Salvadora persica: Nature's Gift for Periodontal Health

Green Alternatives as Antimicrobial Agents in Mitigating Periodontal Diseases: A Narrative Review

Periodontal diseases and dental caries are the most common infectious oral diseases impacting oral health globally. Oral cavity health is crucial for enhancing life quality since it serves as the entranceway to general health. The oral microbiome and oral infectious diseases are strongly correlated. Gram-negative anaerobic bacteria have been associated with periodontal diseases. Due to the shortcomings of several antimicrobial medications frequently applied in dentistry, the lack of resources in developing countries, the prevalence of oral inflammatory conditions, and the rise in bacterial antibiotic resistance, there is a need for reliable, efficient, and affordable alternative solutions for the prevention and treatment of periodontal diseases. Several accessible chemical agents can alter the oral microbiota, although these substances also have unfavorable symptoms such as vomiting, diarrhea, and tooth discoloration. Natural phytochemicals generated from plants that have historically been used as medicines are categorized as prospective alternatives due to the ongoing quest for substitute products. This review concentrated on phytochemicals or herbal extracts that impact periodontal diseases by decreasing the formation of dental biofilms and plaques, preventing the proliferation of oral pathogens, and inhibiting bacterial adhesion to surfaces. Investigations examining the effectiveness and safety of plant-based medicines have also been presented, including those conducted over the past decade.

Persicaline, an alkaloid from Salvadora persica, inhibits proliferation and induces apoptosis and cell-cycle arrest in MCF-7 cells

Cancer is the second largest cause of mortality worldwide. Many natural bioactive chemicals generated from plants have favorable impacts on health, including cancer chemoprevention, compared to their manufactured counterparts. Persicaline, a novel sulfur-containing imidazoline alkaloid derived from Salvadora persica, has been shown to display promising antioxidant activity. In this study, the antiproliferative activity of persicaline was tested against different cancer cells using (3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide assay. The cell death mode and cell-cycle arrest were examined using flow cytometry analysis. In addition, the proapoptotic and molecular mechanism effects of persicaline against mammary MCF-7 cell line were explored. Furthermore, the impact of persicaline on apoptotic genes markers, generation of reactive oxygen species (ROS), and mitochondrial membrane potential were monitored. It was found that persicaline inhibits cell proliferation in a dose-dependent manner. Persicaline-treated MCF-7 cells also showed initiation of apoptotic events and G1 cell-cycle arrest. In addition, persicaline treatment led to an increase in ROS generation, Bax and caspase upregulation while the Bcl-2 was downregulated. Hence, for the first time, this study showed that persicaline causes G1 phase arrest and apoptosis induction in MCF-7 cells. Increased proapoptotic genes and ROS levels were required for the antiproliferative and apoptotic effects of persicaline.

In Vitro Antiviral Effect and Potential Neuroprotection of Salvadora persica L. Stem Bark Extract against Lipopolysaccharides-Induced Neuroinflammation in Mice: LC-ESI-MS/MS Analysis of the Methanol Extract

Neuroinflammation is a serious immunomodulatory complex disorder that causes neurological and somatic ailments. The treatment of brain inflammation with new drugs derived from natural sources is a significant therapeutic goal. Utilizing LC-ESI-MS/MS analysis, the active constituents of Salvadora persica extract (SPE) were identified tentatively as exerting antioxidant and anti-inflammatory effects in natural medicine. Herein, we determined the antiviral potential of SPE against herpes simplex virus type 2 (HSV-2) using the plaque assay. HSV-2 is a neurotropic virus that can cause neurological diseases. SPE exhibited promising antiviral potential with a half-maximal cytotoxic concentration (CC50) of 185.960 ± 0.1 µg/mL and a half-maximal inhibitory concentration (IC50) of 8.946 ± 0.02 µg/mL. The in vivo study of the SPE impact against lipopolysaccharide (LPS)-induced neuroinflammation was performed using 42 mice divided into seven groups. All groups were administered LPS (0.25 mg/kg) intraperitoneally, except for the normal and SPE groups 1 and 2. Groups 5, 6, and 7 received 100, 200, and 300 mg/kg SPE. It was revealed that SPE inhibited acetylcholinesterase in the brain. It increased superoxide dismutase and catalase while decreasing malondialdehyde, which explains its antioxidative stress activity. SPE downregulated the gene expression of the inducible nitric oxide synthase, as well as the apoptotic markers (caspase-3 and c-Jun). In addition, it decreased the expression of the proinflammatory cytokines (interleukin-6 and tumor necrosis factor-alpha). Mice administered SPE (300 mg/kg) with LPS exhibited normal neurons in the cerebral cortices, hippocampus pyramidal layer, and cerebellum, as determined by the histopathological analysis. Therefore, using S. persica to prevent and treat neurodegeneration could be a promising new therapeutic strategy to be explored.

Role of Medicinal Herbs in Periodontal Therapy: A Systematic Review

Aims and Objectives

The use of medicinal herbs to prevent gingival and periodontal diseases has become increasingly popular due to their anti-inflammatory and antioxidant properties. This systematic review aims to provide the current literature to validate the traditional use of medicinal herbs in the management of gingival and periodontal diseases.

Materials and Methods

An online literature search was conducted to identify research papers published from 2010 to 2022 in three major scientific databases, PubMed, Scopus, and Web of Science, in June 2022. Original research studies, case reports, and systematic reviews on medicinal plants' application in oral health care were selected to be included in this systematic review. Only high-quality articles identified in the quality assessment were included for evidence synthesis.

Results

Initial keyword research yielded 726 free-text articles published between 2010 and 2022. Of these, 14 articles (8 research papers and 6 reviews) were included for evidence synthesis. The review's findings indicate that the antibacterial property of medicinal plants is due to their alkaline nature and prevents plaque and calculus formation by maintaining acid-alkali balance in saliva. Various parts of medicinal plants help maintain periodontal health. Glycyrrhiza glabra, Ficus religiosa, and Plantago major effectively inhibit primary plaque colonizers and periodontal pathogens. Medicago sativa, Aloe barbadensis Miller, and Trifolium pratense have excellent applications in treating periodontal diseases. Mangifera indica, Pongamia pinnata, the husk of Cocos nucifera, the root of G. glabra and Curcuma longa, leaves of Psidium guajava and Azadirachta indica, fruits of Citrus medica and Punica granatum, Ocimum Moringa oleifera extract, and pomegranate peel extract can serve as a promising alternative in managing chronic gingivitis.

Conclusion

The anti-inflammatory, antioxidant, antibacterial, and astringent action of extracts obtained from various parts of medicinal plants make them effective in reducing gingival and periodontal diseases. Herbal medicine may be a viable alternative to contemporary pharmaceuticals as an adjuvant to scaling and root planning procedures.

Variation in Phenolic Profile, Antioxidant, and Anti-Inflammatory Activities of Salvadora oleoides Decene. and Salvadora persica L. Fruits and Aerial Part Extracts

(1) Background: The objective of this study was to investigate the potential of Salvadora oleoides (S. oleoides) and Salvadora persica (S. persica) polyphenols as antioxidant and anti-inflammatory agents. (2) Methods: Aerial parts and fruits of S. oleoides and S. persica were collected from the periphery of District Bhakkar, Punjab, Pakistan. Methanol extracts were prepared using the Soxhlet extraction technique. Extract yield varied from 8.15 to 19.6 g/100 g dry plant material. RP-HPLC revealed the detection of thirteen phenolic aids and five flavonoids. Gallic acid, hydroxy benzoic acid, chlorogenic acid, and cinamic acid were the major phenolic acids, whereas catechin, rutin, and myricetin were the flavonoids detected. (3) Results: Maximum total phenolic contents (TPCs) (22.2 mg/g of dry plant material) and total flavonoid contents (TFCs) (6.17 mg/g of dry plant material) were found in the fruit extract of S. persica, and the minimum TPC (11.9 mg/g) and TFC (1.72 mg/g) were found in the aerial part of S. oleoides. The fruit extract of S. persica showed the highest DPPH radical scavenging activity. In vivo anti-inflammatory activity of all the extracts was performed on albumin-induced rat paw edema that was comparable with the standard indomethacin; S. persica fruit extract showed remarkable anti-inflammatory activity. Analgesic activity of aerial part and fruit extracts of S. oleoides and S. persica was investigated using a mouse model, and the results showed that maximum possible analgesia of fruit extracts of S. persica was 53.44%, which is better than the PC group (52.98%). (4) Conclusions: The variations in the antioxidant, anti-inflammatory, and analgesic activities of methanolic extracts of S. oleoides and S. persica were found to be significant, and they have therapeutic potential as antioxidant, analgesic, and anti-inflammatory agents.

Evaluating Time-Dependent Extraction of Exfoliated Oral Mucosal Cells from Used Toothbrushes and Miswak

An integral part of forensic work is DNA quantification and profiling, which necessitates many highquality samples for good results. Oral mucosal cells have become an essential source of genomic DNA in epidemiological studies. The time of collecting DNA samples is a critical factor in forensic science. To compares the time-dependent extraction of DNA yield and purity from exfoliated oral epithelial cells from toothbrushes and miswak used for time intervals up to 5 months. Thirty healthy volunteers were given toothbrushes and miswak to use for six days. The used toothbrushes and miswak were collected, stored at room temperature, and analyzed immediately and at the end of the first, second, third, fourth, and fifth months. Comparisons between the two independent groups of toothbrush and miswak were done by an independent two-sample t-test. The changes over time for each outcome were analyzed using repeated-measures ANOVA. DNA yield of the exfoliated oral epithelial cell samples was higher from female samples, while DNA purity was higher in the male samples. The Miswak contained a sufficient amount of DNA similar to toothbrushes. The yield and purity are not significantly altered by storing them for at least five months at room temperature.

Thymoquinone-Mediated Modulation of Toll-like Receptors and Pluripotency Factors in Gingival Mesenchymal Stem/Progenitor Cells

Thymoquinone (TQ), the key active component of Nigella sativa (NS), demonstrates very promising biomedical anti-inflammatory, antioxidant, antimicrobial and anticancer properties. Several investigations have inspected the modulative activities of TQ on different stem/progenitor cell types, but its possible role in the regulation of gingival mesenchymal stem/progenitor cells (G-MSCs) has not yet been characterized. For the first time, this study investigates the effects of TQ on G-MSCs’ stemness and Toll-like receptor expression profiles. G-MSCs (n = 5) were isolated, sorted via anti-STRO-1 antibodies and then disseminated on cell culture dishes to create colony-forming units (CFUs), and their stem/progenitor cell attributes were characterized. TQ stimulation of the G-MSCs was performed, followed by an examination of the expression of pluripotency-related factors using RT-PCR and the expression profiles of TLRs 1−10 using flowcytometry, and they were compared to a non-stimulated control group. The G-MSCs presented all the predefined stem/progenitor cells’ features. The TQ-activated G-MSCs displayed significantly higher expressions of TLR3 and NANOG with a significantly reduced expression of TLR1 (p < 0.05, Wilcoxon signed-rank test). TQ-mediated stimulation preserves G-MSCs’ pluripotency and facilitates a cellular shift into an immunocompetent-differentiating phenotype through increased TLR3 expression. This characteristic modulation might impact the potential therapeutic applications of G-MSCs.

Antiplaque Efficacy of a Novel Moringa oleifera Dentifrice: A Randomized Clinical Crossover Study

OBJECTIVES

 The use of herbal dentifrices has grown exponentially over the years. They are categorically referred to as ethnomedicines. Various agents have been tried with contradicting findings based on phytopharmacological analysis. Miswak is one agent which has been used over the years. A novel Moringa oleifera-based dentifrice has shown promising results in terms of its cytotoxicity, biocompatibility, and as a potent anti-inflammatory agent. Therefore, the present study aims to compare the efficacy of two commercially available miswak- and moringa-based herbal dentifrices on the reduction of plaque and gingivitis scores.

MATERIALS AND METHODS

 This randomized clinical crossover study included 20 subjects with mild to moderate gingivitis. The study was conducted over a total examination period of 20 days with a wash-out period of 2 weeks between the use of both the toothpastes. The plaque index and gingival index of the study subjects were recorded at the designated time intervals throughout the study period.

STATISTICAL ANALYSIS

 The data collected were entered on Microsoft Excel, and statistical analysis using SPSS software (SPSS version 28, IBM Corp, Armonk, New York, United States) was done. The statistical test used was the Wilcoxon signed-rank test. Moreover, p ≤0.05 was considered significant.

RESULTS

 The results showed that the reduction in mean gingival index scores from baseline to day 3 was more statistically significant in the moringa-based dentifrice. Similarly, the plaque index scores showed statistically significant reduction following the use of the moringa-based dentifrice when compared with the miswak dentifrice. This study reveals that the moringa dentifrice is a safe and effective agent in reducing plaque accumulation and treating gingival inflammation.

CONCLUSION

 The current study aims to provide an insight into the possible role of moringa dentifrice as a possible adjunctive oral hygiene aid.

HPLC/MSn Profiling and Healing Activity of a Muco-Adhesive Formula of Salvadora persica against Acetic Acid-Induced Oral Ulcer in Rats

Salvadora persica L. (S. persica, Siwak) is an ethnic plant that is widely used for improving oral hygiene. This study aimed to provide a phytochemical profiling of S. persica ethyl acetate fraction (SPEAF) and to evaluate the healing activity of a muco-adhesive formula of the fraction against acetic acid-induced oral ulcers in rats. HPLC-ESI-QTOF-MS-MS analysis of SPEAF resulted in the tentative identification of 56 metabolites containing fatty acids (23%), urea derivatives (10.5%) and sulphur compounds (10%), in addition to several amides, polyphenols and organic acids (6.5%, 5% and 2%, respectively). For the first time, 19 compounds were identified from S. persica. In vitro and in vivo experiments indicated that the extract is non-toxic. SPEAF exhibited superior healing activities compared to both the negative and positive control groups on days 7 and 14 of tongue ulcer induction. This was confirmed by histopathological examinations of haematoxylin and eosin-stained (H&E) and Masson's trichrome-stained tongue sections. Moreover, SPEAF showed potent anti-inflammatory activities, as evidenced by the inhibited expression of interleukin-6 (IL-6) and tumour necrosis alpha (TNF-α). Moreover, SPEAF exhibited potent antioxidant activity, as it prevented malondialdehyde (MDA) accumulation, reduced glutathione (GSH) depletion and superoxide dismutase (SOD) exhaustion. SPEAF significantly enhanced hydroxyproline tongue content and upregulated collagen type I alpha 1 (Col1A1) mRNA expression. SPEAF also improved angiogenesis, as shown by the increased mRNA expression of the angiopoietin-1 (Ang-1). In conclusion, S. persica has a wide range of secondary metabolites and ameliorates acetic acid-induced tongue ulcers in rats. This can be attributed, at least partly, to its anti-inflammatory, antioxidant, procollagen and angiogenic activities. These findings provide support and validity for the use of S. persica as a traditional and conventional treatment for oral disorders.

Documentation of Commonly Used Ethnoveterinary Medicines from Wild Plants of the High Mountains in Shimla District, Himachal Pradesh, India

The aim of current study is to provide a significant traditional knowledge on wild medicines used for ethnoveterinary purposes in the rural area of Maraog region in district Shimla. The medicinal plants have played a significant role in the treatment of human as well as animal’s diseases. The rural people of the Maraog region were interviewed through a questionnaire and extensive field surveys were conducted from June 2020 to July 2021. The discussion, observations and interviews were conducted in study site and included 96 informants. The information gathered from the residents is presented in a table format and includes scientific and local names, different parts used, diseases treated and mode administration. The most commonly used taxa are calculated with used value. The study revealed 100 plants in which trees (7), shrubs (26), herbs (56), ferns (5), grasses (3) and climbers (3) were identified. The most commonly documented livestock diseases were found to be hoof infections, eyes infections, poisoning and skin infections. In the current study, the Rosaceae family was reported as being the highest number (11), followed by Asteraceae (10) and then Lamiaceae (6). It was found that leaves, roots, flowers and fruits are the commonly used parts for ethnoveterinary medications. The phytochemicals present in the plant, such as alkaloids, sterols, glycosides, flavonoids, lignin, coumarins and terpenoids, etc., may be responsible for their medicinal properties. In this documentation, it was observed that the younger generation does not have good knowledge of medicinal plants as compared to the older ones. Therefore, it is necessary to preserve the traditional knowledge of these medicinal plants before their permanent loss. The documentation and conservation of medicinal plants can be a good start for novel phytopharmacological research in the veterinary field.

Therapeutic Uses of Wild Plants by Rural Inhabitants of Maraog Region in District Shimla, Himachal Pradesh, India

The main aim of this study is to document important ethnomedicinal plants from the Maraog region, located in the district of Shimla in Himachal Pradesh, India. A total of 110 medicinal plant species belonging to 102 genera and 57 families were reported from the study site. All of the species were collected from wild habitats. The rural people of the Maraog region were surveyed through interview methods, group discussions, and participatory observations. In the current study, data were collected from 88 informants through the snowball method. A total of 110 plant species were collected from the study area, including 64 herbs, 24 shrubs, 9 trees, 5 climbers, 3 grasses, and 5 ferns. Most of the plant species, reported from the study area, belong to the Rosaceae and Asteraceae families, each contributing 12 plant species, followed by the Lamiaceae family with 6 plant species. The most used part of the plant in the preparation of herbal medications is the leaves, which have been reported in 62 plants, followed by roots in 14 plants, and flowers and other aerial parts in 9 plants. The ethnomedicinal data were analyzed using “Use Value,” a statistical quantitative method, with Artemisia vestita having the highest use value (1.00), followed by Cannabis sativa (0.79), Rhododendron arboreum (0.79), and Datura stramonium (0.71). Older people were found to have a vast knowledge of wild medicinal plants, while the younger generation’s knowledge was lacking. As a result, traditional knowledge about the use of plants as a source of medicine has decreased day-by-day. Therefore, there is a need to document traditional ethnobotanical knowledge. The data could serve as a basis for research by pharmacological and nutraceutical industries for the development of novel drugs.

Evaluation of Nutritional, Phytochemical, and Mineral Composition of Selected Medicinal Plants for Therapeutic Uses from Cold Desert of Western Himalaya

The aim of this study was to determine the elemental and nutritive values of leaf parts of 10 selected wild medicinal plants, Acer pictum, Acer caecium, Betula utilis, Oxalis corniculata, Euphorbia pilosa, Heracleum lanatum, Urtica dioica, Berberis lycium, Berberis asiaticaand, and Quercus ilex, collected from the high hills of the Chitkul range in district Kinnaur, Western Himalaya. The nutritional characteristics of medicinal plant species were analyzed by using muffle furnace and micro-Kjeldahl methods, and the mineral content in plants was analyzed through atomic absorption spectrometry. The highest percentage of used value was reported in Betula utilis (0.42) and the lowest in Quercus ilex (0.17). In this study, it was found that new generations are not much interested in traditional knowledge of ethnomedicinal plants due to modernization in society. Therefore, there is an urgent need to document ethnomedicinal plants along with their phytochemical and minerals analysis in study sites. It was found that rural people in western Himalaya are dependent on wild medicinal plants, and certain steps must be taken to conserve these plants from extinction in the cold desert of Himalayan region. They are an alternative source of medicine because they contain saponin, alkaloid, and flavonoid etc. as well as minerals. The leaves used for analysis possesses good mineral content, such as Na, N, K, P, Zn, Fe, Cu, Mn, Ca, Mg, and S. Hence, in the current study it was observed that medicinal plants are not only used for therapeutic purposes, but they can also be used as nutritional supplements.