Syzygium aromaticumL.: Traditional herbal medicine against cagA and vacA toxin genes-producing drug resistant Helicobacter pylori

The Pan-Drug Resistant (PDR), Helicobacter pyloriremains an intractable challenge in public health worldwide and this pathogenicity is mainly due to the presence of a cytotoxin-associated gene A (CagA) and vacuolating cytotoxin A (VacA). On the other hand, plant extracts such as Syzygium aromaticumcontain a diverse array of secondary metabolites, which could be potentially used to combat H. pyloripathogens. To our knowledge, this is the first report on the biomedical potential of S. aromaticumextract against cytotoxin-associated genes producing PDR H. pylori. In this investigation, out of 45 gastric antral biopsy specimens of dyspeptic patients, 20 strains were confirmed as H. pylori.Eight (40%) out of 20 strains were PDR H. pyloriwhile the rest of the strains were Multi-Drug Resistant (MDR) strains. Genotypic analyses of PDR H. pyloristrains showed that cagAand vacAgenes were found to be 75% and 87.5%, respectively and m2s2was the most common subtype of vacAgene. S. aromaticumshowed a significant higher anti-H. pyloriactivity compared to that of Cinnamomum zeylanicumand Thymus vulgaris. Eugenol was the major phenolic compound (28.14%) detected in the methanolic extract of S. aromaticum. Clearly, results of the toxicological assessment confirmed the safety of S. aromaticumfor use. Hence, these results suggest that S. aromaticumcould be a new useful natural antimicrobial agent that could potentially combat cytotoxin genes-producing drug-resistant H. pylori. Moreover, these findings provide a scientific basis for the development of antimicrobial agents from traditional herbal medicines for gastroprotection against gastric ulcer.