Therapeutic Effect of Physalis angulata Fruit Extract on Hormone-induced Uterine Fibroids in Wistar Rats

Physalis angulata is an edible medicinal plant found in the tropics, which is used for the treatment of infertility-related issues in traditional medicine. This fruit exhibits antitumour, antiproliferative and anticancer properties. However, the therapeutic efficacy of this extract in the management of uterine fibroids remains largely unexplored. This study seeks to assess the therapeutic effect of Physalis angulata fruit extract on Hormone-induced uterine fibroids in Wistar rats. In the present study, 48 animals were randomly divided into 8 groups.The groups were as follows: Group I- Control group received normal feeds and distilled water for 6 weeks. Group II, III, IV and V- Animals were induced with uterine fibroids by administering Diethylstibesterol (1.35 mg/kg/d) every day for 6 weeks orally using oral gavage, Progesterone injection of 1.0mg/180g intramuscularly three times a week(Monday, Wednesday and Friday) for 5 weeks. 0.9 mg/kg/d adrenal hydrochloride injection was given intramuscularly in the last two weeks of the experiment. After the inducement of fibroids for 6 weeks, animals in Group III, IV and V were treated with 2.2 mg of mifepristone, 500 mg/kg and 1500 mg/kg of extract, respectively, for 6 weeks. Group VI, VII and VIII- animals were treated with 2.2 mg of mifepristone, 500 mg/kg and 1500 mg/kg of body weight offruit extract, respectively, daily for 6 weeks. Plant extracts were administered orally. Animals were sacrificed 24 hours after the last administration. Photochemical studies, gross morphology of the uterus, histological assessment of the uterus using H and E stains, apoptotic and non-apoptotic marker assessments using BAX and BCL2 and hormonal assay were assessed. Phytochemical studies revealed the presence of nineteen bioactive compounds. The relative organ weight increased significantly in fibroid-induced groups and reduced in the treatment groups. Results showed increased levels of estrogen (16.38±0.80) and progesterone (9.66±0.58) in the fibroid induced group, which was reduced in low dose treatment groups (Estrogen= 12.69, Progesterone = 6.90) and high dose treatment groups (Estrogen= 11.64, Progesterone = 6.80) P≤0.05. Histopathological changes were observed in the uterus. Increased apoptotic marker reaction was seen in the low-dose(500 mg/kg/d) group. Prolactin level was significantly higher in the treatment groups (P≤0.05) compared with the control. The study successfully induced fibroid, evident by gross morphology of the uterine horn width, elevated estrogen and progesterone levels, up-regulation of BCL2, and down-regulation of BAX and altered endometrial histology. This study revealed that the extract is not cytotoxic to the organ studied. The extract has the ability to induce apoptosis, suggesting that its mode of action on fibroid may be through the induction of apoptosis, reduction of uterine horn width and correction of hormonal imbalance associated with fibroid development. Physalis angulata fruit extract has a promising potential as a supplement for the management of uterine fibroid.