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. 2018 Sep 18;13:48. doi: 10.1186/s13020-018-0204-y

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

Alamgeer 1,, Waqas Younis 1, Hira Asif 1, Amber Sharif 1, Humayun Riaz 2, Ishfaq Ali Bukhari 3, Asaad Mohamed Assiri 4
PMCID: PMC6145130  PMID: 30250499

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.

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

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Contributor Information

Alamgeer, Email: alam_yuchi@yahoo.com, Email: alamgeer@uos.edu.pk.

Waqas Younis, Email: waqas_uos@outlook.com.

Hira Asif, Email: drhiraasif@gmail.com.

Amber Sharif, Email: dramber_sharif@live.com.

Humayun Riaz, Email: humayunariaz@hotmail.com.

Ishfaq Ali Bukhari, Email: ishfaqbukhari@yahoo.com.

Asaad Mohamed Assiri, Email: prof-asad@hotmail.com.

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