Alternative formulations of E. scaber and S. androgynous extracts as immunomodulatory agents for suppression of bacterial infection in pregnant mice: A case of traditional herbal formulas in reproduction

The use of herbal compounds is a promising therapy to treat bacterial infection, especially in developing countries such as Indonesia. Natural products in Indonesia that are used as traditional medicinal plants are katuk (Sauropus androgynus) and tapak liman (Elephantopus scaber). Parts of these plants have been used for the treatment of a number of diseases in many countries. However, there are no previous reviews on the biological activities of the combination of S. androgynus and E. scaber extracts as immunomodulatory agents. This review presents comprehensive results about the efficacy of these plants for suppression of bacterial infection in pregnant mice. The combination of extracts from E. scaber and S. androgynus leaves has the ability to modulate the immune system, such as increasing IL-2, IFN-γ and CD4 T cells, and decreasing both IL-4 cytokine production and the level of B cells in pregnant mice with Salmonella Typhimurium infection. The combination of these plant extracts also plays a role in modulating immunocompetent cells, especially subsets of CD8⁺ T cells, CD4⁺CD62L^- T cells, CD8⁺CD62L^- T cells and TER-119⁺ cells, during infection by S. Typhi in pregnancy. Extracts of both leaves also modulate the hormonal system, like prolactin hormone in pregnant mice with S. Typhi infection. The formulation of E. scaber and S. androgynus that gave the optimum effect in all investigated parameters was 50% E. scaber:50% S. androgynous, which showed no significant difference compared to healthy pregnant mice. This review was envisaged with the intention to provide scientific information about the immunomodulatory profile of formulations of E. scaber and S. androgynus extracts.