Potential of a novel polyherbal formulation BASANT for prevention of Chlamydia trachomatis infection

In Vitro Antibacterial Activity of Selected Palestinian Medicinal Plants against Chlamydia trachomatis

Chlamydia spp. are intracellular pathogens of humans and animals that cause a wide range of diseases such as blinding trachoma and sexually transmitted infections. According to the World Health Organization (WHO), there are more than 127 million new infections each year worldwide. Chlamydial urogenital infections can cause cervicitis, urethritis, pelvic inflammatory disease and infertility. From within an intracellular niche, termed an inclusion, the Chlamydiae complete their life cycle shielded from host defenses. The host cell defense response used to eliminate the pathogen must subvert this protective shield and is thought to involve the gamma interferon-inducible family of immunity related GTPase proteins and nitric oxide. Typically, azithromycin and doxycycline are the first line drugs for the treatment of chlamydial infections. Although C. trachomatis is sensitive to these antibiotics in vitro, currently, there is increasing bacterial resistance to antibiotics including multidrug-resistant C. trachomatis, which have been described in many instances. Therefore, alternative drug candidates against Chlamydia should be assessed in vitro. In this study, we tested and quantified the activity of plant extracts against Chlamydia-infected HeLa cells with C. trachomatis inclusions. The in vitro results show that post-treatment with Artemisia inculta Delile extract significantly inhibits Chlamydia infection compared to DMSO-treated samples. In conclusion, plant extracts may contain active ingredients with antichlamydial activity potential and can be used as alternative drug candidates for treatment of Chlamydia infection which has significant socio-economic and medical impact.

Genome analysis of Chlamydia trachomatis for functional characterization of hypothetical proteins to discover novel drug targets

C. trachomatis is a Gram-negative bacterium that causes trachoma and sexually transmitted disease (STD) Chlamydia in humans. Chlamydial genital infections are the most frequent among all communicable diseases. The D/UW-3/Cx strain of C. trachomatis contains 935 genes and three pseudogenes. Out of these genes, 887 genes code for proteins while six for rRNA, 37 tRNA, and three genes translate into other RNAs. The proteome of C. trachomatis made of 887 proteins contains 269 Hypothetical proteins (HPs) that are subjected to functional characterization. This study suggests some known methods of functional characterization of such HPs. All of these methods are explicitly used to assign functions to the HPs with the accuracy of more than 90%. After extensive analysis of all the HPs, we have successfully assigned functions to 89 HPs with high precision. In the newly assigned HPs, there are enzymes, transporters, binding proteins, proteins involved in biosynthesis and regulatory processes and proteins with miscellaneous functions. The study suggests that the functionally annotated HPs may play a vital role in the growth and pathogenesis of this organism. Therefore, they can be considered potential drug targets.

Natural Products for the Treatment of Chlamydiaceae Infections

Due to the global prevalence of Chlamydiae, exploring studies of diverse antichlamydial compounds is important in the development of effective treatment strategies and global infectious disease management. Chlamydiaceae is the most widely known bacterial family of the Chlamydiae order. Among the species in the family Chlamydiaceae, Chlamydia trachomatis and Chlamydia pneumoniae cause common human diseases, while Chlamydia abortus, Chlamydia psittaci, and Chlamydia suis represent zoonotic threats or are endemic in human food sources. Although chlamydial infections are currently manageable in human populations, chlamydial infections in livestock are endemic and there is significant difficulty achieving effective treatment. To combat the spread of Chlamydiaceae in humans and other hosts, improved methods for treatment and prevention of infection are needed. There exist various studies exploring the potential of natural products for developing new antichlamydial treatment modalities. Polyphenolic compounds can inhibit chlamydial growth by membrane disruption, reestablishment of host cell apoptosis, or improving host immune system detection. Fatty acids, monoglycerides, and lipids can disrupt the cell membranes of infective chlamydial elementary bodies (EBs). Peptides can disrupt the cell membranes of chlamydial EBs, and transferrins can inhibit chlamydial EBs from attachment to and permeation through the membranes of host cells. Cellular metabolites and probiotic bacteria can inhibit chlamydial infection by modulating host immune responses and directly inhibiting chlamydial growth. Finally, early stage clinical trials indicate that polyherbal formulations can be effective in treating chlamydial infections. Herein, we review an important body of literature in the field of antichlamydial research.

Natural products for the treatment of trachoma and Chlamydia trachomatis

The neglected tropical disease (NTD) trachoma is currently the leading cause of eye disease in the world, and the pathogenic bacteria causing this condition, Chlamydia trachomatis, is also the most common sexually transmitted pathogenic bacterium. Although the serovars of this bacterial species typically vary between ocular and genital infections there is a clear connection between genital C. trachomatis infections and the development of trachoma in infants, such that the solutions to these infections are closely related. It is the unique life cycle of the C. trachomatis bacteria which primarily leads to chronic infections and challenges in treatment using conventional antibiotics. This life cycle involves stages of infective elementary bodies (EBs) and reproductive reticulate bodies (RBs). Most antibiotics only target the reproductive RBs and this often leads to the need for prolonged therapy which facilitates the development of drug resistant pathogens. It is through combining several compounds to obtain multiple antimicrobial mechanisms that we are most likely to develop a reliable means to address all these issues. Traditional and ethnobotanical medicine provides valuable resources for the development of novel formulations and treatment regimes based on synergistic and multi-compound therapy. In this review we intend to summarize the existing literature on the application of natural compounds for controlling trachoma and inhibiting chlamydial bacteria and explore the potential for the development of new treatment modalities.

Sexually transmitted infections and their diagnoses: Bapedi experience

BACKGROUND

The global burden of sexually transmitted infections (STIs) is a major concern to the World Health Organization (WHO).

OBJECTIVE

To document STIs treated by Bapedi traditional healers and their methods of diagnoses in the Limpopo Province, South Africa.

METHODS

A semi-structured questionnaire with closed and open-ended questions was used to collect data from 34 traditional healers, during a face-to-face interview.

RESULTS

Five seemingly dissimilar STIs; gonorrhoea, chlamydia, HIV/AIDS, nta (Bapedi-terminology) and syphilis were identified as being treated by Bapedi traditional healers. With the exclusion of HIV/AIDS, all STIs are known by healers via their vernacular names. Not all of the recorded STIs are treated by all the questioned traditional healers. Generally, diagnosis of these infections was based primarily on the presentation of symptoms and certain behavioural traits; mostly unprotected sexual intercourse with multiple partners.

CONCLUSION

The current study concludes that Bapedi traditional healers play an important role in the treatment STIs in the Limpopo Province. Of concern is their diagnosis which is based primarily on the presentation of symptoms and behavioural traits, which are not always accurate indicators. Thus, to make their contribution to the treatment and management of STIs beneficial, they have to receive elementary training in diagnostic methods particularly for HIV/AIDS.

Differing effects of azithromycin and doxycycline on cytokines in cells from Chlamydia trachomatis-infected women

Chlamydial infection of the lower genital tract usually spreads to the upper genital tract and is then responsible for more serious consequences, such as infertility, ectopic pregnancy, pelvic pain, and pelvic inflammatory disease. Genital infection with Chlamydia trachomatis and the resulting cytokine response largely determines the outcome of infection and disease. To date, studies showing comparative effects of azithromycin and doxycycline treatment for C. trachomatis infection in women with reproductive sequelae like infertility and their effect on immune molecules like cytokines are lacking. Hence, our objective was to study the effect of azithromycin and doxycycline in vitro on cytokines in cells from C. trachomatis-positive fertile and infertile women as well as their efficacy in C. trachomatis infection. Fertile and infertile women with primary and recurrent C. trachomatis infection attending the gynecology outpatient department of Safdarjung Hospital, New Delhi, India, were enrolled. Enzyme-linked immunosorbent assay and real-time reverse transcription-polymerase chain reaction was performed for evaluating cytokines in cells stimulated with chlamydial elementary bodies (EBs) in the presence and absence of antibiotics (azithromycin and doxycycline). C. trachomatis-infected women were also followed up to assess the efficacy of azithromycin and doxycycline. We observed inhibition of cytokines (interleukin [IL]-1beta (β), IL-6, IL-8, IL-10, and tumor necrosis factor-alpha) in the presence of azithromycin in EB-stimulated cells from both fertile and infertile women with primary and recurrent C. trachomatis infection. However, in presence of doxycycline, inhibition of cytokines (IL-1β and IL-6) was only observed in stimulated cells from fertile women with primary C. trachomatis infection. The clinical efficacy of azithromycin was also better than doxycycline in recurrent C. trachomatis infection in women with complications such as infertility. Overall, this study suggests that azithromycin treatment with broader immunomodulatory effects may be preferable to doxycycline for the treatment of recurrent C. trachomatis infection associated with infertility.

An antimicrobial investigation of plants used traditionally in southern Africa to treat sexually transmitted infections

AIM OF THE STUDY

Eighteen plants were assessed for antimicrobial activity against pathogens associated with prevalent urogenital/sexually transmitted infections. Plant selection was based on information obtained from the ethnobotanical literature.

MATERIALS AND METHODS

Dried plant material was submerged in a 1:1 mixture of methanol and dichloromethane for 24 h. Aqueous extracts were prepared by submerging dried plant material in sterile distilled water for 24 h followed by lyophilization. Essential oils were distilled from the two aromatic plant species (Tarchonanthus camphoratus and Croton gratissimus). Antimicrobial activity was assessed using the micro-well minimum inhibitory concentration (MIC) assay with specific modifications to facilitate fastidious growth of pathogens.

RESULTS

Tarchonanthus camphoratus (solvent extract) showed the most significant broad spectrum activity with MIC values ranging between 0.50 and 0.70 mg/ml against five of the six pathogens tested. Other noteworthy activity was found for Hypericum aethiopicum (root) at 0.3 mg/ml (Neisseria gonorrhoeae).Polygala fruticosa and the solvent root extract of Hypericum aethiopicum showed highest sensitivities towards Gardnerella vaginalis at 0.2 mg/ml. Efficacy of the solvent extracts against the pathogen Oligella ureolytica demonstrated antimicrobial activity (MIC values <or=1.0 mg/ml) for seven plant species. The highest activity noted against Ureaplasma urealyticum was for Psidium guajava (solvent extract) at 0.8 mg/ml. In general the aqueous extracts displayed mostly poor anti-STI activity. The most noteworthy susceptibility for the aqueous extracts was noted with the plant extract Syzygium cordatum (MIC value 0.1 mg/ml against Candida albicans). The most noteworthy activity for the essential oils was observed for Tarchonanthus camphoratus (0.8 mg/ml) against Oligella ureolytica.

CONCLUSIONS

Antimicrobial activity was observed for a number of the plant samples against at least one or more pathogen, thus validating the ethnobotanical use as an anti-infective to treat sexually transmitted diseases.