Background Herpes genitalis (HG) is the commonest cause of sexually transmitted ulcerative disease in the world, including Malaysia1. Herpes simplex virus (HSV) type 2 is more frequently implicated than HSV type 1. This pattern has seen some changes in many parts of the world, with increasing HSV type 1 rates2. Objective The aim of this study was to determine the type of HSV implicated in patients with herpes genitalis at the Genito-Urinary Medicine Clinic, Department of Dermatology, Hospital Kuala Lumpur. Methods A retrospective study was undertaken on 242 patients with a diagnosis of herpes genitalis at the Genito-Urinary Medicine Clinic from January 2000 to December 2004. The study included all cases of genital herpes in patients aged over 12 years. The typing was done by a immunofluorescent - labeled monoclonal antibody technique specific for HSV antigens. Results Majority (76%) were between the ages of 20-49 years. Males outnumbered females by 1.6:1. Younger women (20-29 years old) tend to be more frequently affected than their male counterpart. One fourth (25.7%) of the patients reported having sex with sex workers and less than 1% (0.4%) were sex workers. A significant percentage (30.5%) of married men reported extramarital relationship with sex workers or had a casual or regular partner. Usage of condoms was low at 12%. Clinical diagnosis at presentation was primary herpes genitalis (56%) and recurrent (44%). 162 (67%) out of a total of 242 patients had the herpes immunofluorescent test done. 110 (68%) of those done were negative. Only 34 (21%) of patients with herpes genitalis had a positive immunofluorescent antibody test. Of the 21%, herpes simplex virus type 2 was found in 19 (12%) of patients with herpes genitalis, HSV type 1 in 10 (6%) and HSV types 1 & 2 coinfection in 5 (3%) patients. Conclusions In our study, HSV-2 was still more common causing 57% of the cases seen, HSV-1 29% and HSV-1 and HSV-2 coinfection in 14%. An increased rate of HSV-1 seen could possibly be due to a change in sexual behavior of the patients especially with regards to oro-genital sexual contact.

OBJECTIVEDeoxyelephantopin, a sesquiterpene lactone from Elephantopus scaber, showed inhibition of the growth of various tumor cells in vitro. In the present study, we investigated the cytotoxicity and apoptosis-inducing capacity of deoxyelephantopin on lung adenocarcinoma (A549) cells.

METHODSThe cytotoxic effect of deoxyelephantopin on A549 cells and normal lymphocytes was evaluated using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and 50% inhibitory concentration (IC50) value was determined. The self-renewal and proliferating potential of A549 cells after treatment with deoxyelephantopin were examined by colony formation assay. Cellular morphology of deoxyelephantopin-treated cells was observed using phase-contrast microscopy. The induction of apoptosis was evaluated using acridine orange and ethidium bromide staining, Hoechst 33342 staining, terminal deoxynucleotidyl transferase-mediated dUTP biotin nick end-labeling (TUNEL) assay, DNA fragmentation analysis and Annexin V-fluorescein isothiocyanate staining by flow cytometry. Activation of caspases was detected using fluorogenic substrate specific to caspases 2, 3, 8 and 9 and flow cytometric analysis. The total cellular DNA content and expression of cleaved poly (ADP-ribose) polymerase was also analyzed.

RESULTSDeoxyelephantopin exhibited cytotoxicity to A549 cells (IC50 = 12.287 μg/mL), however, there was no toxicity towards normal human lymphocytes. Deoxyelephantopin suppressed the colony-forming ability of A549 cells in a dose-dependent manner. Acridine orange, ethidium bromide and Hoechst 33342 staining showed cell shrinkage, chromosomal condensation and nuclear fragmentation, indicating induction of apoptosis. Deoxyelephantopin increased apoptosis of A549 cells, as evidenced by more TUNEL-positive cells. DNA fragmentation and Annexin V staining revealed late-stage apoptotic cell population. Deoxyelephantopin inhibited A549 cell growth by cell cycle arrest at G2/M phase and induced apoptosis through both extrinsic and intrinsic pathways.

CONCLUSIONThese results suggest that deoxyelephantopin has great potential as a new chemotherapeutic agent to be developed further for the treatment of lung cancer.

Adenocarcinoma ; drug therapy ; pathology ; Antineoplastic Agents, Phytogenic ; pharmacology ; Apoptosis ; drug effects ; Caspases ; physiology ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Dose-Response Relationship, Drug ; Humans ; Lactones ; pharmacology ; Lung Neoplasms ; drug therapy ; pathology ; Sesquiterpenes ; pharmacology