR Artemether/lumefantrine (AL) was used as a positive control, and the untreated control group were administered distilled water (DW).</p>
</caption>
<graphic xlink:href="fntpr-04-1602899-g001.tif"/>
</fig>
</sec>
<sec id="s3-3">
<title>Toxicological profile of BEEMAR in SD rats</title>
<sec id="s3-3-1">
<title>Effect of BEEMAR<sup>&#xae;</sup> at the acute level</title>
<p>The acute toxicity study indicated that the BEEMAR product caused no mortality at a 5% (w/v) concentration within the first 24&#xa0;h and for the subsequent 14 days. Administration of the product did not result in any clinical signs of toxidromes such as abnormality in movements, salivation, difficulty in breathing, frequency, and consistency of stool, and mortality as compared to the control group. There was, however, a significant increase (p &#x3d; 0.0033, Student&#x2019;s t-test) in the body weight of the BEEMAR product-treated rat (25.20 &#xb1; 2.332) compared to the control (13.2 &#xb1; 1.744) as shown in <xref ref-type="table" rid="T3">Table 3</xref>. Though the relative weights of the kidneys, spleen, heart and lungs were similar, a significant variation in the liver weight between the test and control groups was observed (p &#x3d; 0.025, Student&#x2019;s t-test, <xref ref-type="table" rid="T4">Table 4</xref>). Post-mortem examination of the viscera, kidney, liver, brain, spleen and heart revealed no visible abnormal changes in the treatment groups in comparison with the control. Haematology and serum biochemistry analyses at the end of the 14-day study did not reveal statistically significant differences in most parameters except for a reduction in the % monocytes and plate counts (<xref ref-type="table" rid="T5">Table 5</xref>) as well as an increase in ALP (<xref ref-type="table" rid="T6">Table 6</xref>) in treated mice compared to controls.</p>
<table-wrap id="T3" position="float">
<label>TABLE 3</label>
<caption>
<p>Effect of BEEMAR on body weight in the acute toxicity study.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="left">Days</th>
<th align="left">Control</th>
<th align="left">BEEMAR-treated</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td align="left">Day 0</td>
<td align="left">199.6 &#xb1; 3.7</td>
<td align="left">170.8 &#xb1; 5.1</td>
</tr>
<tr>
<td align="left">Day 15</td>
<td align="left">212.8 &#xb1; 3.2</td>
<td align="left">196.0 &#xb1; 7.3</td>
</tr>
<tr>
<td align="left">Weight change (g)</td>
<td align="left">13.20 &#xb1; 1.7</td>
<td align="left">25.20 &#xb1; 2.3&#x2a;</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>Data are expressed as Mean &#xb1; Standard Error (SEM). n &#x3d; 5; Cases and controls compared by Student&#x2019;s t-test. &#x2a;Significantly different compared to the control group, p &#x3d; 0.0033.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="T4" position="float">
<label>TABLE 4</label>
<caption>
<p>Effect of BEEMAR on relative organ weight in the acute toxicity study.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th rowspan="2" align="left">Organ</th>
<th colspan="2" align="center">Relative organ weights (g)</th>
</tr>
<tr>
<th align="left">Control</th>
<th align="left">BEEMAR-treated</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td align="left">Liver</td>
<td align="left">0.0319 &#xb1; 0.0005</td>
<td align="left">0.0294 &#xb1; 0.0009&#x2a;</td>
</tr>
<tr>
<td align="left">Kidneys</td>
<td align="left">0.0033 &#xb1; 0.0000</td>
<td align="left">0.00298 &#xb1; 0.0001</td>
</tr>
<tr>
<td align="left">Spleen</td>
<td align="left">0.0029 &#xb1; 0.0001</td>
<td align="left">0.00246 &#xb1; 0.0003</td>
</tr>
<tr>
<td align="left">Heart</td>
<td align="left">0.00318 &#xb1; 0.0001</td>
<td align="left">0.0033 &#xb1; 0.0000</td>
</tr>
<tr>
<td align="left">Lungs</td>
<td align="left">0.0067 &#xb1; 0.0004</td>
<td align="left">0.00616 &#xb1; 0.0002</td>
</tr>
<tr>
<td align="left">Brain</td>
<td align="left">0.008 &#xb1; 0.0001</td>
<td align="left">0.00828 &#xb1; 0.0005</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>Data are expressed as Mean &#xb1; Standard Error (SEM). n &#x3d; 5; Cases and controls compared by Student&#x2019;s t-test. &#x2a;Significantly different compared to the control group, p &#x3d; 0.025.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="T5" position="float">
<label>TABLE 5</label>
<caption>
<p>Effect of BEEMAR on the haematological indices of rats at the acute level.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="left">Parameter</th>
<th align="left">Control</th>
<th align="left">BEEMAR-treated</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td align="left">WBC (10&#x5e;9/L)</td>
<td align="left">6.6 &#xb1; 2.0</td>
<td align="left">5.19 &#xb1; 0.5</td>
</tr>
<tr>
<td align="left">Lymphocyte percent (%)</td>
<td align="left">25.00 &#xb1; 6.4</td>
<td align="left">37.3 &#xb1; 9.1</td>
</tr>
<tr>
<td align="left">Monocytes percent (%)</td>
<td align="left">24.1 &#xb1; 3.3</td>
<td align="left">13.9 &#xb1; 2.7&#x2a;</td>
</tr>
<tr>
<td align="left">Neutrophils percent (%)</td>
<td align="left">43.5 &#xb1; 4.0</td>
<td align="left">38.4 &#xb1; 9.0</td>
</tr>
<tr>
<td align="left">Eosinophils percent (%)</td>
<td align="left">6.9 &#xb1; 2.1</td>
<td align="left">3.4 &#xb1; 0.9</td>
</tr>
<tr>
<td align="left">Basophils percent (%)</td>
<td align="left">0.6 &#xb1; 0.1</td>
<td align="left">0.4 &#xb1; 0.2</td>
</tr>
<tr>
<td align="left">Lymphocytes (10&#x5e;9/L)</td>
<td align="left">0.4 &#xb1; 0.1</td>
<td align="left">0.5 &#xb1; 0.2</td>
</tr>
<tr>
<td align="left">Monocytes (10&#x5e;9/L)</td>
<td align="left">0.3 &#xb1; 0.1</td>
<td align="left">0.2 &#xb1; 0.03</td>
</tr>
<tr>
<td align="left">Neutrophils (10&#x5e;9/L)</td>
<td align="left">0.5 &#xb1; 0.1</td>
<td align="left">0.4 &#xb1; 0.1</td>
</tr>
<tr>
<td align="left">Eosinophils (10&#x5e;9/L)</td>
<td align="left">0.08 &#xb1; 0.03</td>
<td align="left">0.04 &#xb1; 0.01</td>
</tr>
<tr>
<td align="left">Basophils (10&#x5e;9/L)</td>
<td align="left">0.006 &#xb1; 0.002</td>
<td align="left">0.004 &#xb1; 0.002</td>
</tr>
<tr>
<td align="left">RBC (10&#x5e;12/L)</td>
<td align="left">8.6 &#xb1; 0.1</td>
<td align="left">9.0 &#xb1; 0.9</td>
</tr>
<tr>
<td align="left">HGB (g/dL)</td>
<td align="left">15.9 &#xb1; 0.1</td>
<td align="left">16.4 &#xb1; 1.3</td>
</tr>
<tr>
<td align="left">HCT (%)</td>
<td align="left">41.5 &#xb1; 0.4</td>
<td align="left">44.1 &#xb1; 4.4</td>
</tr>
<tr>
<td align="left">MCV (fL)</td>
<td align="left">48.5 &#xb1; 0.7</td>
<td align="left">49.2 &#xb1; 0.6</td>
</tr>
<tr>
<td align="left">MCH (pg)</td>
<td align="left">18.5 &#xb1; 0.3</td>
<td align="left">18.4 &#xb1; 0.4</td>
</tr>
<tr>
<td align="left">MCHC (g/dL)</td>
<td align="left">38.2 &#xb1; 0.2</td>
<td align="left">37.2 &#xb1; 0.8</td>
</tr>
<tr>
<td align="left">RDW (%)</td>
<td align="left">11.8 &#xb1; 0.1</td>
<td align="left">12.7 &#xb1; 0.1</td>
</tr>
<tr>
<td align="left">RDW_SD (fL)</td>
<td align="left">43.9 &#xb1; 0.7</td>
<td align="left">46.0 &#xb1; 0.5</td>
</tr>
<tr>
<td align="left">RDW_CV (%)</td>
<td align="left">11.8 &#xb1; 0.1</td>
<td align="left">12.7 &#xb1; 0.1</td>
</tr>
<tr>
<td align="left">Platelets (10&#x5e;9/L)</td>
<td align="left">1624 &#xb1; 317.7</td>
<td align="left">882.8 &#xb1; 276.9&#x2a;</td>
</tr>
<tr>
<td align="left">MPV (fL)</td>
<td align="left">4.4 &#xb1; 0.1</td>
<td align="left">4.4 &#xb1; 0.1</td>
</tr>
<tr>
<td align="left">PDW (fL)</td>
<td align="left">7.7 &#xb1; 0.9</td>
<td align="left">5.9 &#xb1; 0.6</td>
</tr>
<tr>
<td align="left">PCT (%)</td>
<td align="left">0.7 &#xb1; 0.2</td>
<td align="left">0.4 &#xb1; 0.1</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>Data are expressed as Mean &#xb1; Standard Error (SEM). n &#x3d; 5; Cases and controls compared by Student&#x2019;s t-test. &#x2a;Significantly different compared to the control group, p &#x3d; 0.044 and 0.009 for MON% and Platelets respectively.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="T6" position="float">
<label>TABLE 6</label>
<caption>
<p>Effect of BEEMAR on the serum biochemical parameters of rats in the acute toxicity study.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="left">Parameter</th>
<th align="left">Control</th>
<th align="left">BEEMAR-treated</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td align="left">TBIL (&#x3bc;mol/L)</td>
<td align="left">7.1 &#xb1; 0.6</td>
<td align="left">7.8 &#xb1; 0.5</td>
</tr>
<tr>
<td align="left">DBIL (&#x3bc;mol/L)</td>
<td align="left">3.3 &#xb1; 0.7</td>
<td align="left">4.5 &#xb1; 0.4</td>
</tr>
<tr>
<td align="left">Total Protein (g/L)</td>
<td align="left">86.5 &#xb1; 9.0</td>
<td align="left">70.9 &#xb1; 2.7</td>
</tr>
<tr>
<td align="left">Albumin (g/L)</td>
<td align="left">40.6 &#xb1; 1.2</td>
<td align="left">37.6 &#xb1; 0.7</td>
</tr>
<tr>
<td align="left">AST (U/L)</td>
<td align="left">1.4 &#xb1; 0.2</td>
<td align="left">2.0 &#xb1; 0.6</td>
</tr>
<tr>
<td align="left">ALT (U/L)</td>
<td align="left">79.2 &#xb1; 8.0</td>
<td align="left">98.2 &#xb1; 11.6</td>
</tr>
<tr>
<td align="left">ALP (U/L)</td>
<td align="left">259.8 &#xb1; 30.7</td>
<td align="left">413.8 &#xb1; 27.0&#x2a;</td>
</tr>
<tr>
<td align="left">GGT (U/L)</td>
<td align="left">45.0 &#xb1; 18.6</td>
<td align="left">52.2 &#xb1; 21.0</td>
</tr>
<tr>
<td align="left">Urea (mmol/L)</td>
<td align="left">4.0 &#xb1; 0.2</td>
<td align="left">5.1 &#xb1; 0.2</td>
</tr>
<tr>
<td align="left">Creatinine (&#x3bc;mol/L)</td>
<td align="left">91.6 &#xb1; 25.0</td>
<td align="left">119.4 &#xb1; 10.7</td>
</tr>
<tr>
<td align="left">Globulin (g/L)</td>
<td align="left">30.2 &#xb1; 7.4</td>
<td align="left">47.3 &#xb1; 14.1</td>
</tr>
<tr>
<td align="left">Albumin/Globulin ratio</td>
<td align="left">52.1 &#xb1; 15.7</td>
<td align="left">41.9 &#xb1; 16.3</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>Data are expressed as Mean &#xb1; Standard Error (SEM). n &#x3d; 5; Cases and controls compared by Student&#x2019;s t-test. &#x2a;Significantly different compared to the control group, p &#x3d; 0.005.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</sec>
<sec id="s3-3-2">
<title>Effect of BEEMAR on weight of rats at the sub-acute level</title>
<p>There was no significant difference in the body weight between animals who were treated with different concentrations of BEEMAR and control mice over the 28&#xa0;days (<xref ref-type="fig" rid="F2">Figure 2</xref>). The relative organ weights of the animals were also not significantly different between the treated groups and the control group (<xref ref-type="table" rid="T7">Table 7</xref>).</p>
<fig id="F2" position="float">
<label>FIGURE 2</label>
<caption>
<p>Effect of BEEMAR on body weight (g) during the 28-day sub-acute acute toxicity study. The bars represent the average weight of animals in each treatment group and error bars represent the standard deviation of weights per treatment group. Low dose &#x3d; 1% (w/v) of BEEMAR in enhanced marine plasma, medium dose &#x3d; 2.5%(w/v), and high dose &#x3d; 5%(w/v).</p>
</caption>
<graphic xlink:href="fntpr-04-1602899-g002.tif"/>
</fig>
<table-wrap id="T7" position="float">
<label>TABLE 7</label>
<caption>
<p>Effect of BEEMAR on relative organ weights in the 28-day sub-acute toxicity study.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th rowspan="2" align="left">Organ</th>
<th colspan="4" align="center">Relative weight <italic>(g)</italic>
</th>
</tr>
<tr>
<th align="left">Control</th>
<th align="left">Low dose</th>
<th align="left">Medium dose</th>
<th align="left">High dose</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td align="left">Liver</td>
<td align="left">0.0397 &#xb1; 0.0019</td>
<td align="left">0.0411 &#xb1; 0.0019</td>
<td align="left">0.0384 &#xb1; 0.0014</td>
<td align="left">0.0306 &#xb1; 0.0018</td>
</tr>
<tr>
<td align="left">Kidneys</td>
<td align="left">0.0036 &#xb1; 0.0002</td>
<td align="left">0.0036 &#xb1; 0.0003</td>
<td align="left">0.0036 &#xb1; 0.0002</td>
<td align="left">0.0030 &#xb1; 0.0003</td>
</tr>
<tr>
<td align="left">Spleen</td>
<td align="left">0.0031 &#xb1; 0.0003</td>
<td align="left">0.0029 &#xb1; 0.0002</td>
<td align="left">0.0028 &#xb1; 0.0001</td>
<td align="left">0.0024 &#xb1; 0.0002</td>
</tr>
<tr>
<td align="left">Heart</td>
<td align="left">0.0037 &#xb1; 0.0003</td>
<td align="left">0.0035 &#xb1; 0.0002</td>
<td align="left">0.0039 &#xb1; 0.000</td>
<td align="left">0.0030 &#xb1; 0.0003</td>
</tr>
<tr>
<td align="left">Lungs</td>
<td align="left">0.0072 &#xb1; 0.0004</td>
<td align="left">0.0084 &#xb1; 0.0007</td>
<td align="left">0.0075 &#xb1; 0.0006</td>
<td align="left">0.0065 &#xb1; 0.0007</td>
</tr>
<tr>
<td align="left">Brain</td>
<td align="left">0.0081 &#xb1; 0.0005</td>
<td align="left">0.0083 &#xb1; 0.0004</td>
<td align="left">0.0087 &#xb1; 0.0005</td>
<td align="left">0.0069 &#xb1; 0.0007</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>Data are expressed as Mean &#xb1; Standard Error (SEM). n &#x3d; 5; Groups compared by One-way ANOVA, followed by the Tukey <italic>post hoc</italic> test where necessary. &#x2a;Significantly different compared to the control group, p &#x3c; 0.05.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</sec>
<sec id="s3-3-3">
<title>Effect of BEEMAR on haematological indices of rats at the sub-acute level</title>
<p>Results of the study indicate that the administration of the product generally caused no variation in the haematological parameters of the rats. However, there was a significant decrease in the red cell distribution width (RDW) and RDW_CV for the high dose, when compared to the control (p &#x3d; 0.02, Tukey <italic>post hoc</italic> test, <xref ref-type="table" rid="T8">Table 8</xref>). With respect to biochemical parameters, the medium (p &#x3d; 0.013, Tukey Post-hoc test) and high (p &#x3d; 0.019, Tukey Post-hoc test) doses of the product resulted in statistically significant increase in ALT of treated animals compared to controls (<xref ref-type="table" rid="T9">Table 9</xref>). Also, the high dose of the product resulted in a significantly higher ALT/AST ratio compared to the control animals.</p>
<table-wrap id="T8" position="float">
<label>TABLE 8</label>
<caption>
<p>Effect of BEEMAR on the haematological indices of the rats in the 28-day sub-acute toxicity study.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="left">Parameter</th>
<th align="left">Control</th>
<th align="left">Low dose</th>
<th align="left">Medium dose</th>
<th align="left">High dose</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td align="left">WBC (10&#x5e;9/L)</td>
<td align="left">8.0 &#xb1; 1.4</td>
<td align="left">8.1 &#xb1; 2.6</td>
<td align="left">5.8 &#xb1; 1.6</td>
<td align="left">4.8 &#xb1; 1.3</td>
</tr>
<tr>
<td align="left">Lymphocyte (%)</td>
<td align="left">45.2 &#xb1; 2.7</td>
<td align="left">40.7 &#xb1; 2.5</td>
<td align="left">39.7 &#xb1; 4.0</td>
<td align="left">48.1 &#xb1; 5.4</td>
</tr>
<tr>
<td align="left">Monocytes (%)</td>
<td align="left">19.2 &#xb1; 5.9</td>
<td align="left">10.8 &#xb1; 1.4</td>
<td align="left">19.0 &#xb1; 3.2</td>
<td align="left">10.0 &#xb1; 2.0</td>
</tr>
<tr>
<td align="left">Neutrophils (%)</td>
<td align="left">31.3 &#xb1; 4.2</td>
<td align="left">41.4 &#xb1; 3.2</td>
<td align="left">34.9 &#xb1; 4.2</td>
<td align="left">34.7 &#xb1; 5.1</td>
</tr>
<tr>
<td align="left">Eosinophils (%)</td>
<td align="left">3.9 &#xb1; 1.2</td>
<td align="left">6.9 &#xb1; 1.1</td>
<td align="left">6.1 &#xb1; 1.0</td>
<td align="left">7.0 &#xb1; 2.4</td>
</tr>
<tr>
<td align="left">Basophils (%)</td>
<td align="left">0.3 &#xb1; 0.2</td>
<td align="left">0.3 &#xb1; 0.1</td>
<td align="left">0.2 &#xb1; 0.1</td>
<td align="left">0.3 &#xb1; 0.2</td>
</tr>
<tr>
<td align="left">Lymphocytes (10&#x5e;9/L)</td>
<td align="left">0.9 &#xb1; 0.3</td>
<td align="left">0.8 &#xb1; 0.1</td>
<td align="left">0.91 &#xb1; 0.3</td>
<td align="left">0.6 &#xb1; 0.1</td>
</tr>
<tr>
<td align="left">Monocytes (10&#x5e;9/L)</td>
<td align="left">0.3 &#xb1; 0.1</td>
<td align="left">0.2 &#xb1; 0.04</td>
<td align="left">0.4 &#xb1; 0.1</td>
<td align="left">0.15 &#xb1; 0.1</td>
</tr>
<tr>
<td align="left">Neutrophils (10&#x5e;9/L)</td>
<td align="left">0.70 &#xb1; 0.2</td>
<td align="left">0.6 &#xb1; 0.2</td>
<td align="left">0.7 &#xb1; 0.2</td>
<td align="left">0.5 &#xb1; 0.2</td>
</tr>
<tr>
<td align="left">Eosinophils (10&#x5e;9/L)</td>
<td align="left">0.1 &#xb1; 0.04</td>
<td align="left">0.1 &#xb1; 0.02</td>
<td align="left">0.1 &#xb1; 0.04</td>
<td align="left">0.1 &#xb1; 0.03</td>
</tr>
<tr>
<td align="left">Basophils (10&#x5e;9/L)</td>
<td align="left">0.006 &#xb1; 0.003</td>
<td align="left">0.01 &#xb1; 0.002</td>
<td align="left">0.004 &#xb1; 0.002</td>
<td align="left">0.004 &#xb1; 0.002</td>
</tr>
<tr>
<td align="left">RBC (10&#x5e;12/L)</td>
<td align="left">8.3 &#xb1; 0.3</td>
<td align="left">8.1 &#xb1; 0.4</td>
<td align="left">7.4 &#xb1; 0.5</td>
<td align="left">7.7 &#xb1; 0.4</td>
</tr>
<tr>
<td align="left">HGB (g/dL)</td>
<td align="left">15.2 &#xb1; 0.4</td>
<td align="left">14.6 &#xb1; 0.7</td>
<td align="left">13.7 &#xb1; 0.9</td>
<td align="left">13.9 &#xb1; 0.9</td>
</tr>
<tr>
<td align="left">HCT (%)</td>
<td align="left">43.6 &#xb1; 1.5</td>
<td align="left">41.3 &#xb1; 2.2</td>
<td align="left">38.9 &#xb1; 3.1</td>
<td align="left">39.4 &#xb1; 2.9</td>
</tr>
<tr>
<td align="left">MCV (fL)</td>
<td align="left">52.7 &#xb1; 0.7</td>
<td align="left">51.1 &#xb1; 0.5</td>
<td align="left">52.1 &#xb1; 1.0</td>
<td align="left">50.9 &#xb1; 1.1</td>
</tr>
<tr>
<td align="left">MCH (pg)</td>
<td align="left">18.3 &#xb1; 0.1</td>
<td align="left">18.0 &#xb1; 0.3</td>
<td align="left">18.4 &#xb1; 0.2</td>
<td align="left">17.9 &#xb1; 2.0</td>
</tr>
<tr>
<td align="left">MCHC (g/dL)</td>
<td align="left">34.8 &#xb1; 0.4</td>
<td align="left">35.4 &#xb1; 0.5</td>
<td align="left">35.6 &#xb1; 0.7</td>
<td align="left">35.2 &#xb1; 0.5</td>
</tr>
<tr>
<td align="left">RDW (%)</td>
<td align="left">12.6 &#xb1; 0.2</td>
<td align="left">12.5 &#xb1; 0.4</td>
<td align="left">11.9 &#xb1; 0.1</td>
<td align="left">11.5 &#xb1; 0.2&#x2a;</td>
</tr>
<tr>
<td align="left">RDW_SD (fL)</td>
<td align="left">52.4 &#xb1; 0.8</td>
<td align="left">50.1 &#xb1; 1.1</td>
<td align="left">50.8 &#xb1; 1.2</td>
<td align="left">48.5 &#xb1; 1.2</td>
</tr>
<tr>
<td align="left">RDW_CV (%)</td>
<td align="left">12.6 &#xb1; 0.2</td>
<td align="left">12.5 &#xb1; 0.4</td>
<td align="left">11.9 &#xb1; 0.1</td>
<td align="left">11.5 &#xb1; 0.2&#x2a;</td>
</tr>
<tr>
<td align="left">Platelets (10&#x5e;9/L)</td>
<td align="left">1148.0 &#xb1; 124.9</td>
<td align="left">1241.0 &#xb1; 461.9</td>
<td align="left">752.2 &#xb1; 296.1</td>
<td align="left">574.2 &#xb1; 310.1</td>
</tr>
<tr>
<td align="left">MPV (fL)</td>
<td align="left">4.7 &#xb1; 0.03</td>
<td align="left">4.5 &#xb1; 0.2</td>
<td align="left">4.5 &#xb1; 0.1</td>
<td align="left">4.5 &#xb1; 0.2</td>
</tr>
<tr>
<td align="left">PDW (fL)</td>
<td align="left">6.9 &#xb1; 0.3</td>
<td align="left">7.2 &#xb1; 1.3</td>
<td align="left">6.08 &#xb1; 0.6</td>
<td align="left">5.9 &#xb1; 1.0</td>
</tr>
<tr>
<td align="left">PCT (%)</td>
<td align="left">0.5 &#xb1; 0.1</td>
<td align="left">0.6 &#xb1; 0.2</td>
<td align="left">0.3 &#xb1; 0.1</td>
<td align="left">0.3 &#xb1; 0.2</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>Data are expressed as Mean &#xb1; Standard Error (SEM). n &#x3d; 5; Groups compared by One-way ANOVA, followed by the Tukey <italic>post hoc</italic> test where necessary. Significantly different compared to the control group, p &#x3d; 0.02.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="T9" position="float">
<label>TABLE 9</label>
<caption>
<p>Effect on the biochemical parameters in the 28-day sub-acute toxicity study.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th rowspan="2" align="left">Parameter</th>
<th colspan="4" align="center">Groups</th>
</tr>
<tr>
<th align="left">Control</th>
<th align="left">Low dose</th>
<th align="left">Medium dose</th>
<th align="left">High dose</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td align="left">TBIL (&#x3bc;mol/L)</td>
<td align="left">15.4 &#xb1; 10.7</td>
<td align="left">7.2 &#xb1; 1.2</td>
<td align="left">5.9 &#xb1; 0.6</td>
<td align="left">4.9 &#xb1; 1.2</td>
</tr>
<tr>
<td align="left">DBIL (&#x3bc;mol/L)</td>
<td align="left">2.9 &#xb1; 0.6</td>
<td align="left">6.2 &#xb1; 1.7</td>
<td align="left">4.4 &#xb1; 0.8</td>
<td align="left">3.3 &#xb1; 1.4</td>
</tr>
<tr>
<td align="left">Total Protein (g/L)</td>
<td align="left">78.8 &#xb1; 3.0</td>
<td align="left">79.8 &#xb1; 8.6</td>
<td align="left">65.2 &#xb1; 3.1</td>
<td align="left">64.1 &#xb1; 1.8</td>
</tr>
<tr>
<td align="left">Albumin (g/L)</td>
<td align="left">38.5 &#xb1; 1.5</td>
<td align="left">36.9 &#xb1; 1.5</td>
<td align="left">34.4 &#xb1; 0.6</td>
<td align="left">35.7 &#xb1; 2.5</td>
</tr>
<tr>
<td align="left">AST (U/L)</td>
<td align="left">140.0 &#xb1; 16.0</td>
<td align="left">291.8 &#xb1; 55.5</td>
<td align="left">227.6 &#xb1; 43.2</td>
<td align="left">204.6 &#xb1; 77.6</td>
</tr>
<tr>
<td align="left">ALT (U/L)</td>
<td align="left">80.6 &#xb1; 4.8</td>
<td align="left">111.6 &#xb1; 13.1</td>
<td align="left">309.2 &#xb1; 35.2&#x2a;</td>
<td align="left">296.8 &#xb1; 82.8&#x2a;</td>
</tr>
<tr>
<td align="left">ALP (U/L)</td>
<td align="left">355.6 &#xb1; 54.1</td>
<td align="left">412.0 &#xb1; 28.5</td>
<td align="left">337.4 &#xb1; 56.2</td>
<td align="left">261.8 &#xb1; 19.7</td>
</tr>
<tr>
<td align="left">GGT (U/L)</td>
<td align="left">26.0 &#xb1; 14.6</td>
<td align="left">71.20 &#xb1; 42.2</td>
<td align="left">36.00 &#xb1; 11.5</td>
<td align="left">89.6 &#xb1; 52.2</td>
</tr>
<tr>
<td align="left">Urea (mmol/L)</td>
<td align="left">3.5 &#xb1; 0.1</td>
<td align="left">4.0 &#xb1; 0.2</td>
<td align="left">3.1 &#xb1; 0.4</td>
<td align="left">4.0 &#xb1; 0.2</td>
</tr>
<tr>
<td align="left">Creatinine (&#x3bc;mol/L)</td>
<td align="left">105.2 &#xb1; 13.6</td>
<td align="left">84.8 &#xb1; 26.0</td>
<td align="left">112.2 &#xb1; 24.5</td>
<td align="left">107.4 &#xb1; 17.9</td>
</tr>
<tr>
<td align="left">Globulin (g/L)</td>
<td align="left">41.7 &#xb1; 3.6</td>
<td align="left">40.3 &#xb1; 2.0</td>
<td align="left">28.2 &#xb1; 2.9</td>
<td align="left">31.4 &#xb1; 1.8</td>
</tr>
<tr>
<td align="left">Albumin/Globulin ratio</td>
<td align="left">0.6 &#xb1; 0.1</td>
<td align="left">0.4 &#xb1; 0.1</td>
<td align="left">1.4 &#xb1; 0.1</td>
<td align="left">2.5 &#xb1; 0.7</td>
</tr>
<tr>
<td align="left">ALT/AST ratio</td>
<td align="left">0.580 &#xb1; 0.058</td>
<td align="left">0.420 &#xb1; 0.108</td>
<td align="left">1.420 &#xb1; 0.116</td>
<td align="left">2.500 &#xb1; 0.734&#x2a;</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>Data are expressed as Mean &#xb1; Standard Error (SEM). n &#x3d; 5; Groups compared by One-way ANOVA, followed by the Tukey <italic>post hoc</italic> test where necessary. For ALT, medium (p &#x3d; 0.013) and high (p &#x3d; 0.019) doses were significantly different compared to the control group, while for the ALT/AST, ratio, only the high dose was significantly different compared to control (, p &#x3d; 0.011)032.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</sec>
<sec id="s3-3-4">
<title>Effect of BEEMAR on tissue damage</title>
<p>Histological evaluations of all six main organs were performed to verify the product&#x2019;s overall toxicological profile at both acute and sub-acute levels. No necropsy or other histological damages were observed in the brain, heart, kidney, liver, or spleen at the acute stage (<xref ref-type="fig" rid="F3">Figure 3</xref>). Although none of the treated rats (n &#x3d; 5) exhibited any congestion, haemorrhage or interstitial fibrosis in the lungs, there was mild interstitial inflammation (pockets of interstitial space infiltration, n &#x3d; 5) with significant (p &#x3c; 0.0001) histological quantification score compared to the control (<xref ref-type="fig" rid="F4">Figure 4</xref>).</p>
<fig id="F3" position="float">
<label>FIGURE 3</label>
<caption>
<p>Micrographs of organs of rats under acute treatment compared with control. Images were captured at both x40 <bold>(A)</bold> and &#xd7;100 <bold>(B)</bold> objective magnifications and a &#xd7;10 eyepiece magnification using an Olympus light microscope.</p>
</caption>
<graphic xlink:href="fntpr-04-1602899-g003.tif"/>
</fig>
<fig id="F4" position="float">
<label>FIGURE 4</label>
<caption>
<p>Effect of BEEMAR on rat lung at the acute level. <bold>(A)</bold> Photomicrograph of lung sections (H&#x26;E, x 4, scale bar &#x3d; 150&#xa0;um) of BEEMAR treated rats (acute) with mild infiltration of the interstitial space. Note the corresponding thicker septum (arrow). <bold>(B)</bold> Normal lung tissue of a control (CTRL). Note the relatively thinner septum (arrow). <bold>(C)</bold> Histological scoring (H.S) of acute treated rats compared with controls. The difference in scores was significant (p &#x3c; 0.0001) upon analysis with the Man-Whitney U test.</p>
</caption>
<graphic xlink:href="fntpr-04-1602899-g004.tif"/>
</fig>
<p>This was further demonstrated at the sub-acute level, where there was mild to moderate interstitial lymphocytic infiltration in the lungs: low dose (n &#x3d; 3), medium dose (n &#x3d; 1), and high dose (n &#x3d; 4). Two low dose and three high dose rats showed moderate interstitial lymphocytic infiltration of the interstitium, which thickened the interalveolar septa without causing fibrosis (<xref ref-type="fig" rid="F5">Figure 5</xref>).</p>
<fig id="F5" position="float">
<label>FIGURE 5</label>
<caption>
<p>Photomicrograph of lung sections from sub-acute study (H&#x26;E, x 10, scale bar &#x3d; 150&#xa0;um). <bold>(A)</bold> BEEMAR treated rats (sub-acute) showing moderate lymphocytic interstitial infiltration. Note the thickened septa (arrow). <bold>(B)</bold> Control mice with fairly normal lung tissue. Note the relatively normal thickness of the septum (arrow) <bold>(C)</bold> The median histological scores (H.S) for sub-acute (S.A) treated rats compared with control mice (CTRL) were statistically significant (p &#x3c; 0.0001) upon analysis with the Mann-Whitney&#x2019;s U test.</p>
</caption>
<graphic xlink:href="fntpr-04-1602899-g005.tif"/>
</fig>
<p>Kidneys of <italic>BEEMAR</italic> treated rats (sub-acute) showed mild interstitial lymphocytic infiltration but with normal architecture of glomeruli, tubules and vessels as compared to the control group (<xref ref-type="fig" rid="F6">Figure 6</xref>). The median histological scores compared to control, however, was not statistically significant (p &#x3e; 0.05). In the case of the liver, without sinusoidal congestion, haemorrhage, hydropic alteration, steatosis, bridging necrosis, or inflammation, two high dose rats developed isolated moderate periportal inflammation (<xref ref-type="fig" rid="F7">Figure 7</xref>). The lobular architecture was normal, and the median histological scores showed no significant difference statistically (p &#x3e; 0.05).</p>
<fig id="F6" position="float">
<label>FIGURE 6</label>
<caption>
<p>Photomicrograph of kidney sections from sub-acute study (H&#x26;E, x 10, scale bar &#x3d; 150&#xa0;um). <bold>(A)</bold> BEEMAR treated rats (sub-acute) showing mild interstitial lymphocytic infiltration (arrows). Note the glomeruli, tubules and vessels are all normal in architecture. <bold>(B)</bold> Control rats with fairly normal histological architecture. <bold>(C)</bold> The median histological scores (H.S) for sub-acute (S.A) treated rats as compared to control (CTRL) rats. Note that the difference between the two animal groups is not statistically significant (p &#x3e; 0.05) upon analysis with the Mann-Whitney&#x2019;s U test.</p>
</caption>
<graphic xlink:href="fntpr-04-1602899-g006.tif"/>
</fig>
<fig id="F7" position="float">
<label>FIGURE 7</label>
<caption>
<p>Photomicrograph of liver sections from sub-acute study (H&#x26;E, x 10, scale bar &#x3d; 150&#xa0;um). <bold>(A)</bold> BEEMAR treated rats (sub-acute) showing mild periportal lymphocytic infiltration (arrow). <bold>(B)</bold> control rats with relativley normal liver histological architecture. <bold>(C)</bold> Median histological scores (H.S) for sub-acute (S.A) treated rats compared with controls (CTRL). Note the difference is not statisticaly significant (p &#x3e; 0.05).</p>
</caption>
<graphic xlink:href="fntpr-04-1602899-g007.tif"/>
</fig>
<p>All other organs were normal. There was neither fibrosis nor necrosis, nor was there any intramuscular bleeding in the heart. The brains of all test animals were free of congestion, haemorrhage, inflammatory infiltration, oedema, and gliosis while the spleens, on the other hand, displayed typical red and white pulp and no macroscopic abnormalities.</p>
</sec>
</sec>
</sec>
<sec sec-type="discussion" id="s4">
<title>Discussion</title>
<p>Despite potentially encountering several microbes as they forage for nectar, and the possibility of easy spread of such microbes through their social interactions in populated hives, honeybees seem quite resilient to infection and disease-causing microbes. Humans have historically used honeybee products for medical and therapeutic purposes. However, their utility in modern medicine is limited due to a lack of scientific support. The potential side effects and adverse reactions associated with these remedies, like the cytotoxicity of honeybee venom, raise concerns about their widespread use in medical treatments. Few investigations on bioactive molecules and compounds derived from honeybee products have sought to understand their modes of action and targets, and more specifically their antigenicity, immunogenicity, and allergenicity. Honeybee products including propolis, honey, royal jelly, honeybee venom and wax have all been demonstrated to have antimicrobial properties (<xref ref-type="bibr" rid="B35">Loukas and Maria, 2023</xref>; <xref ref-type="bibr" rid="B10">Obeidat et al., 2024</xref>). Research on the pharmacological activity of honeybee products has increased in recent decades, disclosing numerous biological properties. The medicinal properties of honeybee products may in part be due to their strong innate immune defences, and lysozymes secreted by honeybees have been identified as one key component of this efficient innate defence. This forms the basis for the formulation of BEEMAR, which is an extract of bioactive compounds from specific parts of honeybee colony frames that are rich in lysozymes and other immune derivatives, and suspended in Enhanced Marine Plasma, a modified ion rich seawater obtained from highly specific locations in ocean vortices. This study therefore evaluated the anti-plasmodial and toxicological effects of BEEMAR using both <italic>in vitro</italic> and <italic>in vivo</italic> approaches.</p>
<p>The tested product showed <italic>in vitro</italic> activity against the 3D7 laboratory strain of <italic>P. falciparum</italic> tested although with a high IC<sub>50</sub> of 0.55&#xa0;mg/mL. The BEEMAR production protocol is expected to yield a high concentration of proteins, mainly lysozymes, which have been reported to have activity against microbes (<xref ref-type="bibr" rid="B16">Kunat-Budzy&#x144;ska et al., 2023</xref>). Confirmation of the antimalarial activity of honeybee lysozyme alone, however, will require purification of the honeybee lysozyme from the crude product for subsequent testing, which was not done in this study. Although no study has reported on any type of lysozyme as having antimalarial activity <italic>in vitro</italic>, <italic>in vivo</italic> studies have shown that silencing lysozyme activity in mosquitoes decreased their infectivity with mouse malaria parasites (<xref ref-type="bibr" rid="B11">Kajla et al., 2011</xref>), suggesting a protective role of mosquito lysozyme for the malaria parasite. There is the possibility that the antimalarial activity of BEEMAR observed in this study is due to other components of BEEMAR that may be playing an indispensable role together with the lysozyme to produce the observed antimalarial activity. Also, as a crude extract, BEEMAR is expected to have some other honeycomb-extract bioactive compounds such as polyphenols and free fatty acids as reported from hydro-ethanolic extracts from honeycomb (<xref ref-type="bibr" rid="B34">Zhao et al., 2020</xref>). Polyphenols from different sources have also been reported to have anti-plasmodial activity (<xref ref-type="bibr" rid="B6">Dumitru et al., 2022</xref>; <xref ref-type="bibr" rid="B21">Mamede et al., 2020</xref>).</p>
<p>The <italic>in vivo</italic> anti-plasmodial assessment was done using a mouse model since the model considers the possible involvement of the immune system and prodrug effect in the activity of the test substance against the parasite (<xref ref-type="bibr" rid="B14">Kifle et al., 2020</xref>). ICR mice were chosen because they provide an excellent model that allows for rapid parasitaemia establishment with <italic>P. berghei</italic> and this presents a similar model of <italic>P. falciparum</italic> malaria in man suitable for <italic>in vivo</italic> drug testing. Several conventional antimalarial agents such as chloroquine, halofantrine, mefloquine and more recently artemisinin derivatives have been identified using the rodent model (<xref ref-type="bibr" rid="B31">Tarkang et al., 2014</xref>). Rane&#x2019;s test was used to study curative ability during established infection by <italic>P. berghei</italic> (which is sensitive to chloroquine). <italic>In vivo</italic> anti-plasmodial activity can be classified as moderate, good, and very good if an extract displayed a percentage parasitaemia suppression equal to or greater than 50% (<xref ref-type="bibr" rid="B5">Deharo et al., 2001</xref>). Based on this classification, BEEMAR has shown a very good anti-plasmodial activity, suppressing up to 69% of parasites <italic>in vivo</italic>, making the product qualified for further evaluation of its antimalarial property. Additionally, the prolongation of the survival time of the infected mice for up to 29 days by the product was comparable to that of the standard drug and is further proof of the strong antimalarial potential of the product.</p>
<p>Toxicity may be described as the degree to which a chemical substance causes damage to exposed tissue and includes its effect on the entire organism as well as cells and organs (<xref ref-type="bibr" rid="B22">Mensah M et al., 2019</xref>). In this study, acute and 28-day subacute oral toxicity was done to ascertain the safety of the product. At a high dose of 5% (see dosage preparation), the product did not result in any death of the experimental animals, and no clinical signs of local or systemic toxic effects were observed. These results were positive signs of general safety and denoted that the product does not affect general behaviour.</p>
<p>At the acute level, there was a significant elevation in ALP and reduced relative weight of the liver. Increased hepatic enzyme activity demonstrably parallels the rise in serum ALP activity and may remain elevated for up to 1 week after the resolution of biliary obstruction (<xref ref-type="bibr" rid="B9">Green and Sambrook, 2020</xref>) but moderate levels are nonspecific as it can occur in a variety of conditions affecting the liver (<xref ref-type="bibr" rid="B18">Lowe et al., 2023</xref>). Additionally, relative organ weight indicates whether the organ has been exposed to injury or otherwise (<xref ref-type="bibr" rid="B13">Kharchoufa et al., 2020</xref>). In effect, elevated ALP coupled with the reduced relative weight of the liver suggests some damage to the liver, but this was not the case in the histopathological examination (<xref ref-type="fig" rid="F3">Figure 3</xref>). Acute toxicity data are usually of limited clinical application. Therefore, sub-acute toxicity study was carried out. The normal levels of ALP and relative organ weight of the liver during the 28&#x2013;day subacute study (<xref ref-type="table" rid="T8">Tables 8</xref>, <xref ref-type="table" rid="T9">9</xref>) suggest the damage during the acute study was reversible.</p>
<p>The repeated dose toxicity tests provide information on toxic effects, identification of target organs, effects on animal physiology, haematology, biochemical profile, and histopathology. In the present study, the body weight and the relative organ weights of all treated rats did not differ significantly (P &#x3e; 0.05) from those of the control groups. It indicates that the product did not affect appetite or adverse effects on the growth of the animals.</p>
<p>Histologically, given that interstitial inflammation (in the lungs and kidney) and periportal inflammation (in the liver) was evident in treated rats, compared to controls, and was more evident in those that received the high dose (<xref ref-type="fig" rid="F4">Figures 4</xref>&#x2013;<xref ref-type="fig" rid="F7">7</xref>), it is possible that this was caused by exposure to the product (drug reaction). The effects were particularly significant on the lungs at both acute and sub-acute levels, but the test animals&#x2019; ability to perform cardiorespiratory functions was unaffected, nevertheless. Nonetheless, this calls for further investigation into the effect of BEEMAR on lung health.</p>
<p>Rats that received the high dose treatment had minor, focal periportal inflammation in their liver, which did not harm the hepatocytes. This was consistent with the animals&#x2019; normal liver biochemistry tests performed. Honey products are widely recognized for their abundant vitamin content and bioactive components, which enhance their potential therapeutic benefits, with demonstrated hepato-protection (<xref ref-type="bibr" rid="B23">Mohd et al., 2024</xref>). Overall, we can conclude that the rats either acutely or sub-acutely tolerated the product at the dosage tested.</p>
<p>In summary, the results from this study show that BEEMAR has both <italic>in vitro</italic> and <italic>in vivo</italic> anti-plasmodial activity as it inhibits the growth of the 3D7 strain of <italic>P. falciparum</italic> and suppresses the growth of the NK65 strain of the <italic>P. berghei</italic>, respectively. The product also exhibited a generally safe profile at the acute and sub-acute oral toxicity levels, with few exceptions such as increased ALT levels, the significantly moderate interstitial inflammation in the lungs, and decreased monocyte and platelet counts compared to control animals. These results highlight the application of insect immune factors as potential treatment for human diseases and warrants further investigations into the effectiveness of the products against other pathogens.</p>
</sec>
</body>
<back>
<sec sec-type="data-availability" id="s5">
<title>Data availability statement</title>
<p>The original contributions presented in the study are included in the article/<xref ref-type="sec" rid="s12">Supplementary Material</xref>, further inquiries can be directed to the corresponding author.</p>
</sec>
<sec sec-type="ethics-statement" id="s6">
<title>Ethics statement</title>
<p>The animal study was approved by University of Ghana Institutional Animal Care and Use Committee (Certified Protocol Number: UG-IACUC 009/21-22). The study was conducted in accordance with the local legislation and institutional requirements.</p>
</sec>
<sec sec-type="author-contributions" id="s7">
<title>Author contributions</title>
<p>SA: Conceptualization, Investigation, Methodology, Supervision, Validation, Writing &#x2013; original draft. RO-K: Data curation, Formal Analysis, Investigation, Writing &#x2013; review and editing. IA: Data curation, Formal Analysis, Investigation, Visualization, Writing &#x2013; review and editing. CA-T: Data curation, Investigation, Visualization, Writing &#x2013; review and editing. DA: Investigation, Visualization, Writing &#x2013; review and editing. SO: Formal Analysis, Investigation, Visualization, Writing &#x2013; original draft. FA: Formal Analysis, Methodology, Visualization, Writing &#x2013; review and editing. SD: Data curation, Formal Analysis, Investigation, Supervision, Visualization, Writing &#x2013; review and editing. KD: Data curation, Investigation, Validation, Visualization, Writing &#x2013; review and editing. MN: Investigation, Methodology, Validation, Writing &#x2013; review and editing. MH: Data curation, Formal Analysis, Investigation, Visualization, Writing &#x2013; review and editing. IE: Data curation, Formal Analysis, Investigation, Visualization, Writing &#x2013; review and editing. FK: Data curation, Formal Analysis, Investigation, Methodology, Writing &#x2013; original draft, Writing &#x2013; review and editing. LA: Investigation, Methodology, Validation, Visualization, Writing &#x2013; original draft. KK: Conceptualization, Data curation, Funding acquisition, Investigation, Methodology, Project administration, Resources, Supervision, Validation, Visualization, Writing &#x2013; original draft, Writing &#x2013; review and editing.</p>
</sec>
<sec sec-type="funding-information" id="s8">
<title>Funding</title>
<p>The author(s) declare that financial support was received for the research and/or publication of this article. This project was made possible with financial support from CellNUA UK Ltd, who also own the BEEMAR product formula. Funders however had no role in the study performance, manuscript preparation or the decision to publish this report.</p>
</sec>
<ack>
<p>Authors are grateful to the animal care and technical staff of the Animal Experimentation, Electron Microscopy and Histopathology as well as Immunology Departments at NMIMR. The following reagents were obtained through BEI Resources, NIAID, NIH: <italic>Plasmodium berghei</italic>, Strain NK65, MRA-268, contributed by Victor Nussenzweig and <italic>Plasmodium falciparum</italic>, Strain 3D7, MRA-102, contributed by Daniel J. Carucci.</p>
</ack>
<sec sec-type="COI-statement" id="s9">
<title>Conflict of interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec sec-type="ai-statement" id="s10">
<title>Generative AI statement</title>
<p>The author(s) declare that no Generative AI was used in the creation of this manuscript.</p>
</sec>
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