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Hala El-Adawi etal ,J Biosci Tech, Vol 2 (1),2011,223-231 ISSN:0976-0172

Journal of Bioscience And Technology


www.jbstonline.com

SOME MEDICINAL PLANT EXTRACTS EXHIBIT POTENCY


AGAINST VIRAL HEPATITIS C
*Hala El-Adawi , Maha El-Demellawy and Abeer Abd El-Wahab
Medical Biotechnology Dept., GEBRI, Universities and Research Center District, New
Borg El-Arab, Egypt, P.O. BOX: 21934. Tel: 203-4593422, Fax: 203-4593407,
*E-mail address: Halaeladawi@hotmail.com
ABSTRACT
Background: Hepatitis C virus (HCV) infection is gaining increasing attention as
a global health crisis. HCV may lead to a substantial health and, consequently,
economic burden over the next 10-20 years. Aim of the work: This research
seeks to demonstrate antiviral activity of naturally derived extracts on HCV. Keywords:
Aqueous extracts of Milk thistle (MSE) as well as lyophilized juice of ginger Reverse transcriptase- PCR,
were tested in-vitro at different concentrations (100, 200, 300, and 400μg/ml) Antiviral drug,
using the HepG2 cell line infected with HCV. Inhibition of viral replication was Hepatitis C,
detected by the amplification of viral RNA using the reverse transcriptase (RT)- Medicinal plants
PCR technique. Both the MSE and juice were considered active upon inhibiting
the viral replication inside the HCV-infected HepG2 cells, as evidenced by the
disappearance of the (+) and/or (-) strands of viral RNA- amplified products
detected by RT-PCR (compared with the positive control). Results: The effective
anti-viral dose was 100 μg /ml for Ginger and 300 μg /m l for MSE. Conclusion:
This study provides results justifying preclinical evaluation of the tested extracts
as antiviral therapy for HCV infections.

1. INTRODUCTION replicate HCV has prevented this trial for a


Hepatitis C virus (HCV), first identified in long time. Recently, a model for in-vitro
1989 [1], is the major aetiological agent of anti-HCV screening was established [6-10].
non-A non-B hepatitis. The infection occurs
principally through blood or blood- derived This circumstance prompted us to engage in
products and affects globally more than 270 search for unprecedented HCV invasion
million people [2]. Egypt reports the highest inhibitors from medicinal plants. Many
prevalence of HCV worldwide, ranging herbal medicines possess antioxidant
from 6% to more than 40% among different properties, which may play an important
regions and demographic groups [3]. HCV role in therapeutics [11-16]. Two of the most
frequently leads to chronic hepatitis and beneficial medicinal plants are Ginger and
cirrhosis, in addition to being associated Milk thislte. Ginger (Zingiber officinale) has
with the development of hepatocellular long been used in traditional medicine as a
carcinoma [4]. In spite the highly vigorous cure for some diseases including
and extensive research in this field, a inflammatory diseases [17]. Ginger contains
protective vaccine and effective treatment active phenolic compounds such as gingerol,
are not yet available. paradol and shogoal which possess
antioxidant,[18] anti-cancer,[19] anti-
The mainstay of anti-HCV therapy, inflammatory,[20&21] anti-angiogenesis [22] and
interferon (IFN-α) along with ribvirin leads, anti-artherosclerotic properties[23]. Milk
at best, to viral clearance for about 40-50% thistle has been reported to have protective
of patients infected with HCV [5]. effects on the liver and to greatly improve its
Therefore, exploration for new anti-HCV function. It is typically used to treat liver
principles is urgently needed. However, the cirrhosis, chronic hepatitis (liver
absence of an efficient cell culture system to

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Hala El-Adawi etal ,J Biosci Tech, Vol 2 (1),2011,223-231 ISSN:0976-0172
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inflammation), toxin-induced liver damage For MSE, Eluent A: 200 mL of methanol


and gallbladder disorders [24&25]. were mixed with 800 mL of water. 5 mL of
phosphoric acid (85%, ACS Reagent grade)
The current work seeks to justify preclinical were mixed into 995 mL of the methanol:
evaluation of the extracts of these natural Water (20:80).
products as antiviral therapy for HCV Eluent B: Mix 800 mL of
infections. methanol with 200 mL of water. Mix 5 mL
of phosphoric acid into 995 mL of the
2. MATERIALS AND METHODS methanol: Water (80:20).
2.1 supplies
Bulk ginger rhizome (from Zingiber 2.3 Determination of phenol content
officinale) was obtained from Metro The classic technique employed in phenol
supermarket, washed through with tap analysis is the 4-aminoantipyrine
water, peeled and cross-sectional cut into colorimetric procedure [27]. The absorbance
2±mm thickness in order to squeeze them to of the samples was read against blank at 500
get the juice. Milk thistle (Silybum nm using spectrophotometer (PerkinElmer
marianum) seeds (were obtained from a Lambda EZ 201, USA). The concentration
local market at Alexandria, Egypt. The seeds of the sample was calculated from the
of Milk thistle were washed with water and standard curve prepared previously.
air dried away from direct sunlight. Seeds
were crushed in a coffee grinder for a total 2.4 Determination of antioxidant activity
of 4 min at 15 s on &off intervals (actual The antioxidant activities of the herbs water
grinding time: 2 min) to avoid heating the extracts were determined using the ferric
sample. The crushed seeds were wrapped thiocyanate (FTC) method [28] with slight
and stored at -18°C until extraction [26]. modification. Sample (20 mg) was dissolved
in 4 mL of 95% (w/v) ethanol, then was
2.2 HPLC analysis mixed with 4.1 mL of linoleic acid [2.51%
The HPLC grade solvents, including (v/v) in 99.5% (w/v) ethanol], 8 mL of 0.05
methanol and phosphoric acid were obtained M phosphate buffer pH 7.0 and 3.9 mL
from Merck (Darmstadt-Germany) and distilled water and kept in screw-cap
nanopure water was used. The phenolic containers at 40°C in the dark. To 0.1 mL of
compounds standards were obtained from this solution was then added 9.7 mL of 75%
Sigma –Aldrich (St. Louis, Mo) and used as (v/v) ethanol and 0.1 mL of 30% (w/v)
received. The analysis was done using a ammonium thiocyanate. Precisely 3 min
Beckman-C18 column (100X4.6 mm, 5um after the addition of 0.1 mL of 20 mM
particle size), equipped with an auto ferrous chloride in 3.5% (v/v) hydrochloric
sampler, quaternary pump and UV/Visible acid to the reaction mixture, the absorbance
multi-wavelength detector. The components at 500 nm of the resulting red solution was
of the ginger and MSE samples were measured, and it was measured again every
separated as described by National Science 24 h until the time when the absorbance of
Foundation (NSF). The eluent A and eluent the control reached the maximum value.
B for the three extracts was as follows:

For ginger, Eluent A: Water


Eluent B: acetonitrile

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Hala El-Adawi etal ,J Biosci Tech, Vol 2 (1),2011,223-231 ISSN:0976-0172
Journal of Bioscience And Technology
www.jbstonline.com

The percent inhibition of linoleic acid (Gibco-BRL), PBMC were stimulated with
peroxidation was calculated as: 5,10,25,50,100,150,200, 250 and 300 µg/mL
of each extract. All samples were assayed in
(%)𝑖𝑛ℎ𝑖𝑏𝑖𝑡𝑖𝑜𝑛 triplicates. A positive control culture was
𝑎𝑏𝑠𝑜𝑟𝑏𝑎𝑛𝑐𝑒 𝑖𝑛𝑐𝑟𝑒𝑎𝑠𝑒 𝑜𝑓 𝑡ℎ𝑒 𝑠𝑎𝑚𝑝𝑙𝑒
= 100 − �� � 𝑋100� included, where PBMC was stimulated with
𝑎𝑏𝑠𝑜𝑟𝑏𝑎𝑛𝑐𝑒 𝑖𝑛𝑐𝑟𝑒𝑎𝑠𝑒 𝑜𝑓 𝑡ℎ𝑒 𝑐𝑜𝑛𝑡𝑟𝑜𝑙
2 µg/mL phytohemaglutinin-L (PHA,
Sigma).
All tests were run in duplicate, and analyses
of all samples were run in triplicate and Proliferation was determined after
o
averaged. incubation for 3 days at 37 C, 5% CO 2 and
P P R R

95% humidity, by addition of 20 mL of


2.5 Cell Culture BrdU labeling reagent (Roche, Penzberg,
Germany) in the last 2 h of the culture. The
In the last few years, a number of cell
labeled cultures were harvested and Brdu
culture systems have been developed that
uptake was determined using Cell
support reliable and efficient progression of
proliferation ELISA, Brdu (colorimeteric)
this virus. Among several human hepatocyte
kit (Roche) following the manufactures
cell lines analyzed, the hepatocellular
instructions. Data were presented as
carcinoma HepG2 cell line was found to be
stimulation index (SI), where proliferation is
the most susceptible to HCV infection [29].
considered positive if SI is ≥ 2.
HepG2 cells were washed twice with
2.7 Qualitative in-vitro Anti-HCV
RPM11640 media supplemented with
Screening
200µM L-glutamine and 25µM HEPES
PBMC and HepG2 cell culture were
buffer; N-[2-hydroxyethyl] piperazine-N`-
prepared as discussed, then infected with 2%
[2-ethanesulphonic acid] (all chemicals and
HCV-infected serum in RPMI culture
media, Cambrex). The cells were suspended
medium containing 8% FBS. Aqueous
at 2X10 5 cells/ mL in RPM1 culture media
extract of MSE as well as lyophilized juice
P P

(RPM1 supplemented media, 10% fetal


of ginger was added at concentrations of
bovine serum (FBS); Gibco-BRL). The cells
5,10,25,50,100,150,200, 250 and 300
were left to adhere on the polystyrene 6-well
µg/mL. Positive and negative control
plates for 4 h in an incubator (37◌C, ֯ 5%
cultures were included. After 96 h of
CO 2 , 95% humidity). The cells were washed
incubation at 37oC, 5% CO 2 and 95%
R R

twice from debris and dead cells by using


P P R R

humidity, another dose of the tested extract


RPM1 supplemented media.
was added. The cells were incubated for
another 96 h at 37oC, 5% CO 2 and 95%
P P R R

2.6 Proliferative activities


humidity, followed by total RNA extraction.
Peripheral blood mononuclear cells (PBMC)
The positive strand and its replicating form
were isolated from a healthy individual by
(negative strand) were detected by RT-PCR
Ficoll-Hypaque (Sigma, St.Louis,MO,USA)
using HCV specific primers to the 5`-
gradient centrifugation. The purified cells
untranslated region of the virus.
was cultured at 1.0X10 6 cell/mL in RPM1
P P

complete medium (Camprex, Verviers,


Belgium) supplemented with 25mM N-[2- 2.8 RNA extraction from PBMCs and
hydroxyethyl] piperazine-N`-[2- HepG2 cells
ethanesulphonic acid] (HEPES) (Sigma), Monitoring of the HCV viremia pre-and
4mM L-glutamine (Camprex), and 10% FBS post-antiviral therapy through the detection

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Hala El-Adawi etal ,J Biosci Tech, Vol 2 (1),2011,223-231 ISSN:0976-0172
Journal of Bioscience And Technology
www.jbstonline.com

of viral (+) and /or (-) RNA strands by the cells RNA, 40 U of RNAsin (Clontech,
use of qualitative RT-PCR has become the USA), a final concentration of 0.2 mmol/L
most frequently used, reliable and sensitive from each dNTP (Promega, Madison,WI,
technique. Recently, it has been reported USA) and 50 pmol of the reverse primer
that the detection of the (-) strand HCV- 1CH (for plus strand) or 50 pmol of the
RNA using the RT-PCR is a very important forward primer 2CH (for minus strand). The
tool for understanding the life cycle of the reaction was incubated at 42ºC for 60 min
HCV. It provides a reliable marker for the and denatured at 98 for 10 min.
diagnosis of HCV and monitors the viral Amplification of the highly conserved 5'-
response to antiviral therapy [6]. UTR sequences was done using two rounds
of PCR with two pairs of nested primers.
Based on these facts, the adopted method in First round amplification was done in 50 μL
the present study contributes to the reaction mixture, containing 50 pmol from
simultaneous detection of the (+) and /or(-) each of 2CH forward primer and P2 reverse
HCV-RNA strands isolated from peripheral primer, 0.2 mmol/L from each dNTP, 10 μL
blood mononuclear cells (PBMC) of from RT reaction mixture as template and 2
infected patients as well as, HCV RNA U of Taq DNA polymerase (Promega, USA)
isolated from HepG2 cells. RNA was in a 1× buffer supplied with the enzyme.
isolated from PBMCs and HepG2 cells as The thermal cycling protocol was as
described by Lohr et al.1995 [30]. Briefly, follows: 1 min at 94ºC, 1 min at 55ºC and 1
cells were precipitated and washed in the min at 72ºC for 30 cycles. The second round
same buffer to remove adherent viral amplification was done similar to the first
particles before lysis in 4 mol/L round, except for use of the nested reverse
guanidinium isothiocyanate containing primer D2 and forward primer F2 at 50 pmol
25mmol/L sodium citrate, 0.5% sarcosyl and each. A fragment of 174 bp was identified in
0.1 mol/L |β|-mercaptoethanol and 100 μL positive samples. Primer sequences were as
sodium acetate. The lysed cells were follows: 1CH: 5'ggtgcacggtctacgagacctc-3',
centrifuged at 12000 rpm for 10 min at 4ºC. 2CH: 5'-aactactgtcttcacgcagaa-3', P2: 5'-
The aqueous layer was collected and mixed tgctcatggtgcacggtcta-3', D2: 5'-
with equal volume of isopropanol. After actcggctagcagtctcgcg- 3' and F2: 5'-
incubation at 20ºC overnight, RNA was gtgcagcctccaggaccc-3'. To control false
precipitated by centrifugation at 12000 rpm detection of negative-strand HCV RNA and
for 30 min at 4ºC and the precipitate RNA known variations in PCR efficiency, specific
was washed twice with 70% ethanol. control assays and rigorous standardization
of the reaction were employed: (1) cDNA
2.9 PCR of genomic and anti-genomic synthesis without RNA templates to exclude
RNA strands of HCV product contamination; (2) cDNA synthesis
Reverse transcription-nested PCR was without RTase to exclude Taq polymerase
carried out according to Lohr et al.,1995 RTase activity; (3) cDNA synthesis and
[30], with few modifications. PCR step done with only the reverse or
Retrotranscription was performed in 25 μL forward primer to confirm no contamination
reaction mixture containing 20 U of AMV from mixed primers. These controls were
reverse transcriptase (Clontech, USA) with consistently negative. In addition, cDNA
either 400 ng of total HepG2 or PBMCs

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Hala El-Adawi etal ,J Biosci Tech, Vol 2 (1),2011,223-231 ISSN:0976-0172
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Fig.1.
Resulting chromatogram and gradient elution schedule for
HPLC-UV analysis of (A): Ginger, (B): Milk thistle Extract

Fig. 2.
Inhibition of linoleic peroxidation by ascorbic acid as a standard and ginger (A),
and MSE (B), as measured by the FTC method. Absorbance values represent
means of triplicates of different samples analyzed

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Hala El-Adawi etal ,J Biosci Tech, Vol 2 (1),2011,223-231 ISSN:0976-0172
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Fig.3.
Dose response curve of tested extract effect on lymphocyte proliferation of healthy individuals.
The data expressed as the Optical density of the BrdU in corporation assay as mentioned
in materials and methods. All reading above dashed line are positive

Fig.4.
RT-PCR amplification products on gel electrophoresis: A, represents the PCR product of HCV RNA (+) and (―)
strands isolated from HepG2 cells at different concentrations of ginger (1), and MSE (2). B, represents the PCR
product of HCV RNA (+) and (―) strands isolated from peripheral blood mononuclear cells (PBMC) of infected
patients at different concentrations of ginger (1) and MSE (2).

synthesis was carried out using only one the extracts. Fig.1. showed high sensitivity
primer present followed by heat inactivation and reproducibility, which agrees with the
of RTase activity at 95ºC for 1 h, in an standard chromatograms produced by NSF.
attempt to diminish false detection of The resulting chromatogram A which
negative-strand prior to the addition of the illustrated in Fig.1 shows that the three
second primer. major compounds in ginger were 6-
gingerdiol, 6-gingerol and 10-gingerol. In
3. RESULTS the chromatogram C there were two major
3.1 HPLC compounds taxifolin and silychristin.
We adopted the HPLC method for analyzing Taxifolin derivative is also present in a
the isolated compounds as well as screening significant amount, as well, low amount of

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Hala El-Adawi etal ,J Biosci Tech, Vol 2 (1),2011,223-231 ISSN:0976-0172
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both silybinin A and B were also recorded. Out of the tested extracts, lyophilized juice
All compounds were identified by their of ginger proved to inhibit HCV replication
retention times against standard samples. completely at concentration 100μg/ml, while
Other peaks in both chromatograms were MSE inhibited HCV replication at
not identified due to the lack of standards, concentration 300μg/ml as shown in fig. 4.
they are most probably, phenolic compounds
in a sense they contributed significantly to 4. DISCUSSION
the total phenolics in the extract because Usually, screening of antiviral compounds
total phenolics measured were much higher has been snagged due to the lack of
than the sum of the individual phenolic representative smaller animal model.
concentration identified and quantified by However, in the case of HCV infection in
HPLC. humans, vector-based assay techniques have
been very helpful in screening a variety of
3.2 The phenolic content antiviral agents [31], but measuring the viral
Both extracts recorded high phenolic RNA synthesis in the absence and presence
content. It was 40.1% for ginger and 77.3% of the agent in an efficient cell culture
for MSE. system remains important. Real time PCR
has proven to be accurate for determination
3.3 The antioxidant activity of antiviral drug susceptibility of herpes
Figure 2 shows the inhibition of linoleic viruses [32&33]. The real time PCR assay
peroxidation by ginger and MSE was used in the current study to determine
respectively in comparison with ascorbic whether the HCV–RNA replication is
acid as a standard inhibited in infected cells (PBMC and
HepG2) by the plant extract or not.
3.4 The immuonomodulatory effect
The overall immuonomodulatory profiles of, Our data showed that lyophilized juice of
ginger and MSE enhanced lymphocyte ginger caused complete inhibition of
proliferation at concentrations up to 200 intracellular viral replication at 100μg/ml. This
µg/ml, Figure 3. These results demonstrate confirms the previous investigation done by
that not only do the extracts show no Sookkongwaree et al, 2005 [34], where they
cytotoxicity effect but they also augment reported the inhibition of HCV NS3 protease
lymphocyte proliferation (immuno- by ginger extract. They expressed the full
stimulatory effect) in a dose dependant length of HCV NS3 protease and then they
manner. purified and started the assay at enzymatic
level. The second extract tested in the
3.5 Anti-viral effect current study was the MSE, showing an
Inhibition of viral replication was detected inhibitory effect at 300μg/ml. We have two
by amplification of the viral RNA segments records about the antiviral effect of MSE, the
first is the clinical study done by Ferenci et al,
using RT-PCR technique. The test extract is
2008 [35], where they stated that silibinin ( one
considered to be active when it is capable of of the main constituents of MSE) is a potent
inhibiting the viral replication inside The antiviral agent in patients with chronic HCV not
HCV-infected cells, as evidenced by the responding to pegylated interferon/ribavirin
disappearance of the (+) and /or (-) strands therapy. The second record is the in vitro study
RNA amplified products detected by the done by Bonifaz et al., 2009 [36]. They
RT-PCR (compare to positive control). concluded that the silymarin (MSE)
significantly downregulated HCV core

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mRNA (by 20%–36%) and protein (by hepatocellular carcinoma. Proc Natl Acad Sci U
30%–60%) in CNS3 cells. Our current study S A. Sep;87(17):6547-6579
[5] Fried MW, Shiffman ML, Reddy KR, Smith C,
confirms those previous studies, and Marinos G, Gonçales FL Jr, Häussinger D,
emphasizes the importance of screening of Diago M, Carosi G, Dhumeaux D, Craxi A, Lin
several herbs aiming identifying an anti- A, Hoffman J and Yu J. 2002. Peginterferon
infectious agent offer a great potential in the alfa-2a plus ribavirin for chronic hepatitis C
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982.
[6] El-Awady M.K., Ismail S.M, El-Sagheer M,
5. CONCLUSION Sabour Y.A and Amr K.S. 1999. Assay for
It can be fairly concluded that lyophilized hepatitis C virus in peripheral blood
juice of ginger and MSE have a great mononuclear cells enhances sensitivity of
potential as sources for novel lead diagnosis and monitoring of HCV-associated
hepatitis. Clin. Chim. Acta 283: 1-14
compounds with specific antiviral [7] El-Awady M.K, Tabll A.A,, Redwan E.M, ,
properties. Further bioassays guiding Youssef S.S, Omran M.H and El-Demellawy
separation and isolation of the active M. (2005). Flow Cytometric Detection of
compounds is therefore of interest. Finally, Hepatitis C Virus Antigens in Infected
it is also of interest to determine whether the Peripheral Blood Leukocytes: Binding and
Entry.World J Gastroenterol. 11:5203-5208
inhibitory effects are due to a synergistic [8] El-Awady M.K, Tabll A.A, El-Abd Y.S, Bahgat
effect of more than one effective compound M.M, Shoeb H.A, Youssef S.S, Bader El Din
or due to the sole effect of a highly potent N.G, , Redwan E.M, El-Demellawy M, Omran
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6.AKNOWLEGEMENTS and El-Saadani M.A.2007. Anti-HCV lectin
The work has been recieved the financial from Egypatian Pisum sativum. Australian
support from Mubarak City for Scientific Journal of Basic and Applied Sciences, 1(3):
213-219
Research and Technology Applications [10] El-Fakharany E.M, Tabll A.M, Abd El-Wahab
(MUCSAT).The authors thank Dr. Marwa A.E, Haroun B.M and Redwan E.M. 2008.
Ali for her excellent technical assistance Potential activity of camel milk-amylase and
lactoferrin against HCV infectivity in HepG2
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