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Anti-Acanthamoeba synergistic effect of chlorhexidine and Garcinia mangostana extract or α-mangostin against Acanthamoeba triangularis trophozoite and cyst forms

Sangkanu S 1 , Mitsuwan W 1 , Mahabusarakam W 2 , Jimoh TO 3 , Wilairatana P 4 , Girol AP 5 Show all authors , Verma AK 6 , de Lourdes Pereira M 7 , Rahmatullah M 8 , Wiart C 9 , Siyadatpanah A 10 , Norouzi R 11 , Mutombo PN 12 , Nissapatorn V 13

Affiliations 

  • 1 School of Allied Health Sciences, Southeast Asia Water Team (SEA Water Team), World Union for Herbal Drug Discovery (WUHeDD), and Research Excellence Center for Innovation and Health Products (RECIHP), Walailak University, Nakhon Si Thammarat, Thailand
  • 2 Division of Physical Science, Faculty of Science, Prince of Songkla University, Songkhla, Thailand
  • 3 Department of Pharmacognosy and Pharmaceutical Botany, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
  • 4 Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. polrat.wil@mahidol.ac.th
  • 5 Department of Biology, Faculty of Sciences, São Paulo State University, São Paulo, Brazil
  • 6 Department of Microbiology, National Institute of Tuberculosis & Respiratory Diseases (NITRD), New Delhi, India
  • 7 Department of Medical Sciences, CICECO-Aveiro Institute of Materials &, University of Aveiro, Aveiro, Portugal
  • 8 Department of Biotechnology & Genetic Engineering, University of Development Alternative Lalmatia, Dhaka, Bangladesh
  • 9 School of Pharmacy, University of Nottingham Malaysia Campus, Selangor, Malaysia
  • 10 Ferdows School of Paramedical and Health, Birjand University of Medical Sciences, Birjand, Iran
  • 11 Department of Pathobiology, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran
  • 12 School of Public Health and Community Medicine, UNSW Medicine, UNSW, Sydney, NSW, Australia
  • 13 School of Allied Health Sciences, Southeast Asia Water Team (SEA Water Team), World Union for Herbal Drug Discovery (WUHeDD), and Research Excellence Center for Innovation and Health Products (RECIHP), Walailak University, Nakhon Si Thammarat, Thailand. nissapat@gmail.com
Sci Rep, 2021 04 13;11(1):8053.
PMID: 33850179 DOI: 10.1038/s41598-021-87381-x

Abstract

Acanthamoeba spp. can cause amoebic keratitis (AK). Chlorhexidine is effective for AK treatment as monotherapy, but with a relative failure on drug bioavailability in the deep corneal stroma. The combination of chlorhexidine and propamidine isethionate is recommended in the current AK treatment. However, the effectiveness of treatment depends on the parasite and virulence strains. This study aims to determine the potential of Garcinia mangostana pericarp extract and α-mangostin against Acanthamoeba triangularis, as well as the combination with chlorhexidine in the treatment of Acanthamoeba infection. The minimal inhibitory concentrations (MICs) of the extract and α-mangostin were assessed in trophozoites with 0.25 and 0.5 mg/mL, for cysts with 4 and 1 mg/mL, respectively. The MIC of the extract and α-mangostin inhibited the growth of A. triangularis trophozoites and cysts for up to 72 h. The extract and α-mangostin combined with chlorhexidine demonstrated good synergism, resulting in a reduction of 1/4-1/16 of the MIC. The SEM results showed that Acanthamoeba cells treated with a single drug and its combination caused damage to the cell membrane and irregular cell shapes. A good combination displayed by the extract or α-mangostin and chlorhexidine, described for the first time. Therefore, this approach is promising as an alternative method for the management of Acanthamoeba infection in the future.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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