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.
Highlights
Oral candidiasis is associated with predisposing factors, which includes the disruption of the oral bacterial community by Archives of Orofacial Sciences. 2021; 16(Supp. 1): 17–24 http://aos.usm.my/ Penerbit Universiti Sains Malaysia. 2021
The immunosuppressed group (IS) had the lowest expression of p38 Mitogen-activated protein kinase (MAPK) (26.00 ± 2.32) compared to immunosuppression with oral candidiasis without treatment (ISC) (26.40 ± 3.71), immunosuppression with oral candidiasis and nystatin treatment (ISC+N) (34.20 ± 0.99), and ISC+AI (36.05 ± 1.54), while the highest expression of p38 MAPK appeared in the group of subjects which had been induced with C. albicans and treated topically with 20% A. ilicifolius L. methanolic extract (ISC+AI) compared to other groups (Fig. 2)
least significant different (LSD) statistical test confirmed significant differences existed between ISC+AI and ISC+N to IS and ISC (p < 0.05)
Summary
Immunosuppressive drugs are the drugs that suppress the immune system used to prevent the production of antibodies. Due to their non-selective action, they have various side effects (Kant et al, 2009). Increased risk of opportunistic infections such as fungal infection are associated with these drugs. Oral candidiasis is associated with predisposing factors, which includes the disruption of the oral bacterial community by Archives of Orofacial Sciences. The Candida species is one of the common human fungal pathogens, which are benign commensals of the normal skin and mucosal flora in approximately 80% of the population (Tang et al, 2016). Among the Candida spp., Candida albicans (C. albicans) ranks first in isolation frequency and morphological flexibility that plays crucial roles in several aspects of infection and host recognition (Brunke & Hube, 2013; Noble et al, 2017)
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