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Note that the oil used in this study was the linalool variety ...

 

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http://www.sums.ac.ir/~ijms/9734/zolfagha9734.html

 

CLINICAL TRIAL OF EFFICACY OF MYRTLE OIL IN THE TREATMENT OF HERPES

SIMPLEX

 

 

M.E. Zolfaghari, P. Salamian, A. Riazi, G. Khaksa

 

 

Pharmaceutical Research Center, Darou-Pakhsh Co., Tehran, Iran

 

 

 

ABSTRACT The efficacy of an essential oil (myrtle oil) of Myrtus

communis linn in the treatment of type 1 herpes simplex virus (HSV-1)

infection was investigated. A double-blind randomized placebo controlled

trial of topical myrtle oil ointment and matching placebo was carried

out in 80 patients with HSV-1 infection (myrtle oil; n = 60, and

placebo; n = 20). Patients were instructed to apply the ointment 3 to 5

times a day for up to 5 days. Total duration and severity of clinical

signs and symptoms in all patients (time of healing, complete crusting

of lesions, pain and itching) were significantly reduced in test group

by day 2, (p<0.01) compared with placebo-treated group.

 

Irn J Med Sci 1997; 22(3 & 4):137.

 

 

 

Keywords: herpes simplex, antiviral drugs

 

 

 

Introduction

 

 

Herpes simplex is one of the most common skin and mucosal infections

affecting almost 33% of the general population and its incidence is on

the rise. Herpes simplex virus (HSV) infection of the lips and/or facial

area (herpes labialis, cold sores, fever blister) tends to occur more

frequently and more severely.8,10,11 Herpes simplex infection is treated

with topical antiviral agents such as acyclovir<sup>9, and iodoxuridine.

The concerns about the safety and potential side effects of these drugs

prompted us to search for alternative therapeutic agents among the

natural resources. Many plants have been identified and evaluated for

their antiviral activities in recent years.3,4,6,15

 

 

M. communis belongs to the family of myrtaceae. It is an ever-green

plant that grows abundantly in damp places in temperate climates, such

as riverbanks. The plant can be collected throughout the year, however,

the aerial parts of the plant (ripe berries and leaves) which contain an

essential volatile oil (myrtle oil) are collected at the end of spring.

M. communis has been used, since ancient times in perfumery, and in the

eastern traditional herbal medicine for the treatment of respiratory and

urinary tract infections, skin diseases, and diarrheal conditions.5

Antimicrobial<sup>2 and antifungal properties have also been ascribed to

myrtle oil. As mouth wash, it is commonly used in the treatment of

aphthous stomatitis.

 

 

The goal of this study was to determine the efficacy and possible

antiviral activity of myrtle oil on HSV type 1 infection.

 

 

 

 

Patients and Methods

 

 

To obtain the myrtle oil, the plant was authenticated, dried and the

essence of dry powdered aerial parts were extracted for four hours with

water using a cleavenger. The yield of the procedure was 1.2% w/w of

essence to dry plant.

 

 

A total of 80 patients of both sexes in an age range of 2-53 years with

clinically diagnosed HSV infection were enrolled in this clinical trial.

After obtaining informed consents they were randomly assigned to receive

either myrtle oil (n = 60) or placebo (n = 20), on a double-blind bases.

The treatment was begun once lesions were present. Patients were given a

tube containing five grams of myrtle oil ointment or the placebo, and

they were instructed to smear them as a thin film over the affected area

3 to 5times a day for up to 5 days. Patients were clinically monitored

and skin changes were evaluated first after 48 hours and then at regular

daily intervals until complete healing had occurred. Clinical

assessments included recording the presence of symptoms (e.g., itching,

pain, burning) and their severity was graded as: 0 = none; + = mild; ++

= moderate; +++ = severe. The stage of lesions (erythema, papule,

vesicle, ulcer/crust), were scored on a percent basis.

 

 

 

 

Results

 

 

Application of myrtle oil ointment was associated with a reduction in

the duration of lesions as well as local pain and itching in the study

group as compared with placebo recipients. Out of 60 patients treated

with myrtle oil, 22 (36.7%) were completely healed (Fig. 1), 37 (61.7%)

were cured between 50% and 100% (loss of crust but not completely

healed), while only one patient showed recovery below 50%. Meanwhile,

the placebo recipients showed a recovery of under 25% (presence of

lesions).

 

 

The mean duration of healing time was 3 days in test group, and was

significantly shorter than that in placebo-treated group (5 days)

(p<0.01).

 

 

No significant differences were detected for other evaluated parameters

(i.e., age, sex, duration of infection and size of the lesions), between

the test formula and placebo-treated group.

 

 

The acute oral LD<sub>50</sub>'s were 3.7 ml/kg in rats and 2.2 ml/kg in

mice.13 The allergic reaction was tested in guinea-pigs following

application of the ointment and matching placebo. No allergic reactions

were observed except an erythema developed at the site of application

with test formula after the end of the 3rd day. One patient, however,

reported adverse reaction.

 

 

 

 

Discussion

 

 

The results of our study indicates that two days after application of

the myrtle oil ointment, the healing rate of herpes simplex was 100% in

22 (36.7%), and between 50% to 100% in 37 (61.7%) patients. Although one

patient had a score below 50%, it is still better compared to that of

placebo group with 25% recovery after five days of application.

 

 

HSV type 1 infections are more severe in patients with impaired cellular

immunity; a simple fever blister of the lips may progress to pneumonia,

or disseminated disease.14 Acyclovir and iodoxuridine are synthetic

drugs with proven antiviral activities that are widely used against

herpes viruses, particularly HSV type 1 (herpes labialis)12, and genital

herpes.7 The lack of anti-inflammatory, analgesic and antihistaminic

properties of these synthetic drugs has led to the development of

alternative natural-based therapeutic agents with high specific activity

against HSV type 1 and 2, that modifies the course and management.

 

 

Anti-inflammatory activity of M. communis extract in intact rats has

been reported previously.1 Having this property, and on account of our

results, myrtle oil ointment, exhibited very promising antiviral

efficacy against HSV type 1 with little side effects. The mechanism by

which the test formula exerts its antiviral effect is unclear and

requires further study.

 

 

 

 

References

 

 

1 Al-Hindawi MK, et al.: Anti-inflammatory action of some Iraq plant

using intact rats. J Ethnopharmacol 1989; 26: 163-8.

 

 

2 Al-Zohyri AM, et al.: Cardiovascular and antimicrobial effects of

Myrtus communis. Indian J Pharmacol 1985; 17: 233-5.

 

 

3 Hayashi K, et al.: Virucidal effects of the steam distillate from

Houttuynia cordata and its components on HSV-1, influenza virus, and

HIV. Planta Med 1995; 61: 237-41.

 

 

4 Matsuo R, et al.: Effects of traditional chinese herbal medicine,

Kanzo-bushito, on the resistance of thermally injected mice infected

with herpes simplex virus type-1.Int J Immunopharmacol 1994; 16: 855-63.

 

 

 

5 Nadkami KM: Indian Material. Medica 1982; 1: 838.

 

 

6 Nagasaka K, et al.: Efficacy of Kakkon-to, a traditional herbal

medicine in herpes simplex virus type-1 infection in mice. J Med Virol

1995; 46(1): 28-34.

 

 

7 Nilsen AE, et al.: Efficacy of oral acyclovir in the treatment of

initial recurrent genital herpes. Lancet 1982; 11: 571-3.

 

 

8 Overall JC Jr: Antiviral chemotherapy of oral and genital herpes

simplex virus infections. In: Nahmisa A, Dowdle W, Schinazi R (eds): The

human herpes viruses: an interdisciplinary perspective. New York:

Elsevier 1981; pp: 447-65.

 

 

9 Schaeffer HJ, et al.: 9-(2-hydroxymethylocymethyl) guanine activity

against viruses of the herpes group. Nature 1978; 272: 583-5.

 

 

10 Ship II, et al.: Recurrent aphthous ulcerations and recurrent herpes

labialis in a professional school population. 1. Exper Oral Surg 1960;

13: 1191-202.

 

 

11 Ship II, et al.: The patient with recurrent aphthous ulcers and the

patient with recurrent herpes labialis: a study of two populations

samples. J Am Dent Assoc 1967; 75: 645-54.

 

 

12 Spruance SL, et al.: Treatment of herpes simplex labialis with

Topical acyclovir in polyethylene glycol. J Infect Dis 1982; 146: 85-90.

 

 

 

13 Uehleke H, et al.: Oral toxicity of an essential oil from myrtle and

adaptive liver stimulation. Toxicol 1979; 12: 335-42.

 

 

14 Wade JC, Meyers JD: Neurologic symptoms associated with parenteral

acyclovir treatment after marrow transplantation. Ann Intern Med 1983;

98: 921-5.

 

 

15 Zheng MS, Luzy: Antiviral effect of magniferin and isomagniferin on

herpes simplex virus. Chin Med J Engl 1990; 103(2): 160-5.

 

 

 

 

 

 

 

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