In-vitro and In-vivo Anti-Candidal Effect of Cnidoscolus aconitifolius Leaves Extracts

Candidiasis is an opportunistic infection caused by pathogens of the genus Candida. Due to the increase in antifungal resistance by Candida species, there is a need for alternatives in its treatment. Cnidoscolus aconitifolius is a medicinal plant with vast nutritional and antimicrobial properties. This study evaluated the in-vitro and in-vivo anti-candidal effect of Cnidoscolus aconitifolius (spinach tree) leaves extract. Clinical isolates of Candida albicans, Candida krusei, Candida tropicalis, Candida dublinensis, Candida glabrata, and Candida parapsilosis were used in this study and Cold maceration technique was employed in the plant extraction process, to obtain its ethanolic, methanolic, and aqueous extract. The agar well diffusion method and 2-fold dilution process -to obtain 250 mg/ml to 15.625mg/ml of the extracts -were used for the antimicrobial sensitivity test and three weeks old female Wistar rats infected with 20µl of standardized C. albicans were used for the in-vivo evaluation. Statistical analysis was done using Statistical package for Social Sciences (SPSS) version 22. In-vitro assay revealed ethanolic extract as the most potent extract with the highest inhibition zone diameter of 12.67±1.15c, 11.67±1.15c, and 12.33±0.58c at 250mg/ml against C. tropicalis, C. krusei2, and C. parapsilosis respectively. C. parapsilosis was the most sensitive to all the extracts. In-vivo, the disappearance of disease symptoms and progressive decrease in rats Candida burden- from 6.35×103 CFU/ml obtained after infection to 2.15×103CFU/ml after treatment revealed the ability of the plant to treat candidiasis. The study suggests that extract of Cnidoscolus aconitifolius leaves could act individually or synergistically as effective drug candidates in the treatment of candidiasis; thus if its individual antifungal constituents are purified, this plant could be the next major anti-candidal agent.