Previous Article | Next Article 
Antimicrobial Agents and Chemotherapy, March 2003, p. 1137-1139, Vol. 47, No. 3
0066-4804/03/$08.00+0 DOI: 10.1128/AAC.47.3.1137-1139.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.
In Vitro Susceptibilities of Shigella flexneri and Streptococcus pyogenes to Inner Gel of Aloe barbadensis Miller
Valerie A. Ferro,* Fiona Bradbury, Pamela Cameron, Eisin Shakir, Sabita R. Rahman, and William H. Stimson
Department of Immunology, University of Strathclyde, Glasgow G4 ONR, United Kingdom
Received 24 September 2002/
Returned for modification 12 November 2002/
Accepted 2 December 2002

ABSTRACT
Aloe barbadensis Miller (or
Aloe vera) has widespread use in
health products, and despite numerous reports on the whole plant,
little work has been performed on the inner gel, which has been
used extensively in these products. This report describes the
in vitro susceptibilities of two bacteria to this component.

TEXT
Global antibiotic resistance by bacteria is becoming an increasing
public health concern, and the race to discover new antibacterial
agents is on (
2). One approach involves the search for new therapeutic
agents with novel modes of action from natural resources (
4,
11). Plants belonging to the genus
Aloe (Liliaceae) have been
known for their medicinal properties for many centuries, and
Aloe barbadensis Miller (or
Aloe vera) is of particular renown
(
1,
19). In the last decade, aloe vera (AV) has been used extensively
in health drinks, topical creams, toiletries, and cosmetics
(
1), and there are many reported claims of its beneficial properties,
encompassing a broad range of conditions (
17,
18). These claims
remain largely anecdotal, and scientific evidence is often sparse
and inconsistent (
1,
17). Major sources of confusion arise from
preexperimental treatment of the plant, such as storage conditions,
the use of fresh or dried components, variations in extraction
methods, use of different parts of the plant, growing conditions,
and the age of the plants at harvest (
12,
13,
21,
23).
The fresh whole leaves of the succulent are fleshy, and removal of the thick outer cuticle reveals a mucilaginous inner gel (1). This is the major component in many reputable commercial products (1, 17), found in a preserved but otherwise untreated form (12, 13, 17). To date, more than 75 active ingredients have been identified from the inner gel (1, 17, 19), each of which may have a range of mechanisms of action, acting synergistically or individually to explain the numerous curative properties. This has led to a trend to isolate and analyze individual ingredients in an attempt to attribute therapeutic potential to each ingredient (20, 22). This has not necessarily shed light on the issue, and in particular, in vivo studies have not been able to distinguish between the antimicrobial effects of the plant and stimulation of the immune system. Whole-leaf components proposed to have direct antibacterial properties include anthraquinones (3) and saponins (17, 19), while polysaccharides have been attributed with indirect bactericidal activity through stimulation of phagocytic leukocytes to destroy bacteria (10, 16).
Since there has been limited research on the inner gel, the aim of this study was to provide evidence for the antibacterial effectiveness of this component prior to extensive experimentation. The ultimate goal would be to attempt to characterize the factors that provide biologic activity. The main microorganism used in this study was Shigella flexneri, a nonmotile rod belonging to the Enterobacteriaceae family. Shigella species are an important cause of gastrointestinal illness, which is manifest by watery diarrhea that progresses to mucoid bloody diarrhea and shigellosis. In the past, antibiotic therapy has been effective (14), but increasing multiple antibiotic resistance, particularly resistance to ampicillin, chloramphenicol, nalidixic acid, and co-trimoxazole, is of major concern (14, 15). There is also increasing evidence that antibiotic therapy can exacerbate the symptoms of gastrointestinal diseases (6, 9), and an alternative treatment would be beneficial. In addition, susceptibility of the gram-positive Streptococcus pyogenes to AV was briefly investigated, as this is another organism which is beginning to show antibiotic resistance (7, 8).
Shigella flexneri (NCTC 9950) and Streptococcus pyogenes Gp A (ATCC 19615) were purchased from the Public Health Laboratory Services (Porton Down, Salisbury, United Kingdom). Stock cultures were subcultured and maintained in tryptic soy broth (TSB; Difco Laboratories Ltd., Detroit, Mich.), at 37°C. Freeze-dried AV was obtained from the United States and consisted of inner gel from plants that were approximately 2 years old at the time of harvest. The powder was reconstituted in phosphate-buffered saline (pH 7.5) at 37°C for 30 min and then sterile filtered through a 0.22-µm-pore-size filter. For comparison, a commercial health drink, Aloe Vera Gel (Forever Living Products, Scottsdale, Ariz.) consisting of undiluted, unfiltered inner-leaf gel, was used as well. This was filtered through sterile Whatman no. 54 filter paper. It was not possible to accurately determine the amount of active material lost by this process. Ampicillin (AMP) and/or nalidixic acid (NAL) (Sigma-Aldrich Ltd., Poole, Dorset, United Kingdom), also used for comparison, were dissolved in phosphate-buffered saline and filtered through a 0.22-µm-pore-size filter. Reagents used in this study were obtained from the following sources: Muller-Hinton broth from Oxoid, Basingstoke, Hampshire, United Kingdom; agar from Unipath Ltd., Bedford, United Kingdom; Alamar blue from Serotec Ltd., Kidlington, United Kingdom; plasticware from Greiner Bio-One Ltd., Stonehouse, United Kingdom, and 96-well tissue culture plates from TPP, Trasadingen, Switzerland; all other reagents were from BDH Ltd., Poole, United Kingdom.
The zones of inhibition were calculated by agar diffusion. Wells were cut into nutrient agar plates, and 75 µl of the test agent, AV (7 to 450 mg/ml) or antibiotic (2 to 512 µg/ml), was added to each well. An S. flexneri lawn was seeded on the agar for 24 h at 37°C. The diameters of the inhibition zones were measured (Table 1). Concentrations greater than 112 mg of AV per ml, 32 µg of AMP per ml, and 128 µg of NAL per ml showed significant (P < 0.001) growth inhibition compared with untreated control wells. It was not possible to make a comparison with the Aloe Vera Gel due to difficulties encountered with diffusion through the agar. An attempt was made to mix the Aloe Vera Gel with the agar prior to seeding the S. flexneri on the surface to obtain a total viable count, but the agar failed to set, which was attributed to the presence of pectinase in the preparation.
Growth curves were generated as follows. A 96-well microtiter
plate containing 100 µl of TSB per well was inoculated
with 10 µl of the organism (10
2 CFU) at 37°C for 30
h (this was done in triplicate). The plate was agitated, and
A620 readings were taken at hourly intervals on a Titertek Multiscan
MCC/340 plate reader. The number of bacteria per milliliter
was calculated from the following equation: (
A620 x 2
x 10
8)/0.2.
Growth curves were also set up with 100 µl of test agent:
AV (7 to 450 mg/ml), Aloe Vera Gel (5 to 90%), AMP (2 to 512
µg/ml), or NAL (2 to 512 µg/ml). The untreated bacteria
reached log phase between 3 to 10 h, with maximum growth after
22 h. All the test agents suppressed bacterial growth for up
to 24 h, to various degrees. The 50% inhibition doses were 30
mg of AV per ml, 15% (vol/vol) Aloe Vera Gel, 3 µg of
NAL per ml, and 4 µg of AMP per ml. The growth inhibition
of AV was further quantified by incubating 100 µl of Muller-Hinton
broth with 100 µl of twofold dilutions of AV (in triplicate)
and 10 µl of
S. flexneri (10
2 CFU) at 37°C for 6 h.
Control wells contained bacteria (positive) or broth (negative)
only. Alamar blue (10 µl) was added to each well and incubated
at 37°C for a further 2 h. The plate was centrifuged for
10 min at 12,000
x g to pellet the bacteria, and the supernatant
was transferred to a fresh microtiter plate.
A570 and
A600 readings
were taken on a SpectraMax 190 spectrometer, and the percentage
growth was calculated using the following equation: (mean
A570 -
A600 of test agent/mean
A570 -
A600 of the positive control)
x 100. Figure
1 shows the dose response of
S. flexneri to AV
after 8 h. Since the Alamar blue assay incorporates a colorimetric
growth indicator to detect metabolic activity, it is useful
in cytotoxicity experiments. These assays were designed on a
small scale in microtiter plates to reduce the amount of material
used; however, the same results were obtained from large-scale
experiments using an inoculum size of >5
x 10
5 CFU/ml. It
was important to optimize the assay for microtiter plates, since
preliminary follow-up experiments have shown that extraction
of the plant material can produce a low yield depending on the
solvents used.
To compare the effect of AV against a gram-positive bacterium,
growth curves were set up with
S. flexneri and
Streptococcus pyogenes. Effective growth inhibition, up to 24 h, was achieved
with concentrations of more than 100 mg of AV per ml for
S. flexneri and 25 mg of AV per ml for
Streptococcus pyogenes (Fig.
2). The reduction in the amount of AV needed to suppress the
growth of the gram-positive bacterium was attributed to the
structural differences between the two organisms. As far as
we are aware, this is the first report of the susceptibility
of both these organisms to AV.
In view of the complexities of examining the pharmacology of
this plant, simple assays, which can be easily replicated to
test multiple fractions are essential to establish antimicrobial
activity. The assays described in this report enable easy multiparameter
comparison and allow a range of bacterial species to be examined.
This preliminary study established the susceptibilities of
S. flexneri and
Streptococcus pyogenes to the inner gel of
A. barbadensis Miller or
A. vera. The next stage will involve solvent and aqueous
extraction of the inner gel to isolate and identify molecules
for further research. Although the activities of the AV and
Aloe Vera Gel appear to be low in comparison to those of NAL
and AMP, individual components may have greater activity. Glycosides
of anthraquinones and dihydroxyanthraquinones (
3,
22), acemannan
(
5), and saponins (
1,
17) are active antibacterial components
found in the whole plant and known to be constituents of the
inner gel. Therefore, further research on these and other molecules
will provide further evidence of the therapeutic potential of
the inner gel. The direct effect of the inner gel on bacteria
which are found in accessible areas of the body enables future
development of antimicrobial products, which can protect the
mucosa.

ACKNOWLEDGMENTS
We thank Roger Poore (Aloe Vera of America Inc., Dallas, Tex.),
Aidan O'Hare (Forever Living Products, Dallas, Tex.), Charles
Smith (Forever Living Products, Shotts, United Kingdom), Alexander
Gray (Department of Pharmaceutical Sciences, University of Strathclyde),
and Graham Park (Lamellar Therapeutics Ltd., Glasgow, United
Kingdom) for invaluable advice and assistance.

FOOTNOTES
* Corresponding author. Mailing address: Department of Immunology, University of Strathclyde, 27 Taylor St., Glasgow G4 ONR, United Kingdom. Phone: 44 0141 548 3724. Fax: 44 0141 548 4645. E-mail:
v.a.ferro{at}strath.ac.uk.


REFERENCES
1 - Atherton, P. 1998. Aloe vera: magic or medicine? Nurs. Stand. 41:49-54.
2 - Bax, R., N. Mullan, and J. Verhoef. 2000. The millenium bugs-the need for and development of new antibacterials. Int. J. Antimicrob. Agents 16:51-59.[CrossRef][Medline]
3 - Boateng, J. S. 2000. Analysis of commercial samples of aloe. Ph.D. thesis. University of Strathclyde, Glasgow, United Kingdom.
4 - Bombardelli, E. 2001. Approaches to the quality characteristics of medicinal plant derivatives. Eur. Phytojournal 1:30-33.
5 - Davis, R. H., J. J. D. Donato, G. M. Hartman, and R. C. Haas. 1994. Anti-inflammatory and wound healing activity of a growth substance in Aloe vera. J. Am. Podiatric Med. Assoc. 84:77-81.[Abstract]
6 - Dofferhoff, A. S. M., M. T. Esselink, and H. G. de Vries-Hospers. 1993. The release of endotoxin from antibiotic-treated Escherichia coli and the production of tumour necrosis factor by human monocytes. J. Antimicrob. Chemother. 31:373-384.[Abstract/Free Full Text]
7 - Gur, D., M. Ozalp, B. Sumerkan, A. Kaygusuz, K. Toreci, I. Koksal, U. Over, and G. Soyletir. 2002. Relevance of antimicrobial resistance in Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis and Streptococcus pyogenes: results of a multicentre study in Turkey. Int. J. Antimicrob. Agents 19:207-211.[CrossRef][Medline]
8 - Hsueh, P. R., L. J. Teng, L. N. Lee, P. C. Yang, S. W. Ho, H. C. Lue, and K. T. Luh. 2002. Increased prevalence of erythromycin resistance in streptococci: substantial upsurge in erythromycin-resistant M phenotype in Streptococcus pyogenes (1979-1998) but not in Streptococcus pneumoniae (1985-1999) in Taiwan. Microb. Drug Resist. 8:27-33.[CrossRef][Medline]
9 - Hurley, J. C. 1992. Antibiotic induced release of endotoxin: a reappraisal. Clin. Infect. Dis. 15:840-854.[Medline]
10 - Lawless, J., and J. Allan. 2000. The chemical composition of Aloe vera, p. 161-171. In Aloe vera natural wonder cure. Thorsons, Publishing Ltd., London, United Kingdom.
11 - Marr, C., and S. Bent. 1999. An evidence based review of the 10 most commonly used herbs. West. J. Med. 171:168-171.[Medline]
12 - McAnalley, B. H. April 1988. Process for preparation of aloe products, produced thereby and composition thereof. U.S. patent 4,735,935.
13 - McAnnalley, B. H. April 1990. Process for preparation of aloe products, produced thereby and composition thereof. U.S. patent 4,917,890.
14 - Navia, M. M., L. Capitano, J. Ruiz, M. Vargas, H. Urassa, D. Schellemberg, J. Gascon, and J. Vila. 1999. Typing and characterization of mechanisms of resistance of Shigella spp. isolated from feces of children under 5 years of age from Ifakara, Tanzania. J. Clin. Microbiol. 37:3113-3117.[Abstract/Free Full Text]
15 - Prats, G., B. Mirelis, T. Llovet, C. Munoz, E. Miro, and F. Navarro. 2000. Antibiotic resistance trends in enteropathogenic bacteria isolated in 1985-1987 and 1995-1998 in Barcelona. Antimicrob. Agents Chemother. 44:1140-1145.[Abstract/Free Full Text]
16 - Pugh, N., S. A. Ross, M. A. Elsohly, and D. S. Pasco. 2001. Characterization of Aloeride, a new high-molecular-weight polysaccharide from Aloe vera with potent immunostimulatory activity. J. Agric. Food Chem. 49:1030-1034.[CrossRef][Medline]
17 - Reynolds, T., and A. C. Dweck. 1999. Aloe vera leaf gel: a review update. J. Ethnopharmacol. 68:3-37.[CrossRef][Medline]
18 - Shelton, R. M. 1991. Aloe vera: its chemical and therapeutic properties. Int. J. Dermatol. 30:679-683.[Medline]
19 - Urch, D. 1999. Aloe vera the plant, p. 8-17. In Aloe vera nature's gift. Blackdown Publications, Bristol, United Kingdom.
20 - Vazquez, B., G. Avila, D. Segura, and B. Escalante. 1996. Anti-inflammatory activity of extracts from Aloe vera gel. J. Ethnopharmacol. 55:69-75.[CrossRef][Medline]
21 - Vogler, B. K., and E. Ernst. 1999. Aloe vera: a systemic review of its clinical effectiveness. Br. J. Gen. Pract. 447:823-828.
22 - Wang, H. H., J. G. Chung, C. C. Ho, C. T. Wu, and S. H. Chang. 1998. Aloe-emodin effects on arylamine N-acetyl transferase activity in the bacteria Helicobacter pylori. Planta Med. 64:176-178.[Medline]
23 - Yarron, A. 1993. Characterisation of Aloe vera gel composition and autodegradation, and stabilisation of the natural fresh gel. Phytother. Res. 7:S11-S13.[CrossRef]
Antimicrobial Agents and Chemotherapy, March 2003, p. 1137-1139, Vol. 47, No. 3
0066-4804/03/$08.00+0 DOI: 10.1128/AAC.47.3.1137-1139.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.