Antifungal activity of propolis extract against yeasts isolated from vaginal exudates

3D-printed nanocomposite denture base resin: The effect of incorporating TiO2 nanoparticles on the growth of Candida albicans

PURPOSE

To develop a biocompatible denture base resin/TiO2 nanocomposite material with antifungal characteristics that is suitable for 3D-printing denture bases.

MATERIALS AND METHODS

TiO2 nanoparticles (NPs) with a 0.10, 0.25, 0.50, and 0.75 weight percent (wt.%) were incorporated into a commercially available 3D-printed resin material. The resulting nanocomposite material was analyzed using Lactate dehydrogenase (LDH) and AlamarBlue (AB) assays for biocompatibility testing with human gingival fibroblasts (HGF). The composite material was also tested for its antifungal efficacy against Candida albicans. Fourier transform infrared (FTIR) and Energy Dispersive X-ray Spectroscopy (EDX) mapping were conducted to assess the surface coating and the dispersion of the NPs.

RESULTS

LDH and AB assays confirmed the biocompatibility of the material showing cell proliferation at a rate of nearly 100% at day 10, with a cytotoxicity of less than 13% of the cells at day 10. The concentrations of 0.10, 0.25, and 0.50 wt.% caused a significant reduction (p < 0.05) in the number of candida cells attached to the surface of the specimens (p < 0.05), while 0.75 wt.% did not show any significant difference compared to the control (no TiO2 NPs) (p > 0.05). FTIR and EDX analysis confirmed the presence of TiO2 NPs within the nanocomposite material with a homogenous dispersion for 0.10 and 0.25 wt.% groups and an aggregation of the NPs within the material at higher concentrations.

CONCLUSION

The addition of TiO2 NPs into 3D-printed denture base resin proved to have an antifungal effect against Candida albicans. The resultant nanocomposite material was a biocompatible material with HGFs and was successfully used for 3D printing.

Efficacy of Propolis Gel on Mature Biofilm Formed by Neocosmospora keratoplastica Isolated from Onychomycosis

This article describes Neocosmospora keratoplastica as an etiological onychomycosis agent. Ex vivo studies were initially performed to demonstrate the ability of this species to grow and form a well-organized characteristic biofilm on sterilized healthy nails. Based on the history of excellent results, both for antifungal and antibiofilm, of propolis resin gum, we evaluated its activity using artificially formed biofilm. In vitro, the minimal biofilm eradication concentration of the propolis extract (PE) was 375 µg of total polyphenol content (TPC) per mL, while for the propolis gel (PG) it was 450 µg of TPC per mL. In biofilm exposed to the propolis products, a decrease in hyphae and conidia was evident, accompanied by a disorganization of the extracellular matrix. Additionally, this low concentration of PE was able to significantly reduce the number of colony-forming units and the metabolic activity. Furthermore, the treatment of a 15-year nail infection due to N. keratoplastica was carried out exclusively using a topical treatment with a gel containing propolis (30%) with a daily dosage. This treatment achieved complete remission of the onychomycosis in 12 months. It is important to point out that some inconveniences previously reported by other patients treated with propolis extract were eliminated, increasing adherence to treatment.

Promising effect of propolis and a by-product on planktonic cells and biofilm formation by the main agents of human fungal infections

Few antifungals available today are effective in treating biofilms. Thus, it is urgent to discover new compounds, such as natural products, that provide improvements to existing treatments or the development of new antifungal therapies. This study aimed to perform a comparative analysis between the green propolis extract (PE) and its by-product, a waste of propolis extract (WPE) through a screening with Candida sp., Fusarium sp. and Trichophyton sp. The antifungal property of PE and WPE was assessed by the minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) determination in planktonic cells. The influence of both extracts on the inhibition of biofilm formation in these fungi was also tested. The WPE MIC and MFC values (68.75 to 275.0 µg/mL) were three to twelve times lower than the values obtained for PE (214.06 to 1712.5 µg/mL). PE was more efficient than WPE in inhibiting the biofilm initial phase, especially in C. albicans. Meanwhile, WPE had dose-dependent behavior for the three fungi, being more effective on filamentous ones. Both PE and WPE showed excellent antifungal activity on planktonic cells and demonstrated great efficacy for inhibiting biofilm formation in the three fungi evaluated.

Relevant insights into onychomycosis' pathogenesis related to the effectiveness topical treatment

Onychomycosis (OM) is a fungal infection, responsible for about 50% of nail diseases. OM has been attributed to the ability of fungi to naturally organize themselves into biofilms on nail surfaces. However, little is known about the exact role of the biofilm in the etiopathogenesis of OM, as well as its influence in the permeation of a topical treatment. The objectives of this study were to review the literature for topical OM treatments in clinical trials, assess the efficiency of these treatments, and discuss factors that could affect the success of these treatments. First, a systematic search of articles published in the MEDLINE database (PubMed) between January 2010 and December 2019 was conducted, focusing on drugs under clinical trials for the topical treatment of OM. Of the publications selected, it was clear that none of them had considered the fungi organized in biofilm. Therefore, we reflected on some important variables involved in OM, such as the nail structure and the mechanism of fungal invasion. Some methods, such as histopathologic analysis and spectroscopy techniques, were found to be effective in the detection of nail biofilm, and could be used in future drug permeation studies. This review allowed us to conclude that novel antifungals for the topical treatment of OM must consider the drug to permeate through biofilm. Natural products, such as propolis, seem strong candidates in this respect.

Potential of propolis antifungal activity for clinical applications

The high incidence of skin diseases of microbial origin along with the widespread increase of microbial resistance demand for therapeutic alternatives. Research on natural compounds has been opening new perspectives for the development of new therapies with health positive impacts. Propolis, a resinous mixture produced by honeybees from plant exudates, is widely used as a natural medicine since ancient times, mainly due to its antimicrobial properties. More recently, antioxidant, anti-tumor, anti-inflammatory, hepatoprotective and immunomodulatory activities were also reported for this natural product, highlighting its high potential pharmacological interest. In the present work, an extensive review of the main fungi causing skin diseases as well as the effects of natural compounds, particularly propolis, against such disease-causing microorganisms was organized and compiled in concise handy tables. This information allows to conclude that propolis is a highly effective antimicrobial agent suggesting that it could be used as an alternative skin treatment against pathogenic microorganisms and also as a cosmeceutic component or as a source of bioactive ingredients.

An Overview of the Evidence and Mechanism of Drug-Herb Interactions Between Propolis and Pharmaceutical Drugs

With the growing interest in the medicinal use of propolis, numerous studies have reported significant interactions between propolis extract and pharmaceutical drugs which may result in great clinical benefits or risks. The present study aims to review the drug-herb interactions of the full-spectrum propolis extract and main pharmaceutical drugs from the pharmacodynamic and pharmacokinetic aspects and elucidate the underlying pharmacological mechanisms. A literature search was conducted between June 2021 and February 2022 in Google Scholar, PubMed, MEDLINE, and EMBASE databases to include English studies from years 2000 to 2022 that evaluated the interaction of full-spectrum propolis extract and standard pharmaceutical drugs/cytochromes P450s. Studies that looked into geopropolis, propolis fractions, and isolated compounds, or interaction of propolis with foods, bioactive molecules, or receptors other than standard pharmaceutical drugs were excluded. From a pharmacodynamic perspective, propolis extract exhibited positive or synergistic interaction with several chemotherapeutic drugs by enhancing antitumor activity, sensitizing the chemoresistance cell lines, and attenuating multi-organ toxicity. The molecular mechanisms were associated with upregulating the apoptotic signal and immunomodulatory activity and attenuating oxidative damage. Propolis extract also enhanced the anti-bacterial and antifungal activities of many antimicrobial drugs against sensitive and resistant organisms, with an effect against the gram-positive bacteria stronger than that of the gram-negative bacteria. The synergistic action was related to strengthened action on interfering cell wall integrity and protein synthesis. The strong antioxidant activity of propolis also strengthened the therapeutic effect of metformin in attenuating hyperglycemia and pancreatic damage, as well as mitigating oxidative stress in the liver, kidney, and testis. In addition, propolis showed a potential capacity to enhance short-term and long-term memory function together with donepezil and improve motor function with levodopa and parasite killing activity with praziquantel. Pharmacokinetic studies showed inhibitory activities of propolis extracts on several CYP450 enzymes in vitro and in vivo. However, the effects on those CYP450 were deemed insignificant in humans, which may be attributed to the low bioavailability of the contributing bioactive compounds when administered in the body. The enhanced bioactivities of propolis and main pharmaceutical drugs support using propolis in integrative medicine in anti-cancer, anti-microbial, antidiabetic, and neurological disorders, with a low risk of altered pharmacokinetic activities.

Antifungal and anti-biofilm activity of a new Spanish extract of propolis against Candida glabrata

Background

Resistance to traditional antifungal agents is a considerable health problem nowadays, aggravated by infectious processes related to biofilm formation, usually on implantable devices. Therefore, it is necessary to identify new antimicrobial molecules, such as natural products, to develop new therapeutic strategies to prevent and eradicate these infections. One promising product is propolis, a natural resin produced by honeybees with substances from various botanical sources, beeswax and salivary enzymes. The aim of this work was to study the effect of a new Spanish ethanolic extract of propolis (SEEP) on growth, cell surface hydrophobicity, adherence and biofilm formation of Candida glabrata, a yeast capable of achieving high levels of resistance to available anti-fungal agents.

Methods

The antifungal activity of SEEP was evaluated in the planktonic cells of 12 clinical isolates of C. glabrata. The minimum inhibitory concentration (MIC) of propolis was determined by quantifying visible growth inhibition by serial plate dilutions. The minimum fungicide concentration (MFC) was evaluated as the lowest concentration of propolis that produced a 95% decrease in cfu/mL, and is presented as MFC₅₀ and MFC₉₀, which corresponds to the minimum concentrations at which 50 and 90% of the C. glabrata isolates were inhibited, respectively. Influence on cell surface hydrophobicity (CSH) was determined by the method of microbial adhesion to hydrocarbons (MATH). The propolis effect on adhesion and biofilm formation was determined in microtiter plates by measurement of optical density (OD) and metabolic activity (XTT-assay) in the presence of sub-MIC concentrations of SEEP.

Results

SEEP had antifungal capacity against C. glabrata isolates, with a MIC₅₀ of 0.2% (v/v) and an MFC₅₀ of 0.4%, even in azole-resistant strains. SEEP did not have a clear effect on surface hydrophobicity and adhesion, but an inhibitory effect on biofilm formation was observed at subinhibitory concentrations (0.1 and 0.05%) with a significant decrease in biofilm metabolism.

Conclusions

The novel Spanish ethanolic extract of propolis shows antifungal activity against C. glabrata, and decreases biofilm formation. These results suggest its possible use in the control of fungal infections associated with biofilms.

Propolis ethanolic extract has double-face in vitro effect on the planktonic growth and biofilm formation of some commercial probiotics

This study investigated the in vitro effect of propolis ethanolic extract (PEE) on planktonic growth and biofilm forming abilities of five commercial probiotics (Enterol, Protexin, Normaflore, BioGaia and Linex). Broth microdilution method was used to investigate the susceptibility of the microbes of five commercial probiotics to PEE. Crystal violet assay was used for the quantitative assessment of biofilm formation and mature biofilm eradication tests. Effect of PEE on autoaggregation ability and swarming motility of Normaflore microbes was determined. Planktonic forms of probiotics showed varied susceptibilities with minimal inhibitory concentration values in the range of 100-800 µg/mL of PEE. However, low PEE concentrations significantly enhanced the planktonic growth of Linex and BioGaia microbes. Biofilm studies revealed that Enterol and Protexin were non-biofilm formers, while BioGaia, Linex and Normaflore showed weak biofilms, which were inhibited by 12.5, 25, and 800 µg/mL of PEE, respectively. PEE revealed double-face effect on the biofilms of Normaflore and Linex, which were enhanced at low concentrations of PEE and inhibited at higher concentrations. Interestingly, Normaflore biofilms were shifted from weak to strong biofilms at low PEE concentrations (12.5, 25, and 50 µg/mL). In conclusion, PEE has strain dependent controversial effects on the planktonic growth and biofilm forming ability of the tested probiotics, although high concentrations have inhibitory effect on all of them, low concentrations may have strain dependent prebiotic effect.

Preclinical approaches in vulvovaginal candidiasis treatment with mucoadhesive thermoresponsive systems containing propolis

Vulvovaginal candidiasis (VVC) is a common vaginitis that affects women, especially in childbearing age, caused by Candida albicans in almost 80% of cases. Considering the limited drug arsenal available and the increasing fungal resistance profile, the search for new therapeutic sources with low toxicity and easy administration should be supported. Propolis has been used as a traditional medicine for multiple diseases, considering its particular composition and pharmaceutical properties that permits its wide applicability; it has also emerged as a potential antifungal agent. Thus, this study performed an in vitro and in vivo investigation into the efficacy of a new mucoadhesive thermoresponsive platform for propolis delivery (MTS-PRPe) in a preclinical murine model of VVC treatment caused by C. albicans. The methodologies involved chemical analysis, an assessment of the rheological and mucoadhesive properties of propolis formulations, in vitro and in vivo antifungal evaluations, histological evaluations and electron microscopy of the vaginal mucosa. The results demonstrated the antifungal activity of propolis extract and MTS-PRP against the standard strain and a fluconazole-resistant clinical isolate of C. albicans, in both in vitro and in vivo assays. These results were similar and even better, depending on the propolis concentration, when compared to nystatin. Thus, the formulation containing propolis exhibited good performance against C. albicans in a vulvovaginal candidiasis experimental model, representing a promising opportunity for the treatment of this infection.

In Vitro Antifungal and Antivirulence Activities of Biologically Synthesized Ethanolic Extract of Propolis-Loaded PLGA Nanoparticles against Candida albicans

Propolis is a natural substance and consists of bioactive compounds, which gives it antioxidant and antimicrobial properties. However, the use of propolis is limited by the low solubility in aqueous solutions. Thus, nanoparticles may be likely to accomplish enhanced delivery of poorly water-soluble phytomedicine. The aim of the present study was to fabricate and evaluate the biological activity of ethanolic extract of propolis-loaded poly(lactic-co-glycolic acid) nanoparticles (EEP-NPs). The EEP-NPs were prepared using the oil-in-water (o/w) single-emulsion solvent evaporation technique. The physicochemical properties of EEP-NPs were characterized and tested on their cytotoxicity, antifungal activity, and impact on key virulence factors that contribute to pathogenesis of C. albicans. EEP-NPs were successfully synthesized and demonstrated higher antifungal activity than EEP in free form. Moreover, EEP-NPs exhibited less cytotoxicity on Vero cells and suppressed the virulence factors of C. albicans, including adhesion, hyphal germination, biofilm formation, and invasion. Importantly, EEP-NPs exhibited a statistical decrease in the expression of hyphal adhesion-related genes, ALS3 and HWP1, of C. albicans. The results of this study revealed that EEP-NPs mediates a potent anticandidal activity and key virulence factors by reducing the gene-encoding virulence-associated hyphal- adhesion proteins of C. albicans and, thereby, disrupting the morphologic presence and attenuating their virulence.

Propolis Extract for Onychomycosis Topical Treatment: From Bench to Clinic

Onychomycosis is a chronic fungal infection of nails, commonly caused by dermatophyte fungi, primarily species of Trichophyton. Because of the limited drug arsenal available to treat general fungal infections and the frequent failure of onychomycosis treatment, the search for new therapeutic sources is essential, and topical treatment with natural products for onychomycosis has been encouraged. Propolis, an adhesive resinous compound produced by honeybees (Apis mellifera), has shown multiple biological properties including significant antifungal and anti-biofilm activities in vitro. In spite of promising in vitro results, in vivo results have not been reported so far. This study assessed an ethanol propolis extract (PE) as a topical therapeutic option for onychomycosis, including its characterization in vitro and its applicability as a treatment for onychomycosis (from bench to clinic). The in vitro evaluation included analysis of the cytotoxicity and the antifungal activity against the planktonic cells and biofilm formed by Trichophyton spp. We also evaluated the capacity of PE to penetrate human nails. Patients with onychomycosis received topical PE treatments, with a 6-month follow-up period. The results of the in vitro assays showed that PE was non-toxic to the cell lines tested, and efficient against both the planktonic cells and the biofilm formed by Trichophyton spp. The results also showed that PE is able to penetrate the human nail. The results for PE applied topically to treat onychomycosis were promising, with complete mycological and clinical cure of onychomycosis in 56.25% of the patients. PE is an inexpensive commercially available option, easy to obtain and monitor. Our results indicated that PE is a promising natural compound for onychomycosis treatment, due to its ability to penetrate the nail without cytotoxicity, and its good antifungal performance against species such as Trichophyton spp. that are resistant to conventional antifungals, both in vitro and in patients.

Propolis: A natural biomaterial for dental and oral healthcare

The field of health has always emphasised on the use of natural products for curing diseases. There are varieties of natural products (such as silk, herbal tea, chitosan) used today in the biomedical application in treating a large array of systemic diseases. The natural product "Propolis" is a non-toxic resinous material having beneficial properties such as antimicrobial, anticancer, antifungal, antiviral and anti-inflammatory; hence gain the attention of researchers for its potential for bio-dental applications. The study aims to explore the properties and chemistry of propolis concerning biomedical and dental applications. In addition, status and scope of propolis for current and potential future in bio-dental applications have been discussed. This review gives an insight to the reader about the possible use of propolis in modern-day dentistry.

Role of a proprietary propolis-based product on the wait-and-see approach in acute otitis media and in preventing evolution to tracheitis, bronchitis, or rhinosinusitis from nonstreptococcal pharyngitis

Antipyretics and/or anti-inflammatory drugs along with a wait-and-see approach are the only treatments recommended in early acute otitis media (AOM) or viral pharyngitis. Propolis has been widely investigated for its antibacterial, antiviral, and anti-inflammatory properties and could perhaps be administered as an add-on therapy during watchful waiting in AOM or for better control of symptoms in nonstreptococcal pharyngitis. However, propolis has well-known problems of poor solubility and low oral bioavailability. We therefore analyzed a proprietary propolis-based product (Propolisina^®) developed to overcome these limitations, in a retrospective, open-label, controlled study of Streptococcus pyogenes-negative children with a diagnosis of AOM or pharyngitis. Our results show that the use of propolis supplement for 72 hours lessens the severity of AOM and viral pharyngitis, reduces the use of antipyretics and anti-inflammatory drugs, and decreases the rate of evolution to tracheitis, bronchitis, and rhinosinusitis. Our study shows that propolis could be used as a safe add-on therapy in case of AOM and/or viral pharyngitis.

Antifungal activity and influence of propolis against germ tube formation as a critical virulence attribute by clinical isolates of Candida albicans

OBJECTIVE

The potentiality to switch between yeast and hyphal morphologies plays an important role in the virulence of Candida albicans (C. albicans). The objective of the present study was to evaluate the chemical composition, antifungal activity and influence of propolis upon germ tube formation of C. albicans clinical isolates.

METHODS

The major compounds of propolis ethanolic extract (PEE) was revealed by gas chromatography-mass spectrometry (GC/MS) analysis. Broth microdilution method was used for determination of minimal inhibitory concentration (MIC) and minimal fungicidal concentration (MFC) of this extract. C. albicans isolates were exposed to sub-MIC concentrations of propolis and germ tube reduction percent (GRP) and morphological transition from yeast to filamentous form were monitored microscopically.

RESULTS

Phenolic compounds, aromatic acids, aliphatic acids, sugars and polycyclic aromatic hydrocarbons were the major compound classes in PEE. Mean of MIC and MFC values of PEE against C. albicans isolates were 360.6μg·mL^-1 and 1250.1μg·mL^-1, respectively. The increase in concentration led to a significant reduction in germ tube formation, so mean of GRP was 36.7±11.1 and 22±10.1 at concentration of ½ MIC and ¼ MIC of PEE, respectively.

CONCLUSIONS

In conclusion, the present study indicated that PEE has interesting potential as a therapeutic agent that targets germ tube formation by C. albicans as a critical virulence factor.

Bioactive properties and functional constituents of Hypericum androsaemum L.: A focus on the phenolic profile

Hypericum androsaemum L. ethanol:water extract acted as a lipid peroxidation inhibitor and free radical scavenger. A marked inhibition of the growth of breast, lung, cervical and hepatocellular human carcinoma cell lines was also observed, whereas no toxicity was shown against non-tumor porcine liver cells (>400μg/mL). The extract was also effective in inhibiting nitric oxide production, as an indicator of the anti-inflammatory potential. The anti-Candida effects varied among different strains of the same species, C. glabrata and C. tropicalis being the most sensible species with an effect directly related with the extract concentrations tested. A significant anti-biofilm formation potential was also observed, namely for C. glabrata and C. tropicalis (biofilm reduction >90%). 5-O-Caffeoylquinic and 3-O-caffeoylquinic acids were the most abundant phenolic compounds identified in the extract, and might be related with the observed bioactive effects. Nevertheless, future studies should be carried out to obtain dose-response curves of the isolated active compounds, in order to perform further pre-clinically testing to quantify the presence of the most active compounds in the extract.

Propolis: a potential natural product to fight Candida species infections

AIM

To evaluate the effect of propolis against Candida species planktonic cells and its counterpart's biofilms.

MATERIALS & METHODS

The MIC values, time-kill curves and filamentation form inhibition were determined in Candida planktonic cells. The effect of propolis on Candida biofilms was assessed through quantification of CFUs.

RESULTS

MIC values, ranging from 220 to 880 µg/ml, demonstrated higher efficiency on C. albicans and C. parapsilosis than on C. tropicalis cells. In addition, propolis was able to prevent Candida species biofilm's formation and eradicate their mature biofilms, coupled with a significant reduction on C. tropicalis and C. albicans filamentation.

CONCLUSION

Propolis is an inhibitor of Candida virulence factors and represents an innovative alternative to fight candidiasis.

Cellular Structural Changes in Candida albicans Caused by the Hydroalcoholic Extract from Sapindus saponaria L

Vulvovaginal candidiasis (VVC) is a disease caused by the abnormal growth of yeast-like fungi in the mucosa of the female genital tract. Candida albicans is the principal etiological agent involved in VVC, but reports have shown an increase in the prevalence of Candida non-C. albicans (CNCA) cases, which complicates VVC treatment because CNCA does not respond well to antifungal therapy. Our group has reported the in vitro antifungal activity of extracts from Sapindus saponaria L. The present study used scanning electron microscopy and transmission electron microscopy to further evaluate the antifungal activity of hydroalcoholic extract from S. saponaria (HE) against yeast obtained from VVC and structural changes induced by HE. We observed the antifungal activity of HE against 125 vaginal yeasts that belonged to four different species of the Candida genus and S. cerevisae. The results suggest that saponins that are present in HE act on the cell wall or membrane of yeast at the first moments after contact, causing damage to these structures and cell lysis.

Effect of highly active antiretroviral therapy on vaginal Candida spp. isolation in HIV-infected compared to HIV-uninfected women

Vulvovaginal candidiasis (VVC) in HIV-infected women contributed to the impairment of their quality of life. The aim of this study was to evaluate the effect of highly active antiretroviral therapy (HAART) use on the vaginal Candida spp. isolation in HIV-infected compared to HIV-uninfected women. This cross-sectional study included 178 HIV-infected (HIV group) and 200 HIV-uninfected women (control) that were studied at the Specialized Assistance Service (SAE) for sexually transmitted diseases (STD)/AIDS of the city of Maringá, Brazil, from April 1 to October 30, 2011. The yeasts were isolated and identified by phenotypic and molecular methods. The in vitro antifungal susceptibility to fluconazole, itraconazole, nystatin and amphotericin B was tested by the reference microdilution method. Higher frequencies of total vaginal Candida spp. isolation were found in the HIV-infected group than in the control group. However, both groups showed a similar frequency of colonization and VVC. Although C. albicans was the most frequent and sensitive to azolics and polyenes in both HIV-infected and uninfected women, the emerging resistance of C. glabrata to amphotericin B in the HIV-infected women was observed. Although higher frequency of vaginal Candida spp. isolation had been observed in the HIV-infected than in HIV-uninfected women, colonization and VVC showed similar frequency in both groups, indicating that HAART appears to protect against vaginal colonization and VVC.

Propolis Is an Efficient Fungicide and Inhibitor of Biofilm Production by Vaginal Candida albicans

Vulvovaginal candidiasis (VVC) is one of the most common genital infections in women. The therapeutic arsenal remains restricted, and some alternatives to VVC treatment are being studied. The present study evaluated the influence of a propolis extractive solution (PES) on biofilm production by Candida albicans isolated from patients with VVC. Susceptibility testing was used to verify the minimum inhibitory concentration (MIC) of PES, with fluconazole and nystatin as controls. The biofilm formation of 29 vaginal isolates of C. albicans and a reference strain that were exposed to PES was evaluated using crystal violet staining. Colony-forming units were evaluated, proteins and carbohydrates of the matrix biofilm were quantified, and scanning electron microscopy was performed. The MIC of PES ranged from 68.35 to 546.87 μg/mL of total phenol content in gallic acid. A concentration of 546.87 μg/mL was able to cause the death of 75.8% of the isolates. PES inhibited biofilm formation by C. albicans from VVC. Besides antifungal activity, PES appears to present important antibiofilm activity on abiotic surfaces, indicating that it may have an additional beneficial effect in the treatment of VVC.

In vitro susceptibility profile of 200 recent clinical isolates of Candida spp. to topical antifungal treatments of vulvovaginal candidiasis, the imidazoles and nystatin agents

OBJECTIVE

Topical antifungal treatment of vulvovaginal candidiasis is widely recommended. The most commonly recommended topical antifungals (the imidazoles clotrimazole, miconazole and econazole and the polyene nystatin) have been on the market for more than 30 years. There are only a few recent data available on the susceptibility of different Candida species to these antifungals, especially of non-albicans Candida species which appear to be less responsive to treatment with imidazoles. The study aimed to determine the in vitro susceptibility profile of a large number of recent clinical isolates of Candida spp. to the most commonly recommended topical antifungals.

MATERIALS AND METHODS

An antifungal susceptibility test was performed according to the CLSI M27-A3 broth microdilution method, and minimal inhibitory concentrations were determined for econazole, miconazole, clotrimazole and nystatin.

RESULTS

The clinical isolates comprised of: 113 Candida albicans, 54 Candida glabrata, 11 Candida krusei, 11 Candida tropicalis and 11 Candida parapsilosis. The three azoles agents exhibited MIC90 values of 0.06 mg/L against C. albicans isolates, while nystatin exhibited a MIC90 of 4 mg/L. For non-albicans Candida isolates, MIC90 values ranged from 0.5 to 8 mg/L, from 1 to 4 mg/L and from 0.12 to 4 mg/L, for econazole, miconazole, clotrimazole, respectively. Nystatin MIC90 remained at 4 mg/L for all non-albicans Candida species tested.

CONCLUSION

These results confirmed the susceptibility of C. albicans to the most frequently used topical agents and may support the use of alternative agents to imidazoles, such as nystatin, to treat vulvovaginal candidiasis caused by non-albicans Candida species.

Early state research on antifungal natural products

Nosocomial infections caused by fungi have increased greatly in recent years, mainly due to the rising number of immunocompromised patients. However, the available antifungal therapeutic arsenal is limited, and the development of new drugs has been slow. Therefore, the search for alternative drugs with low resistance rates and fewer side effects remains a major challenge. Plants produce a variety of medicinal components that can inhibit pathogen growth. Studies of plant species have been conducted to evaluate the characteristics of natural drug products, including their sustainability, affordability, and antimicrobial activity. A considerable number of studies of medicinal plants and alternative compounds, such as secondary metabolites, phenolic compounds, essential oils and extracts, have been performed. Thus, this review discusses the history of the antifungal arsenal, surveys natural products with potential antifungal activity, discusses strategies to develop derivatives of natural products, and presents perspectives on the development of novel antifungal drug candidates.

Prevalence of Candida albicans and non-albicans isolates from vaginal secretions: comparative evaluation of colonization, vaginal candidiasis and recurrent vaginal candidiasis in diabetic and non-diabetic women

CONTEXT AND OBJECTIVE

Vulvovaginal candidiasis (VVC) is caused by abnormal growth of yeast-like fungi on the female genital tract mucosa. Patients with diabetes mellitus (DM) are more susceptible to fungal infections, including those caused by species of Candida. The present study investigated the frequency of total isolation of vaginal Candida spp., and its different clinical profiles - colonization, VVC and recurrent VVC (RVVC) - in women with DM type 2, compared with non-diabetic women. The cure rate using fluconazole treatment was also evaluated.

DESIGN AND SETTING

Cross-sectional study conducted in the public healthcare system of Maringá, Paraná, Brazil.

METHODS

The study involved 717 women aged 17-74 years, of whom 48 (6.7%) had DM type 2 (mean age: 53.7 years), regardless of signs and symptoms of VVC. The yeasts were isolated and identified using classical phenotypic methods.

RESULTS

In the non-diabetic group (controls), total vaginal yeast isolation occurred in 79 (11.8%) women, and in the diabetic group in 9 (18.8%) (P = 0.000). The diabetic group showed more symptomatic (VVC + RVVC = 66.66%) than colonized (33.33%) women, and showed significantly more colonization, VVC and RVVC than seen among the controls. The mean cure rate using fluconazole was 75.0% in the diabetic group and 86.7% in the control group (P = 0.51).

CONCLUSION

We found that DM type 2 in Brazilian women was associated with yeast colonization, VVC and RVVC, and similar isolation rates for C. albicans and non-albicans species. Good cure rates were obtained using fluconazole in both groups.

Identification of the cell targets important for propolis-induced cell death in Candida albicans

Candida albicans is the most common fungal pathogen of humans, forming both commensal and opportunistic pathogenic interactions, causing a variety of skin and soft tissue infections in healthy people. In immunocompromised patients C. albicans can result in invasive, systemic infections that are associated with a high incidence of mortality. Propolis is a complex mixture of several resinous substances which are collected from plants by bees. Here, we demonstrated the fungicidal activity of propolis against all three morphogenetic types of C. albicans and that propolis-induced cell death was mediated via metacaspase and Ras signaling. To identify genes that were involved in propolis tolerance, we screened ~800 C. albicans homozygous deletion mutants for decreased tolerance to propolis. Fifty-one mutant strains were identified as being hypersensitive to propolis including seventeen genes involved in cell adhesion, biofilm formation, filamentous growth, phenotypic switching and pathogenesis (HST7, GIN4, VPS34, HOG1, ISW2, SUV3, MDS3, HDA2, KAR3, YHB1, NUP85, CDC10, MNN9, ACE2, FKH2, and SNF5). We validated these results by showing that propolis inhibited the transition from yeast-like to hyphal growth. Propolis was shown to contain compounds that conferred fluorescent properties to C. albicans cells. Moreover, we have shown that a topical pharmaceutical preparation, based upon propolis, was able to control C. albicans infections in a mouse model for vulvovaginal candidiasis. Our results strongly indicate that propolis could be used as a strategy for controlling candidiasis.

Microparticles containing propolis and metronidazole: in vitro characterization, release study and antimicrobial activity against periodontal pathogens

Ethylcellulose microparticles containing metronidazole and propolis extractive solution were prepared and evaluated in vitro against periodontal pathogens. Scanning electron microscopy, particle size analysis, drug entrapment efficiency and drug release of microparticles were determined. The antimicrobial activity of microparticles was evaluated against microorganisms of periodontal importance (Enterococcus faecalis, Streptococcus pyogenes, Streptococcus mutans, Staphylococcus aureus, Klebsiella pneumoniae and Escherichia coli). It was obtained particles with regular morphology, mean diameter of 1.23 µm, and entrapment efficiency for propolis and metronidazole were 91.41% and 22.23%, respectively. In vitro release studies of propolis and metronidazole from microparticles showed prolonged drug release and controlled by Fickian diffusion. Both propolis and metronidazole displayed activity against the tested strains. Moreover, the results showed that the strains of E. faecalis, S. pyogenes and S. mutans were more susceptible to the propolis and E. faecalis to the metronidazole. It was also observed that the amount of metronidazole to inhibit the microorganism strains in the physical mixture with propolis was smaller than in the metronidazole alone, suggesting potentiation effect between propolis and metronidazole. These microparticles would be useful for developing intermediary or eventual dosage form to be administered into the periodontal pocket more easily and safely.

Transcriptional profiling of Saccharomyces cerevisiae exposed to propolis

BACKGROUND

Propolis is a natural product of plant resins collected by honeybees (Apis mellifera) from various plant sources. Our previous studies indicated that propolis sensitivity is dependent on the mitochondrial function and that vacuolar acidification and autophagy are important for yeast cell death caused by propolis. Here, we extended our understanding of propolis-mediated cell death in the yeast Saccharomyces cerevisiae by applying systems biology tools to analyze the transcriptional profiling of cells exposed to propolis.

METHODS

We have used transcriptional profiling of S. cerevisiae exposed to propolis. We validated our findings by using real-time PCR of selected genes. Systems biology tools (physical protein-protein interaction [PPPI] network) were applied to analyse the propolis-induced transcriptional bevavior, aiming to identify which pathways are modulated by propolis in S. cerevisiae and potentially influencing cell death.

RESULTS

We were able to observe 1,339 genes modulated in at least one time point when compared to the reference time (propolis untreated samples) (t-test, p-value 0.01). Enrichment analysis performed by Gene Ontology (GO) Term finder tool showed enrichment for several biological categories among the genes up-regulated in the microarray hybridization such as transport and transmembrane transport and response to stress. Real-time RT-PCR analysis of selected genes showed by our microarray hybridization approach was capable of providing information about S. cerevisiae gene expression modulation with a considerably high level of confidence. Finally, a physical protein-protein (PPPI) network design and global topological analysis stressed the importance of these pathways in response of S. cerevisiae to propolis and were correlated with the transcriptional data obtained thorough the microarray analysis.

CONCLUSIONS

In summary, our data indicate that propolis is largely affecting several pathways in the eukaryotic cell. However, the most prominent pathways are related to oxidative stress, mitochondrial electron transport chain, vacuolar acidification, regulation of macroautophagy associated with protein target to vacuole, cellular response to starvation, and negative regulation of transcription from RNA polymerase II promoter. Our work emphasizes again the importance of S. cerevisiae as a model system to understand at molecular level the mechanism whereby propolis causes cell death in this organism at the concentration herein tested. Our study is the first one that investigates systematically by using functional genomics how propolis influences and modulates the mRNA abundance of an organism and may stimulate further work on the propolis-mediated cell death mechanisms in fungi.

[Propolis: origin, composition and properties]

La propolis est une substance résineuse récoltée par les abeilles (Apis mellifera) dont la composition biochimique dépend de l’origine botanique. Cette revue dresse une liste non exhaustive des différentes propolis étudiées sur les différents continents avec leurs principaux composés. Les divers effets biologiques et/ou thérapeutiques attribués à la propolis et/ou à ses principaux constituants sont passés en revue. Enfin, bien que prometteur, un travail pour établir des critères de qualité reste indispensable.

In vivo activity of Sapindus saponaria against azole-susceptible and -resistant human vaginal Candida species

Background

Study of in vivo antifungal activity of the hydroalcoholic extract (HE) and n-BuOH extract (BUTE) of Sapindus saponaria against azole-susceptible and -resistant human vaginal Candida spp.

Methods

The in vitro antifungal activity of HE, BUTE, fluconazole (FLU), and itraconazole (ITRA) was determined by the broth microdilution method. We obtained values of minimal inhibitory concentration (MIC) and minimum fungicide concentration (MFC) for 46 strains of C. albicans and 10 of C. glabrata isolated from patients with vulvovaginal candidiasis (VVC). VVC was induced in hyperestrogenic Wistar rats with azole-susceptible C. albicans (SCA), azole-resistant C. albicans (RCA), and azole-resistant C. glabrata (RCG). The rats were treated intravaginally with 0.1 mL of HE or BUTE at concentrations of 1%, 2.5% and 5%; 100 μg/mL of FLU (treatment positive control); or distilled water (negative control) at 1, 24, and 48 h after induction of the infection, and the progress of VVC was monitored by culturing and scanning electron microscopy (SEM). The toxicity was evaluated in cervical cells of the HeLa cell line.

Results

The extracts showed in vitro inhibitory and fungicidal activity against all the isolates, and the MIC and MFC values for the C. glabrata isolates were slightly higher. In vivo, the SCA, RCA, and RCG infections were eliminated by 21 days post-infection, with up to 5% HE and BUTE, comparable to the activity of FLU. No cytotoxic action was observed for either extract.

Conclusions

Our results demonstrated that HE and BUTE from S. saponaria show inhibitory and fungicidal activity in vitro, in addition to in vivo activity against azole-resistant vaginal isolates of C. glabrata and azole-susceptible and resistant isolates of C. albicans. Also considering the lack of cytotoxicity and the low concentrations of the extracts necessary to eliminate the infection in vivo, HE and BUTE show promise for continued studies with purified antifungal substances in VVC yeast isolates.

In vitro antifungal activity of propolis samples of Czech and Slovak origin

Propolis has been used in traditional folk medicine for ages owing to a number of biological effects. Four propolis samples of Czech and one of Slovak origin were extracted using Soxhlet apparatus and analysed by thin-layer chromatography. Raw propolis samples and their extracts were tested by microdilution broth method to determine minimal inhibitory concentration (MIC) in eight strains of human pathogenic fungi. Raw propolis samples showed a lower in vitro antifungal activity than their extracts. In general, the petroleum ether extracts exhibited the highest in vitro antifungal activity (MIC range of 16–64 µg/ml). The content of flavonoids in the samples varied according to region. The highest amount of flavonoids was found in sample A that originated from Broumov (4%). The most susceptible to the propolis extracts were Trichophyton mentagrophytes and Candida albicans. The propolis samples of Czech and Slovak origin and their extracts showed a considerable in vitro antifungal effect which was associated especially with nonpolar petroleum ether and toluene extracts. There was only a partial correlation between flavonoids content and in vitro antifungal activity.

Molecular characterization of propolis-induced cell death in Saccharomyces cerevisiae

Propolis, a natural product of plant resins, is used by the bees to seal holes in their honeycombs and protect the hive entrance. However, propolis has also been used in folk medicine for centuries. Here, we apply the power of Saccharomyces cerevisiae as a model organism for studies of genetics, cell biology, and genomics to determine how propolis affects fungi at the cellular level. Propolis is able to induce an apoptosis cell death response. However, increased exposure to propolis provides a corresponding increase in the necrosis response. We showed that cytochrome c but not endonuclease G (Nuc1p) is involved in propolis-mediated cell death in S. cerevisiae. We also observed that the metacaspase YCA1 gene is important for propolis-mediated cell death. To elucidate the gene functions that may be required for propolis sensitivity in eukaryotes, the full collection of about 4,800 haploid S. cerevisiae deletion strains was screened for propolis sensitivity. We were able to identify 138 deletion strains that have different degrees of propolis sensitivity compared to the corresponding wild-type strains. Systems biology revealed enrichment for genes involved in the mitochondrial electron transport chain, vacuolar acidification, negative regulation of transcription from RNA polymerase II promoter, regulation of macroautophagy associated with protein targeting to vacuoles, and cellular response to starvation. Validation studies indicated that propolis sensitivity is dependent on the mitochondrial function and that vacuolar acidification and autophagy are important for yeast cell death caused by propolis.