Dynamic Changes in Maternal Treg, CD4+, and CD8+ T Cells After Administration of Candle Bush Leaves (Cassia alata) Extract in Gestational Diabetes Mellitus

Gestational diabetes mellitus is characterized by glucose intolerance during pregnancy, leading to elevated glucose levels, oxidative stress, and inflammation. Candle bush (Cassia alata) extract (CBE) is an alternative potential therapeutic approach due to its anti-diabetic and anti-inflammatory properties. This study aims to evaluate the efficacy of Candle bush leaf extract during GDM by dynamic changes of CD4+, CD8+, and regulatory T cells (Tregs). Simplicia of Candle bush leaf was extracted by maceration with distilled water (1:10; w:v) for 42 hours at 40°C. Twenty-five pregnant mice were spread randomly into five groups (n=5). Mice were induced to develop GDM using 300 mg/kg BW niacinamide (NA) and 145 mg/kg BW streptozotocin (STZ) via intraperitoneal injection. The treatment groups received metformin (307 mg/kg BW) and CBE (Dose 1 with 500 mg/kg BW and Dose 2 with 1,500 mg/kg BW) orally once a day from Gestational-day/GD6 to GD18. The pancreas and spleen organs were isolated for immunostaining. The antioxidant activity was analyzed using 0.4mM 2,2-diphenyl-1-picrylhydrazyl (DPPH). The results demonstrated that CBE significantly reduced blood glucose levels, increased insulin secretion, and modulated immune cell populations by decreasing cytotoxic T cells (CD8+) as factor that induce inflammation and increasing helper T cells (CD4+) and Tregs activities as modulator to induce anti-inflammatory (P < 0.05). Furthermore, CBE has antioxidant activity with IC50 475 μg/ml. In conclusion, the Dose 1 appears as a promising potential treatment for GDM by greater improvements in glucose regulation, insulin secretion, and immune modulation compared to metformin and the higher dose of CBE.