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Antimicrobial Agents and Chemotherapy, May 2007, p. 1859-1862, Vol. 51, No. 5
0066-4804/07/$08.00+0 doi:10.1128/AAC.00426-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.
Susceptibility of Drug-Resistant Clinical Herpes Simplex Virus Type 1 Strains to Essential Oils of Ginger, Thyme, Hyssop, and Sandalwood
Paul Schnitzler,1*
Christine Koch,1,2 and
Jürgen Reichling2
Department of Virology, Hygiene Institute,1
Department of Biology, Institute of Pharmacy and Molecular Biotechnology, University of Heidelberg, Heidelberg, Germany2
Received 5 April 2006/
Returned for modification 8 June 2006/
Accepted 2 March 2007

ABSTRACT
Acyclovir-resistant clinical isolates of herpes simplex virus
type 1 (HSV-1) were analyzed in vitro for their susceptibilities
to essential oils of ginger, thyme, hyssop, and sandalwood.
All essential oils exhibited high levels of virucidal activity
against acyclovir-sensitive strain KOS and acyclovir-resistant
HSV-1 clinical isolates and reduced plaque formation significantly.

TEXT
Herpes simplex virus type 1 (HSV-1) is a highly prevalent pathogen
among children and adults, causing primary infections which
present clinically as herpes labialis or as primary herpetic
gingivostomatitis, and is able to establish a latent infection
in the nervous system that can be reactivated quite frequently
(
10,
31,
32). Acyclovir has been widely used for the management
of herpes virus infections, and its preferential phosphorylation
by the HSV-encoded thymidine kinase (TK) makes it a selective
antiviral drug (
8,
14). The emergence of virus strains resistant
to commonly used antiherpesvirus drugs is a problem in the clinical
setting, particularly in immunocompromised patients (
3,
4,
6,
19,
30). This trend has led to a search for alternative antiherpetic
agents that have a wide range of efficacy without serious adverse
effects and are effective for viral strains resistant to current
antiviral agents. HSV develops resistance predominantly as a
result of mutations in genes that code for TK, but resistance
can also result from mutations in DNA polymerase. The antiherpes
activities of Australian tea tree oil (
16,
23), peppermint oil
(
25), and manuka oil (
17) have previously been published. In
the present study, we analyzed the virucidal activities of essential
oils derived from ginger, thyme, hyssop, and sandalwood against
acyclovir-sensitive and acyclovir-resistant clinical HSV-1 isolates
for which therapy with acyclovir failed.
Essential oils from ginger (Zingiber officinale), thyme (Thymus vulgaris), hyssop (Hyssopus officinalis), and sandalwood (Santalum album) were investigated. The main components (composing about 5 to 10%) of ginger oil are sesquiterpenes (e.g., zingiberene, β-bisabolene, sesquiphellandrene, and curcumen), thyme oil consists mainly of thymol and carvacrol, hyssop oil consists mainly of monoterpenes (e.g., 1-pinocamphone, isopinocamphone, pinocarvone, and
-pinene), and sandalwood oil is mainly composed of sesquiterpene alcohols (e.g., santalol, bergamotol, and santalene). Acyclovir-sensitive HSV-1 strain KOS (15) and acyclovir-resistant patient isolates 1246/99 and 496/02 were used for the experiments. Each of the two hospital specimens from infected patients revealed a single-point mutation in the coding sequence of the TK gene which resulted in frameshifts, and probably only truncated, nonfunctional TK was expressed. These mutations were both located in homopolymer stretches of guanines downstream of the ATP-binding site for 1246/99 and cytosines downstream of the nucleoside-binding site for 496/02 and have been reported previously (1, 5, 9, 21, 22). The well-characterized acyclovir-resistant HSV-1 strain Angelotti was also used in the experiments and exhibits a single-point mutation in the DNA polymerase gene (12). Viruses were routinely grown on RC-37 cells as described previously (20). Genomic DNA was extracted from the supernatant of plaque-purified virus and amplified by PCR (5), and PCR products were sequenced as described previously (24). All essential oils were dissolved in ethanol and added to the medium at a final concentration of 1% ethanol for cytotoxicity assays, which determined the viability and proliferation of the cells (25, 29).
The cytotoxic concentration of the drug which reduced viable cell number by 50% (CC50) and the effective concentration of the test compound which inhibited plaque numbers by 50% (EC50) were determined from dose-response curves (Table 1). Selectivity indices for different essential oils were calculated as CC50/EC50 ratios and are given in Table 1. Ginger oil and hyssop oil exhibited selectivity indices of 20 and 75, respectively. The maximum noncytotoxic concentrations of the tested essential oils were determined at 0.003% for ginger oil, 0.005% for thyme oil and hyssop oil, and 0.0006% for sandalwood oil. The dose-response curves shown in Fig. 1 demonstrate dose-dependent activities for the tested essential oils. The inhibitory effects of the essential oils against HSV were tested by adding the oils at different times during the infection cycle of HSV (Table 2). To identify the step at which replication might be inhibited, cells were infected with these HSV-1 strains after preincubation of the cells for 1 h with essential oils; after pretreatment of the virus strains for 1 h with the essential oils prior to infection; after addition of the essential oils, during adsorption; or after adsorption, during the intracellular-replication period. In all experiments, untreated, virus-infected cells were used as controls. Percent reduction was calculated relative to the amount of virus produced in the absence of the compounds. Pretreatment of HSV with the analyzed essential oils prior to infection caused significant reductions of infectivity, ranging from 95.9% to 99.9% for the acyclovir-sensitive and drug-resistant HSV-1 strains.
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TABLE 2. Virucidal effects of essential oils against acyclovir-sensitive HSV-1 strain KOS, acyclovir-resistant strain Angelotti, and acyclovir-resistant clinical isolates 1246/99 and 496/02a
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These results indicate that essential oils derived from ginger,
thyme, hyssop, and sandalwood affected the virus before adsorption
and in a different manner than acyclovir since plaque formation
levels for acyclovir-resistant patient isolates HSV-1 1246/99
and 496/02 were significantly reduced, too. A high level of
virucidal activity during the pretreatment of HSV-1 was detected
previously by using the essential oil of
Salvia fruticosa (
28).
Essential oils seem to be mostly efficient on cell-free virus
but have limited effects on virus replication in cells and on
the cell-to-cell spread of the virus (
13). These results suggest
that the investigated essential oils might interfere with virion
envelope structures which are necessary for adsorption to or
entry into host cells or might dissolute the HSV envelope. Treatment
of HSV-1 with oregano essential oil has been shown to disrupt
the viral envelope (
27). In preliminary electron microscopical
studies, we also demonstrated a disruption of the viral envelope
after pretreatment of HSV with essential oils, thereby impairing
their abilities to infect host cells. Shogan et al. (
26) investigated
the antiviral mechanisms of a GT-rich oligonucleotide which
potently inhibited attachment of HSV to cells by induction of
a conformational change in glycoprotein B, resulting in inactivation
of infectivity. The virucidal activity of the GT-rich oligonucleotide
is time dependent and causes an irreversible loss of infectivity.
A resistant virus with mutations in the UL27 gene was isolated
by these authors, and attachment of HSV to cells was not inhibited
in the mutant strain. Since lipophilic essential oils inhibit
attachment only moderately and most likely exert their virucidal
activities by disrupting the viral lipid membrane, resistant
strains of HSV could not be detected. After pretreatment of
HSV with essential oils, the few remaining infectious viruses
are still sensitive to treatment with essential oils. Essential
oils are complex mixtures of compounds with low molecular weights,
such as monoterpene hydrocarbons, sesquiterpene hydrocarbons,
and their corresponding oxidized products (e.g., alcohols, aldehydes,
and ketones); homologues of phenylpropanoids; and small amounts
of diterpenoids. The active components of essential oils might
consist of lipophilic carbohydrates that interact with the lipid
membrane (
18). These antibacterially active substances (
7,
11)
might exhibit similar activities against viral envelopes. Interestingly,
acyclovir-resistant clinical isolates were significantly inhibited
by the essential oils, and the titers of HSV were reduced by
95.9% to 99.9%. Since essential oils are able to inhibit acyclovir-resistant
HSV-1 isolates, the mechanism of interaction between these compounds
and acyclovir for HSV must be different. Acyclovir inhibits
virus replication by interference with the DNA polymerase inside
the cell, whereas essential oils probably inactivate HSV before
it enters the cell. The effective dosage for a systemic application
of essential oils is rather high and leads to cytotoxic effects.
Furthermore, a short-term systemic bioavailability makes a systemic
application unlikely. Therefore, other antiherpetic agents which
are effective against viral mutants resistant to current antiviral
agents are of great interest for additional topical treatment
of recurrent acyclovir-susceptible and acyclovir-resistant HSV-1
infections, as has been demonstrated by topical application
of tea tree oil (
2) against recurrent herpes labialis.

ACKNOWLEDGMENTS
We thank U. Bahr, University of Heidelberg, for sequencing and
E. Daum for technical assistance. We also thank A. Sauerbrei,
Institute for Antiviral Chemotherapy, University of Jena, Germany,
for kindly providing the HSV-1 clinical isolates 1246/99 and
496/02 and C. W. Knopf for providing HSV-1 strain Angelotti.

FOOTNOTES
* Corresponding author. Mailing address: Hygiene Institute, Department of Virology, University of Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany. Phone: 49-6221-56 50 16. Fax: 49-6221-56 50 03. E-mail:
Paul_Schnitzler{at}med.uni-heidelberg.de 
Published ahead of print on 12 March 2007. 

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Antimicrobial Agents and Chemotherapy, May 2007, p. 1859-1862, Vol. 51, No. 5
0066-4804/07/$08.00+0 doi:10.1128/AAC.00426-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.