IJMAP_4_1_3_allium_moringa.pdf

Int. J. Med. Arom. Plants, ISSN 2249 – 4340RESEARCH ARTICLE

Vol. 4, No. 1, pp. 16-25, March 2014

*Corresponding author: (E-mail) gkinuthia <@> daystar.ac.ke http://www.openaccessscience.com

© 2014 Copyright by the Authors, licensee Open Access Science Research Publisher. [email protected]

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Efficacy of crude methanolic extracts of Allium sativum L. and Moringastenopetala (Baker f.) Cufod. against Leishmania majorGeoffrey K. KINUTHIA1, Ephantus W. KABIRU2, Christopher O. ANJILI3, Elizabeth M.KIGONDU4, Veronica N. NGURE5, Johnstone M. INGONGA3, Nicholas K. GIKONYO6

1Department of Science & Engineering, Daystar University, PO BOX 44400, Nairobi, Kenya2School of Public Health, Kenyatta University, PO BOX 43844, Nairobi, Kenya3Center for Biotechnology Research and Development, Kenya Medical Research Institute, PO BOX 54840,Nairobi, Kenya.4Center for Traditional Medicine & Drug Research, Kenya Medical Research Institute, PO BOX 54840, Nai-robi, Kenya.5Directorate of Research, Extension & Consultancy, Laikipia University, Po BOX 1100, Nyahururu, PostCode 20300, Kenya.6Department of Pharmacy and Complementary/Alternative Medicine, Kenyatta University, PO BOX 43850,Nairobi, Kenya.

Article History: Received 14th February 2014, Revised 21st March 2014, Accepted 24th March 2014.

Abstract: Leishmania major is a protozoan parasite responsible for cutaneous leishmaniasis (CL) in humans. CL istransmitted via a bite by infected female phlebotomine sand fly. Research on herbal therapy for leishmaniases is increas-ing globally because conventional drugs are costly, toxic and require a prolonged administration. In vitro and in vivoantileishmanial activities of dried Allium sativum (garlic) and Moringa stenopetala methanolic extracts against L. majorwere studied. Minimum inhibitory concentrations (MICs) of methanolic extracts of A. sativum (A) and M. stenopetala(M) against L. major were 3 and 5 mg/ml and IC50 of 863.12 and 1752.92 µg/ml respectively. The blend AM (1:1) hadIC50 of 372.1µg/ml and promastigotes’ viability of 71.03% compared to IC50 of 0.26 and 0.82µg/ml and promastigotes’viability of 18.41% and 12.22% for Pentostam and Liposomal amphotericin B respectively. Multiplication indices (MIs)of L. major amastigotes ranged from 43.67% to 45.93% after treatment with extracts A or M or blend AM at 125µg/mland were significantly different (P < 0.05) from Liposomal amphotericin B at 12.5µg/ml. Oral extract A reduced signifi-cantly (P > 0.05) L. major caused foot pad lesions in BALB/c mice while oral extract M did not. Blend AM (ip) reducedthe lesion sizes and its efficacy was close to Pentostam and Liposomal amphotericin B. Oral extract A had a high parasitereduction rate of 60.70% and average LDU of 0.22±0.15 compared to Pentostam at 66.40% and LDU of 0.18±0.08. Inconclusion, methanolic extract of A. sativum showed anti-leishmanial activity both in vitro and in vivo and it decreased L.major caused foot pad lesions in BALB/c mice. Methanolic extracts of M. stenopetala (ip) reduced the amastigotes bur-den in spleens of BALB/c mice. A blend of garlic and moringa methanolic extracts (AM at 1:1) were active against L.major. The active ingredients in crude methanolic extracts of garlic and moringa plants should be established and testedagainst L. major when blended.

Keywords: A. sativum; M. stenopetala; methanolic extracts; blend; antileishmanial; Leishmania major.

Introduction

Cutaneous leishmaniasis (CL) is one of theneglected tropical protozoan diseases and it istransmitted by a bite of an infected femalephlebotomine sand fly (Diptera: Psychodidae).The protozoan responsible for this disease be-longs to the genus Leishmania (Kinetoplastida:Trypanosomatida) and it is endemic in 98 coun-

tries worldwide (WHO, 2010). An estimatedyearly incidence of about 1.2 million cases ofCL occur each year worldwide (Alvar et al.,2012). The main clinical manifestations of CLare painful skin lesions that can elicit socialstigmatization and significant morbidity in thesufferers (Bailey, 2013).

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17Int. J. Med. Arom. Plants Antileishmanial activity of A. sativum and M. stenopetala methanol extracts

Kinuthia et al. http://[email protected]

According to Nilforoushzadeh et al. (2007),there is no effective and safe treatment forleishmaniases. The CL drugs which includePentavalent antimonials, Amphotericin B andPentamidine among others are toxic, expensiveand are often associated with several healthcomplications. Drug resistances by Leishmaniaparasites and therapeutic failure have also beenobserved in leishmaniasis patients. Leishmaniamajor (Kinetoplastida: Trypanomastidae) is oneof the species that cause CL in Kenya and it isendemic in Baringo County, in the great RiftValley.

Herbal products are potential sources of anti-leishmanial compounds since they have a widechemistry, remarkable diversity and a high ac-cessibility in nature (Monzote, 2009). Increasedresearch on plant derived anti-leishmanial com-pounds has identified herbal products that areeffective against Leishmania parasites. Alliumsativum L. (garlic) is a perennial plant that be-longs to the family Amaryllidaceae and it hasbeen used as food, spice and medicine for thou-sands of years in different parts of the world(Singh & Singh, 2008). The medicinal proper-ties of A. sativum range from antimicrobial,hypolipidemic, antithrombotic to antitumouractivities (Augusti, 1996). Previous studieshave indicated that garlic extracts or their frac-tions augment parasite engulfment and destruc-tion of intracellular Leishmania amastigotes byBALB/c mice peritoneal macrophages(Ghazanfari et al., 2006). Similarly, McClure etal. (1996) reported that Allicin, the active anti-microbial compound in A. sativum, demon-strates a significant inhibitory effect onleishmanial cell growth.

Moringa stenopetala (Baker f.) Cufod. is asmooth barked, deciduous flowering plant wide-ly distributed in southern parts of Ethiopia andnorthern Kenya (Mekonnen et al., 1999) particu-larly in Lake Baringo islands. M. stenopetalabelongs to the monogeneric family Moringaceae(Order Capparales). In Ethiopia, the leaves andfruits of M. stenopetala are eaten as vegetableswhich are rich in proteins, calcium, phospho-rous, iron plus vitamins A and C. The leaves,roots, fruits and the barks of the M. stenopetalaare used to treat different ailments includingstomach problems, malaria, hypertension, diabe-

tes, asthma and expelling retained placenta(Mekonnen et al., 1999). Fresh root wood etha-nol extracts and dried leaves acetone extracts ofM stenopetala have been reported to possessantitrypanosomal property (Mekonnen et al.,1999). In our previous study, dried leaves crudeaqueous extract of M. stenopetala was demon-strated to possess in vitro inhibitory effectagainst L. major promastigotes at a concentra-tion of 3mg/ml (Kinuthia et al., 2013).

It is against this background that the presentstudy was designed to investigate the in vitroand in vivo activity of crude methanolic extractsof A. sativum L. and M. stenopetala (Baker f.)Cufod. against L. major. The crude methanolicextracts were studied singly or as blends.

Materials and methods

Plant materials

Bulbs of A. sativum were purchased fromNakumat super market in Nairobi, Kenya whileyoung leaves of M. stenopetala were pickedfrom trees growing on the slopes of LakeBaringo islands in Kenya. The study plants wereauthenticated at University of Nairobi Herbari-um, in the department of Botany, ChiromoCampus. The young leaves of M. stenopetalaand thin slices of A. sativum cloves were dried atroom temperature at Kenya Medical ResearchInstitute (KEMRI), Leishmania unit, until theyattained a constant weight. The dried plant mate-rials were labeled appropriately and then trans-ferred to the Center of Traditional Medicine &Drug Research (CTMDR) at KEMRI, wherethey were ground into a powder using an electricmill and then stored at minus 20oC until requiredfor extraction.

Crude Extracts

The crude methanolic extracts were preparedas described by Cock (2008). Briefly, a 100g ofground plant material was soaked in 500 ml ofanalytical grade methanol for 72 hours at roomtemperature with gentle shaking, then filteredand concentrated using a rotary evaporator toobtain the crude methanolic extracts. The dryextracts were weighed and stored at 4oC untilrequired for the bioassays. The methanolic crude





extracts of A. sativum was coded as extract Awhile that of M. stenopetala was coded as ex-tract M. With an initial weight of 100g groundplant material, the methanolic crude extracts ofA. sativum (A) was 5.698g (5.70%) while that ofM. stenopetala (M) was 9.217g (9.22%).

Leishmania parasites

The Leishmania major strain(IDUB/KE/94=NLB-144) used in this study wasacquired from Institute of Primate Research(IPR) Kenya, where it had been maintained bycryopreservation in liquid nitrogen. The para-sites were grown to stationary phase at 25oC inSchneider’s insect medium supplemented with20% heat inactivated fetal bovine serum, 100U/ml penicillin and 500μg/ml streptomycin(Hendricks & Wright, 1979), and 250μg/ml of5-fluorocytosine arabinoside (Kimber et al.,1981). The stationary-phase metacyclic stagepromastigotes were then harvested by centrifu-gation at 1500 rpm for 15 minutes at 4oC. Themetacyclic promastigotes were then used for thein vitro and in vivo assays.

Experimental animals

Eight week old male inbred BALB/c micewere used for in vivo macrophage assay for theplant extracts. The inbred BALB/c mice wereobtained from International Livestock ResearchInstitute (ILRI), Kenya. They were then housedat the KEMRI animal house at 23oC to 25oC andwere fed on standard commercial diet in theform of mice pencils and were given tap waterad libitum. The mice were handled in accord-ance with the regulations that have been set byKEMRI’s Animal Care and Use Committee(ACUC).

Evaluation of minimum inhibitory concentration(MIC)

The MIC was determined as described byWabwoba et al. (2010). Promastigotes at a con-centration of 1×106 metacyclic promastigotesper ml of culture medium were exposed to sev-eral concentrations of the test individual plantextracts A and M. The lowest concentration of

the test plant extracts that inhibitedpromastigotes growth was taken to be the MIC.

In vitro anti-promastigote assay

This was evaluated as described byWabwoba et al. (2010). The metacyclicpromastigotes at a concentration of 1x106

promastigotes per ml were incubated in culturemedium in 24-well plates in presence of differ-ent concentrations of plant extracts for five daysat 25oC. The aliquots of parasites were thentransferred into 96-well micro-titer plates, andincubated at 27oC for 24 hours. Two hundredmicro liters of test extracts A and M sampleswere then added to the parasite cultures at con-centrations ranging from 5 mg/ml to 0.5 mg/mlof extracts. The plates were then incubated fur-ther at 27oC for 48 hours. The control wells con-tained culture alone. Ten micro liters of 2, 5-diphenyltetrazolium bromide (MTT) reagentwas added into all the wells and incubated for 4hours. The medium together with MTT wereaspirated off, followed by addition of 100μl ofdimethyl sulfoxide (DMSO) per well and shakenfor 5 minutes. Absorbance was measured foreach well at 562 nm using a micro-titer reader.The absorbance readings were used to generatethe 50% inhibitory concentration (IC50) valuesfor extracts A and M. Percentage promastigotes’viability (%) was determined using the formuladescribed by Mosmann (1983), in which, viablepromastigotes (%) = (at – ab) / (ac) × 100,where at was the absorbance of treated samplesand ab was the absorbance of the blank wellsand ac was the absorbance of the control wells.

In vitro anti-amastigote assay

This was carried out as described byDelorenzi et al. (2001). Peritoneal macrophageswere obtained from clean BALB/c mice. Tenmilliliters of sterile cold phosphate-buffered sa-line (PBS) was injected into the peritoneum ofanaesthetized BALB/c mice whose body surfacehad been disinfected with 70% ethanol. ThePBS containing the macrophages was washedthrough centrifugation at 2,000 rpm for 10minutes and the macrophages were adsorbed insterile 24-well plates for 4 hours at 37oC in 5%





CO2. Adherent macrophages were infected withpromastigotes and further incubated at 37oC in5% CO2 for 4 hours and then washed with ster-ile PBS to remove the free promastigotes. Thiswas followed by further incubation of the in-fected macrophages for 24 hours in RPMI 1640culture medium. The infected macrophages werethen treated with extracts A and M. Pentostamand Liposomal amphotericin B were used aspositive control drugs. The medium, test extractsand control drugs were replenished daily for 3days. After 5 days, the macrophages werewashed with PBS at 37oC, fixed in methanol andstained with 10% Giemsa. The number ofamastigotes was determined by counting at least100 macrophages in duplicate cultures, and theresults was expressed as infection rate (IR) andmultiplication index (MI) as described by Ber-man & Lee (1984).

Infection and treatment of BALB/c mice

The BALB/c mice were placed into 10groups caged separately, where each group wascomprised of at least 5 mice. All the mice ineach group were infected with L. majorpromastigotes in the foot pads as described byWabwoba et al., 2010. Briefly, the thickness ofthe hind legs footpads was measured using areading vernier caliper prior to infection. Theleft hind footpads of the mice were then subcu-taneously inoculated with 1×106 stationaryphase infective metacyclic promastigotes of L.major in 40μl sterile PBS. Lesion developmentwas monitored for four weeks after whichtreatment commenced. A four week treatmentwas given to the infected mice that had devel-oped footpad lesions. Groups of mice weretreated with individual methanolic extracts A,extracts M, blend of A and M in a ratio of 1:1,and with positive and negative controls. Treat-ment was administered orally daily using a can-nula for each extract or intra-peritoneally usinga fine 1ml 30 gauge insulin needles (BD Micro-Fine Plus®, USA) at a dose of 20 mg/kg dailyfor each extract. The positive control groups ofmice were treated intra-peritoneally withPentostam and Liposomal amphotericin Bleishmaniases drugs at a dose of 20 mg/kg perday. Two groups of negative control mice weretreated with phosphate buffered saline (PBS),

one group orally and the other intraperitoneally.The progression of the foot pads lesions sizeswas monitored weekly using a vernier caliper tomeasure the thickness of the infected left hindfoot pad and comparing it with that of non in-fected right hind foot pad as described by Nolan& Farrel (1987).

Post treatment parasite burden in BALB/c micespleens

After a four week treatment period, the micewere sacrificed using 100μl pentobarbitone so-dium (Sagatal®). At necropsy, the spleens wereweighed and spleen impression smears weremade as described by Chulay & Bryceson(1983). The impression smears were fixed inmethanol and stained with Giemsa. The smearswere examined under a microscope to enumer-ate the number of amastigotes per 1000 nucleat-ed spleen cells. The relative and total numbersof parasites in the spleen were estimated by cal-culating the spleen index (%), Leishman-Donovani Units (LDUs) and total Leishman-Donovani Units (total LDUs) as described byBradley & Kirkley (1977). Spleen index (%)was determined using the formula: Spleenweight (g) divided by body weight (g) × 100%.LDU was the number of amastigote per 1000nucleated splenocytes while the total LDU wascalculated using the formula: LDU × spleenweight (g) × (2 × 105).

Data analysis

Data was analyzed using SPSS version 17.0for windows at 5% level of significance. Oneway ANOVA (F test) was used to comparepromastigotes viabilities (%) after differenttreatments. Other variables compared using Ftest were infection rates (IRs) and multiplicationindices (MIs) of amastigotes in peritoneal mac-rophages and also the lesion sizes in differentgroups of BALB/c mice under different treat-ments. Cases in which homogeneity test of vari-ance (Levene’s test) were significant, robusttests of equality of means that included Brown-forsythe and Welch tests were carried out as al-ternative versions of the F-statistics. Multiplecomparisons of the individual treatments were





done using both Tukey HSD and Games-Howellpost hoc tests.

Results

MIC, IC50 and viability of L. majorpromastigotes

The MICs of crude methanolic extracts Aand M against L. major were 3 and 5 mg/ml re-spectively compared to 1.25 × 10-2 and 6.25 ×10-3 mg/ml for Pentostam and Liposomal am-photericin B respectively. The IC50 of extracts Aand M were 863.12 and 1752.92 µg/ml respec-tively compared to 0.26 and 0.82 µg/ml forPentostam and Liposomal amphotericin B re-spectively. The viabilities (%) of L. major

promastigotes after treatment with crude ex-tracts A and M at concentrations that rangedfrom 5 to 0.5 mg/ml were 67.80% and 80.84%respectively while the promastigotes viability inPentostam and Liposomal amphotericin B were18.41% and 12.22% respectively at an initialconcentration of 0.1mg/ml which was seriallydiluted by a factor of 2. A blend of crudemethanolic extracts of A. sativum (A) and M.stenopetala (M) at fixed ratios (AM) and at theMIC based concentrations, exhibited additiveinteraction at ratios 1:1, 2:8, and 1:9 with corre-sponding promastigotes’ viability of 76.56%,59.79% and 34.59% respectively. The IC50 ofblend AM at ratios ranging from 9:1 to 1:9 was372.1µg/ml with overall promastigotes viabilityof 71.03%.

Table 1: The in vitro infection rates (IR) and multiplication indices (MI) of L. major amastigotes inperitoneal macrophages following treatment with methanolic extracts and control drugs.Test extracts Amastigotes& controls Conc (µg/ml) IR (%) per 100 cells MI (%)Single extractsA 125.00 46 193 43.67

62.50 49 201 45.4831.25 51 216 48.8715.63 70 230 52.04

M 125.00 70 203 45.9362.50 75 210 47.5131.25 83 316 71.4915.63 87 353 79.86

Blend (1:1)AM 125.00 73 193 43.67ControlsRPMI a (3 replicas) 1st 89 451 n/a

2nd 79 403 n/a3rd 86 472 n/aAverage 84.67±2.96 442 100.00

Pentostam 50.00 14 51 11.5425.00 38 123 27.8312.50 67 210 47.51

6.25 81 307 69.46Lip ampho B 50.00 6 38 8.60

25.00 10 49 10.8612.50 19 54 12.22

6.25 23 62 14.03

RPMI a: Negative control in which the amastigotes multiplied in RPMI 1640 culture medium; n/a = not applicable; A= A. sativum while M = M. stenopetala; Lip ampho B = Liposomal amphotericin B.

Extracts in vitro effect on L. major amastigotes

RPMI 1640 medium supported the growth of L.major amastigotes in peritoneal macrophagesmore effectively as was indicated by a high in-fection rate (IR) of 84.67± 2.96 %. Liposomal

amphotericin B and Pentostam inhibited the sur-vival of L. major amastigotes peritoneal macro-phages as was indicated by low IRs of 6% and14% respectively at a concentration of 50µg/ml.A similar trend was observed in multiplication





indices (MIs) as shown in Table 1. Effects ofextracts A and M was dose dependent, wherehigh extracts concentration led to low IRs andMIs. Methanolic extracts of garlic (A) weremore effective in inhibiting the survival ofamastigotes in peritoneal macrophages in vitro(Table 1). Blend AM at a concentration of125µg/ml was associated with 43.67%multiplication index for L. major amastigotes inperitoneal macrophages, and this activity wasclose to that of pentostam (47.51%) at 12.50µg/ml (Table 1). Tukey’s post hoc test showedthat the difference between the IRs and MIs ofextracts A, M and blend AM and those of Lipo-somal amphotericin B were statistically signifi-cant (P < 0.05).

Effect of crude extracts on L. major caused le-sions in mice

The orally administered methanolic extractA (A. sativum) into infected BALB/c mice led toa decrease of their foot pad lesions. The differ-ence between the mean lesion sizes of micetreated with extract A and that of mice treatedwith drugs Pentostam and Liposomal amphoter-icin B (Figure 1) was not significant (P = 0.986and 0.898 respectively). Orally administeredmethanolic extract M (M. stenopetala) did notreduce the footpad lesions in the infectedBALB/c mice and this compared closely withthat of mice treated with PBS (Figure 1).Tukey’s post hoc test showed that orally admin-istered extracts M had an efficacy that was sig-nificantly different from that of orally adminis-tered extract A (P = 0.0001). Extracts A, admin-istered intra-peritoneally (ip) had a significantreduction of the footpad lesions in BALB/c micewhile extracts M were not very active in reduc-ing foot pad lesions when compared to intraperitoneally administered PBS (P = 0.853).

Figure 1: The foot pad swelling after oral treatment of L. major infected BALB/c mice with testmethanolic extracts of A. sativum (A), M. stenopetala (M) compared to intra peritoneally adminis-tered Pentostam & Liposomal amphotericin B, and orally administered phosphate buffered saline(PBS).

Orally administered methanolic blend of A.sativum and M. stenopetala at a ratio of A:M =1:1, stagnated the lesion sizes progression butthis reduction was not significantly differentfrom lesions sizes in BALB/c mice treated with

orally administered PBS (P = 0.072). The com-parison of mean lesion sizes in BALB/c micetreated with orally administered blend AM andmean lesion sizes in mice treated with Liposo-mal amphotericin B, and those treated with





Pentostam indicated that the difference was notsignificant (F (2,28) = 0.946, P = 0.479). BlendAM administered intra-peritoneally into infectedBALB/c mice, reduced the lesion sizes steadily

from the second week (Figure 2) and its efficacywas significantly different from that ofPentostam and Liposomal amphotericin B (P <0.05).

Figure 2: The foot pad lesion sizes in L. major-infected BALB/c mice after treatment with intraperitoneally administered blend AM (1:1) comprising of methanolic extracts of A. sativum (A) andM. stenopetala (M) compared to intra peritoneally administered Pentostam (Pento), Liposomal am-photericin B (Lip amph B), and phosphate buffered saline (PBS).

Table 2: The average spleen index ± SE, LDU ± SE and total LDU ± SE for groups of L. major in-fected BALB/c mice that were treated with methanolic extracts, and Pentostam, Liposomal ampho-tericin B and PBS controls.Extracts Ave spleen Ave total % parasite& controls Route index (%) Ave LDU LDU(×1000) reductiona

Individual:A (Garlic) oral 0.60±0.05 0.22±0.15 4.83±3.20 60.70

ipb 0.55±0.05 0.52±0.04 11.31±0.21 07.97M (Moringa) oral 1.31±0.13 0.36±0.07 15.00±1.53 -22.05

ip 1.31±0.31 0.16±0.02 6.36±2.90 48.25Blend (1:1)AM oral 0.54±0.11 0.53±0.18 12.14±6.53 01.22

ip 0.59±0.11 0.44±0.17 10.48±4.19 14.73Controls:Pentostam ip 0.73±0.19 0.18±0.08 4.13±1.10 66.40Lip amph B ip 0.61±0.02 0.24±0.02 4.84±0.38 60.62PBS ip 0.54±0.04 0.38±0.21 8.74±5.30 28.89PBS oral 0.56±0.06 0.61±0.22 12.29±4.49 00.00a means that the % was calculated in reference to total LDU for PBS oral which was taken to repre-sent 100% parasite burden; ipb = intra-peritoneal; A = Allium sativum; M = Moringa stenopetala; Lipamph B = Liposomal amphotericin B; PBS = phosphate buffered saline.





Effects of extracts on spleen parasite burden inmice

Orally administered extract A (A. sativum)had the highest parasite load reduction of60.70% while orally administered extract M (M.stenopetala) had the lowest at -22.05% com-pared to 66.40% for Pentostam (Table 2). Theaverage values of LDU±SE for intra peritoneallyadministered extracts A and M were 0.52±0.04and 0.16±0.02 respectively compared to0.18±0.08, 0.24±0.02, and 0.38±0.21 for intra-peritoneally administered Pentostam, Liposomalamphotericin B and PBS respectively (Table 2).The route of extracts’ administration had a sig-nificant influence on the total LDU values ob-tained as was the case for extract M whose meantotal LDU for oral route and that for intra peri-toneal route differed significantly (P = 0.016).Blend AM (1:1) reduced the spleen parasiteburden by 14.73% when administered intra-peritoneally compared to 60.62% and 28.89%for Liposomal amphotericin B and PBS respec-tively.

Discussion

Among the new strategies of controllingleishmaniasis is the use of herbal materials,which are regarded as safer, cheap and less like-ly to be associated with drug resistance. Themedicinal properties of A. sativum L (garlic)includes antibacterial, antifungal, antiviral andantiparasitic (Goncagul & Ayaz, 2010). Themedicinal property of garlic has been attributedto its organosulfur compounds which includealliin, allicin, diallyl sulfide, diallyl disulfide,ajoene among others (Islam et al., 2011). Previ-ous studies have reported on the antileishmanialproperty of garlic extracts in vitro and in vivo(Ahmadi-Renani, et al., 2002; Gamboa-Leon etal., 2007; and Wabwoba, et al., 2010). Accord-ing to McClure et al. (1996), allicin (diallylthiosulfinate) inhibits leishmanial cell growthsignificantly and it is less inhibitory to thegrowth of mammalian cell lines. The presentstudy concurs with the previous studies becauseit demonstrates that methanolic extract of driedgarlic have a low toxicity and inhibits the sur-vival of L. major promastigotes and amastigotesin vitro, as well as reducing the size of L. majorinduced foot pad lesions in BALB/c mice. In

addition, this study shows that garlic lowers theamastigotes burden in the spleens of infectedmice. According to Ahmadi-Renani et al.(2002), aqueous extract of garlic reduced thediameter of L. major induced lesions within 30days of treatment and the healing correlatedwith nitric oxide (NO) release by the host mac-rophages. According to Gamboa-Leon (2007),garlic shows immune modulatory property thatenhances the release of nitric oxide (NO) by thehost macrophages and kills Leishmania para-sites in experimental BALB/c mice.

The medicinal and nutritional values ofMoringa stenopetala (Baker f.) Cufod. havebeen widely investigated by Mekonnen and herresearch collaborators (Mekonnen et al., 1999).The current study indicates that intraperitoneally administered methanolic extract ofM. stenopetala into L. major infected BALB/cmice was active in reducing the amastigotesburden by 48.25% in their spleens at a dose of20mg/kg/day for four weeks, but it seemed notto be active in reducing the L. major caused footpad lesions in the infected mice at the same doseand treatment period. Plants in the orderCapparales, including M. stenopetala are rich inglucosinolates which are phytochemicals thatare precursors of a wide range of bioactive anti-biotic compounds (Fahay, 2005; Bellostas et al.,2010). This could explain the plant’s in vivo in-hibitory activity against L. major amastigotes inBALB/c mice, observed in the current study. Inour previous study, aqueous extracts of M.stenopetala supported an in vitro L. majoramastigotes infection rate of 58% in BALB/cmice peritoneal macrophages (Kinuthia, et al.,2013).

Recent literature reports have established theeffectiveness of natural products as potentiallyrich sources of new and selective agents for thetreatment of tropical diseases caused by proto-zoan parasites (Mishra et al., 2011). In mostcommunity based herbal therapies, differentherbal materials are used in combination to treata specific medical condition. The blending ofherbal materials or drugs could be advantageouswhen synergistic or additive interactions ensue.Antagonistic interactions are often disadvanta-geous (Tahany, 2010).





In the present study, blends of methanolicextracts of A. sativum and M. stenopetala at 1:1,2:8 and 1:9 ratios interacted additively. Thiscould have explained the activity of the blend(ratio 1:1) in reducing the spleen parasite burdenby 14.73% when administered intra-peritoneallyin BALB/c mice and also in significantly reduc-ing the L. major caused foot pad lesion sizes inthe mice. Since garlic is rich in organosulfurcompounds while moringa is rich inglucosinolates, therefore a blend of the two mayhave contained the two compounds thus ex-plaining the antileishmanial activity. Previousstudies have shown that blends of aqueous ex-tracts of A. sativum and M. stenopetala that in-teracted synergistically or additively showed invitro and in vivo antileishmanial activity(Kinuthia, et al., 2013).

Conclusion

The methanolic crude extracts of Alliumsativum L (garlic) are less toxic compared toleshmaniasis standard drugs Pentostam and Lip-osomal amphotericin B, and in addition thecrude extracts are active against L. major bothin vitro and in vivo. Intra-peritoneally adminis-tered M. stenopetala methanolic crude extractsinto L. major infected BALB/c mice lowered theamastigotes burden in their spleens. Similarly, ablend of A. sativum and M. stenopetalamethanolic crude extracts at a ratio 1:1 was rela-tively less toxic and it reduced the size of L. ma-jor caused foot pad lesions in BALB/c mice sig-nificantly.

Acknowledgements: The authors thank all theresearchers from Kenya Medical Research Insti-tute (KEMRI-Nairobi), Kenyatta University,and University of Nairobi for their technical ad-vice and their active roles in this project. Thisstudy formed part of the requirements for PhDdegree for the first author.

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