Acanthus ilicifolius L. Treatment for Oral Candidiasis with Immunosuppressive Conditions Subjected to p38 MAPK Enhancement

Abstract

Methanolic extract from the leaves of Acanthus ilicifolius L. (A. ilicifolius L.) is a potent inhibitor of Candida albicans (C. albicans) growth and anti-inflammatory. C. albicans causes oral candidiasis in immunosuppressive condition. Mitogen-activated protein kinase (MAPK) signalling via p38 appears to discriminate between yeast and hyphal cells of C. albicans. Activation of p38 MAPK by hyphae results in the upregulation of proinflammatory cytokines. The p38 MAPK activation is known to impair corticosteroid action. The research was conducted to investigate the effect of methanolic extract A. ilicifolius L. treatment of oral candidiasis with the immunosuppressive condition through enhancement of p38 MAPK expression in the epithelial cells. Immunosuppressed conditions were obtained when 16 healthy male Rattus norvergicus (Wistar) was given oral administration of dexamethasone and tetracycline for 14 days and induced with C. albicans (ATCC-10231) 1 McFarland. The subjects were divided into four groups (n = 4/group): immunosuppression (IS), immunosuppression with oral candidiasis without treatment (ISC), immunosuppression with oral candidiasis and nystatin treatment (ISC+N), and immunosuppression with oral candidiasis and A. ilicifolius L. treatment (ISC+AI), and were treated for 14 days. Later, the rats were euthanised, and their tongue were biopsied. The p38 MAPK expression was subjected to immunohistochemical examination, observed under a microscope (400× magnification) and statistically analysed (one-way ANOVA, LSD-test, p < 0.05). The p38 MAPK expression of ISC+AI (36.05 ± 1.54) was higher than IS (26 ± 2.32), ISC (26.4 ± 3.71), IS+N (34.2 ± 0.99). Significant differences existed between ISC+AI and ISC+N to IS and ISC (p < 0.05). No significant differences were present between IS and ISC; ISC+AI and ISC+N (p > 0.05). Therefore, this treatment could enhance p38 MAPK expression in oral candidiasis with the immunosuppressed condition.

Acanthus ilicifolius Methanolic Extract for Oral Candidiasis Treatment through Tongue Epithelial STAT3 and Cell Death Evaluation

“…20 These secondary metabolites of A. ilicifolius extract contribute to its antifungal property by increasing the expression of Toll-like receptor 2, IL-22, and P38 in immunosuppressed rats with oral candidiasis. 3 13 14 These three markers are known to play a role in the inflammatory mechanism against C. albicans infection.…”

“…18 Previous studies have shown that A. ilicifolius extract has antifungal and antioxidant effects in vitro and antifungal activity in mice suffering from oral candidiasis under immunosuppressed conditions. 12 13 14…”

“…The solvent was evaporated at low pressure using a rotary evaporator to obtain a viscous mass, which was evaporated again in a water bath to separate the extract from the solvent to produce pure A. ilicifolius leaf extract. 12…”

“…2 Methanolic extracts of A. ilicifolius are potent inhibitors of Candida albicans growth and show anti-inflammatory effects via the mitogen-activated protein kinase pathway. 3 These extracts have strong antioxidant and antifungal activity, and the plant's phytochemical compounds are potential candidates for antifungal therapy. 2…”

“…2 Methanolic extracts of A. ilicifolius are potent inhibitors of Candida albicans growth and show anti-inflammatory effects via the mitogen-activated protein kinase pathway. 3 These extracts have strong antioxidant and antifungal activity, and the plant's phytochemical compounds are potential candidates for antifungal therapy. 2 C. albicans, the main causative agent of oral yeast infection, is a commensal organism that transforms into a pathogen in hosts suffering from systemic diseases, such as diabetes mellitus, leukopenia, human immunodeficiency virus/acquired immunodeficiency syndrome (AIDS), and malignancies, as well as conditions related to hematinic deficiency, carbohydrate-rich diets, drugs, or immunosuppression (e.g., autosomal dominant hyper-immunoglobulin E syndrome [AD-HIES]).…”