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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.
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1 Walailak University, 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), Nakhon Si Thammarat, Thailand (GRID:grid.412867.e) (ISNI:0000 0001 0043 6347)
2 Walailak University, 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), Nakhon Si Thammarat, Thailand (GRID:grid.412867.e) (ISNI:0000 0001 0043 6347); Akkhraratchakumari Veterinary College and Research Center of Excellence in Innovation of Essential Oil, Walailak University, Nakhon Si Thammarat, Thailand (GRID:grid.412867.e) (ISNI:0000 0001 0043 6347)
3 Prince of Songkla University, Division of Physical Science, Faculty of Science, Songkhla, Thailand (GRID:grid.7130.5) (ISNI:0000 0004 0470 1162)
4 Chulalongkorn University, Department of Pharmacognosy and Pharmaceutical Botany, Faculty of Pharmaceutical Sciences, Bangkok, Thailand (GRID:grid.7922.e) (ISNI:0000 0001 0244 7875); Islamic University in Uganda, Department of Biochemistry, Habib Medical School, Kampala, Uganda (GRID:grid.442655.4) (ISNI:0000 0001 0042 4901)
5 Mahidol University, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Bangkok, Thailand (GRID:grid.10223.32) (ISNI:0000 0004 1937 0490)
6 São Paulo State University, Department of Biology, Faculty of Sciences, São Paulo, Brazil (GRID:grid.410543.7) (ISNI:0000 0001 2188 478X)
7 National Institute of Tuberculosis & Respiratory Diseases (NITRD), Department of Microbiology, New Delhi, India (GRID:grid.419345.e) (ISNI:0000 0004 1767 7309)
8 CICECO-Aveiro Institute of Materials &, University of Aveiro, Department of Medical Sciences, Aveiro, Portugal (GRID:grid.7311.4) (ISNI:0000000123236065)
9 University of Development Alternative Lalmatia, Department of Biotechnology & Genetic Engineering, Dhaka, Bangladesh (GRID:grid.443057.1) (ISNI:0000 0004 4683 7084)
10 University of Nottingham Malaysia Campus, School of Pharmacy, Selangor, Malaysia (GRID:grid.440435.2)
11 Birjand University of Medical Sciences, Ferdows School of Paramedical and Health, Birjand, Iran (GRID:grid.411701.2) (ISNI:0000 0004 0417 4622)
12 University of Tabriz, Department of Pathobiology, Faculty of Veterinary Medicine, Tabriz, Iran (GRID:grid.412831.d) (ISNI:0000 0001 1172 3536)
13 UNSW Medicine, UNSW, School of Public Health and Community Medicine, Sydney, Australia (GRID:grid.1005.4) (ISNI:0000 0004 4902 0432); Burnet Institute, Centre for Biomedical Research, Melbourne, Australia (GRID:grid.1056.2) (ISNI:0000 0001 2224 8486)