Effect of 13 traditional Chinese medicine drug preparations against Neisseria gonorrhoeae

Wenfeng Liao¹Ke Zhou²Yan Zhang³Yuanqin Huang⁴Xia Zhang⁵Yueping Yin^6,7Qian Zhou^6,7Shaochun Chen^6,7Weiyun Li²Wenqi Xu^6,7*

• ¹Department of Urologic Oncology, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Nanjing, China
• ²Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
• ³Taizhou Center for Disease Control and Prevention, Taizhou, China
• ⁴State Key Laboratory of Green Pesticide, Center for Research and Development of Fine Chemicals, Guizhou University, Guiyang, China
• ⁵Hong Kong Baptist University, Hong Kong, Hong Kong, SAR China
• ⁶Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
• ⁷STD Reference Laboratory, National Center for Sexually Transmitted Diseases Control, Chinese Center for Disease Control and Prevention, Nanjing, China

Introduction: Gonorrhea poses severe health complications, with an estimated 82.4 million new adult infections reported globally in 2020. Currently, ceftriaxone monotherapy remains the first-line treatment in China. However, rising antimicrobial drug resistance necessitates has spurred the urgent need to explore novel therapeutic strategies. This study assessed the antibacterial activity of 13 traditional Chinese medicines (TCMs) against Neisseria gonorrhoeae (N. gonorrhoeae), aiming to identify alternative agents to combat antimicrobial drug resistance. Methods: The minimum inhibitory concentrations (MICs) of 13 TCMs on 280 N. gonorrhoeae isolates were determined using the agar dilution method. The correlation between the MICs of TCMs and those of antibiotics was analyzed using the correlation coefficient (R value). The chemical profiles of TCMs were identified using Gas Chromatography-Mass Spectrometry (GC-MS) and Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS). The MICs of representative chemical metabolites on 53 N. gonorrhoeae isolates were determined using the agar dilution method. Results: Coptidis Rhizoma (CR) exhibited the lowest MIC10 of ≤0.06 mg/mL and lowest MIC90 of ≤0.5 mg/mL. Six TCMs showed no correlation with the MIC values of ceftriaxone, spectinomycin or azithromycin. Discussion: This study represents the first report about the antibacterial activity of these 13 TCMs against N. gonorrhoeae. The results indicate that CR, Phellodendri Chinensis Cortex (PCC), Forsythiae Fructus (FF), Taraxaci Herba (TH), and Scutellariae Radix (SR) exhibited good antibacterial activity against N. gonorrhoeae, highlighting their potential as promising therapeutic options for gonococcal infections. In contrast, the MICs of Bupleuri Radix (BR), Cimicifugae Rhizoma (CFR) showed correlations with those of ceftriaxone, azithromycin, and spectinomycin, suggesting that they may be unsuitable for monotherapy of gonococcal infections, given the potential risk of cross-resistance. Nevertheless, further in vitro experiments and clinical studies are required to validate these observations.