COMPARATIVE ASSESSMENT OF THE INHIBITORY POTENTIALS OF GARLIC AND TUMERIC IN TREATMENT OF VULVOVAGINAL CANDIDIASIS
iABSTRACT
The irecurrent inature iof iyeast iinfections iand ithe isubsequent iuse iof iantifungal imedicines ifor itreatment, ipose ia ipotential ithreat ito iwomen’s ihealth iand isafety iworldwide, iwhich icould ialso igive irise ito iantifungal iresistance. iThe iaim iof ithis istudy iis ito ievaluate ithe iantimicrobial iefficacy iof igarlic iand itumeric iagainst imulti-drug iresistance iof iCandida ialbicans, iassociated iwith iVulvovaginal iinfection. iResults iof ithe ianti-microbial isusceptibility itest iby idisc idiffusion imethod irevealed ithat iethanolic iextract iof iboth iherbal iproducts, iwas igenerally imore ieffective iin iinhibiting ithe igrowth iof iCandida ialbicans. iAs iobserved ifrom ithe iresults, igarlic iwas i1.3 itimes, imore ieffective ithan iturmeric, iat ia iconcentration iof i400mg/ml. iIn iaddition, ieach iof ithe iconcentrations iof iethanolic iextract iof igarlic iwas imore ieffective ithan ithe icorresponding iconcentrations iof itumeric iextract. iThe iantimicrobial iactivity iof ithe igarlic iextract idisplayed imore ieffective iresult iagainst iCandida ialbicans. iThe iminimum iinhibitory iconcentration itest iwas icarried iout iusing iconcentrations iof i200mg/ml iof ieach iextract iand ithe iMIC iwas iobserved iat iconcentration iof i6.1 iand i7.1 iof ithe igarlic ifor iboth iethanol iand iaqueous iextract iand ifor ithe itumeric iit iwas iobserved iat iconcentration iof i4.1 iand i5.1 ifor iboth iethanolic iand iaqueous iextract. iIn iaddition, inatural iproducts isuch ias igarlic iand itumeric ipromise ia igreat ialternation iin ithe ifuture ias ia icompliment ito iantifungal idrug iin ithe itreatment iof ivulvovaginal icandidiasis. iThe ireason iis ibecause igarlic icontains iallicin, iwhich iis ione iof ithe iactive iprinciples ithat ihomogenate ia ivariety iof iantimicrobial iactivities. iAllicin iinhibits ithe igrowth iof ifungal iand ibacterial iactivities.
iCHAPTER iONE
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iINTRODUCTION
1.1. iBackground iof istudy
The irecurrent inature iof iyeast iinfections iand ithe isubsequent iuse iof iantifungal imedicines ifor itreatment, ipose ia ipotential ithreat ito iwomen’s ihealth iand isafety iworldwide, iwhich icould ialso igive irise ito iantifungal iresistance i(Pfaller, i2014). iStatistically iopportunistic ipathogen ilike iCandida ispecies iare ithe imain icausative iagent iof iabout i50-70% icauses imorbidity iand imortality iworldwide iand ithus ia iserious ithreat ito ihealth ipublic. iCandidiasis iis ia ifungal iinfection icaused iby iyeast icalled iCandida. iCandidiasis ican ialso ibe icaused iby iother ispecies inot ijust iCandida ialbicans. iCandida ialbicans iis iopportunistic iyeast ithat inaturally iinhibits ithe ithroat, imouth, idigestive itract iand igenitourinary itract iof ihumans. iIn iits iyeast istate, iCandida ialbicans ilives iin iharmonious ibalance iwith iother iintestinal iflora ibut iif ithe ibalance iof ithe iintestinal iflora iis idisrupted, iit imultiplies iand iconvert iinto iits iparasitic ifungal iform, ian iovergrowth ican ilead ito iCandidiasis i(Lisa, i2010).
The ipathogen iCandida ialbicans ican ibe ifound iin ithe ioral itract iin iup ito i80% iof ihealthy ihumans. i
Candida ispecies iare inow irecognized ias icausing idisease iwith ithe ihigh ifrequency iand iare iof ithe imost iprevalent isources iof inosocomial iinfection i(Veryduyn iet ial, i1990).
iThe iapparent iexplosion iin ifungal iinfection imay ibe iexplained iby ithe iincreasing inumbers iof ipeople iwith iimpaired iimmune isystems iand ithose isuffering ifrom idiabetics, icystic ifibrosis iand ileukemia. i(Pfaller, i1994).
Garlic ihas ilong ibeen iused ito itreat iinfections iaround ithe iworld; iResearch isupports iits iantimicrobial iactivity iagainst ibacteria, iparasites, iviruses iand ifungi. iGarlic iwas ifound ito ibe ia igood ialternative ito ian iantifungal idrug i(Fluconazole) iin ithe itreatment iof ivaginal iyeast iinfections. iThey ikill iyeast iand ireduces iit isymptoms iof ivaginal iredness, icheesy idischarge iand irashes. iGarlic ienhances ithe isensitivity iof iyeast ito iother iantifungal idrugs i(Hammani iand iElmay, i2021).
iTraditional imedicine iuses iturmeric iprimarily ias ian ianti-inflammatory iagent iand ialso ias ian iantimicrobial iagainst iseveral idifferent itypes iof iinfections. iTumeric iimpacts icurry iwith iits ibright iyellow icolor iand ipungent itaste iand ibecause ithis ispice iis ifound iin imost ikitchens, iit iis ione iof ithe icommon ihome iremedies ifor iyeast iinfections. i(Hammani iand iElmay, i2021)
Candiasis ican ibe imanifested ias ivaginal iyeast iinfection, ioral icandidiasis i(Called ithrush), iand/or ithe imore iserious icondition. iResearch ihas iclearly ishown ithat igarlic iand iturmeric ihave iantimicrobial iactivity, iinhibiting iboth ithe igrowth iand ifunction iof iCandida ialbicans i(Adetumbi iet ial, i1986). iIt iis iinteresting ito inote ithat iwhen igarlic icompounds iwere istudied, iit iwas ithe iajoene ifraction ithat ihad ithe istrongest iactivity iagainst iCandida. iThis isuggests ithat iwhen ishopping ifor igarlic iand iturmeric isupplement, iit iis ibest istandardized ifor iits iajoene iand inot ijust ithe itypical iallicin icontent.
iGarlic iand iturmeric ihave ian ieffect ion iCandida iby icompromising ithe istructure iand iintegrity iof ithe iouter isurface iof ithe iyeast icell, ioxidizing icertain iessential iproteins. iThis icauses iinactivation iof ithe iyeast ienzymes iand isubsequent imicrobial igrowth iinhibition.
The itreatment iregimes iused ito imanage icandida iinfection ivary iand idepend ion ithe ianatomical ilocation iof ithe iinfection ifoci, ithe iimmune istatus iof ithe ipatients iand ithe iassociated irisk ifactors. iHowever, iEchinocandis, iextended ispectrum iazoles iand iamphotericin iB iare igenerally ithe idrugs iof ichoice. iFluconazole iis iconsidered ithe ifirstline idrug ifor ipatients iwith icandidemia ior isuspected iinvasive icandidiasis i(Jose iA iHidalgo i2014).
iOpportunistic ipathogens, ilike iCandida ispecies, iare ia imajor icause iof imorbidity iand imortality iworldwide iand ithus ia iserious ithreat ito ipublic ihealth i(Pfaller iet.al, i2014; iMathaiou iet ial., i2015; ipaper iet ial., i2016). iFurther, iCandida ispecies ican icause ioral iCandidiasis, iCutaneous iCandidiasis ietc. i(Wachtler iet ial.2012). iCandidemia iis ithe imost ifrequent ihospital iinfection iaccounting ifor iup ito i15% iof ibloodstream iinfection iand icandida ispecies iis ithe imain icausative iagent iin i50-70% iof isystemic ifungal iinfections. i(Cornely iet ial.,2012); iLionakis iand iNetea,2013; iBarchiesi iet ial.,2016)
The ipathogenesis iof iCandida ispecies iis ipoorly iunderstood iand ithe irate iof iinfection iis iincreasing irapidly. iFurthermore, ia isteady iincrement iin iresistance ito itraditional iantifungal ihas iresulted iin ithe ineed ito icontrol; iCandidal iinfections ithrough iearly idiagnosis iand ialternative iprevention iof iCandidiasis.
Within ithe ilimited iantifungal iarmamentarium, ithe iazole iantifungal iare ithe imost ifrequent iclass iused ito itreat iCandida iinfection.Azole iantifungal isuch ias ifluconazole iare ioften ipreferred itreatment iI imany iCandida iinfections iare ithey iare iinexpensive, iexhibit ilimited itoxicity iand iare iavailable ifor ioral iadministration iAzole. iHowever, ithe ipresence iof iintrinsic iand ideveloped iresistance iagainst iazole iantifungals ihas ibeen iextensively idocumented iamong iseveral iCandida ispecies i(David iVallenet,2017). iThe iadvent iof ioriginal iand ireemergence iof iclassical ifungal idiseases ihave ioccurred ias ia iconsequence iof ithe idevelopment iof ithe iantifungal iresistance. iIt iis ithus iimperative ithat inew iand isatisfactory itherapy ifor ifungal idiseases ibe ideveloped ialternative ito ipresent iday idrugs. iNatural iproducts ifrom iand itraditional imedicines iprovide inew ipromises iin ithe imodern iclinic i(Ankri iS, iMirelman iD i1999).
iThese inatural iproducts ideveloped ialternative idrugs ithat iare imore iefficient iand itolerant ithan ithe iantifungal idrugs. iThe ireasons iare ias ifollows:
iGarlic imay iwork isynergistically iwith iantifungal idrugs. iAllicin ienhances ithe iactivity iand idecreases idrug iresistance iof iseveral iantifungal idrugs iincluding iamphotericin iB iand ifluconazole i(Hammani iand iElmay i2021). iFurthermore, igarlic ienhances ithe isensitivity iof iyeast ito iother iantifungals idrugs.
Tumeric icontains icurcumin iwhich ipossesses iantifungal iactivity. iThis ibright iyellow icompound ikills iCandida iby iincreasing ioxidative istress ileading ito iearly icell ideath iof ithe iyeast ito ihyphae iform, ia imajor ivirulence ifactor iof iCandida, iin iaddition, icurcumin ihas isynergetic ieffect iwhen itaken iwith iantifungal idrugs i(Fulconazole) ito iimprove itheir iefficacy iand ireduce idrug iresistance i(Hammani iand iElmay i2020).
1.2. i i i iSTATEMENT iPROBLEM
Garlic icontain iallicin iwhich ipossess ia icompound icalled iajoene, iGarlic ihas ilong ibeen iused ito itreat iinfections iaround ithe iworld. iResearch isupports iits iantimicrobial iactivities iagainst ibacteria, iviruses, iparasites iand ifungi. iGarlic iwas ifound ito ibe ia igood ialternative ito iantifungal idrug iin ithe itreatment iof iVulvovaginal iinfection i(David iVallenet, i2017). Tumeric ion ithe iother ihand icontains icurcumin iwhich ipossesses iantifungal iactivity. iThe ibright iyellow icompound ikills iCandida ialbicans iby iincreasing ioxidative istress ileading ito iearly icell ideath iof ithe iyeast.it ialso iprevents ithe itransition ifrom iyeast ito ihyphae iform, ia imajor ivirulence ifactor iof ithe iCandida ialbicans i(Hammani iand iElmay,2021).
Many iwomen isuffer ifrom ichronic irecurrent iyeast iinfection ioften iantifungal idrugs ithat iprovide itemporary irelief ibut ithe iinfection isoon ireturns. iAntifungal idrugs iare ioften ieffective, ibut imight ilead ito iserious iadverse ieffects ithat isome iindividuals iprefer inot ito iuse ithem, ifurthermore idrug iresistance iis ion ithe iincrease iand ias ia iresult, iantifungal idrugs iare inot ialways ieffective. iIndividuals ithus ioften iseek inatural ior ihome iremedies ifor itreatment iof iyeast iinfections, ieither ias ia istand-alone itreatment icomplement ito iantifungal idrugs i(Harrison iand iBrawled, i2018).
Unavailability ior ilack iof iaccess ito ihealth icare ifacilities idue ito ilow iincome ior ipoverty, iespecially iin ithe irural iarea, i(David iVallenet,2017) ihas iled ito iself- imedication ithrough ithe iuse iof inatural iplants/herbs isuch ias igarlic iand itumeric. iThe iresearch ibase ion itesting ithe ieffectiveness iand icreating ialternative iusing igarlic iand itumeric ito igenerate ia isolution ito ithe iproblem iand ialso iserve ias ifirst iaid itreatment ispecifically ito iless iprivileged.
1.3. iJUSTIFICATION
The ithreat iof iantifungal iresistance iand ithe imany iside ieffects iof itaking isynthetic ichemotherapeutic iagents inecessitate ithe iurgent ineed ifor ithe idiscovery iof inatural iherbal ialternatives. iThis iis iespecially icritical ifor ipeople iwith ilow iincome iin irural iand iurban iareas iand iwithout iaccess ito istandard ihealth icare ifacilities
Traditionally, igarlic iand iturmeric ihas ibeen iused ito itreat iurinary itract iinfection icaused iby iCandida ialbicans. iGarlic i(Allium isativum) ihas ibeen itraditionally iused ifor ithe itreatment iof idiseases isince iancient itimes. iA iwide irange iof imicroorganisms iincluding ibacteria, ifungi, iprotozoa iand iviruses iare iknown ito ibe isensitive ito igarlic iand iturmeric ipreparations. iAllicin iand iother isulphur icompounds iare ithought ito ibe imajor iantimicrobial ifactors iin igarlic iand iturmeric, ibecause ithey icontain ioil iand iwater-soluble iorganosulfur icompounds i(Pertanika, i2015).
The iefficacy iof igarlic iand iturmeric iagainst iVVC ihas ibeen iinvestigated ielsewhere ibut ito ithe ibest iof iour iknowledge, ithere ihas ibeen ino iexact ipublished idata iavailable ion iisolates iobtained ifrom iBarau iDikko ihospital, iKaduna.
1.4. i iAIM
To ianalyze ithe iinhibitory ipotential iof igarlic iand iturmeric iin ithe itreatment iof iCandida ialbicans iassociated iwith iVulvovaginal icandidiasis.
i i iOBJECTIVES
- Analyze ithe iinhibitory ipotentials iof iboth iaqueous iand iethanolic iextract iof igarlic iand iturmeric ion iCandida ialbicans
- To iestablish ithe iMinimum iInhibitory iConcentration i(MIC) iof iextracts iof iGarlic iand i i
- To icharacterize ithe iisolates iof iCandida ialbicans.
COMPARATIVE ASSESSMENT OF THE INHIBITORY POTENTIALS OF GARLIC AND TUMERIC IN TREATMENT OF VULVOVAGINAL CANDIDIASIS