PAPAYA LEAVES IN TREATMENT OF DENGUE HEMORRHAGIC FEVER

MOHD SAQUIB KHANM.Sc III SEMESTERDEPARTMENT OF BIOCHEMISTRY & MOLECULAR BIOLOGYPONDICHERRY UNIVERSITY

CONTENTS

o What is dengueo Symptoms o Epidemiologyo Mechanism of Actiono Diagnosiso Ineffectiveness of Medicineo Administration of Papaya Leaves

Extracto Blood Reporto Gene Expression Studieso Conclusiono References

Aedes aegypti

WHAT IS DENGUE

o Dengue fever also known as breakbone fever, is an infectious tropical disease caused by the dengue virus.

o Arthropod-borne viral disease carried by Aedes aegypti as the vector, caused by 4 possible viral serotypes, namely, serotype I, II, III, and IV of the Flaviviridae family.

o With rapid urbanization and global travel leading to drastic demographic changes, dengue is a threat to almost 40% of the world’s population i.e. over 2.5 billion people.

o WHO currently estimates there may be 50–100 million dengue infections worldwide every year.

o Dengue infection is mainly of three types -Dengue Fever(DF) -Dengue Hemorrhagic Fever(DHF) -Dengue Shock Syndrome(DSS)

SYMPTOMS

EPIDEMIOLOGY

MECHANISM OF ACTION

DIAGNOSIS

o Specific test for DHF is tourniquet test.

o In terms of dengue status, all patients recruited had either dengue NS1 or IgM or both detected by the technique of ELISA.

o Once a current dengue infection was confirmed, a thorough screening of the patient was conducted.

INEFFECTIVENESS OF MEDICINE

o Attempts to identify a potential antiviral for the treatment of dengue has been faced with several challenges such as the presence of four distinct viral serotypes which frequently undergo mutations.

o Effective vaccination to prevent DHF requires tetravalent vaccine because preexisting heterotypic dengue antibody is a risk factor for DHF.

o In 2007 a new serotype came into existence called the Fifth serotype during the dengue outbreak in Malaysia,for vaccine developers, factoring a new strain could be a major outbreak.

ADMINISTRATION OF PAPAYA LEAVES EXTRACT

o Leaves of papaya were collected & thoroughly washed with water.

o Leaves were grinded in fruit juicer.

o About 25 ml of leaves extract was administered orally,twice daily for 5 consecutive days.

BLOOD REPORT Full blood count was monitored every 24 hours for the first 5 days during the study, to determine the changes in platelet count and haematocrit levels.

PLATELET WBC NEUTROPHIL

Ist DAY 73x10^3/uL 3.8x10^3/uL 56%

IInd DAY 120x10^3/uL 4.4x10^3/uL 64.2%

IIIrd DAY 137x10^3/uL 5.3x10^3/uL 71.1%

IVth DAY 159x10^3/uL 5.9x10^3/uL 73%

Vth DAY 168x10^3/uL 7.7x10^3/uL 78.3%

GENE EXPRESSION STUDIES

o Blood for RNA extraction was taken on day 5 after the last dose of the juice to conduct expression studies on the PTAFR and the ALOX 12 genes.

o Gene expression was determined using gene expression assays by Applied Biosystems on the ABI 7500 Fast System on 12 RNA samples from the experimental group and 12 RNA samples from the control group.

o Specific predesigned MGB probes were used for ALOX 12 and the PTAFR gene.

o There was a 15-fold increase in the ALOX 12 gene activity among the patients in the experimental group as compared to those in the control group at the end of the 5 days.

o ALOX12 is known to be associated with increased megakaryocyte production as well as its conversion to platelets through 12-HETE mediated pathway which in turn leads to increased platelet production.

o The PTAFR gene was expressed 13.42-folds among the patients who consumed the juice as compared to the control group.

Activated platelets Free arachidonic acid ALOX12 12 hydroxyeicosatetraenoic acid (12HETE)

CONCLUSION

o These finding supports the claim that the juice consumption during the course of dengue infection has the potential to induce the rapid production of platelets. This was clearly demonstrated by the significant increase in the mean platelet count after 40 hours and 48 hours of juice consumption.

o Dengue is now a global threat and is endemic or epidemic in almost every country located in the tropics. While we wait for new tools such as vaccines, antiviral drugs and improved diagnostics, better use should be made of the interventions that are currently available.

REFERENCES

o Dengue fever treatment with Carica papaya leaves extracts Nisar Ahmad, Hina Fazal , Muhammad Ayaz, Bilal Haider Abbasi, Ijaz Mohammad, Lubna Fazal. 2011 Asian Pacific Journal of Tropical Biomedicine

o Carica papaya Leaves Juice Significantly Accelerates the Rate of Increase in Platelet Count among Patients with Dengue Fever and Dengue Haemorrhagic Fever.Subenthiran S, Choon TC, Cheong KC, Thayan R, Teck MB, Muniandy PK, Afzan A, Abdullah NR, Ismail Z. Received 7 January 2013; Revised 21 March 2013; Accepted 21 March 2013.

o Salutary effects of carica papaya leaf extract in dengue fever patients– a pilot study S Hettige1 Sri Lankan Family Physician, 2008.

o G. Kaur, G. Jalagadugula, G.Mao, and A. K. Rao, “RUNX1/core binding factor A2 regulates platelet 12-lipoxygenase gene (ALOX12): studies in human RUNX1 haplodeficiency,” Blood,vol. 115, no. 15, pp. 3128–3135, 2010.

"Dengue will be with us for many years" Plianbangchang laments. And as bad as

it is, he says, it "could get worse."