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Ehtezazi T, Kteich A, Abdulkarim R, Anderson V, Algellay M, McCloskey AP, Carter N, Roberts M, Assi S, Al-Jumeily D, Thompson M, Mohamed FA, Sarker SD. Reducing Temperature of Fused Deposition Modelling 3D Printing for Linalool Fast Dissolving Oral Films by Increasing Printer Nozzle Diameter. J Pharm Sci 2024; 113:2374-2382. [PMID: 38621439 DOI: 10.1016/j.xphs.2024.04.008] [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: 03/07/2024] [Revised: 04/10/2024] [Accepted: 04/10/2024] [Indexed: 04/17/2024]
Abstract
Oral thrush and throat infections can occur in a wide range of patients. Treatments are available; however, resistance to drugs is a major problem for treating oral and throat infections. Three-dimensional printing (3DP) of fast dissolving oral films (FDFs) of linalool oil may provide an alternative solution. Linalool oil FDFs were printed by fused deposition modelling across 1-18 % w/w linalool content range with nozzle diameters of 0.4 or 1 mm at the temperature range of 150 °C-185 °C. The FDFs were evaluated for physicochemical and mechanical properties. Increasing the printer nozzle diameter to 1 mm allowed reducing the printing temperature from 185 °C to 150 °C; consequently, more linalool was quantified in the films with improved content uniformity. The higher linalool content in the films increased the film disintegration time and mechanical strength. FDFs containing 10% w/w linalool showed clear antifungal activity against Candida albicans. Raman spectroscopy suggested linalool separation from excipients at higher temperature printing. Viscoelastic measurements indicated that to achieve printing; the elastic modulus of molten filament needed to be higher than the loss modulus at low angular frequencies. In conclusion, increasing the printing nozzle diameter may avoid loss of the active ingredient by reducing the temperature of the 3DP process.
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Affiliation(s)
- Touraj Ehtezazi
- Centre for Natural Product Discovery, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, United Kingdom; School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, United Kingdom.
| | - Asmaa Kteich
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, United Kingdom
| | - Rana Abdulkarim
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, United Kingdom
| | - Vicki Anderson
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, United Kingdom
| | - Marwan Algellay
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, United Kingdom
| | - Alice P McCloskey
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, United Kingdom
| | - Neve Carter
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, United Kingdom
| | - Matthew Roberts
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, United Kingdom
| | - Sulaf Assi
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, United Kingdom
| | - Dhiya Al-Jumeily
- School of Computer Science and Mathematics, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, United Kingdom
| | - Molly Thompson
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, United Kingdom
| | - Fazreelia Abu Mohamed
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, United Kingdom
| | - Satyajit D Sarker
- Centre for Natural Product Discovery, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, United Kingdom; School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, United Kingdom
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Ribeiro AB, Pizziolo PG, Clemente LM, Aguiar HC, Poker BDC, Silva AAME, Makrakis LR, Fifolato MA, Souza GC, Oliveira VDC, Watanabe E, Lovato da Silva CH. Strategies for Preventing and Treating Oral Mucosal Infections Associated with Removable Dentures: A Scoping Review. Antibiotics (Basel) 2024; 13:273. [PMID: 38534708 DOI: 10.3390/antibiotics13030273] [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: 01/30/2024] [Revised: 03/01/2024] [Accepted: 03/14/2024] [Indexed: 03/28/2024] Open
Abstract
Oral infections occur due to contact between biofilm rich in Candida albicans formed on the inner surface of complete dentures and the mucosa. This study investigated historical advances in the prevention and treatment of oral mucosal infection and identified gaps in the literature. Bibliographic research was conducted, looking at PubMed, Embase, Web of Science, and Scopus, where 935 articles were found. After removing duplicates and excluding articles by reading the title and abstract, 131 articles were selected for full reading and 104 articles were included. Another 38 articles were added from the gray literature. This review followed the PRISMA-ScR guidelines. The historical period described ranges from 1969 to 2023, in which, during the 21st century, in vitro and in vivo studies became more common and, from 2010 to 2023, the number of randomized controlled trials increased. Among the various approaches tested are the incorporation of antimicrobial products into prosthetic materials, the improvement of oral and denture hygiene protocols, the development of synthetic and natural products for the chemical control of microorganisms, and intervention with local or systemic antimicrobial agents. Studies report good results with brushing combined with sodium hypochlorite, and new disinfectant solutions and products incorporated into prosthetic materials are promising.
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Affiliation(s)
- Adriana Barbosa Ribeiro
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Pillar Gonçalves Pizziolo
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Lorena Mosconi Clemente
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Helena Cristina Aguiar
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Beatriz de Camargo Poker
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Arthur Augusto Martins E Silva
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Laís Ranieri Makrakis
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Marco Aurelio Fifolato
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Giulia Cristina Souza
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Viviane de Cássia Oliveira
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Evandro Watanabe
- Department of Restorative Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Cláudia Helena Lovato da Silva
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
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Bencze B, Temesfői V, Das S, Papp H, Kaltenecker P, Kuczmog A, Jakab F, Kocsis B, Kőszegi T. Development of a novel, entirely herbal-based mouthwash effective against common oral bacteria and SARS-CoV-2. BMC Complement Med Ther 2023; 23:138. [PMID: 37127611 PMCID: PMC10150350 DOI: 10.1186/s12906-023-03956-3] [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: 07/28/2022] [Accepted: 04/11/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Parallel to the growth of the oral healthcare market, there is a constantly increasing demand for natural products as well. Many customers prefer products that contain fewer toxic agents, therefore providing an environmentally friendly solution with the benefit of smaller risk to the user. Medieval and early modern medicinal knowledge might be useful when looking for natural, herbal-based components to develop modern products. Along with these considerations we created, tested, and compared an entirely natural mouthwash, named Herba Dei. METHODS The manufacturing procedure was standardized, and the created tincture was evaluated by GC/MS analysis for active compounds, experimentally tested in cell-based cytotoxicity, salivary protein integrity, cell-free antioxidant activity, anti-bacterial and anti-viral assays, and compared with three market-leading mouthwashes. RESULTS Our tincture did not show significant damage in the cytotoxicity assays to keratinocyte and Vero E6 cells and did not disrupt the low molecular weight salivary proteins. Its radical scavenging capacity surpassed that of two tested, partly natural, and synthetic mouthwashes, while its antibacterial activity was comparable to the tested products, or higher in the bacterial aerobic respiratory assay. The active compounds responsible for the effects include naturally occurring phenylpropanoids, terpenes, and terpenoids. Our mouthwash proved to be effective in vitro in lowering the copy number of SARS-CoV-2 in circumstances mimicking the salivary environment. CONCLUSIONS The developed product might be a useful tool to impede the transmission and spread of SARS-CoV-2 in interpersonal contact and aerosol-generating conditions. Our mouthwash can help reduce the oral bacterial flora and has an antioxidant activity that facilitates wound healing and prevents adverse effects of smoke in the oral cavity.
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Affiliation(s)
- Bálint Bencze
- Department of Laboratory Medicine, Clinical Centre, Medical School, University of Pécs, Ifjúság Út 13, Pécs, 7624, Hungary
| | - Viktória Temesfői
- Department of Laboratory Medicine, Clinical Centre, Medical School, University of Pécs, Ifjúság Út 13, Pécs, 7624, Hungary.
- Lab-On-a-Chip Research Group, János Szentágothai Research Centre, University of Pécs, Ifjúság Útja 20, Pécs, 7624, Hungary.
- Hungarian National Laboratory On Reproduction, University of Pécs, Pécs, 7624, Hungary.
| | - Sourav Das
- Department of Laboratory Medicine, Clinical Centre, Medical School, University of Pécs, Ifjúság Út 13, Pécs, 7624, Hungary
- Lab-On-a-Chip Research Group, János Szentágothai Research Centre, University of Pécs, Ifjúság Útja 20, Pécs, 7624, Hungary
| | - Henrietta Papp
- National Laboratory of Virology, University of Pécs, Ifjúság Útja 20, Pécs, 7624, Hungary
- Institute of Biology, Faculty of Sciences, University of Pécs, Ifjúság Útja 6, Pécs, 7624, Hungary
| | - Péter Kaltenecker
- Lab-On-a-Chip Research Group, János Szentágothai Research Centre, University of Pécs, Ifjúság Útja 20, Pécs, 7624, Hungary
- Hungarian National Laboratory On Reproduction, University of Pécs, Pécs, 7624, Hungary
| | - Anett Kuczmog
- National Laboratory of Virology, University of Pécs, Ifjúság Útja 20, Pécs, 7624, Hungary
- Institute of Biology, Faculty of Sciences, University of Pécs, Ifjúság Útja 6, Pécs, 7624, Hungary
| | - Ferenc Jakab
- National Laboratory of Virology, University of Pécs, Ifjúság Útja 20, Pécs, 7624, Hungary
- Institute of Biology, Faculty of Sciences, University of Pécs, Ifjúság Útja 6, Pécs, 7624, Hungary
| | - Béla Kocsis
- Department of Medical Microbiology and Immunology, Clinical Centre, Medical School, University of Pécs, Szigeti Út 12, Pécs, 7624, Hungary
| | - Tamás Kőszegi
- Department of Laboratory Medicine, Clinical Centre, Medical School, University of Pécs, Ifjúság Út 13, Pécs, 7624, Hungary
- Lab-On-a-Chip Research Group, János Szentágothai Research Centre, University of Pécs, Ifjúság Útja 20, Pécs, 7624, Hungary
- Hungarian National Laboratory On Reproduction, University of Pécs, Pécs, 7624, Hungary
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Di Vito M, Garzoli S, Rosato R, Mariotti M, Gervasoni J, Santucci L, Ovidi E, Cacaci M, Lombarini G, Torelli R, Urbani A, Sanguinetti M, Bugli F. A New Potential Resource in the Fight against Candida auris: the Cinnamomum zeylanicum Essential Oil in Synergy with Antifungal Drug. Microbiol Spectr 2023; 11:e0438522. [PMID: 36975835 PMCID: PMC10101117 DOI: 10.1128/spectrum.04385-22] [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: 10/27/2022] [Accepted: 03/10/2023] [Indexed: 03/29/2023] Open
Abstract
Candida auris is a multidrug-resistant fungus known to be a global public health problem. The skin-based transmission, together with the marked resistance to drugs, resulted in its rapid spread to all continents. The aim of this study was to identify an essential oil (EO) active in the fight against C. auris. A total of 15 EOs were tested against 10 clinical strains of C. auris. Cinnamomum zeylanicum EO (CZ-EO) was the most effective (MIC90 and MFC90 equal to 0.06% vol/vol). Three fractions obtained from CZ-EO, and the cinnamaldehyde (CIN), the major chemical compound, were tested to identify the principal compound effectives against C. auris. All CIN-containing samples showed anti-fungal activity. To study the synergy with fluconazole, CZ-EO, its active fraction (FR2), and CIN were tested in checkerboard tests. Results show that CZ-EO and FR2, but not CIN, synergize with fluconazole. Furthermore, only the copresence of CZ-EO or FR2 synergize with fluconazole at therapeutic concentrations of the drug (0.45 ± 0.32 μg/mL and 0.64 ± 0.67 μg/mL, respectively), while CIN only shows additive activity. In vivo studies conducted on Galleria mellonella larvae show the absence of toxicity of CZ-EO up to concentrations of 16% vol/vol, and the ability of CZ-EO to reactivate the efficacy of fluconazole when formulated at synergic concentrations. Finally, biochemical tests were made to study the mechanism of action of CZ-EO. These studies show that in the presence of both fluconazole and CZ-EO, the activity of fungal ATPases decreases and, at the same time, the amount of intracellular drug increases. IMPORTANCE This study highlights how small doses of CZ-EO are able to inhibit the secretion of fluconazole and promote its accumulation in the fungal cell. In this manner, the drug is able to exert its pharmacological effects bypassing the resistance of the yeast. If further studies will confirm this synergy, it will be possible to develop new therapeutic formulations active in the fight against C. auris resistances.
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Affiliation(s)
- M. Di Vito
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
| | - S. Garzoli
- Dipartimento di Chimica e Tecnologie del Farmaco, Università di Roma Sapienza, Rome, Italy
| | - R. Rosato
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
| | - M. Mariotti
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
| | - J. Gervasoni
- UOC Chimica, Biochimica e Biologia Molecolare Clinica, Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - L. Santucci
- UOC Chimica, Biochimica e Biologia Molecolare Clinica, Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - E. Ovidi
- Department for Innovation in Biological, Agro-Food and Forest Systems DIBAF—University of Tuscia, Viterbo, Italy
| | - M. Cacaci
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - G. Lombarini
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
| | - R. Torelli
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - A. Urbani
- UOC Chimica, Biochimica e Biologia Molecolare Clinica, Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - M. Sanguinetti
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - F. Bugli
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Marinković J, Rakašević D, Nemoda M, Nikolić B, Marković T, Matijević S, Marković D. EO-based mouthwashes: Is there something that should be known? BALKAN JOURNAL OF DENTAL MEDICINE 2023. [DOI: 10.5937/bjdm2301032m] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
The possibility to utilize the antibacterial and antibiofilm potential of essential oils (EOs) in dentistry is recognized and best seen in the design of EO-based mouthwashes. The up-to-date results, obtained with the most commonly used formulation being consisted of thymol, eucalyptol, menthol, and methyl salicylate (Listerine), proved its efficacy against plaque and gingival inflammation. However, novel alcohol-free products remain to be further investigated. Commercially available mouthwash containing curcumin, clove oil, mentha oil, eucalyptol, thymol and tea tree oil, and the mouthwash based on ginger EO (a-zingiberene, b-bisabolene, b-sesquiphellandrene, curcumene), reduced plaque index and improved periodontal status of the patients. The plaque index was also reduced and overall healing was improved after the surgical removal of the third molar by mouthwash containing John wort oil. In addition, Cinnamomum zeylanicum EO-based mouthwash and mouthwash containing peppermint oil were efficient against stomatitis and xerostomia, respectively. In addition to beneficial effects achieved in the mouth, i.e. at the appropriate site of application, novel investigations pointed-out that EO-based mouthwashes could be recognized as efficient in the reduction of bacterial and viral aerosols. This has been shown for Listerine, and for several mouthwashes containing following active substances of plants' EO origin: a-farnesene, b-farnesene, farnesol, nerolidol, a-bulnesene, eremanthin, b-sesquiphellandrene, spiroether, cinnamylacetate, cinnamaldehyde, eugenol, menthol, and carvacrol. This finding could be of special interest, in order to be included in further clinical studies related to COVID -19 pandemic.
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Rai A, Misra SR, Panda S, Sokolowski G, Mishra L, Das R, Lapinska B. Nystatin Effectiveness in Oral Candidiasis Treatment: A Systematic Review & Meta-Analysis of Clinical Trials. Life (Basel) 2022; 12:1677. [PMID: 36362833 PMCID: PMC9697841 DOI: 10.3390/life12111677] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/18/2022] [Accepted: 10/21/2022] [Indexed: 02/12/2024] Open
Abstract
Oral candidiasis is the most common opportunistic fungal infection caused by commensal Candida species. Since there are various local and systemic predisposing factors for the disease, the treatment also varies from topical to systemic antifungal agents. Nystatin is a common antifungal agent used topically. The aim of this systematic review was to evaluate and compare the efficacy of different antifungal agents and the safety of nystatin in the treatment of oral candidiasis. Three electronic databases were searched for randomized controlled trials comparing nystatin with other anti-fungal therapies or placebo. Clinical and/or mycological cure was the outcome evaluation. A meta-analysis and descriptive study on the efficacy, treatment protocols, and safety of nystatin was also conducted. The meta-analysis included five studies, which compared the efficacy of nystatin suspensions with photodynamic therapy. A significant difference in the colony-forming units per milliliters (CFU/mL) of Candida species was observed at 60 days intervals for both palatal mucosa and denture surfaces, with both groups favoring nystatin with low heterogeneity at a 95% confidence interval. Nystatin and photodynamic therapy were found to be equally effective for the clinical remission of denture stomatitis as well as a significant reduction of CFU/mL of Candida species from dentures and palatal surfaces of the patients.
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Affiliation(s)
- Anamika Rai
- Department of Oral Medicine & Radiology, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, India
| | - Satya Ranjan Misra
- Department of Oral Medicine & Radiology, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, India
| | - Saurav Panda
- Department of Periodontics, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, India
| | - Grzegorz Sokolowski
- Department of Prosthetics, Medical University of Lodz, 251 Pomorska St., 92-213 Lodz, Poland
| | - Lora Mishra
- Department of Conservative Dentistry & Endodontics, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, India
| | - Rupsa Das
- Department of Oral Medicine & Radiology, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, India
| | - Barbara Lapinska
- Department of General Dentistry, Medical University of Lodz, 251 Pomorska St, 92-213 Lodz, Poland
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Recent Advances in the Application of Essential Oils as Potential Therapeutic Candidates for Candida-Related Infections. Appl Microbiol 2022. [DOI: 10.3390/applmicrobiol2020030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Candidiasis (oral, vulvovaginal, or systemic bloodstream infections) are important human fungal infections associated with a high global prevalence in otherwise healthy adults but are also opportunistic infections in immunocompromised patients. With the recent discovery of the multidrug resistant—and often difficult to treat—Candida auris, as well as the rising costs associated with hospitalisations and the treatment of infections caused by Candida species, there is an urgent need to develop effective therapeutics against these pathogenic yeasts. Essential oils have been documented for many years as treatments for different ailments and are widely known and utilised in alternative and complementary therapies, including treating microbial infections. This review highlights knowledge from research on the effects of medicinal plants, and in particular, essential oils, as potential treatments against different Candida species. Studies have been evaluated that describe the experimental approaches used in investigating the anticandidal effects of essential oils (in vivo and in vitro), the established mode of action of the different compounds against different Candida species, the effect of a combination of essential oils with other compounds as potential therapies, and the evidence from clinical trial studies.
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Safety and tolerability of cinnamaldehyde in orabase for oral candidiasis treatment: phase I clinical trial. Clin Oral Investig 2022; 26:4825-4833. [PMID: 35305150 DOI: 10.1007/s00784-022-04450-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 03/12/2022] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To advance studies on the effect of a new pharmaceutical formulation for the treatment of oral fungal infections, we evaluated the safety and tolerability of orabase ointment containing cinnamaldehyde for use on the oral mucosa. MATERIAL AND METHODS A clinical trial (phase I) was carried out on 35 individuals with healthy oral mucosa divided into three groups: ointments at 200 µg/mL, n = 12; 300 µg/mL, n = 11; and 400 µg/mL, n = 12. Product safety was assessed using three parameters: (a) clinical evolution as recorded by trained examiners; (b) evolution of the inflammatory process as registered by an exfoliative cytology exam and analyzed by trained pathologists; (c) mucosal swab to count Candida spp. colony-forming units (CFU). These parameters were analyzed both beforehand and at 15 days of treatment. RESULTS The three ointment concentrations evaluated did not trigger inflammatory processes. The mycological analyses revealed a reduction of at least 99% in the number of Candida spp. CFU. In the exfoliative cytology analyses, the cells were found to be healthy. Participants reported a pleasant taste, yet 17% reported a slight burning sensation when applying the product. CONCLUSIONS The ointment is safe and tolerable for use on healthy oral mucosa. TRIAL REGISTRATION Registration number: RBR-7zwzs3. CLINICAL RELEVANCE The ointment proved to be safe and tolerable for use on oral mucosa, encouraging studies to evaluate its clinical efficacy in patients with oral candidiasis, and contributing to a new therapeutic proposal for the treatment of fungal infections caused by Candida spp.
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Alves DDN, Martins RX, Ferreira EDS, Alves AF, de Andrade JC, Batista TM, Lazarini JG, Amorim LS, Rosalen PL, Farias DF, de Castro RD. Toxicological Parameters of a Formulation Containing Cinnamaldehyde for Use in Treatment of Oral Fungal Infections: An In Vivo Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:2305695. [PMID: 34722758 PMCID: PMC8556081 DOI: 10.1155/2021/2305695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 10/04/2021] [Indexed: 01/14/2023]
Abstract
OBJECTIVE We aimed to define the safety and toxicity of both isolated and embedded cinnamaldehyde using a pharmaceutical formulation for the treatment of oral fungal infections in an in vivo study. MATERIALS AND METHODS Acute toxicity was assessed in studies with Galleria mellonella larvae and Danio rerio embryos (zebrafish), and genotoxicity was assessed in a mouse model. The pharmaceutical formulation (orabase ointment) containing cinnamaldehyde was evaluated for verification of both in vitro antifungal activity and toxicity in keratinized oral rat mucosa. RESULTS In Galleria mellonella larvae, cinnamaldehyde was not toxic up to the highest dose tested (20 mg/kg) and presented no genotoxicity up to the dose of 4 mg/kg in the model using mice. However, it was found to be toxic in zebrafish embryos up to a concentration of 0.035 μg/mL; LC50 0.311; EC50 0.097 (egg hatching delay); and 0.105 (Pericardial edema). In the orabase antifungal susceptibility test, cinnamaldehyde exhibited activity in concentrations greater than 200 μg/mL. As for safety in the animal model with rats, the orabase ointment proved to be safe for use on keratinized mucosa up to the maximum concentration tested (700 μg/mL). CONCLUSIONS At the concentrations tested, cinnamaldehyde was not toxic in vertebrate and invertebrate animal models and did not exhibit genotoxic activity. In addition, when used in the form of an ointment in orabase, having already recognized antifungal activity, it was shown to be safe up to the highest concentration tested.
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Affiliation(s)
- Danielle da Nóbrega Alves
- Department of Clinical and Social Dentistry, Graduate Program in Natural and Synthetic Bioactive Products (PgPNSB), Center for Health Sciences, Federal University of Paraiba, João Pessoa PB, Brazil
| | - Rafael Xavier Martins
- Graduate Program in Molecular and Cell Biology, Center for Health Sciences, Federal University of Paraiba, João Pessoa PB, Brazil
| | - Elba dos Santos Ferreira
- Experimental Pharmacology and Cell Culture Laboratory, Center for Health Sciences, Federal University of Paraiba, João Pessoa PB, Brazil
| | - Adriano Francisco Alves
- Department of Physiology and Pathology, Health Sciences Center, Federal University of Paraiba, João Pessoa PB, Brazil
| | - Jéssica Cabral de Andrade
- Graduate Program in Natural and Synthetic Bioactive Products (PgPNSB), Health Sciences Center, Federal University of Paraiba, João Pessoa PB, Brazil
| | - Tatianne Mota Batista
- Graduate Program in Natural and Synthetic Bioactive Products (PgPNSB), Health Sciences Center, Federal University of Paraiba, João Pessoa PB, Brazil
| | - Josy Goldoni Lazarini
- Graduate Program in Dentistry (PPGO), Health Sciences Center, University of Campinas, Campinas SP, Brazil
| | - Luana Souza Amorim
- Experimental Pharmacology and Cell Culture Laboratory, Health Sciences Center, Federal University of Paraiba, João Pessoa PB, Brazil
| | - Pedro Luiz Rosalen
- Department of Physiological Sciences, Center for Biological Sciences, Piracicaba Dental School, University of Campinas, Campinas, São Paula, Brazil
| | - Davi Felipe Farias
- Laboratory for Risk Assessment of Novel Technologies (LabRisk), Department of Molecular Biology, Federal University of Paraiba, Campus I, 58051-900 João Pessoa, Brazil
| | - Ricardo Dias de Castro
- Department of Clinical and Social Dentistry, Center for Health Sciences, Federal University of Paraiba, João Pessoa PB, Brazil
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10
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Niculescu AG, Grumezescu AM. Natural Compounds for Preventing Ear, Nose, and Throat-Related Oral Infections. PLANTS 2021; 10:plants10091847. [PMID: 34579380 PMCID: PMC8468404 DOI: 10.3390/plants10091847] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 09/01/2021] [Accepted: 09/03/2021] [Indexed: 12/18/2022]
Abstract
Oral health is an essential element in maintaining general well-being. By preserving the complex equilibrium within the oral microbial community, commensal microorganisms can protect against extrinsic pathogenic threats. However, when an imbalance occurs, the organism is susceptible to a broad range of infections. Synthetic drugs can be administered to help the body fight against the fungal, bacterial, or viral burden. Nonetheless, they may produce undesirable consequences such as toxicity, adverse effects, and drug resistance. In this respect, research has focused on finding safer and more efficient alternatives. Particularly, increasing attention has been drawn towards developing novel formulations based on natural compounds. This paper reviews the plant-based, algae-based, and beehive products investigated for their antimicrobial properties, aiming to thoroughly present the state of the art on oral infection prevention in the ear, nose, and throat (ENT) field.
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Affiliation(s)
- Adelina-Gabriela Niculescu
- Faculty of Engineering in Foreign Languages, University Politehnica of Bucharest, 060042 Bucharest, Romania;
- Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, 060042 Bucharest, Romania
| | - Alexandru Mihai Grumezescu
- Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, 060042 Bucharest, Romania
- Research Institute of the University of Bucharest—ICUB, University of Bucharest, 050657 Bucharest, Romania
- Academy of Romanian Scientists, 3 Ilfov Street, 50044 Bucharest, Romania
- Correspondence: ; Tel.: +40-21-402-3997
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11
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Biomaterials for the Prevention of Oral Candidiasis Development. Pharmaceutics 2021; 13:pharmaceutics13060803. [PMID: 34072188 PMCID: PMC8229946 DOI: 10.3390/pharmaceutics13060803] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 05/18/2021] [Accepted: 05/25/2021] [Indexed: 12/19/2022] Open
Abstract
Thousands of microorganisms coexist within the human microbiota. However, certain conditions can predispose the organism to the overgrowth of specific pathogens that further lead to opportunistic infections. One of the most common such imbalances in the normal oral flora is the excessive growth of Candida spp., which produces oral candidiasis. In immunocompromised individuals, this fungal infection can reach the systemic level and become life-threatening. Hence, prompt and efficient treatment must be administered. Traditional antifungal agents, such as polyenes, azoles, and echinocandins, may often result in severe adverse effects, regardless of the administration form. Therefore, novel treatments have to be developed and implemented in clinical practice. In this regard, the present paper focuses on the newest therapeutic options against oral Candida infections, reviewing compounds and biomaterials with inherent antifungal properties, improved materials for dental prostheses and denture adhesives, drug delivery systems, and combined approaches towards developing the optimum treatment.
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12
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Hossain S, Urbi Z, Karuniawati H, Mohiuddin RB, Moh Qrimida A, Allzrag AMM, Ming LC, Pagano E, Capasso R. Andrographis paniculata (Burm. f.) Wall. ex Nees: An Updated Review of Phytochemistry, Antimicrobial Pharmacology, and Clinical Safety and Efficacy. Life (Basel) 2021; 11:348. [PMID: 33923529 PMCID: PMC8072717 DOI: 10.3390/life11040348] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/02/2021] [Accepted: 04/03/2021] [Indexed: 02/07/2023] Open
Abstract
Infectious disease (ID) is one of the top-most serious threats to human health globally, further aggravated by antimicrobial resistance and lack of novel immunization options. Andrographis paniculata (Burm. f.) Wall. ex Nees and its metabolites have been long used to treat IDs. Andrographolide, derived from A. paniculata, can inhibit invasive microbes virulence factors and regulate the host immunity. Controlled clinical trials revealed that A. paniculata treatment is safe and efficacious for acute respiratory tract infections like common cold and sinusitis. Hence, A. paniculata, mainly andrographolide, could be considered as an excellent candidate for antimicrobial drug development. Considering the importance, medicinal values, and significant role as antimicrobial agents, this study critically evaluated the antimicrobial therapeutic potency of A. paniculata and its metabolites, focusing on the mechanism of action in inhibiting invasive microbes and biofilm formation. A critical evaluation of the secondary metabolites with the aim of identifying pure compounds that possess antimicrobial functions has further added significant values to this study. Notwithstanding that A. paniculata is a promising source of antimicrobial agents and safe treatment for IDs, further empirical research is warranted.
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Affiliation(s)
- Sanower Hossain
- Department of Biomedical Science, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Kuantan 25200, Pahang, Malaysia
| | - Zannat Urbi
- Department of Industrial Biotechnology, Faculty of Industrial Sciences & Technology, Universiti Malaysia Pahang, Kuantan 26300, Pahang, Malaysia;
| | - Hidayah Karuniawati
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Muhammadiyah Surakarta, Surakarta 57102, Indonesia;
| | - Ramisa Binti Mohiuddin
- Department of Pharmacy, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Santosh 1902, Tangail, Bangladesh;
| | - Ahmed Moh Qrimida
- Department of Agriculture, Higher Institute of Overall Occupations-Sooq Al Khamees Imsahil, Tripoli 1300, Libya; (A.M.Q.); (A.M.M.A.)
| | - Akrm Mohamed Masaud Allzrag
- Department of Agriculture, Higher Institute of Overall Occupations-Sooq Al Khamees Imsahil, Tripoli 1300, Libya; (A.M.Q.); (A.M.M.A.)
| | - Long Chiau Ming
- PAP Rashidah Sa’adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Jalan Tungku Link, Gadong BE1410, Brunei;
| | - Ester Pagano
- Department of Pharmacy, University of Naples Federico II, 80131 Naples, Italy;
| | - Raffaele Capasso
- Department of Agricultural Sciences, University of Naples Federico II, 80055 Portici, Italy
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