For example, with provenance, the inclusion of the minor components sabinene, globulol, and viridiflorol is potentially helpful, since it may render the formulation of artificial oil from individual components difficult or economically untenable. The observation that TTO may be useful adjunct therapy for onychomycosis has been made by Klimmek et al. Thank you for sharing this Clinical Microbiology Reviews article. The commercial TTO industry was born after the medicinal properties of the oil were first reported by Penfold in the 1920s (121-124) as part of a larger survey into Australian essential oils with economic potential. However, α-terpineol does not represent a significant proportion of the oil. (31), who examined 64 MRSA isolates from Australia and the United Kingdom, including 33 mupirocin-resistant isolates. In subsequent work the same TTO solution was compared with an alcohol-free TTO solution (149). SUMMARY Complementary and alternative medicines such as tea tree (melaleuca) oil have become increasingly popular in recent decades. Instead, research has concentrated on how this organism is able to tolerate higher concentrations of TTO and/or components. Lastly, a study comparing a 2.5% TTO gel, a 0.2% chlorhexidine gel, and a placebo gel found that although the TTO group had significantly reduced gingival index and papillary bleeding index scores, their plaque scores were actually increased (139). Since hydrocarbons partition preferentially into biological membranes and disrupt their vital functions (138), TTO and its components were also presumed to behave in this manner. Employed largely for its antimicrobial properties, TTO is incorporated as the active ingredient in many topical formulations used to treat cutaneous infections. However, onychomycosis is considered to be largely unresponsive to topical treatment of any kind, and a high rate of cure should therefore not be expected. It is likely that the multicomponent nature of TTO may reduce the potential for resistance to occur spontaneously, since multiple simultaneous mutations may be required to overcome all of the antimicrobial actions of each of the components. The effectiveness of TTO in treating tinea pedis has been evaluated in two trials. In addition, by applying TTO at different stages in the virus replicative cycle, TTO was shown to have the greatest effect on free virus (prior to infection of cells), although when TTO was applied during the adsorption period, a slight reduction in plaque formation was also seen (132). Tea tree oil and peppermint appeared to be most useful for repelling lice. Antifungal ActivityComprehensive investigations of the susceptibility of fungi to TTO have only recently been completed. This proposed mechanism is further supported by work showing that the terpene eugenol inhibits mitochondrial respiration and energy production (46). The earliest reported use of the M. alternifolia plant that presumably exploited this property was the traditional use by the Bundjalung Aborigines of northern New South Wales. The native habitat of M. alternifolia is low-lying, swampy, subtropical, coastal ground around the Clarence and Richmond Rivers in northeastern New South Wales and southern Queensland (142), and, unlike several other Melaleuca species, it does not occur naturally outside Australia. However, the term has been adopted by the Australian Therapeutic Goods Administration as the official name for TTO. Evaluation of the antimicrobial activity of TTO has been impeded by its physical properties; TTO and its components are only sparingly soluble in water (Table 2), and this limits their miscibility in test media. In addition, tea tree leaves were soaked to make an infusion to treat sore throats or skin ailments (101, 135). A modest loss of 280-nm-light-absorbing material has also been reported (50). This observation contrasts sharply with historical claims that the activity of TTO may in fact be enhanced in the presence of organic matter such as blood and pus. There has also been one report suggesting that E. coli strains harboring mutations in the multiple antibiotic resistance (mar) operon, so-called Mar mutants, may exhibit decreased susceptibility to TTO (66). The 50% lethal dose for TTO in a rat model is 1.9 to 2.6 ml/kg (129), and rats dosed with ≤1.5 g/kg TTO appeared lethargic and ataxic (D. Kim, D. R. Cerven, S. Craig, and G. L. De George, Abstr. Caboi et al. Interestingly, the inhibition of germ tube formation was shown to be reversible, since cells were able to form germ tubes after the removal of the TTO (78). As a result, TTO was promoted as a therapeutic agent (5-7). [10] Indigenous Australians of eastern inland areas use "tea trees" as a traditional medicine by inhaling the oils from the crushed leaves to treat coughs and colds. All rights reserved. Follow-up swabs were taken at 2 and 14 days posttreatment, with the exception of 12 patients who were lost to follow-up. Hello there, just became aware of your weblog thru Google, and found that it's truly informative. The effectiveness of a 4% TTO nasal ointment and a 5% TTO body wash was compared to that of conventional treatment with mupirocin nasal ointment and Triclosan body wash in a small pilot study (28). This same essential oil solution has now been shown to aid in the healing of malodorous malignant ulcers (154). From the early 1990s onwards, many reports describing the antimicrobial activity of TTO appeared in the scientific literature.

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