Int.J.Curr.Microbiol.App.Sci (2015) 4(8): 343-351

ISSN: 2319-7706 Volume 4 Number 8 (2015) pp. 343-351 http://www.ijcmas.com

Review Article Medicinal indica and Prosopis gladulosa an Alternative Medication for Candidiasis

A.L. Tariq1*, U. Priya1 and Reyaz Ahmad Lone2

1Department of Microbiology, Sree Amman Arts and Science College, Erode-638102, Tamil Nadu, 2Department of Biotechnology, Periyar University, Salem-636011, Tamil Nadu, India *Corresponding author

A B S T R A C T

Candidiasis is the infection caused by the species of genus Candida. These are thin walled, ovoid yeast cells typically 4-6 cm in size. More than one hundred fifty species are identified in that nine species are pathogenic to human beings. Candida and other yeast like organisms often form the normal flora of skin, mouth, vagina, K e y w o r d s intestine and known to be opportunistic pathogens in infected persons with low body defense mechanism. Patients usually with HIV infection, diabetes mellitus, Candida drug addiction or inhaled steroids were risk cases for Candida infections. The infections, development of microbial resistant to antibiotics has led the research to investigate Medicinal the alternative source for the treatment of resistant strains. One possible approach is plants, to screen local medicinal plants to get the compound, which can be directly use as Acalypha antifungal agents or can serve as template for drug development. Medicinal plants indica, have been used as an exemplary source from centuries as an alternative remedy for Prosopis treating human diseases because they contain numerous active constitutes of gladulosa therapeutic value. Bioactive compounds currently extracted from plants are used as medicines. Many of the species have traditional value and scientifically evaluated for their possible medicinal application. Here in this review we investigated the medicinal plants Acalypha indica and Prosopis gladulosa an alternative medication for candidiasis. Introduction

Herbal medicine is the oldest form of health for medicinal purpose in India has been care known to mankind and it will not be documented in ancient literature (Kirtikr and annex aggregation to say that use of herbal Basu, 1975). The world health organization drug for human health is probably as ancient has estimated that 80% population of the as mankind (Amita and Kalpana, 2009). developing countries is unable to afford the India is represented by rich culture, pharmaceutical drugs and rely on traditional tradition, natural biodiversity and offer herbal medicine to sustain their primary unique opportunity for the drug discovery health care needs (Sankaranarayanan et al., researches. Utilization of plants 2010). The development of microbial

343 Int.J.Curr.Microbiol.App.Sci (2015) 4(8): 343-351 resistant to antibiotics has led the research to tube forms within two hours of incubation in investigate the alternative source for the Candida albicans. The carbohydrate treatment of resistant strains (Lata et al., assimilation test for Candida albicans is 2010). Various techniques have been positive for dextrose, maltose, sucrose, adopted for enhancing bioactive molecules galactose, xylose and trehalose. At the same in medicinal plants. Recent advantage in the time, the tests are negative for lactose, molecular biology, enzymology and melibiose, cellobiose, inositol, reffinose and fermentation technology of plant cell culture ducitol. Similarly, the carbohydrate suggest that their system may become a fermentation tests for Candida albicans are viable source of important secondary dextrose, maltose, galactose and trehalose metabolites (Mohammed Yaseen et al., were positive but negative for fermentation 2009). The valuable and in-depth knowledge of sucrose and lactose. about the medicinal plant in India gathered over a long period of time need to be Vulvovaginalitis candidiasis exploited scientifically to the maximum extent. Thrush is caused by Candida albicans, which may be present in the vagina of up to Identification of Candida albicans 20% of sexually active women initially but may become pathogenic when conditions of Candida species are thin walled; ovoid yeast vagina changes, particularly when there is a cells typically 4-6 cm in size. More than one rise in vaginal pH or an excess of glycogen hundred fifty species are identified in that that has not been converted to lactic acid by nine are pathogenic to human beings. Lactobacilli (Alison, 2000). Symptoms of Candida and other yeast like organisms vaginitis involve itching, burning, cheesy often form the normal flora of skin, mouth, white scant discharge is uncommon (Sobel, vagina, intestine and known to be 1997). It has been reported that in Candida opportunistic pathogens infect persons with albicans the cytosolic enzyme and enolase low body defense mechanism (Yung- Liang, act as an immuno-dominant antigen 2003). Candida albicans grow at 37oC and (Mitsuake et al., 1994). Vaginal thrush is produce germ tubes and chlamydospores on characterized by typical white lesion corn meal agar and blood plasma. Negative developed on the epithelial surface of results are shown for pellicle growth and gas vagina, vulva and cervix (Saravana Bhavan on Sabouraud s broth and for ascospores et al., 2010). Water change is the most formation, nitrate production and growth on common cause of vaginitis. Physical seed agar tests, but growth occurs on Eosin examination finding include a vagina and methylene blue agar with tetracycline (Gow, labia that are usually erythematous, a thick 1997). Candida is also able to assimilate curd like discharge and a norma cervix upon sucrose, dextrose, galactose, maltose, speculum examination (Sobel et al., 2003). trehalose and xylose but not lactose, Candidiasis infection caused by Candida reffinose and cellobiose. These characters albicans can be acute or chronic, superficial are the typical one used for Candida or deep, and its clinical symptoms are so albicans confirmation. When the suspected wide that a more specific definition cannot strains of Candida albicans is inoculated be made (Changdeo, 2014; Francois et al., with human serum the formation of germ 2013). Various identification tests like tube was seen as long tube like projection growth pattern, sugar fermentation, urease extending from the yeast cells. The germ production and development of germ tube in

344 Int.J.Curr.Microbiol.App.Sci (2015) 4(8): 343-351 human serum confirms the presence of Ketaconazole and 5-Fluorocystisine Candida albicans (Al-Fattani and Douglas, (Wayne, 2004). One of the major increases 2006). Candida is harmless initially, but in the Candida is the development of its may become pathogenic when the resistant strains to azoles drugs used in the conditions in the vagina change, particularly prophylaxis and treatment of candidiasis. when there is a rise in vaginal pH or an The nature of the resistant to a few drugs has excess of glycogen that has not been been identified as related to altered related converted to lactic acid by Lactobacilli transport, modification of an enzyme and (Calderone and Fonzi, 2001). change in the membrane composition (Segal and Elad, 1998). However a broad spectrum Risk factors identified initially as combined resistance to benomyl and Methotixate and later as Patients with diabetes are at increased risk resistance to four additional antigens, of developing vulvovaginal candidiasis appeared to be an inherent characteristic of (VVC). Unlike non-diabetic women these the species so therefore there is a real need patients have a higher proportional of for next generation safer and more potent colonization (Wu et al., 1996). Patients antifungal agents. An antibiogram test is usually with a history of HIV infection, reported that the antibiotics used against diabetes mellitus, drug addiction or inhaled Candida spp Amphotericin B, Fluconazole, steroids, and with low body defense Caspofungin, Itraconazole, 5-Flurocytosine mechanisms are risk cases for Candida and Voriconazole are used as drug of choice infections (Mavor et al., 2005). Candidiasis for treatment (CLSI, 2004). Candida is caused by infection with species of the albicans shows susceptibility pattern of genus Candida is a ubiquitous fungus that about 99% to Amphotericin B, 97% to represent the most common fungal Fluconazole, 99% to 5-Flurocytosine and pathogens that affect human and there is a 94% to Voriconazole (Kothavade et al., positive correlation between smoking and 2010; Angiolella et al., 1996). However a candidiasis (Bader et al., 2003). Candida broad spectrum resistance initially as species produce a wide spectrum of combined resistance to benomyl and diseases, ranging from superficial methotrixate, then later on resistant to four mucocutaneous to invasive illness additional agents appeared to be an inherent (Deshpande et al., 2010). Candida albicans characteristic of the species and are shown enolase with the plasmiogen system may to be determined by a single gene encoding contribute to invasive of the tissue barrier a polypeptide of 564 aminoacid with a series (Jong, 2008). Antifungal susceptibility of of features typical of prokaryotic and Vaginal yeast isolates in a rural community eukaryotic transporter protein and multidrug of India, since majority of Candida albicans resistant efflux pumps (Shahid et al., 2006). isolates were susceptible to Fluconazole, its Antifungal susceptibility of vaginal yeast use is continued for empirical therapy of isolates in a rural community of India, since uncomplicated Candidal vulvovaginitis in majority of Candida albicans isolates were the community (Masia Canuto et al., 2000). susceptible to Fluconazole, its use may be continued for empirical therapy of Drug resistant uncomplicated candidal vulvovaginitis in the community. Use of alternative agents like The antibiotics used for the treatment are Boric acid and Flucytosine may be azoles such as Amphotericin, Fluconazole, considered when treating vulvovaginitis Itraconazole, Caspofungin, Vericonazole, 345 Int.J.Curr.Microbiol.App.Sci (2015) 4(8): 343-351 caused by non-albicans (Srujana et al., (Sardi et al., 2011). 2007). The over expression of the multidrug transporter Cdr1p (Candida drug resistance Medicinal plants protein 1), a member of the ABCI (ATP Binding Cassette) transporter super family One possible approach is to screen local (1-3), is an account for a clinically medicinal plants to get the compound, which significant mechanisms of azoles resistance can directly use as antifungal agents or can in the pathogenic yeast Candida albicans serve as template for drug development (Willis et al., 2001). This is especially clear (Vaghasiya and Chanda, 2009). The plant is in Fluconazole resistant clinical isolates of selected according to its availability and Candida albicans, where enhanced ethanobotanical significance in the treatment expression of Cdr1p promoter efflux of of opportunistic mycosis. The use of therapeutic azoles, thus facilitating cell medicinal plants as a source for relief from survival. Cdr1p, like other ABC illness can be treated back over five transporters, uses ATP hydrolysis to power millennia to written documents of the early the transport of substrates across the civilization in china, India and the Near East membrane (Sudhanshu et al., 2007). but it is doubtless an art as old as mankind. The potential for higher studies as source for Prevalence new drugs is still largely unexplored. Among the estimated 250,00-500,00 plant Approximately three-quarters of all women species, only a small percentage has been experience at least one episode of investigated phytochemically and fraction vulvovaginal candidiasis during their submitted to biological or pharmacological lifetime nearly half of them suffer from screen is even small (Mahesh and Sathish, multiple episode. The majority of cases of 2008). Established and tested drugs from vulvovaginal candidiasis are caused by medicinal plant heal various diseases and Candida albicans. Candida species are disorder to which there are no solutions currently the fourth leading cause of hospital from modern medicine even today and acquired blood stream infections, reaching a hence ethanotherapeutics has been reported. mortality rate of up to 35-40% for systemic Since time commercial Ayurvedha and or disseminated infections. Among all Siddha systems of medicine are the Candida species Candida albicans is still traditional heritage of India wherein diverse the most frequently isolated species, about plant has been used (Rahmatullah et al., 15 20% in Europe (Mendes et al., 2007). 2009). India is blessed with two (Eastern Vaginal candidiasis is the second most Himalayas and Western Ghats) of the common cause of vaginitis after anaerobic eighteen world s hotspots of plant diversity bacterial vaginitis. Among various groups and is seventh among the sixteen-mega vaginal candidiasis is most common in diverse countries, where 70% of the world s pregnant women having incidence of 66.1% plant species occurred collectively. followed by Candida glabaratai 44.1% Medicinal plants have been used as an (Crowe et al., 2003). It is estimated that out exemplary source of centuries as an of 1050 women Aligarh, India, 20.47% were alternative remedy for treating human positive for Candida spp. In that Candida diseases because they contain numerous albicans accounted for 46.9%. The most active constitutes of therapeutic value common signs and symptoms in 215 women (Ezzat, 2001). There is an urgent need to with positive were pruritus with or without search for alternative to synthetic antibiotics. vaginal discharge and vaginal erythema 346 Int.J.Curr.Microbiol.App.Sci (2015) 4(8): 343-351

The revolution of the discovery of new Role of Acalypha indica as medicinal plant groups of antimicrobial peptides makes natural antibiotics, the basic element of a The Acalypha indica belongs to the novel generation of drug for the treatment of following taxonomic classification bacterial and fungal infections (Tariq and Reyaz, 2012). The global demand for herbal Kingdom : Plantae medicine is large, growing rapidly and is the Class : Magnoliopsida most exclusive source saving drugs for Order : Euphorviales majority of the world s population. Family : Bioactive compounds currently extracted Sub family : Acalyphoideae from plants are used as medicines have Genus : Acalypha traditional value and scientifically evaluated Species : Acalypha indica linn for their possible medicinal application (Sangeetha et al., 2010). An increasing It is commonly known as kucinggalak or prevalence infections caused by newer Rumputlislis. Kuppaimeni in Tamil and emerging fungal pathogens have been Kuppaikunjan in Malayalam. It is a main detected in humans, although it appeared weed in many part of Asia including India, that many drugs are available for the Pakisthan, Yemen, Srilanka throughout treatment of systemic and superficial tropical Africa and South America mycosis clinical usefulness is hampered by (Ramachandran, 2008). It is an annual herb, drawbacks associated with safely or about 80cm height (Buskill, 1985). This efficiently (Karkowska-Kuleta et al., 2009). plant is used as diuretic, antihelminthic and Plants have been used as source of medicine for respiratory tract problem such as since the dawn of civilization established bronchitis, asthuma and pneumonia (Varier, tested drugs from medicinal plants heals 1996). The root of Acalypha indica is used various diseases and disorders to which as laxative and leaves for scabies and other there is no solution from medicine even cutaneous disease, this plant has today and hence ethanotherapeutics has been antimicrobial activity against several Gram reported (Ahmad et al., 1989). positive bacteria (Govindarajan et al., 2008). This plant has been extensively in herbal Medicinal plants used against candidiasis medicine in many tropical and subtropical countries reported that the antimicrobial Medicinal plants have been used as an activity of water, ethanol and chloroform exemplary source for centuries as an extracts of Acalypha indica was tested alternative remedy for treating human against four bacterial and fungal strains diseases because they contain numerous using the disc diffusion method (Krishnaraj active constituents of therapeutic value et al., 2010). The antifungal activity is more (Gayathri and Kannabiran, 2009). The pronounced only in chloroform extracts development of microbial resistant to when compared to standard antibiotics such antibiotics has led the research to investigate as Ketoconazole, Itraconazole and the alternative source for the treatment of Fluconazole. Findings from the current resistant strains. Presently 80% of the world study support the use of Acalypha indica in population relies or plant derived medicines, traditional medicine for the treatment of serve as first line of defense in maintaining various bacterial and fungal infections health and computing many diseases. (Somchit et al., 2010). Major phytochemical identified from Acalypha indica are

347 Int.J.Curr.Microbiol.App.Sci (2015) 4(8): 343-351 aclphine, cyanogenic , inositol, selected according to its availability and resin, triacetomamin and volatile oils ethnobotanical significance in the treatment (Winter and Griffith, 1998). Acalypha indica of opportunistic mycosis a choice of has antibacterial activity against several treatment (Burkhart, 1976; Kanthasamy et gram positive bacteria, analgesic, anti- al., 1989). Prosopis gladulosa is commonly inflammatory effects and antifungal activity used to treat infections, open wounds, (Johnson et al., 1995). The maximum deontological ailments, acting much as an antifungal activity of Acalypha indica plant anti-acid, it can also treat digestive problems salt was shown against Candida albicans and antiseptic properties (Uddin et al., and Cryptococcus neoformans, followed by 2006). The bark and roots of Prosopis Aspergillus flavus in higher concentrations gladulosa also contain alkaloids. The plant (Suresh et al., 2009). contain 80% carbohydrates, 13% protein 25% fiber and 3% fat (Samoylenko et al., Role of Prosopis gladulosa as medicinal 2009). plant References The Prosopis gladulosa belongs to the following taxonomic classification Abdur Rahman, A., Volodymyr, S., Melissa, J.A., Rajnish, S., Surendra, J.K., Shabana, Kingdom : Plantae K.I., Babu, T.L., Ilias, M. 2011. SubKingdom: Tracheobionta Antiparasitic and antimicrobial Division : Magnoliophyta indolizidines from the leaves of Prosopis Class : Magnoliopsida glandulosa var. glandulosa. Planta Med., Subclass : Rosidae 77(14): 1639 1643. Order : Fabales Ahmad, A., Khursheed, A.K., Sabiha, Q., Family : Fabaceae Viqaruddin, A. 1989. Antifungial activity Genus : Prosopis of some hydrosoluble Prosopis juliflora Species : Prosopis gladulosa alkaloids. Fitoterapia, 60: 86 89. Al-Fattani, M.A., Douglas, L.J. 2006. Biofilm Prosopis gladulosa is commonly used to matrix of Candida albicans and Candida treat infections, open wounds, tropicalis: chemical composition and role dennatological ailments, anti-acid can treat in drug resistance. J. Med. Microbiol., 55: digestive problems and its aqueous extract 999 1008. has antibacterial as well as antiseptic Alison, C. 2000. Vaginal thrush: perceptions and experience of women of south Asian properties (Uniyal et al., 2006). The descent. Oxford J. Med. Health Edu. Res., phytochemicals of Prosopis gladulosa such 16(1): 9 16. as S-hydroxytryptamine have anti- Amita, A., Kalpana, C. 2009. Some medicinal depressant activity, apigenin have anti- plant among the tribes of Chatarpur allergic, anti-bacterial, anti-dermatic, anti- District (M.P) India. Ecoprint., 16: 43 inflammatory and anti-viral activity, 50. isorhamnetin-3-digluciside has Angiolella, L., Facchin, M., Stringaro, A., hepatoprotective activity, L-arabinose and Maras, B., Simonetti, N., Cassone, A. quercetin have analgesic, anti-allergic, anti- 1996. Identification of glucan associated bacterial, anti-diabetic, anti-inflammatory enolase as a main cell wall protein and anti-viral activity (Abdur Rahman et al., Candida albicans and indirect target of 2011). The plant Prosopis gladulosa is lipopeptide antimycotics. J. Infect. Dis., 173: 684 690. 348 Int.J.Curr.Microbiol.App.Sci (2015) 4(8): 343-351

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