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Retore YI, Lucini F, Rial RC, Cardoso CAL, Souza PFN, Simionatto S, Rossato L. Antifungal activity of Caryocar brasiliense camb. Alone or along with antifungal agents against multidrug-resistant Candida auris. JOURNAL OF ETHNOPHARMACOLOGY 2024; 330:118240. [PMID: 38677574 DOI: 10.1016/j.jep.2024.118240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 04/16/2024] [Accepted: 04/21/2024] [Indexed: 04/29/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Candida auris poses a severe global health threat, with many strains resistant to antifungal treatments, complicating therapy. Exploring natural compounds alongside conventional drugs offers promising therapeutic avenues. The antifungal potential of the ethanolic extract from Caryocar brasiliense (Cb-EE), a plant native to the Brazilian cerrado and renowned for its medicinal properties, was investigated against C. auris. AIM OF THE STUDY The study examined the chemical composition, antifungal activity, mechanisms of action, and in vivo effects of Cb-EE. MATERIALS AND METHODS Leaves of C. brasiliense were processed to extract ethanolic extract, which was evaluated for phenolic compounds, flavonoids, and tannins. The antifungal capacity was determined through broth microdilution and checkerboard methods, assessing interaction with conventional antifungals. RESULTS Cb-EE demonstrated fungistatic activity against various Candida species and Cryptococcus neoformans. Synergy with fluconazole and additive effects with other drugs were observed. Cb-EE inhibited C. auris growth, with the combination of fluconazole extending inhibition. Mechanistic studies revealed interference with fungal membranes, confirmed by sorbitol protection assays, cellular permeability tests, and scanning electron microscopy (SEM). Hemocompatibility and in vivo toxicity tests on Tenebrio molitor showed safety. CONCLUSION Cb-EE, alone or in combination with fluconazole, effectively treated C. auris infections in vitro and in vivo, suggesting its prospective role as an antifungal agent against this emerging pathogen.
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Affiliation(s)
- Yasmim Isabel Retore
- Health Sciences Research Laboratory, Federal University of Grande Dourados, Dourados, Mato Grosso do Sul, Brazil
| | - Fabíola Lucini
- Health Sciences Research Laboratory, Federal University of Grande Dourados, Dourados, Mato Grosso do Sul, Brazil
| | - Rafael Cardoso Rial
- Federal Institut of Mato Grosso Do Sul - IFMS, Nova Andradina, Mato Grosso do Sul, Brazil
| | - Claudia Andrea Lima Cardoso
- Center of Studies in Natural Resources, State University of Mato Grosso Do Sul, Dourados, Mato Grosso do Sul, Brazil
| | | | - Simone Simionatto
- Health Sciences Research Laboratory, Federal University of Grande Dourados, Dourados, Mato Grosso do Sul, Brazil
| | - Luana Rossato
- Health Sciences Research Laboratory, Federal University of Grande Dourados, Dourados, Mato Grosso do Sul, Brazil.
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Ganeshkumar A, Muthuselvam M, de Lima PMN, Rajaram R, Junqueira JC. Current Perspectives of Antifungal Therapy: A Special Focus on Candida auris. J Fungi (Basel) 2024; 10:408. [PMID: 38921394 PMCID: PMC11205254 DOI: 10.3390/jof10060408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 05/29/2024] [Accepted: 06/03/2024] [Indexed: 06/27/2024] Open
Abstract
Candida auris is an emerging Candida sp. that has rapidly spread all over the world. The evidence regarding its origin and emerging resistance is still unclear. The severe infection caused by this species results in significant mortality and morbidity among the elderly and immunocompromised individuals. The development of drug resistance is the major factor associated with the therapeutic failure of existing antifungal agents. Previous studies have addressed the antifungal resistance profile and drug discovery for C. auris. However, complete coverage of this information in a single investigation is not yet available. In this review, we have mainly focused on recent developments in therapeutic strategies against C. auris. Based on the available information, several different approaches were discussed, including existing antifungal drugs, chemical compounds, essential oils, natural products, antifungal peptides, immunotherapy, antimicrobial photodynamic therapy, drug repurposing, and drug delivery systems. Among them, synthetic chemicals, natural products, and antifungal peptides are the prime contributors. However, a limited number of resources are available to prove the efficiency of these potential therapies in clinical usage. Therefore, we anticipate that the findings gathered in this review will encourage further in vivo studies and clinical trials.
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Affiliation(s)
- Arumugam Ganeshkumar
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos 12245-000, SP, Brazil;
- Department of Materials Physics, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences (SIMTS), Chennai 602105, Tamil Nadu, India
| | - Manickam Muthuselvam
- Department of Biotechnology, Bharathidasan University, Tiruchirappalli 620024, Tamil Nadu, India;
| | - Patricia Michelle Nagai de Lima
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos 12245-000, SP, Brazil;
| | - Rajendren Rajaram
- Department of Marine Science, Bharathidasan University, Tiruchirappalli 620024, Tamil Nadu, India;
| | - Juliana Campos Junqueira
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos 12245-000, SP, Brazil;
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Silva NBS, Menezes RP, Gonçalves DS, Santiago MB, Conejo NC, Souza SL, Santos ALO, da Silva RS, Ramos SB, Ferro EAV, Martins CHG. Exploring the antifungal, antibiofilm and antienzymatic potential of Rottlerin in an in vitro and in vivo approach. Sci Rep 2024; 14:11132. [PMID: 38750088 PMCID: PMC11096346 DOI: 10.1038/s41598-024-61179-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 05/02/2024] [Indexed: 05/18/2024] Open
Abstract
Candida species have been responsible for a high number of invasive infections worldwide. In this sense, Rottlerin has demonstrated a wide range of pharmacological activities. Therefore, this study aimed to evaluate the antifungal, antibiofilm and antivirulence activity of Rottlerin in vitro against Candida spp. and its toxicity and antifungal activity in vivo. Rottlerin showed antifungal activity against all yeasts evaluated, presenting Minimum Inhibitory and Fungicidal Concentration (MIC and MFC) values of 7.81 to > 1000 µg/mL. Futhermore, it was able to significantly inhibit biofilm production, presenting Biofilm Inhibitory Concentration (MICB50) values that ranged from 15.62 to 250 µg/mL and inhibition of the cell viability of the biofilm by 50% (IC50) from 2.24 to 12.76 µg/mL. There was a considerable reduction in all hydrolytic enzymes evaluated, with emphasis on hemolysin where Rottlerin showed a reduction of up to 20%. In the scanning electron microscopy (SEM) analysis, Rottlerin was able to completely inhibit filamentation by C. albicans. Regarding in vivo tests, Rottlerin did not demonstrate toxicity at the therapeutic concentrations demonstrated here and was able to increase the survival of C. elegans larvae infected. The results herein presented are innovative and pioneering in terms of Rottlerin's multipotentiality against these fungal infections.
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Affiliation(s)
- Nagela Bernadelli Sousa Silva
- Laboratory of Antimicrobial Testing, Institute of Biomedical Sciences (ICBIM), Federal University of Uberlândia (UFU), Av. Pará, 1720 - Umuarama, Uberlândia, 38405-320, Brazil
| | - Ralciane Paula Menezes
- Technical School of Health (ESTES), Federal University of Uberlândia (UFU), Uberlândia, Brazil
| | - Daniela Silva Gonçalves
- Laboratory of Antimicrobial Testing, Institute of Biomedical Sciences (ICBIM), Federal University of Uberlândia (UFU), Av. Pará, 1720 - Umuarama, Uberlândia, 38405-320, Brazil
| | - Mariana Brentini Santiago
- Laboratory of Antimicrobial Testing, Institute of Biomedical Sciences (ICBIM), Federal University of Uberlândia (UFU), Av. Pará, 1720 - Umuarama, Uberlândia, 38405-320, Brazil
| | - Noemi Chagas Conejo
- Laboratory of Antimicrobial Testing, Institute of Biomedical Sciences (ICBIM), Federal University of Uberlândia (UFU), Av. Pará, 1720 - Umuarama, Uberlândia, 38405-320, Brazil
| | - Sara Lemes Souza
- Laboratory of Antimicrobial Testing, Institute of Biomedical Sciences (ICBIM), Federal University of Uberlândia (UFU), Av. Pará, 1720 - Umuarama, Uberlândia, 38405-320, Brazil
| | - Anna Lívia Oliveira Santos
- Laboratory of Antimicrobial Testing, Institute of Biomedical Sciences (ICBIM), Federal University of Uberlândia (UFU), Av. Pará, 1720 - Umuarama, Uberlândia, 38405-320, Brazil
| | - Robinson Sabino da Silva
- Innovation Center in Salivary Diagnostic and Nanotheranostics, Institute of Biomedical Sciences (ICBIM), Federal University of Uberlandia (UFU), Uberlândia, Brazil
| | - Salvador Boccaletti Ramos
- Department of Engineering and Exact Sciences, Faculty of Agricultural and Veterinary Sciences - Jaboticabal (FCAV), São Paulo State University (UNESP), Jaboticabal, Brazil
| | - Eloisa Amália Vieira Ferro
- Laboratory of Immunophysiology of Reproduction, Institute of Biomedical Sciences (ICBIM), Federal University of Uberlandia, Uberlândia, Brazil
| | - Carlos Henrique Gomes Martins
- Laboratory of Antimicrobial Testing, Institute of Biomedical Sciences (ICBIM), Federal University of Uberlândia (UFU), Av. Pará, 1720 - Umuarama, Uberlândia, 38405-320, Brazil.
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Elshaer M, Herrada J, Gamal A, McCormick TS, Ghannoum M. Efficacy of chlorhexidine in advanced performance technology formulation in decolonizing the skin using Candida auris skin colonization mouse model. Am J Infect Control 2023; 51:836-837. [PMID: 36417953 PMCID: PMC10199144 DOI: 10.1016/j.ajic.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 11/21/2022]
Abstract
The incidence of Candida auris, an emerging multidrug resistant fungal species, is increasing. The ability of this yeast to colonize the human skin could lead to infections. Identifying agents to reduce the skin fungal burden is critical. Chlorhexidine formulated in a new Advanced Performance Technology formulation (APT-CH) was significantly more effective than untreated controls. Additional studies are warranted.
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Affiliation(s)
- Mohammed Elshaer
- Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt; Department of Dermatology, Case Western Reserve University, Cleveland, OH
| | - Janet Herrada
- Department of Dermatology, Case Western Reserve University, Cleveland, OH
| | - Ahmed Gamal
- Department of Dermatology, Case Western Reserve University, Cleveland, OH
| | - Thomas S McCormick
- Department of Dermatology, Case Western Reserve University, Cleveland, OH
| | - Mahmoud Ghannoum
- Department of Dermatology, Case Western Reserve University, Cleveland, OH.
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Karine Marcomini E, Negri M. Fungal quorum-sensing molecules and antiseptics: a promising strategy for biofilm modulation? Drug Discov Today 2023:103624. [PMID: 37224996 DOI: 10.1016/j.drudis.2023.103624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/27/2023] [Accepted: 05/17/2023] [Indexed: 05/26/2023]
Abstract
New strategies to control fungal biofilms are essential, especially those that interfere in the biofilm organization process and cellular communication, known as quorum sensing. The effect of antiseptics and quorum-sensing molecules (QSMs) have been considered with regard to this; however, little has been elucidated, particularly because studies are often restricted to the action of antiseptics and QSMs against a few fungal genera. In this review, we discuss progress reported in the literature thus far and analyze, through in silico methods, 13 fungal QSMs with regard to their physicochemical, pharmacological, and toxicity properties, including their mutagenicity, tumorigenicity, hepatotoxicity, and nephrotoxicity. From these in silico analyses, we highlight 4-hydroxyphenylacetic acid and tryptophol as having satisfactory properties and, thus, propose that these should be investigated further as antifungal agents. We also recommend future in vitro approaches to determine the association of QSMs with commonly used antiseptics as potential antibiofilm agents.
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Combination of Cetylpyridinium Chloride and Chlorhexidine Acetate: A Promising Candidate for Rapid Killing of Gram-Positive/Gram-Negative Bacteria and Fungi. Curr Microbiol 2023; 80:97. [PMID: 36738393 PMCID: PMC9899061 DOI: 10.1007/s00284-023-03198-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 01/19/2023] [Indexed: 02/05/2023]
Abstract
Combined use of the present antimicrobial drugs has been proved to be an alternative approach for antimicrobial agents' development since the co-existed of the drugs working in different mechanism have been demonstrated potentially enhance their antimicrobial activity. In this work, antibacterial and antifungal activity of the cetylpyridinium chloride (CPC)/chlorhexidine acetate (CHA) combination was evaluated for the first time, while a universal concentration for the rapid killing of gram-positive/gram-negative bacteria and fungi was also proposed. The minimum inhibitory concentrations (MIC) of CPC and CHA used alone or in combination were first measured, showing that the combined treatment decreased the MIC against tested gram-positive/gram-negative bacteria and fungi to 1/8-1/2. Growth curve assays demonstrated CPC and CHA had dynamic combined effects against the tested microorganisms at the concentration equal to MIC. Besides, combined use of these two drugs could also enhance their biocidal activity, which was illustrated by fluorescence microscopy and SEM images, as well as soluble protein measurement. More importantly, in vitro acute eye and skin irritation tests showed short-term contact with CPC/CHA combination would not cause any damage to mammalian mucosa and skin. In a word, CPC/CHA combination exhibited broad-spectrum antibacterial and antifungal activity against tested gram-positive/gram-negative bacteria and fungi while without any acute irritation to mammalian mucosa and skin, providing a new perspective on the selection of personal disinfectants.
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Tu J, Liu N, Huang Y, Yang W, Sheng C. Small molecules for combating multidrug-resistant superbug Candida auris infections. Acta Pharm Sin B 2022; 12:4056-4074. [DOI: 10.1016/j.apsb.2022.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 07/09/2022] [Accepted: 07/25/2022] [Indexed: 01/12/2023] Open
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Augmenting Azoles with Drug Synergy to Expand the Antifungal Toolbox. Pharmaceuticals (Basel) 2022; 15:ph15040482. [PMID: 35455479 PMCID: PMC9027798 DOI: 10.3390/ph15040482] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 03/25/2022] [Accepted: 03/26/2022] [Indexed: 12/23/2022] Open
Abstract
Fungal infections impact the lives of at least 12 million people every year, killing over 1.5 million. Wide-spread use of fungicides and prophylactic antifungal therapy have driven resistance in many serious fungal pathogens, and there is an urgent need to expand the current antifungal arsenal. Recent research has focused on improving azoles, our most successful class of antifungals, by looking for synergistic interactions with secondary compounds. Synergists can co-operate with azoles by targeting steps in related pathways, or they may act on mechanisms related to resistance such as active efflux or on totally disparate pathways or processes. A variety of sources of potential synergists have been explored, including pre-existing antimicrobials, pharmaceuticals approved for other uses, bioactive natural compounds and phytochemicals, and novel synthetic compounds. Synergy can successfully widen the antifungal spectrum, decrease inhibitory dosages, reduce toxicity, and prevent the development of resistance. This review highlights the diversity of mechanisms that have been exploited for the purposes of azole synergy and demonstrates that synergy remains a promising approach for meeting the urgent need for novel antifungal strategies.
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