Cupidon of the Pahouins: Transition of Musanga cecropioides R.Br. and Alchornea cordifolia Müll.Arg. from Traditional Use to a Rational Anti-Infective Phytodrug. Preclinical and Clinical Efficacy in Treating Microbial and Fungal Infections

Background: The traditional recipe of Cupidon of Pahouins (CP) is an age-old secret kept by the female healers of the Fang people in Central Africa for feminine intimate care. The most widely used formulation is composed of four plant extracts: Alchornea cordifolia (Schumach. & Thonn.) Müll.Arg., Musanga cecropioides R.Br. ex Tedlie, Myrianthus arboreus P.Beauv., and Myrianthus arboreus P.Beauv. Aim of the Study: The first objective of this study was to test the antibacterial, antifungal, and antineoplastic effects of each plant extract alone, and then to test the combination of the most active extracts in a polyherbal formulation (PHF). The secondary objective was to assess the mechanism of action of the PHF. The third objective was to evaluate the clinical benefits of the new formulation (PHF) in a multicenter observational cohort study after the evaluation of side effects. Materials and Methods: Antibacterial and antifungal activities were evaluated using the agar dilution method. Protein synthesis inhibitors were used to target the mechanism of action of CP and its anticancer activity using the seed germination method. The rational formulation of the candidate CP was achieved using the functional approach. Transdermal passage of CP was measured using Franz diffusion chambers. Side effects on skin and eyes were assessed using skin and eye irritation tests. The clinical benefits of CP were evaluated after medical examination in an observational study involving a cohort of 451 patients suffering from different infectious diseases, such as vaginal and oral infections, as well as skin, eye, and ear infections. Results: The plant extracts used in the traditional formulation exhibited antibacterial and antifungal effects. The best results were obtained with Alchornea cordifolia and Musanga cecropioides, which were subsequently combined in a PHF to produce a new CP. On Gram-positive bacteria, CP was most effective against Enterococcus faecalis, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus warneri, Staphylococcus pettenkoferi Staphylococcus agalactiae, as well as Corynebacterium striatum. The same efficacy was observed on Gram-negative bacteria such as Citrobacter freundii, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterobacter aerogenes, Proteus mirabilis, and Salmonella spp. In addition, the effect of CP was synergistic on several microorganisms tested (FICI < 1). The new PHF exhibited antifungal activity against Candida albicans, as well as antineoplastic activity (IC50 = 2.92 ± 0.12 mg/mL). A positive clinical benefit was observed in humans following the use of CP. The phytodrug cleared infections of the skin, ears, eyes, vagina, and mouth, with no obvious adverse effects. Conclusion: This study confirms the efficacy of traditional PHF in treating or preventing bacterial and fungal infections. This study shows that alternative and combination poly-phytotherapy (ACP) can be used to improve the efficacy of traditional treatments.