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Khoury DM, Ghaoui N, El Tayar E, Dagher R, El Hawa M, Rubeiz N, Abbas O, Kurban M. Topical statins as antifungals: a review. Int J Dermatol 2024; 63:747-753. [PMID: 38344878 DOI: 10.1111/ijd.17068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/29/2023] [Accepted: 01/18/2024] [Indexed: 05/25/2024]
Abstract
Cutaneous fungal infections affect millions around the world. However, severe, multi-resistant fungal infections are increasingly being reported over the past years. As a result of the high rate of resistance which urged for drug repurposing, statins were studied and found to have multiple pleiotropic effects, especially when combined with other already-existing drugs. An example of this is the synergism found between several typical antifungals and statins, such as antifungals Imidazole and Triazole with a wide range of statins shown in this review. The main mechanisms in which they exert an antifungal effect are ergosterol inhibition, protein prenylation, mitochondrial disruption, and morphogenesis/mating inhibition. This article discusses multiple in vitro studies that have proven the antifungal effect of systemic statins against many fungal species, whether used alone or in combination with other typical antifungals. However, as a result of the high rate of drug-drug interactions and the well-known side effects of systemic statins, topical statins have become of increasing interest. Furthermore, patients with dyslipidemia treated with systemic statins who have a new topical fungal infection could benefit from the antifungal effect of their statin. However, it is still not indicated to initiate systemic statins in patients with topical mycotic infections if they do not have another indication for statin use, which raises the interest in using topical statins for fungal infections. This article also tackles the different formulations that have been studied to enhance topical statins' efficacy, as well as the effect of different topical statins on distinct dermatologic fungal diseases.
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Affiliation(s)
- Dana M Khoury
- Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Nohra Ghaoui
- Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon
| | | | - Ruby Dagher
- American University of Beirut, Beirut, Lebanon
| | - Mariana El Hawa
- Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Nelly Rubeiz
- Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ossama Abbas
- Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Mazen Kurban
- Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon
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Ostroumova OS, Efimova SS. Lipid-Centric Approaches in Combating Infectious Diseases: Antibacterials, Antifungals and Antivirals with Lipid-Associated Mechanisms of Action. Antibiotics (Basel) 2023; 12:1716. [PMID: 38136750 PMCID: PMC10741038 DOI: 10.3390/antibiotics12121716] [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: 10/31/2023] [Revised: 12/05/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
One of the global challenges of the 21st century is the increase in mortality from infectious diseases against the backdrop of the spread of antibiotic-resistant pathogenic microorganisms. In this regard, it is worth targeting antibacterials towards the membranes of pathogens that are quite conservative and not amenable to elimination. This review is an attempt to critically analyze the possibilities of targeting antimicrobial agents towards enzymes involved in pathogen lipid biosynthesis or towards bacterial, fungal, and viral lipid membranes, to increase the permeability via pore formation and to modulate the membranes' properties in a manner that makes them incompatible with the pathogen's life cycle. This review discusses the advantages and disadvantages of each approach in the search for highly effective but nontoxic antimicrobial agents. Examples of compounds with a proven molecular mechanism of action are presented, and the types of the most promising pharmacophores for further research and the improvement of the characteristics of antibiotics are discussed. The strategies that pathogens use for survival in terms of modulating the lipid composition and physical properties of the membrane, achieving a balance between resistance to antibiotics and the ability to facilitate all necessary transport and signaling processes, are also considered.
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Affiliation(s)
- Olga S. Ostroumova
- Laboratory of Membrane and Ion Channel Modeling, Institute of Cytology, Russian Academy of Sciences, Tikhoretsky Ave. 4, St. Petersburg 194064, Russia;
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Garcia LGS, Rocha MGD, Freire RS, Nunes PIG, Nunes JVS, Fernandes MR, Pereira-Neto WA, Sidrim JJC, Santos FA, Rocha MFG, Rodrigues LKA, Vieira RS, Brilhante RSN. Chitosan microparticles loaded with essential oils inhibit duo-biofilms of Candida albicans and Streptococcus mutans. J Appl Oral Sci 2023; 31:e20230146. [PMID: 37729259 PMCID: PMC10519671 DOI: 10.1590/1678-7757-2023-0146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 08/07/2023] [Accepted: 08/07/2023] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVE Oral candidiasis is a common fungal infection that affects the oral mucosa, and happens when Candida albicans interacts with bacteria in the oral microbiota, such as Streptococcus mutans, causing severe early childhood caries. C. albicans and S. mutans mixed biofilms are challenging to treat with conventional antimicrobial therapies, thus, new anti-infective drugs are required. This study aimed to test a drug delivery system based on chitosan microparticles loaded with geranium and lemongrass essential oils to inhibit C. albicans and S. mutans mixed biofilms. METHODOLOGY Chitosan microparticles loaded with essential oils (CM-EOs) were obtained by spray-drying. Susceptibility of planktonic were performed according CLSI at 4 to 2,048 µg/mL. Mixed biofilms were incubated at 37ºC for 48 h and exposed to CM-EOs at 256 to 4,096 µg/mL. The antimicrobial effect was evaluated using the MTT assay, with biofilm architectural changes analyzed by scanning electron microscopy. RAW 264.7 cell was used to evaluate compound cytotoxicity. RESULTS CM-EOs had better planktonic activity against C. albicans than S. mutans. All samples reduced the metabolic activity of mixed C. albicans and S. mutans biofilms, with encapsulated oils showing better activity than raw chitosan or oils. The microparticles reduced the biofilm on the slides. The essential oils showed cytotoxic effects against RAW 264.7 cells, but encapsulation into chitosan microparticles decreased their toxicity. CONCLUSION This study demonstrates that chitosan loaded with essential oils may provide an alternative method for treating diseases caused by C. albicans and S. mutans mixed biofilm, such as dental caries.
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Affiliation(s)
| | | | | | - Paulo Iury Gomes Nunes
- Universidade Federal do Ceará, Faculdade de Medicina, Departamento de Fisiologia e Farmacologia, Laboratório de Produtos Naturais, Ceará, Brasil
| | | | - Mirele Rodrigues Fernandes
- Universidade Federal do Ceará, Faculdade de Medicina, Departamento de Patologia e Medicina Legal, Centro Especializado em Micologia Médica, Ceará, Brasil
| | - Waldemiro Aquino Pereira-Neto
- Universidade Federal do Ceará, Faculdade de Medicina, Departamento de Patologia e Medicina Legal, Centro Especializado em Micologia Médica, Ceará, Brasil
| | - José Júlio Costa Sidrim
- Universidade Federal do Ceará, Faculdade de Medicina, Departamento de Patologia e Medicina Legal, Centro Especializado em Micologia Médica, Ceará, Brasil
| | - Flavia Almeida Santos
- Universidade Federal do Ceará, Faculdade de Medicina, Departamento de Fisiologia e Farmacologia, Laboratório de Produtos Naturais, Ceará, Brasil
| | | | - Lidiany Karla Azevedo Rodrigues
- Universidade Federal do Ceará, Faculdade de Farmácia, Odontologia e Enfermagem, Departamento de Odontologia Restauradora, Ceará, Brasil
| | | | - Raimunda Sâmia Nogueira Brilhante
- Universidade Federal do Ceará, Faculdade de Medicina, Departamento de Patologia e Medicina Legal, Centro Especializado em Micologia Médica, Ceará, Brasil
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