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Clinical Phytoscience

International Journal of Phytomedicine and Phytotherapy

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Promising anitidiabetic potential of Cuscuta reflexa leaves methanol extract in alloxan-induced diabetic rats

Clinical Phytoscience volume 6, Article number: 26 (2020) Cite this article

A Correction to this article was published on 02 September 2020

This article has been updated

Abstract

Context

Cuscuta reflexa (C. reflexa) Roxb. (Convolvulaceae) has medicinal properties for the effective management of several aliments including diabetes mellitus, inflammation, and gastric ulcer.

Objective

The present investigation focuses on the antidiabetic potential of C. reflexa leaves methanol extract in alloxan-induced diabetic rats.

Materials and methods

The antidiabetic activity of C. reflexa leaves methanol extract (CRME) was evaluated using alloxan-induced diabetes in Wistar albino rats. The duration of the study was 45 days. Diabetic model was developed by i.p. administration of alloxan monohydrate (120 mg/kg). Ingestion of CRME (100, 200, and 400 mg/kg/day) and standard (gliclazide, 10 mg/kg/day) was done via oral route from the day of diabetes induction and continued up to 45 days. The effect of CRME was investigated by evaluating the blood glucose concentrations, HbA1C, insulin, lipid profile and liver function test. Further, the protective potentials of CRME were studied by histopathology of the pancreas, liver, and kidney tissues from experimental rats.

Results

CRME showed significant (p < 0.01 at all doses) reduction of blood glucose level (137.1 ± 5.8, 125.9 ± 6.5, and 109.5 ± 5.4 mg/dL at the doses of 100, 200, and 400 mg/kg, respectively) as compared to the diabetic control (249.7 ± 7.3 mg/dL). Moreover, CRME at the highest dose decreased HbA1C and improved insulin levels (3.96% and 11 ng/ml, respectively) when compared with diabetic control group (7.55% and 6.5 ng/ml, respectively). CRME also revealed pronounced improvement in liver function test and lipid profile test when compared to the diabetic control. Furthermore, CRME notably reversed the histopathological changes that observed in alloxan-induced diabetes.

Conclusion

Our research exertion clearly demonstrates that CRME can be explored as a substantial antidiabetic and organ protective agent in the management of diabetes.

Introduction

Diabetes mellitus is a common disorder of carbohydrate, fat, and protein metabolism in which the circulating glucose concentration is increased and it causes complications such as retinopathy, microangiopathy, neuropathy, and nephropathy [1, 2]. This affects the metabolism of biomolecules (carbohydrate, protein, and lipid) together with injuring β-cells of pancreas and in some cases liver and kidney [3]. Diabetes is becoming one of the major causes of the global rise in morbidity and disabled people [4]. The insulin deficiency in diabetes mellitus gives rise to hyperlipidemia and fatty liver which eventually elevates the risk of heart disease and stroke [5]. Cardiovascular disease (CVD) is a major cause of death and disability among people with diabetes [6]. A good number of oral hypoglycemic agents and insulin have been used for the treatment of diabetes mellitus. However, the adverse effects of these synthetic hypoglycemic agents sometime result in disturbances of liver, kidney, hematological failure, and even coma [5, 7, 8]. Research and development of new remedies for diabetes are, therefore, in great demand. According to the demonstration of the previous studies, natural drugs have wide spread use in the practice of traditional medicine due to their curative values for various ailments [9,10,11]. However, more than 1200 plants have been described to be experimentally or ethnopharmacologically used to treat diabetes [12]. Based on the WHO recommendations, hypoglycemic agents of plant origin are important and warrant attention [13]. As a result, many conventional drugs have been derived from prototypic molecules in medicinal plants for the treatment of diabetes. At present there is a growing demand for herbal medicines worldwide and many pharmaceutical companies in Asia and Australia are conducting extensive phytochemical research on plant material to evaluate their medicinal value [14].

Cuscuta reflexa (C. reflexa) Roxb. (Cuscutaceae) is known as giant dodder in English and “swarna lota” in Bangladesh [15, 16]. This plant species is largely distributed in India, China, Bangladesh, Eastern Asia, and Afghanistan [15]. C. reflexa contains a variety of phytoconstituents for which it has a long history of ethnomedicinal use [17, 18]. The pharmacological activities of C. reflexa involve antiprotozoal, antimicrobial, antiproliferative, anticovulsant, antihypertensive, hepatoprotective, antioxidant, anti-inflammatory, and antipyretic properties [15, 19,20,21,22,23]. The extract of C. reflexa holds a promising contribution in the folk medicine of Bangladesh to control blood sugar in patients suffering from diabetes mellitus [24, 25]. According to previous reports, C. reflexa exhibited significant hypoglycemic response in oral glucose tolerance tests in animal models [24, 26]. Therefore, the present investigation was aimed to focus on antidiabetic and organ protective effects of C. reflexa methanol extract (CRME) in Wistar albino rats to support the traditional and previous scientific claim.

Materials and methods

Plant material

C. reflexa fresh leaves were collected from Banani, Dhaka during May–June 2016. The identity of the plants was authenticated by from the National Herbarium of Bangladesh, Dhaka and the voucher specimen was deposited (no. 43780).

Chemicals

Gliclazide (API) was obtained from Drug International Ltd. Bangladesh. Alloxan monohydrate, chemical used to induce diabetes, was purchased from Sigma Aldrich Chemicals, Germany and all other chemicals (analytical grade) were purchased from Merck (Darmstadt, Germany).

Extraction of plant material

The collected leaves of C. reflexa were washed down with tap water appropriately and then shade dried and grinded into coarse powder. About 600 g of coarse powder of C. reflexa was soaked with 1.8 L methanol for 14 days in a conical flask. This was followed by filtration and the filtrate was subjected drying using rotary evaporator at 45 °C. Later, it was air dried for few days to evaporate solvent residue. Finally, the extract of C. reflexa was weighed (35.7 g) and stored in an air tight humidity protected borosilicate glass container.

Phytochemical screening

A number of qualitative chemical tests were performed to establish the phytochemical profile of CRME by using the standard procedures [27].

Experimental animals

Wistar albino rats of either sex weighing between 140 to 150 g have been used for the present experiment. Animals were kept in polypropylene cages where each cage contained six rats. The environment of the animal house was maintained at 12 h light/dark cycle and 25 ± 2 °C. Before perusing the experiment, one week of acclimatization of animals was done allowing free access to feed and water. During surgery all animals were euthanized via anesthesia using isoflurane (5% in 100% oxygen). The present research protocols as well as animal care were observed according to the guidelines of Guide for the Care and Use of Laboratory Animals (NIH publication No: 85–23, revised in 1985). The experimental procedures for our study have been approved by the Biomedical Research Center, University of Dhaka, Bangladesh (Ref. no. DPT/BMRC/2016–2017/467).

Induction of diabetes

Body weight and fasting blood glucose level of animals were measured before inducing diabetes. Animals with very low or high glucose levels were discarded for experimentation. Diabetes was induced by a sole dose of 120 mg/kg of alloxan monohydrate via intraperitoneal route of each animal. The induction of diabetes was confirmed by measuring fasting serum glucose level after 3 days using accu chek glucometer. Animals with blood glucose level of > 200 to < 280 mg/dL have been selected for the present study. Diabetic rats were randomly grouped and each group consisted of six rats. Treatments for 45 days in all groups were started 3 days after alloxan monohydrate injection [28]. The groups of experimental animals and treatment pattern for the present study have been represented as follows:

Groups Treatment
Group I Healthy control rats.
Group II Alloxan-induced diabetic rats.
Group III Alloxan-induced diabetic rats administered gliclazide at the dose of 10 mg/kg, p.o. once daily.
Group IV Alloxan-induced diabetic rats administered CRME at the dose of 100 mg/kg, p.o. once daily.
Group V Alloxan-induced diabetic rats administered CRME at the dose of 200 mg/kg, p.o. once daily.
Group VI Alloxan-induced diabetic rats administered CRME at the dose of 400 mg/kg, p.o. once daily.

Fasting blood glucose was measured periodically on days 9, 18, 27, 36, and 45. After 45 days of treatment, blood samples were collected from rat by cardiac puncture under anesthesia with 5% isoflurane in presence of 100% oxygen. The serum was collected by centrifugation at 5000 rpm for 5 min.

Evaluation of HbA1C level

HbA1C level in rat blood and the percentage of HbA1c in total hemoglobin were determined by using standard procedure of Nathan et al. (1984) [29]..

Evaluation of insulin level

The concentration of insulin was examined using Rat insulin enzyme-linked immunosorbent assay Kit (RayBiotech Inc. Norcross, GA, USA).

Evaluation of lipid profile

Serum was separated and the observed lipid profile includes: triglycerides, HDL, LDL, and total cholesterol by using a previously established method [30].

Evaluation of liver function

Serum alanine aminotransferase (ALT), alkaline phosphatase (ALP), aspartate aminotransferase (AST), and total bilirubin levels have been estimated by using standard test procedure [31].

Histological observation and evaluation

For histological examination tissues from pancreas, liver, and kidney from rats of different groups have been fixed in freshly prepared 10% neutral buffered formalin. Tissue specimens were processed for paraffin embedding tissue sections (5 μm thick), stained with Hematoxyline and Eosin prior to histopathological evaluation. All sections were examined under light microscope. Photographs of the lesions were taken with an Olympus photo microscope for observation and documentation of histopathological changes.

Data analysis

All experimental data obtained were presented as mean ± S.E.M, and statistical analysis was done by finding the significance among treated and control groups using One Way Analysis of Variance (ANOVA, version 3.0), followed by Dunnett’s test. P < 0.05 was considered as significant value.

Results

Phytochemical screening

The phytochemical tests of CRME revealed the existence of alkaloids, flavonoids, steroids, terpinoids, cumarin, anthraquinones, saponins, and carbohydrates.

Effect of CRME extract on body weight

According to the Table 1, body weight of untreated diabetic model was significantly decreased (22.79%). However, on day 45 the weight of the CRME treated rats were increase to 2.96%, 4.85%, and 7.81% at the doses of 100, 200, and 400 mg/kg, respectively.

Table 1 Effect of CRME on body weight variation
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Effect of CRME extract on blood glucose concentration

Antidiabetic activity of CRME was assessed in alloxan- induced diabetic rats. Injection of alloxan significantly increased (p < 0.01) the blood glucose concentration in all groups when compared with the healthy control group (Table 2). However, treatment with CRME and gliclazide demonstrated noteworthy downregulation of blood glucose concentration in comparison to the diabetic control group from the 18th day onwards. The continuous treatment for 45 days leads to pronounced reduction (p <0.01 at all doses) in blood glucose concentration as compared with the diabetic control group. At the end of the study, gliclazide (10 mg/kg) treated group showed 59.09% inhibition when compared with the initial blood glucose level measured on day 0 (258.4 ± 8.4 mg/dL). On the other hand, CRME at the dose of 400 mg/kg reduced blood glucose level 55.39% as compared to the initial blood glucose level measured on day 0 (245.5 ± 9.5 mg/dL) and the inhibition is comparable to the reference drug, gliclazide.

Table 2 Effect of CRME on blood glucose level
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Effects of CRME on glycosylated hemoglobin and insulin levels

Figure 1a & b portrayed the variation in glycosylated hemoglobin and insulin levels, respectively. The concentration of glycosylated hemoglobin level increased significantly in diabetic control group as compared to healthy control group (p < 0.01). On the other hand, administration of CRME in diabetic rats significantly decreases the glycosylated hemoglobin level as compared to diabetic control group (p < 0.05, p < 0.01, and p < 0.01 at the doses of 100, 200, and 400 mg/kg, respectively).

Fig. 1
figure1

Effect of C. reflexa methanol extract (CRME) on HbA1C (a) and insulin level (b). All values were expressed as mean ± S.E.M (n = 3). (*) designates statistically significant difference from the respective group (**p < 0.01) whereas (η) indicates statistically no significant difference from the relevant group (p > 0.05) using ANOVA, followed by Dunnett’s multiple comparison test. a = while compared with healthy control, b = while compared with diabetic control. Group I = Healthy control, Group II = Diabetic control, Group III = Diabetic control + 10 mg/kg of gliclazide, Group IV = Diabetic control + 100 mg/kg CRME, Group V = Diabetic control + 200 mg/kg CRME, Group VI = Diabetic control + 400 mg/kg CRME

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Insulin concentration in diabetic control decreased significantly compared to healthy control group (p < 0.01). However, treatment with CRME at the higher doses in diabetic rats revealed a noteworthy upregulation of insulin level in comparison with untreated diabetic group (p < 0.05 and p < 0.01 at the doses of 200 and 400 mg/kg, respectively).

Effect of CRME on lipid profiles

Table 3 showed the lipid profiles of healthy control, diabetic control, gliclazide and CRME treated groups. In diabetic rats there was a significant increase in total cholesterol, triglycerides, LDL level (p < 0.01) and significant decrease in HDL level (p < 0.01) in serum as compared with healthy control. However, administration of CRME demonstrated noteworthy reduction in total cholesterol (p < 0.01 at all doses), triglycerides (p < 0.01 at all doses), LDL-cholesterol (p < 0.01 at all doses), and significant increase in HDL-cholesterol (p < 0.01 at all doses) on day 45 in comparison with the diabetic rats. Moreover, treatment with CRME at the highest dose (400 mg/kg) revealed decreases in TC by 43.11%, TG by 46.40%, and LDL by 55.61% whereas improved HDL by 111.8% as compared to diabetic rats.

Table 3 Effect of CRME on serum lipid profile
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Effect of CRME on liver function test

In diabetic model, a significant increase (p < 0.01) in the enzymatic activities of ALT, ALP, AST, and the serum bilirubin level was found as compared with the normal levels (Table 4). On the contrary, CRME revealed a significant reduction in the activities of ALT (p < 0.05, p < 0.05, and p < 0.01 at the doses of 100, 200, and 400 mg/kg, respectively), ALP (p < 0.05, p < 0.01, and p < 0.01 at the doses of 100, 200, and 400 mg/kg, respectively), AST (p < 0.01, p < 0.01, and p < 0.01 at the doses of 100, 200, and 400 mg/kg, respectively), and serum total bilirubin level (p < 0.01, p < 0.01, and p < 0.01 at the doses of 100, 200, and 400 mg/kg, respectively) in comparison to the untreated diabetic rats. Moreover, treatment with CRME at the highest dose (400 mg/kg) revealed inhibition in ALT by 38.05%, ALP by 55.13%, AST by 68.56% and bilirubin by 58.99% as compared to diabetic rats.

Table 4 Effect of CRME on Liver function test
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Effect of CRME on histopathology of pancreas, liver, and kidney

Pancreas

Healthy control rat exhibited usual histological architecture (Fig. 2a). However, alloxan-induced cellular damage to the pancreas, areas of cell necrosis (CN), numerous fatty tissue deposition, and inflammatory cells infiltrations in diabetic control group when compared with the healthy group (Fig. 2b). On the other hand, oral administration of CRME at the doses of 100 and 200 mg/kg, conserved cell architecture and demonstrated moderate inflammatory cell infiltration, and fatty tissue deposition, which is an improvement from what occurred in the untreated alloxan-induced diabetic rats (Fig. 2d & e). Further normal architecture was maintained in gliclazide and CRME (400 mg/kg, p.o.) treated groups (Fig. 2c & f, respectively) but the group treated with gliclazide (10 mg/kg, p.o.) showed deposition of fatty tissue.

Fig. 2
figure2

Histopathology of pancrease. Each picture is a representative for each group as follows: a = Healthy control, b = Diabetic control, c = Diabetic control + 10 mg/kg of gliclazide, d = Diabetic control + 100 mg/kg CRME, e = Diabetic control + 200 mg/kg CRME, f = Diabetic control + 400 mg/kg CRME. Each group was evaluated at 400 x magnification, scale bar: 40 μm

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Liver

Figure 3a showed the histology of the liver tissue of healthy control group. However, the histology of liver tissue from the diabetic rat revealed cell necrosis, expansion, and thickening of the walls of veins, capillaries, and progression of fibrosis (Fig. 2b). However, this was not the case for those treated with CRME at the doses of 200 and 400 mg/kg, p.o. (Fig. 3e & f, respectively). In these instances, the liver tissues were compact and healthy. On the other hand, group treated with gliclazide and CRME (100 mg/kg, p.o.) illustrated moderate cellular necrosis and infiltration of inflammatory cells in the central vein (Fig. 3c & d, respectively).

Fig. 3
figure3

Histopathology of liver. Each picture is a representative for each group as follows: a = Healthy control, b = Diabetic control, c = Diabetic control + 10 mg/kg of gliclazide, d = Diabetic control + 100 mg/kg CRME, e = Diabetic control + 200 mg/kg CRME, f = Diabetic control + 400 mg/kg CRME. Each group was evaluated at 400 x magnification, scale bar: 40 μm

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Kidney

Kidney histological structure was normal in the healthy control group (Fig. 4a). Alloxan-induced diabetic group showed presence of destructed glomeruli and infiltration of inflammatory cells (Fig. 4b). Groups treated with CRME showed improvements in the tissue architecture and more visible glomeruli and moderate inflammatory cells were observed (Fig. 4d & e). However, group treated with methanol extract of C. reflexa at the dose of 400 mg/kg significantly reduced the pathological destructions (Fig. 4f). On the other hand, group treated with gliclazide (10 mg/kg, p.o.) showed moderate destructed glomeruli and infiltration of inflammatory cells (Fig. 4c).

Fig. 4
figure4

Histopathology of kidney. Each picture is a representative for each group as follows: a = Healthy control, b = Diabetic control, c = Diabetic control + 10 mg/kg of gliclazide, d = Diabetic control + 100 mg/kg CRME, e = Diabetic control + 200 mg/kg CRME, f = Diabetic control + 400 mg/kg CRME. Each group was evaluated at 400 x magnification, scale bar: 40 μm

Full size image

Discussion

On phytochemical screening, CRME demonstrated the presence of alkaloids, tannins, steroids, terpinoids, cumarins, anthraquinones, saponins, and flavonoids. Many previous studies have reported that certain terpenoids, steroids, flavonoids, and phenolic compounds have defensive values against hyperglycemia with respect to their antioxidant properties [32, 33]. We hypothesized that phenolic compounds, alkaloids, flavonoids, and tannins in C. reflexa can be credited to their insulinotropic effect that enables the reduction of blood glucose levels due to their antidiabetic effect. Nevertheless, extensive phytochemical analysis must be needed to evaluate the therapeutically active compounds of C. reflexa. With antidiabetic, anti-inflammatory, and antiulcer properties.

A large diversity of animal models has been developed to better understand the pathogenesis of insulin dependent diabetes and new drugs have been introduced into the market to treat the primary cause or to prevent the catastrophe of its complications [34]. Among these models, alloxan-induced diabetes model is by far the most frequently used model which has been useful for the study of multiple aspect of the disease [35,36,37]. Alloxan is a diabetogenetic, hepatotoxic, and nephrotoxic substance which by damaging the pancreatic beta cell membrane, fragmenting DNA, and reacting with enzymes, sharply decreases insulin levels and thereby increases glucose concentrations in animals [38].

The consequences of the present study pointed out that i.p. injection of alloxan destroyed beta cells in rats in which glucose level significantly increased compared to healthy control. However, blood glucose levels reduced in all experimental groups which received CRME. Moreover, the hypoglycemic effect of CRME was comparable to the standard drug, gliclazide. Gliclazide is a sulphonylurea oral hypoglycaemic agent used in the treatment of diabetes. It improves defective insulin secretion and inhibits glucogenolysis and gluconeogenesis in the liver. Through improving insulin binding to surface receptors, they also enhance the insulin sensitivity of target cells [39]. Furthermore, in vivo evidence revealed that gliclazide cause persisted hypoglycaemia in alloxan-induced diabetic rats [40].

CRME showed a dose dependent reduction of blood glucose concentration at the doses of 100, 200, and 400 mg/kg, p.o. while the standard gliclazide (10 mg/kg, p.o.) revealed a significant antidiabetic activity in alloxan-induced diabetes in continuous treatment for 45 days. However, at the end of the study, at the higher dose the normal blood sugar level was achieved by augmented hypoglycemic activity. Such activity of this extract could be due to the particular existence of phenolic, terpenoid, and flavonoid components within the plant parts.

In diabetic rats, the level of HbA1C was increased due to the persistent hyperglycemia which results in glycation of hemoglobin. The concentration of HbA1C is related to diabetic complications and it is considered as a tool for the diagnosis and prognosis of diabetes-associated complications [41, 42]. Therefore, the measurement of glycosylated hemoglobin is supposed to be a very sensitive index for glycemic control. In the present study, the diabetic untreated rats had shown higher rates of hemoglobin glycosylation in comparison with the healthy group. However, administration of CRME significantly decreased the HbA1C level as compared with diabetic group. The ability of CRME to bring about a significant decrease in HbA1C level could be indicative of its potential ability to improve glycemic status and prevent the diabetic-associated complications in diabetic rats.

Moreover, the present results also revealed that alloxan causes a significant reduction in body weight after 45 days. These results promisingly correspond to the previously reported data [43,44,45,46]. All though the food intake is more in diabetic rats than normal healthy group, diabetic rats showed enough weight loss due to catabolism of fats and proteins. Under the circumstances of lack of insulin, the proteolysis causes decrease in protein content within the muscle tissues [44]. Notable mobilization of fat within the skeletal muscle of diabetic model caused significant weight loss as observed in our present investigation. Nonetheless, treating the diabetic model with CRME (200 and 400 mg/kg/day) or gliclazide (10 mg/kg/day) demonstrated small scale reduction of body weight and this might be either as a result of increase of insulin secretion in blood or elevated food consumption.

There is a significant role of lipids that is associated with the pathogenesis of diabetes mellitus. The rise in serum cholesterol, LDL, VLDL, triglycerides, and fall in serum HDL level is one of the significant factors for developing microvascular complication which leads to atherosclerosis and other heart diseases [47, 48] Increased level of triglycerides and LDL-cholesterol was noticed in diabetic rat model [49]. Increased cholesterol level in diabetic rats could be caused by elevated intestinal fat absorption and growing biosynthesis of cholesterol. Treatment with CRME considerably lowered total cholesterol, triglycerides, and LDL levels in serum as per the range of doses applied, while at the same time the beneficial HDL level was observed to rise significantly. Thus, the results of our present investigation clearly reveal that CRME recuperated the disparity of the lipid profile in diabetes-induced rat model as per dose dependent manner.

xIn our study, the enzymatic actions of ALT, ALP, and AST as well as serum bilirubin level were upregulated in diabetic group. Evidence demonstrated that the changes in the levels of ALT, ALP, AST, and bilirubin in diabetic rats are associated with the changes in the rate of metabolic reactions catalyzed by these enzymes. The elevation of transaminases activities occur in scarcity of insulin, due to availability of amino acids, in the blood of diabetes mellitus patients [50]. Such circumstances lead to increased gluconeogenesis and ketogenesis. The recovery of AST and ALT to their normal levels was found in the groups of experimental animals treated with CRME. Serum levels of these enzymes function as biomarker of liver activity as a result of restoration of normal level of these enzymes specify normal functioning of liver. Elevated enzymatic activities of ALP have always been reported in alloxan-induced diabetic model. The enhanced activity of ALP in diabetic model is probably due to the occurrence of cell damage by altered cell membrane morphology. Serum ALP, bilirubin, and total protein levels are associated with the activities of liver cell. The rise in serum ALP level occurs due to growing rate of synthesis under inflation of biliary pressure [51].

Alloxan caused a signifcant elevation in enzyme levels such as ALT, ALP, AST, and bilirubin levels when compared to control. There was a significant restoration of these enzyme levels on the administration of CRME in a dose-dependent manner. However, there was non-significant reduction of ALP and total bilirubin concentrations in group treated with gliclazide in comparison to the diabetic control group.

The data from histopathological examination of pancreas of diabetic model exhibited islet of Langerhans with infiltration of inflammatory cell and distorted pancreas. Oral ingestion of CRME recovered the altered architecture of the pancreas to normal conformation. Moreover, the damaged structure and numerous inflammatory cells have been observed in the liver tissues of diabetic rats. These constructive changes in the hepatic cells were restored in diabetic rats treated with CRME in a dose dependent manner. Furthermore, the damaged glomeruli and numerous inflammatory cells have been noticed in the renal tissues of diabetic model. These injured tissues regained their normal conformation when treated with CRME. As per the results of microscopic examinations, the severity of pancreatic, hepatic, and renal lesions in diabetic animals extensively declined and considerably recovered by the treatment of CRME at medium to higher doses.

Conclusion

Monitoring medicinal plants for biological activity is believed to be one of the key subjects to demonstrate the pharmacological action of the drug. Manifestation of drug’s safety and efficacy with respect to its purpose of use is necessary. For this reason a constructive and progressive order of preclinical (animal) and clinical (human) studies must be performed.

New therapeutic innovations that are dedicated to prevent DM and DM complications are of interest. Our study distinguished the antidiabetic and tissue protective potentials of methanol extract of C. reflexa. Thus, the multifactorial activity of C. reflexa would be a new alternative therapeutic agent for the treatment of DM as well as its complications. This study indicated methanol extract of C. reflexa have potential to decrease blood glucose, HBA1c, and insulin concentrations. In addition, the present treatment improved complications associated with experimental diabetes. Hence, the present study supports the traditional usefulness of this plant in the treatment of diabetes mellitus. In conclusion, the plant C. reflexa could be further investigated for antidiabetic bioactive principles.

Availability of data and materials

Authors are agreed to share raw data and materials upon request.

Change history

  • 02 September 2020

    An amendment to this paper has been published and can be accessed via the original article.

References

  1. 1.

    Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract. 2010;87:4–14.

    CAS  PubMed  Google Scholar 

  2. 2.

    Kumar S, Sharma S, Vasudeva N, Ranga V. In vivo anti-hyperglycemic and antioxidant potentials of ethanol extract from Tecomella undulata. Diabetol Metab Syndr. 2012;4:33.

    CAS  PubMed  PubMed Central  Google Scholar 

  3. 3.

    Ghosh S, Suryawanshi SA. Effect of Vinca rosea extracts in treatment of alloxan diabetes in male albino rats. Indian J Exp Biol. 2001;39:748–59.

    CAS  PubMed  Google Scholar 

  4. 4.

    Chaudhury A, Duvoor C, Dendi R, Sena V, Kraleti S, Chada A, Ravilla R, Marco A, Shekhawat NS, Montales MT, et al. Clinical review of antidiabetic drugs: implications for type 2 diabetes mellitus management. Front Endocrinol. 2017;8:1–12.

    Google Scholar 

  5. 5.

    Bailey CJ, Day C. Traditional plant medicines as treatments for diabetes. Diabetes Care. 1989;12:553–64.

    CAS  PubMed  Google Scholar 

  6. 6.

    Einarson TR, Acs A, Ludwig C, Panton UH. Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007-2017. Cardiovasc Diabetol. 2018;17:1–19.

    Google Scholar 

  7. 7.

    Begum M, Islam A, Begum R, Uddin M, Rahman M, Alam S, et al. Ethnopharmacological inspections of organic extract of Oroxylum indicum in rat models: a promising natural gift. Evid Based Complement Altern Med. 2019;2019:1–13.

  8. 8.

    Begum MM, Sultana Z, Ali ME, Jami MSI, Khondkar P, Khan MM, Haque MM. Additive effect of lipid lowering drug (simvastatin) in combination with antidiabetic drug (Glibenclamide) on alloxan induced diabetic rats with long term dyslipidemia. Indian J Clin Biochem. 2014;29(4):452–61.

    CAS  PubMed  Google Scholar 

  9. 9.

    Marles RJ, Farnsworth NR. Antidiabetic plants and their active constituents. Phytomedicine. 1995;2:137–89.

    CAS  PubMed  Google Scholar 

  10. 10.

    Galehdari H, Negahdari S, Kesmati M, Rezaie A, Shariati G. Effect of the herbal mixture composed of Aloe vera, Henna, Adiantum capillus-veneris, and Myrrha on wound healing in streptozotocin-induced diabetic rats. BMC Complement Altern Med. 2016;16:1–9.

    Google Scholar 

  11. 11.

    Tuhin RH, Begum MM, Rahman MS, Karim R, Begum T, Ahmed SU, Mostofa R, Hossain A, Abdel-Daim M, Begum R. Wound healing effect of Euphorbia hirta Linn. (Euphorbiaceae) in alloxan-induced diabetic rats. BMC Complement Altern Med. 2017;17:1–13.

    Google Scholar 

  12. 12.

    Grover JK, Vats V, Rathi SS, Dawar R. Traditional Indian antidiabetic plants attenuate progression of renal damage in streptozotocin-induced diabetic mice. J Ethnopharmacol. 76: 233-38. Alberti KG, Zimmet PF. 1998. Definition, diagnosis, and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO consultation. Diabet Med. 2001;15:539–53.

    Google Scholar 

  13. 13.

    Alberti KG, Zimmet PF. Definition, diagnosis, and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO consultation. Diabet Med. 1998;15:539–53.

    CAS  PubMed  Google Scholar 

  14. 14.

    Ekor M. The growing use of herbal medicines: issues relating to adverse reactions and challenges in monitoring safety. Front Pharmacol. 2014;4:1–10.

    Google Scholar 

  15. 15.

    Patel S, Sharma V, Chauhan NS, Dixit VK. An updated review on the parasitic herb of Cuscuta reflexa Roxb. Chin J Integr Med. 2012;10:249–55.

    CAS  Google Scholar 

  16. 16.

    Ulhas AS. Pharmacological review of Akashvel (Cuscuta Reflexa Roxb.). Int J Pharmacol Res. 2015;5:152–4.

    Google Scholar 

  17. 17.

    Machado MA, Zetsche K. A structural, functional and molecular analysis of plastids of the holoparasites Cuscuta reflexa and Cuscuta europaea. Planta. 1990;181:91–6.

    CAS  PubMed  Google Scholar 

  18. 18.

    Rai DK, Sharma V, Pal K, Gupta RK. Comparative phytochemical analysis of Cuscuta reflexa Roxb. Parasite grown on North India by GC-MS. Trop Plant Res. 2016;3:428–33.

    Google Scholar 

  19. 19.

    Singh GS, Garg KN. Some pharmacological studies on Cuscuta reflexa plant (Akash Bel). Indian J Pharmacol. 1973;5:344–5.

    Google Scholar 

  20. 20.

    Kayath HP, Goel NK. Effects of Cuscuta stem extract on various animal tissues. Indian J Pharmacol. 1995;27:227–9.

    Google Scholar 

  21. 21.

    Gupta MA, Mazumder UK, Pal D, Bhattacharya S, Chakrabarty SU. Studies on brain biogenic amines in methanol extract of Cuscuta reflexa Roxb. And Corchorus olitorius Linn. Seed treated mice. Acta Pol Pharm. 2003;60:207–10.

    PubMed  Google Scholar 

  22. 22.

    Roy RK, Thakur M, Dixit VK. Development and evaluation of polyherbal formulation for hair growth–promoting activity. J Cosmet Dermatol. 2007;6:108–12.

    PubMed  Google Scholar 

  23. 23.

    Bhattacharya S, Roy B. Preliminary investigation on antipyretic activity of Cuscuta reflexa in rats. J Adv Pharm Technol Res. 2010;1:83–7.

    PubMed  PubMed Central  Google Scholar 

  24. 24.

    Rahman MA. Indigenous knowledge of herbal medicines in Bangladesh. 3. Treatement of skin diseases by tribal communities of the hill tracts districts. Bangladesh J Bot. 2010;39:169–77.

    Google Scholar 

  25. 25.

    Rahmatullah M, Sultan S, Toma T, Lucky S, Chowdhury M, Haque W, Annay E, Jahan R. Effect of Cuscuta reflexa stem and Calotropis procera leaf extracts on glucose tolerance in glucose-induced hyperglycemic rats and mice. Afr J Tradit Complement Altern Med. 2010;7:109.

    Google Scholar 

  26. 26.

    Rath D, Kar DM, Panigrahi SK, Maharana L. Antidiabetic effects of Cuscuta reflexa Roxb. In streptozotocin-induced diabetic rats. J Ethnopharmacol. 2016;192:442–9.

    PubMed  Google Scholar 

  27. 27.

    Kokate CK, Purohit AP, Gokhale SB. Carbohydrate and derived products, drugs containing glycosides, drugs containing tannins, lipids and protein alkaloids. Textbook Pharmacognosy. 2001;7:133–66.

    Google Scholar 

  28. 28.

    Angel J, Sailesh SK, Mukkadan JK. A study on antidiabetic effect of peppermint in alloxan-induced diabetic model of Wistar rats. J Clin Biomed Sci. 2013;3:177–81.

    Google Scholar 

  29. 29.

    Nathan DM, Singer DE, Hurxthal K, Goodson JD. The clinical information value of the glycosylated hemoglobin assay. New Eng J Med. 1984;310:341–6.

    CAS  PubMed  Google Scholar 

  30. 30.

    Sharma B, Viswanath G, Salunke R, Roy P. Effects of flavonoid-rich extract from seeds of Eugenia jambolana (L.) on carbohydrate and lipid metabolism in diabetic mice. Food Chem. 2008;110:697–05.

    CAS  Google Scholar 

  31. 31.

    Thapa BR, Walia A. Liver function tests and their interpretation. Indian J Pediatr. 2007;74:663–71.

    CAS  PubMed  Google Scholar 

  32. 32.

    Chandrasekar MJ, Bommu P, Nanjan M, Suresh B. Chemoprotective effect of Phyllanthus maderaspatensis in modulating cisplatin-induced nephrotoxicity and genotoxicity. Pharm Biol. 2006;44:100–6.

    Google Scholar 

  33. 33.

    Begum R, Sharma M, Pillai KK, Aeri V, Sheliya MA. Inhibitory effect of Careya arborea on inflammatory biomarkers in carrageenan-induced inflammation. Pharm Biol. 2015;53:437–45.

    CAS  PubMed  Google Scholar 

  34. 34.

    Yimam M, Zhao J, Corneliusen B, Pantier M, Brownell L, Jia Q. Blood glucose lowering activity of aloe based composition, UP780, in alloxan-induced insulin dependent mouse diabetes model. Diabetol Metab Syndr. 2014;6:1–8.

    Google Scholar 

  35. 35.

    Xu Z, Wang X, Zhou M, Ma L, Deng Y, Zhang H, Zhao A, Zhang Y, Jia W. The antidiabetic activity of total lignan from Fructus Arctii against alloxan-induced diabetes in mice and rats. Phytother Res. 2008;22:97–01.

    CAS  PubMed  Google Scholar 

  36. 36.

    Adeyi AO, Idowu BA, Mafiana CF, Oluwalana SA, Ajayi OL, Akinloye OA. Rat model of food-induced non-obese-type 2 diabetes mellitus: comparative pathophysiology and histopathology. Int J Physiol Pathophysiol Pharmacol. 2012;4:51–8.

    PubMed  PubMed Central  Google Scholar 

  37. 37.

    Sharmin R, Joarder HH, Alamgir M, Mostofa G, Islam M. Antidiabetic and Hepatoprotective activities of Bombax ceiba young roots in Alloxan-induced diabetic mice. J Nutrition Health Food Sci. 2018;6:1–7.

    Google Scholar 

  38. 38.

    Karimi G, Vahabzadeh M, Lari P, Rashedinia M, Moshiri M. “Silymarin”, a promising pharmacological agent for treatment of diseases. Iran J Basic Med Sci. 2011;14:308–17.

    CAS  PubMed  PubMed Central  Google Scholar 

  39. 39.

    Sarkar A, Tiwari A, Bhasin PS, Mitra M. Pharmacological and pharmaceutical profile of gliclazide: a review. JAPS. 2011;1:11–9.

    Google Scholar 

  40. 40.

    Štětinová V, Květina J, Pastera J, Polášková A, Pražáková M. Gliclazide: pharmacokinetic-pharmacodynamic relationships in rats. Biopharm Drug Dispos. 2007;28:241–8.

    PubMed  Google Scholar 

  41. 41.

    Palsamy P, Subramanian S. Resveratrol, a natural phytoalexin, normalizes hyperglycemia in streptozotocin-nicotinamide induced experimental diabetic rats. Biomed Pharmacother. 2008;62:598–05.

    CAS  PubMed  Google Scholar 

  42. 42.

    Hebi M, Eddouks M. Hypolipidemic activity of Tamarix articulata Vahl. In diabetic rats. J Integr Med. 2017;15:476–82.

    PubMed  Google Scholar 

  43. 43.

    Besse S, Assayag P, Delcayre C, Carre F, Cheav SL, Lecarpentier Y, Swynghedauw B. Normal and hypertrophied senescent rat heart: mechanical and molecular characteristics. Am J Physiol Heart Circ Physiol. 1993;265:H183–90.

    CAS  Google Scholar 

  44. 44.

    Vats V, Yadav SP, Grover JK. Ethanol extract of Ocimum sanctum leaves partially attenuates streptozotocin-induced alterations in glycogen content and carbohydrate metabolism in rats. J Ethnopharmacol. 2004;90:155–60.

    CAS  PubMed  Google Scholar 

  45. 45.

    Howarth FC, Jacobson M, Naseer O, Adeghate E. Short-term effects of streptozotocin-induced diabetes on the electrocardiogram, physical activity and body temperature in rats. Exp Physiol. 2005;90:237–45.

    CAS  PubMed  Google Scholar 

  46. 46.

    Al-Rawi MM. Effect of Trifolium sp. flowers extracts on the status of liver histology of streptozotocin-induced diabetic rats. Saudi J Biol Sci. 2007;14:21–8.

    Google Scholar 

  47. 47.

    Al-Shamaony L, Al-Khazraji SM, Twaij HA. Hypoglycaemic effect of Artemisia herba alba. II Effect of a valuable extract on some blood parameters in diabetic animals. J Ethnopharmacol. 1994;43:167–71.

    CAS  PubMed  Google Scholar 

  48. 48.

    Saravanan R, Pari L. Antihyperlipidemic and antiperoxidative effect of Diasulin, a polyherbal formulation in alloxan-induced hyperglycemic rats. BMC Complement Altern Med. 2005;5:1–8.

    Google Scholar 

  49. 49.

    Bhatti R, Sharma S, Singh J, Ishar MP. Ameliorative effect of Aegle marmelos leaf extract on early stage alloxan-induced diabetic cardiomyopathy in rats. Pharm Biol. 2011;49:1137–43.

    PubMed  Google Scholar 

  50. 50.

    Attia ES, Amer AH, Hasanein MA. The hypoglycemic and antioxidant activities of garden cress (Lepidium sativum L.) seed on alloxan-induced diabetic male rats. Nat Prod Res. 2018;9:1–5.

    Google Scholar 

  51. 51.

    Zhang JJ, Meng X, Li Y, Zhou Y, Xu DP, Li S, Li HB. Effects of melatonin on liver injuries and diseases. Int J Mol Sci. 2017;18:1–27.

    Google Scholar 

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Acknowledgments

Department of Pharmacy, Primeasia University, Dhaka, Bangladesh.

Funding

It is a self-funded research contributed by all authors equally.

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Affiliations

  1. Department of Pharmacy, Primeasia University, Dhaka, 1213, Bangladesh

    Ronia Mostofa, Rayhana Begum, Rubaba Karim, Taslima Begum, Nur Alam Siddiquee, Sonia Sultana & Sumaiya Alam

  2. Department of Pharmaceutical and Biomedical Sciences, College of Pharmacy, California Northstate University, California, USA

    Hongbin Wang

  3. Department of Pharmacy, East West University, Aftabnagar, Dhaka, 1212, Bangladesh

    Mst. Marium Begum & Tasnuva Tasnim Nova

  4. School of Molecular Medical Sciences, University of Nottingham, Nottingham, UK

    Rebeka Sultana

  5. Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Dhaka, Dhaka, 1000, Bangladesh

    A. K. Lutful Kabir

  6. Department of Pharmaceutical Sciences, North South University, Dhaka, 1229, Bangladesh

    Sumaiya Alam

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  1. Ronia Mostofa
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Contributions

Dr. Rayhan Begum conceptualized, designed and supervised the whole research work and drafting manuscript. Ronia Mostafa, Sumiya Alam, Nur Alam Siddiquee and Sonia Sultana conducted all procedures within laboratories, Rubaba Karim, Taslima Begum, Mst. Marium Begum,and Rayhana Begum compiled data, analyzed those and wrote manuscript. Finally Hongbin Wang, Rebeka Sultana, A K Lutful Kabir and Rayhana Begum critically reviewed manuscript for final approval and instructed for submission.

Corresponding author

Correspondence to Rayhana Begum.

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Ethics approval and consent to participate

The experimental procedures for our study have been approved by the Biomedical Research Center, University of Dhaka, Bangladesh (Ref. no. DPT/BMRC/2016–2017/467).

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Mostofa, R., Begum, R., Wang, H. et al. Promising anitidiabetic potential of Cuscuta reflexa leaves methanol extract in alloxan-induced diabetic rats. Clin Phytosci 6, 26 (2020). https://doi.org/10.1186/s40816-020-00169-w

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Keywords

  • Antidiabetic
  • Alloxan monohydrate
  • HbA1C
  • Insulin
  • Lipid profile