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Kurnia D, Lestari S, Mayanti T, Gartika M, Nurdin D. Anti-Infection of Oral Microorganisms from Herbal Medicine of Piper crocatum Ruiz & Pav. Drug Des Devel Ther 2024; 18:2531-2553. [PMID: 38952486 PMCID: PMC11215520 DOI: 10.2147/dddt.s453375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 05/20/2024] [Indexed: 07/03/2024] Open
Abstract
The WHO Global Status Report on Oral Health 2022 reveals that oral diseases caused by infection with oral pathogenic microorganisms affect nearly 3.5 billion people worldwide. Oral health problems are caused by the presence of S. mutans, S. sanguinis, E. faecalis and C. albicans in the oral cavity. Synthetic anti-infective drugs have been widely used to treat oral infections, but have been reported to cause side effects and resistance. Various strategies have been implemented to overcome this problem. Synthetic anti-infective drugs have been widely used to treat oral infections, but they have been reported to cause side effects and resistance. Therefore, it is important to look for safe anti-infective alternatives. Ethnobotanical and ethnopharmacological studies suggest that Red Betel leaf (Piper crocatum Ruiz & Pav) could be a potential source of oral anti-infectives. This review aims to discuss the pathogenesis mechanism of several microorganisms that play an important role in causing health problems, the mechanism of action of synthetic oral anti-infective drugs in inhibiting microbial growth in the oral cavity, and the potential of red betel leaf (Piper crocatum Ruiz & Pav) as an herbal oral anti-infective drug. This study emphasises the importance of researching natural components as an alternative treatment for oral infections that is more effective and can meet global needs.
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Affiliation(s)
- Dikdik Kurnia
- Department of Chemistry, Faculty of Mathematics and Natural Science, Universitas Padjadjaran, Sumedang, Indonesia
| | - Seftiana Lestari
- Department of Chemistry, Faculty of Mathematics and Natural Science, Universitas Padjadjaran, Sumedang, Indonesia
| | - Tri Mayanti
- Department of Chemistry, Faculty of Mathematics and Natural Science, Universitas Padjadjaran, Sumedang, Indonesia
| | - Meirina Gartika
- Department of Pediatric Dentistry, Faculty of Medicine, University of Padjadjaran, Bandung, Indonesia
| | - Denny Nurdin
- Departement of Conservative Dentistry, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
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2
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Kane A, Rothwell JG, Guttentag A, Hainsworth S, Carter D. Bisphosphonates synergistically enhance the antifungal activity of azoles in dermatophytes and other pathogenic molds. mSphere 2024; 9:e0024824. [PMID: 38837382 PMCID: PMC11332346 DOI: 10.1128/msphere.00248-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Accepted: 04/22/2024] [Indexed: 06/07/2024] Open
Abstract
Superficial infections of the skin, hair, and nails by fungal dermatophytes are the most prevalent of human mycoses, and many infections are refractory to treatment. As current treatment options are limited, recent research has explored drug synergy with azoles for dermatophytoses. Bisphosphonates, which are approved to treat osteoporosis, can synergistically enhance the activity of azoles in diverse yeast pathogens but their activity has not been explored in dermatophytes or other molds. Market bisphosphonates risedronate, alendronate, and zoledronate (ZOL) were evaluated for antifungal efficacy and synergy with three azole antifungals: fluconazole (FLC), itraconazole (ITR), and ketoconazole (KET). ZOL was the most active bisphosphonate tested, displaying moderate activity against nine dermatophyte species (MIC range 64-256 µg/mL), and was synergistic with KET in eight of these species. ZOL was also able to synergistically improve the anti-biofilm activity of KET and combining KET and ZOL prevented the development of antifungal resistance. Rescue assays in Trichophyton rubrum revealed that the inhibitory effects of ZOL alone and in combination with KET were due to the inhibition of squalene synthesis. Fluorescence microscopy using membrane- and ROS-sensitive probes demonstrated that ZOL and KET:ZOL compromised membrane structure and induced oxidative stress. Antifungal activity and synergy between bisphosphonates and azoles were also observed in other clinically relevant molds, including species of Aspergillus and Mucor. These findings indicate that repurposing bisphosphonates as antifungals is a promising strategy for revitalising certain azoles as topical antifungals, and that this combination could be fast-tracked for investigation in clinical trials. IMPORTANCE Fungal infections of the skin, hair, and nails, generally grouped together as "tineas" are the most prevalent infectious diseases globally. These infections, caused by fungal species known as dermatophytes, are generally superficial, but can in some cases become aggressive. They are also notoriously difficult to resolve, with few effective treatments and rising levels of drug resistance. Here, we report a potential new treatment that combines azole antifungals with bisphosphonates. Bisphosphonates are approved for the treatment of low bone density diseases, and in fungi they inhibit the biosynthesis of the cell membrane, which is also the target of azoles. Combinations were synergistic across the dermatophyte species and prevented the development of resistance. We extended the study to molds that cause invasive disease, finding synergy in some problematic species. We suggest bisphosphonates could be repurposed as synergents for tinea treatment, and that this combination could be fast-tracked for use in clinical therapy.
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Affiliation(s)
- Aidan Kane
- School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Joanna G. Rothwell
- School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Annabel Guttentag
- School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Steven Hainsworth
- School of Science, Royal Melbourne Institute of Technology, Melbourne, Victoria, Australia
| | - Dee Carter
- School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia
- Sydney Institute for Infectious Diseases, University of Sydney, Sydney, New South Wales, Australia
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Sonego B, Corio A, Mazzoletti V, Zerbato V, Benini A, di Meo N, Zalaudek I, Stinco G, Errichetti E, Zelin E. Trichophyton indotineae, an Emerging Drug-Resistant Dermatophyte: A Review of the Treatment Options. J Clin Med 2024; 13:3558. [PMID: 38930086 PMCID: PMC11204959 DOI: 10.3390/jcm13123558] [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: 05/11/2024] [Revised: 06/11/2024] [Accepted: 06/15/2024] [Indexed: 06/28/2024] Open
Abstract
Background: Dermatophytosis is a prevalent superficial infection caused by filamentous fungi, primarily affecting the skin and/or its appendages. In recent years, there has been a notable increase in mycotic strains resistant to standard antifungal therapies, including Trichophyton indotineae, a dermatophyte of the Trichophyton mentagrophytes complex. This review aims to provide a comprehensive overview of the treatment options for T. indotineae, elucidating their effectiveness in managing this challenging mycotic infection. Methods: For this review, a search was conducted in the PubMed, Scopus, Web of Science, Embase, and Google Scholar databases, encompassing all published data until March 2024. English-language articles detailing therapy outcomes for patients confirmed to be affected by T. indotineae, identified through molecular analysis, were included. Results: Itraconazole was shown to be a good therapeutic choice, particularly when administered at a dosage of 200 mg/day for 1-12 weeks. Voriconazole was also demonstrated to be effective, while terbinafine exhibited a reduced response rate. Griseofulvin and fluconazole, on the other hand, were found to be ineffective. Although topical treatments were mostly ineffective when used alone, they showed promising results when used in combination with systemic therapy. Mutational status was associated with different profiles of treatment response, suggesting the need for a more tailored approach. Conclusions: When managing T. indotineae infections, it is necessary to optimize therapy to mitigate resistances and relapse. Combining in vitro antifungal susceptibility testing with mutational analysis could be a promising strategy in refining treatment selection.
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Affiliation(s)
- Benedetta Sonego
- Dermatology Clinic, Maggiore Hospital, University of Trieste, 34125 Trieste, Italy; (B.S.); (A.C.); (A.B.); (N.d.M.); (I.Z.)
| | - Andrea Corio
- Dermatology Clinic, Maggiore Hospital, University of Trieste, 34125 Trieste, Italy; (B.S.); (A.C.); (A.B.); (N.d.M.); (I.Z.)
| | - Vanessa Mazzoletti
- Institute of Dermatology, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy;
| | - Verena Zerbato
- Infectious Diseases Unit, Trieste University Hospital (ASUGI), 34125 Trieste, Italy;
| | - Alessandro Benini
- Dermatology Clinic, Maggiore Hospital, University of Trieste, 34125 Trieste, Italy; (B.S.); (A.C.); (A.B.); (N.d.M.); (I.Z.)
| | - Nicola di Meo
- Dermatology Clinic, Maggiore Hospital, University of Trieste, 34125 Trieste, Italy; (B.S.); (A.C.); (A.B.); (N.d.M.); (I.Z.)
| | - Iris Zalaudek
- Dermatology Clinic, Maggiore Hospital, University of Trieste, 34125 Trieste, Italy; (B.S.); (A.C.); (A.B.); (N.d.M.); (I.Z.)
| | - Giuseppe Stinco
- Institute of Dermatology, Department of Medicine, University of Udine, 33100 Udine, Italy; (G.S.); (E.E.)
| | - Enzo Errichetti
- Institute of Dermatology, Department of Medicine, University of Udine, 33100 Udine, Italy; (G.S.); (E.E.)
| | - Enrico Zelin
- Institute of Dermatology, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy;
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Arya K, Usmani SA, Bhardwaj N, Kumar M, Rudramurthy SM, Prasad R, Singh A. Impact of sphingolipid synthesis inhibition on the drug susceptibility patterns of Trichophyton species. Diagn Microbiol Infect Dis 2024; 109:116283. [PMID: 38574446 DOI: 10.1016/j.diagmicrobio.2024.116283] [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: 02/21/2024] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 04/06/2024]
Abstract
The well known dermatophyte infections caused by Trichophyton species are an ambiguous problem to treat using the present arsenal of antifungals. This study expounds on the effect of inhibition of sphingolipid pathway on Trichophyton growth. Findings from the drug susceptibility assays suggest sphingolipid inhibition severely restricts the growth of T. interdigitale and T. tonsurans. The observed synergistic effects of combinations of sphingolipid inhibitor and conventional drugs provide a promising treatment strategy against Trichophyton infection.
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Affiliation(s)
- Khushboo Arya
- Department of Biochemistry, University of Lucknow, Lucknow, Uttar Pradesh 226007, India
| | - Sana Akhtar Usmani
- Department of Biochemistry, University of Lucknow, Lucknow, Uttar Pradesh 226007, India
| | - Nitin Bhardwaj
- Department of Zoology and Environmental Science, Gurukula Kangri Vishwavidyalaya, Haridwar, Uttarakhand 249404, India
| | - Manoj Kumar
- CSIR-Indian Institute of Toxicology Research, Lucknow, Lucknow, Uttar Pradesh 226 001, India
| | | | - Rajendra Prasad
- Amity Institute of Integrative Sciences and Health, Amity University, Haryana, India; Amity Institute of Biotechnology, Amity University, Haryana, India
| | - Ashutosh Singh
- Department of Biochemistry, University of Lucknow, Lucknow, Uttar Pradesh 226007, India.
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Lemes TH, Nascentes JAS, Regasini LO, Siqueira JPZ, Maschio-Lima T, Pattini VC, Ribeiro MD, de Almeida BG, de Almeida MTG. Combinatorial effect of fluconazole, itraconazole, and terbinafine with different culture extracts of Candida parapsilosis and Trichophyton spp. against Trichophyton rubrum. Int Microbiol 2024; 27:899-905. [PMID: 37875749 DOI: 10.1007/s10123-023-00438-x] [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: 03/20/2023] [Revised: 09/18/2023] [Accepted: 10/16/2023] [Indexed: 10/26/2023]
Abstract
Onychomycosis is a nail infection caused by dermatophytes, non-dermatophyte fungi, and yeasts, especially Candida species. The present study evaluated the combinatorial effect of different cultured extracts of Candida parapsilosis and Trichophyton mentagrophytes and Trichophyton rubrum with fluconazole, itraconazole, and terbinafine against clinical isolates of Trichophyton rubrum. In addition, investigation of the action of the extracts on the wall or membrane was performed. Pure and mixed cultures of Candida parapsilosis and dermatophytes were filtered through a 0.2-μm membrane and submitted to liquid-liquid extraction using ethyl acetate. After a checkerboard, trial with drugs was performed to evaluate the synergistic interaction with the extract. The results obtained for the minimum inhibitory concentration (MIC) of extracts against the T. rubrum strain in isolation were 500-8000 μg/mL. The MIC range for fluconazole, itraconazole, and terbinafine were 2-32 μg/mL, 0.25-0.5 μg/mL, 0.03-64 μg/mL, respectively. However, when the extract was combined with drugs, the MIC values decreased: extracts 1.9-1000 μg/mL, fluconazole 0.25-4, itraconazole 0.03-0.06 μg/mL, and terbinafine 0.001-0.02 μg/mL. The MIC values of the extracts in the Roswell Park Memorial Institute 1640 medium (RPMI) supplemented with sorbitol did not change, suggesting any action on the cell wall. However, in the presence of RPMI supplemented with ergosterol, MIC values of the extracts increased by up to 2×, indicating action on the fungal cell membrane. A synergistic action was observed between products and drugs, detecting a decrease in MIC values. There is potential and a new therapeutic perspective for fungal control.
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Affiliation(s)
- Thiago Henrique Lemes
- Institute of Biosciences, Humanities and Exact Sciences, São Paulo State University (UNESP), São José do Rio Preto, Brazil.
| | | | - Luis Octávio Regasini
- Institute of Biosciences, Humanities and Exact Sciences, São Paulo State University (UNESP), São José do Rio Preto, Brazil
| | - João Paulo Zen Siqueira
- Dept. of Dermatological, Infectious, and Parasitic Diseases, São José do Rio Preto School of Medicine (FAMERP), São José do Rio Preto, Brazil
| | - Taiza Maschio-Lima
- Institute of Biosciences, Humanities and Exact Sciences, São Paulo State University (UNESP), São José do Rio Preto, Brazil
| | - Veridianna Camilo Pattini
- Institute of Biosciences, Humanities and Exact Sciences, São Paulo State University (UNESP), São José do Rio Preto, Brazil
| | - Mariela Domiciano Ribeiro
- Dept. of Dermatological, Infectious, and Parasitic Diseases, São José do Rio Preto School of Medicine (FAMERP), São José do Rio Preto, Brazil
| | - Bianca Gottardo de Almeida
- Institute of Biosciences, Humanities and Exact Sciences, São Paulo State University (UNESP), São José do Rio Preto, Brazil
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6
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Maschio-Lima T, Lemes TH, Marques MDR, Siqueira JPZ, de Almeida BG, Caruso GR, Von Zeska Kress MR, de Tarso da Costa P, Regasini LO, de Almeida MTG. Synergistic activity between conventional antifungals and chalcone-derived compound against dermatophyte fungi and Candida spp. Int Microbiol 2024:10.1007/s10123-024-00541-7. [PMID: 38819732 DOI: 10.1007/s10123-024-00541-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 05/20/2024] [Accepted: 05/24/2024] [Indexed: 06/01/2024]
Abstract
The scarce antifungal arsenal, changes in the susceptibility profile of fungal agents, and lack of adherence to treatment have contributed to the increase of cases of dermatomycoses. In this context, new antimicrobial substances have gained importance. Chalcones are precursors of the flavonoid family that have multiple biological activities, have high tolerability by humans, and easy synthesis. In this study, we evaluated the in vitro antifungal activity, alone and in combination with conventional antifungal drugs, of the VS02-4'ethyl chalcone-derived compound against dermatophytes and Candida spp. Susceptibility testing was carried out by broth microdilution. Experiments for determination of the target of the compound on the fungal cell, time-kill kinetics, and toxicity tests in Galleria mellonella model were also performed. Combinatory effects were evaluated by the checkerboard method. Results showed high activity of the compound VS02-4'ethyl against dermatophytes (MIC of 7.81-31.25 μg/ml). The compound targeted the cell membrane, and the time-kill test showed the compound continues to exert gradual activity after 5 days on dermatophytes, but no significant activity on Candida. Low toxicity was observed at 250 mg/kg. Excellent results were observed in the combinatory test, where VS02-4'ethyl showed synergistic interactions with itraconazole, fluconazole, terbinafine, and griseofulvin, against all isolates tested. Although further investigation is needed, these results revealed the great potential of chalcone-derived compounds against fungal infections for which treatments are long and laborious.
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Affiliation(s)
- Taiza Maschio-Lima
- Institute of Biosciences, Humanities and Exact Sciences, São Paulo State University (UNESP), São José do Rio Preto, São Paulo, Brazil.
| | - Thiago Henrique Lemes
- Institute of Biosciences, Humanities and Exact Sciences, São Paulo State University (UNESP), São José do Rio Preto, São Paulo, Brazil
| | - Mariela Domiciano Ribeiro Marques
- Department of Dermatological, Infectious, and Parasitic Diseases, School of Medicine São José Do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil
| | - João Paulo Zen Siqueira
- Department of Dermatological, Infectious, and Parasitic Diseases, School of Medicine São José Do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil
| | | | - Glaucia Rigotto Caruso
- School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Marcia Regina Von Zeska Kress
- School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Paulo de Tarso da Costa
- Institute of Biosciences, Humanities and Exact Sciences, São Paulo State University (UNESP), São José do Rio Preto, São Paulo, Brazil
| | - Luis Octávio Regasini
- Laboratory of Antibiotics and Chemotherapy, Institute of Biosciences, Humanities and Exact Sciences, São Paulo State University (UNESP), São José do Rio Preto, São Paulo, Brazil
| | - Margarete Teresa Gottardo de Almeida
- Department of Dermatological, Infectious, and Parasitic Diseases, School of Medicine São José Do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil
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7
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Fernandes C, Sousa-Baptista J, Lenha-Silva AF, Calheiros D, Correia E, Figueirinha A, Salgueiro L, Gonçalves T. Azorean Black Tea ( Camellia sinensis) Antidermatophytic and Fungicidal Properties. Molecules 2023; 28:7775. [PMID: 38067505 PMCID: PMC10707949 DOI: 10.3390/molecules28237775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/17/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023] Open
Abstract
The treatment of dermatophytoses, the most common human fungal infections, requires new alternatives. The aim of this study was to determine the antidermatophytic activity of the aqueous Azorean Black Tea extract (ABT), together with an approach to the mechanisms of action. The phytochemical analysis of ABT extract was performed by HPLC. The dermatophytes susceptibility was assessed using a broth microdilution assay; potential synergies with terbinafine and griseofulvin were evaluated by the checkerboard assay. The mechanism of action was appraised by the quantification of the fungal cell wall chitin and β-1,3-glucan, and by membrane ergosterol. The presence of ultrastructural modifications was studied by Transmission Electron Microscopy (TEM). The ABT extract contained organic and phenolic acids, flavonoids, theaflavins and alkaloids. It showed an antidermatophytic effect, with MIC values of 250 µg/mL for Trichophyton mentagrophytes, 125 µg/mL for Trichophyton rubrum and 500 µg/mL for Microsporum canis; at these concentrations, the extract was fungicidal. An additive effect of ABT in association to terbinafine on these three dermatophytes was observed. The ABT extract caused a significant reduction in β-1,3-glucan content, indicating the synthesis of this cell wall component as a possible target. The present study identifies the antidermatophytic activity of the ABT and highlights its potential to improve the effectiveness of conventional topical treatment currently used for the management of skin or mucosal fungal infections.
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Affiliation(s)
- Chantal Fernandes
- CNC-UC—Center for Neuroscience and Cell Biology of Coimbra, University of Coimbra, 3004-504 Coimbra, Portugal; (C.F.); (J.S.-B.); (A.F.L.-S.); (D.C.); (E.C.)
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal
| | - José Sousa-Baptista
- CNC-UC—Center for Neuroscience and Cell Biology of Coimbra, University of Coimbra, 3004-504 Coimbra, Portugal; (C.F.); (J.S.-B.); (A.F.L.-S.); (D.C.); (E.C.)
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal
- FMUC—Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
| | - Ana Filipa Lenha-Silva
- CNC-UC—Center for Neuroscience and Cell Biology of Coimbra, University of Coimbra, 3004-504 Coimbra, Portugal; (C.F.); (J.S.-B.); (A.F.L.-S.); (D.C.); (E.C.)
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal
| | - Daniela Calheiros
- CNC-UC—Center for Neuroscience and Cell Biology of Coimbra, University of Coimbra, 3004-504 Coimbra, Portugal; (C.F.); (J.S.-B.); (A.F.L.-S.); (D.C.); (E.C.)
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal
- FMUC—Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
| | - Edmilson Correia
- CNC-UC—Center for Neuroscience and Cell Biology of Coimbra, University of Coimbra, 3004-504 Coimbra, Portugal; (C.F.); (J.S.-B.); (A.F.L.-S.); (D.C.); (E.C.)
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal
| | - Artur Figueirinha
- Faculty of Pharmacy, Health Sciences Campus, University of Coimbra, Azinhaga de S. Comba, 3000-548 Coimbra, Portugal; (A.F.); (L.S.)
- Associated Laboratory for Green Chemistry (LAQV) of the Network of Chemistry and Technology (REQUIMTE), University of Porto, 4099-002 Porto, Portugal
| | - Lígia Salgueiro
- Faculty of Pharmacy, Health Sciences Campus, University of Coimbra, Azinhaga de S. Comba, 3000-548 Coimbra, Portugal; (A.F.); (L.S.)
- Chemical Process Engineering and Forest Products Research Centre, Department of Chemical Engineering, Faculty of Sciences and Technology, University of Coimbra, 3030-790 Coimbra, Portugal
| | - Teresa Gonçalves
- CNC-UC—Center for Neuroscience and Cell Biology of Coimbra, University of Coimbra, 3004-504 Coimbra, Portugal; (C.F.); (J.S.-B.); (A.F.L.-S.); (D.C.); (E.C.)
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal
- FMUC—Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
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Ramzi SHT, Arif SA, Majid A, Kumar S, Shumail H, Qudsia F, Zainab Y, Varrassi G, Khatri M. Efficacy of Terbinafine and Itraconazole Combination Therapy Versus Terbinafine or Itraconazole Monotherapy in the Management of Fungal Diseases: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e48819. [PMID: 38106696 PMCID: PMC10722332 DOI: 10.7759/cureus.48819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 11/14/2023] [Indexed: 12/19/2023] Open
Abstract
Fungal infections constitute a common dermatological illness rampant in underdeveloped countries. Combination drug therapy is becoming increasingly well-established owing to drug resistance because of monotherapy. Different studies have been conducted previously to compare the medical regimens for the treatment of fungal infections. However, there is insufficient research on the difference in cure rates and recurrence rates with each regimen. To the best of our knowledge, this meta-analysis is the first to compare the effect of the most widely used oral antifungal medications and their combination usage. A meta-analysis of randomized controlled trials (RCTs) assesses the efficacy of terbinafine or itraconazole monotherapy versus combination therapy in fungal diseases. We queried PubMed and Cochrane Central from their inception to April 2022 for published studies, RCTs, and observational studies without any language restriction that compared itraconazole and terbinafine combination therapy with monotherapy in patients with fungal infections. The results from the studies were presented as risk ratios (RRs) with 95% confidence intervals (CIs) and were pooled using a random-effects model, and a p-value of ≤0.05 was considered significant for the analysis. Endpoints of interest included cure rates and recurrence rates. Cure rates were increased significantly for combination therapy compared to terbinafine monotherapy (RR=2.01 (1.37, 2.94); p=0.0003; I2=67%). On sensitivity analysis, a significant association was observed between combination therapy and itraconazole monotherapy in terms of cure rates (RR=1.91 (1.41, 2.57); p<0.0001; I2=0%) and recurrence rates (RR=0.08 (0.02, 0.44); p=0.003; I2=0%). The findings of this meta-analysis suggest that itraconazole and terbinafine combination therapy has a better cure rate when compared to terbinafine monotherapy.
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Affiliation(s)
| | | | - Abdul Majid
- Internal Medicine, Khyber Medical College, Peshawar, PAK
| | - Satesh Kumar
- Medicine and Surgery, Shaheed Mohtarma Benazir Bhutto Medical University, Karachi, PAK
| | - Hooria Shumail
- Medicine, King Edward Medical University (KEMU), Lahore, PAK
| | - Faiza Qudsia
- Medicine, King Edward Medical University (KEMU), Lahore, PAK
| | - Yumna Zainab
- Medicine, Multan Medical and Dental College, Multan, PAK
| | | | - Mahima Khatri
- Medicine and Surgery, Dow University of Health Sciences, Karachi, PAK
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9
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Ayatollahi Mousavi SA, Mokhtari A, Barani M, Izadi A, Amirbeigi A, Ajalli N, Amanizadeh A, Hadizadeh S. Advances of liposomal mediated nanocarriers for the treatment of dermatophyte infections. Heliyon 2023; 9:e18960. [PMID: 37583758 PMCID: PMC10424084 DOI: 10.1016/j.heliyon.2023.e18960] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 07/29/2023] [Accepted: 08/03/2023] [Indexed: 08/17/2023] Open
Abstract
Due to the adverse effects associated with long-term administration of antifungal drugs used for treating dermatophytic lesions like tinea unguium, there is a critical need for novel antifungal therapies that exhibit improved absorption and minimal adverse effects. Nanoformulations offer a promising solution in this regard. Topical formulations may penetrate the upper layers of the skin, such as the stratum corneum, and release an appropriate amount of drugs in therapeutic quantities. Liposomes, particularly nanosized ones, used as topical medication delivery systems for the skin, may have various roles depending on their size, lipid and cholesterol content, ingredient percentage, lamellarity, and surface charge. Liposomes can enhance permeability through the stratum corneum, minimize systemic effects due to their localizing properties, and overcome various challenges in cutaneous drug delivery. Antifungal medications encapsulated in liposomes, including fluconazole, ketoconazole, croconazole, econazole, terbinafine hydrochloride, tolnaftate, and miconazole, have demonstrated improved skin penetration and localization. This review discusses the traditional treatment of dermatophytes and liposomal formulations. Additionally, promising liposomal formulations that may soon be available in the market are introduced. The objective of this review is to provide a comprehensive understanding of dermatophyte infections and the role of liposomes in enhancing treatment.
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Affiliation(s)
- Seyed Amin Ayatollahi Mousavi
- Department of Medical Parasitology and Mycology, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
- Medical Mycology and Bacteriology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Abnoos Mokhtari
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Science, Kerman University of Medical Sciences, Kerman, Iran
- Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahmood Barani
- Medical Mycology and Bacteriology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Alireza Izadi
- Department of Medical Parasitology and Mycology, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
- Medical Mycology and Bacteriology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Alireza Amirbeigi
- Department of General Surgery, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Narges Ajalli
- Department of Chemical Engineering, Faculty of Engineering, University of Tehran, Tehran, Iran
| | - Azam Amanizadeh
- Department of Medical Parasitology and Mycology, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
- Medical Mycology and Bacteriology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Sanaz Hadizadeh
- Department of Medical Parasitology and Mycology, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
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10
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Shenoy M, Poojari S, Rengasamy M, Vedmurthy M, Barua S, Dhoot D, Barkate H. Management of Dermatophytosis: Real-World Indian Perspective. Indian Dermatol Online J 2023; 14:347-356. [PMID: 37266073 PMCID: PMC10231727 DOI: 10.4103/idoj.idoj_643_22] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/04/2023] [Accepted: 01/21/2023] [Indexed: 06/03/2023] Open
Abstract
Background In spite of the availability of multiple consensus statements on dermatophytosis management, different treatment approaches have been experienced in India and require more scrutiny to further update guidelines and improve patient care. Aim To determine the different approaches in dermatophytosis diagnosis and management among dermatologists in India. Materials and Methods A web-based questionnaire was created and validated by five panelists with experience of >15 years in dermatophytosis and then circulated to about 2,000 dermatologists in India in September 2021 for a real-world management scenario. Results Out of 2,000 dermatologists, 459 responded. About half of the dermatologists (51%) routinely conduct potassium hydroxide mount (KOH) at the initiation of therapy. Similarly, about 53% of dermatologists initiate the management of dermatophytosis with combination therapy in all types of dermatophytosis for 4-6 weeks depending upon severity. Different types of combinations are being practiced, such as either two systemic and one topical, two topicals and one systemic, but the combination of one systemic and one topical (69%) is the most commonly practiced. Itraconazole (100 mg twice a day) and luliconazole are the most commonly prescribed antifungal medications. In case of non-response to routine dose of systemic anti-fungals, about 72% of dermatologists up dose them. Most of them continue these drugs for additional 1-2 weeks after clearance of the disease. Additionally, keratolytics and moisturizers are commonly prescribed. Additionally, 62% advise liver function tests (LFTs) at the initiation of therapy, whereas 72% advise monitoring adverse effects due to systemic antifungal drugs during treatment. Conclusion Combination therapy stood out as the need of the hour in the current menace of dermatophytosis with timely monitoring of laboratory tests for adverse events due to the use of systemic antifungals for a longer duration.
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Affiliation(s)
- Manjunath Shenoy
- Department of Dermatology, Yenepoya Medical College, Mangalore, Karnataka, India
| | - Shital Poojari
- Department of Dermatology, K J Somaiya Medical College, Mumbai, Maharashtra, India
| | - Madhu Rengasamy
- Department of Dermatology, Venerology and Leprosy, Madras Medical College, Chennai, Tamil Nadu, India
| | - Maya Vedmurthy
- Consultant Dermatologist, Apollo Hospital, Chennai, Tamil Nadu, India
| | - Shyamanta Barua
- Department of Dermatology, Assam Medical College and Hospital, Dibrugarh, Assam, India
| | - Dhiraj Dhoot
- Department of Global Medical Affairs, Glenmark Pharmaceuticals Ltd, Mumbai, Maharashtra, India
| | - Hanmant Barkate
- Department of Global Medical Affairs, Glenmark Pharmaceuticals Ltd, Mumbai, Maharashtra, India
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11
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Sahib Sadeq H, Hamed Al-Oebady MA. Detection of LAP1 and LAP2 genes from Trichophyton rubrum. BIONATURA 2022. [DOI: 10.21931/rb/2022.07.04.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Samples of hair, nails and skin were collected, representing people of different ages and races. The number of isolated people gathered between October 2021 and February 2022 from Al-Hussein Teaching Hospital and a private clinic under the supervision of doctors(118) species was examined. Dermatophytes were found in 80 of them; among the 80 positive Trichophyton rubrum species, 30 were produced, which represents less than half of the dermatophytes for each of the 80 positive species (14 cutaneous, nine hair and seven nail isolates)the study's findings included hair hole testing, which came back negative, and urea degradation testing. The results were either negative or inconsistent across the isolates; the growth test in the PDA was positive, the virulence factors that enable the fungus to penetrate host tissues were studied during leucine aminopeptidase (LAP1) and (LAP2), it was observed that there were no significant differences in gene isolates of T. rubrum.
Keywords: LAP1; LAP2; genus Trichophyton rubrum.
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Affiliation(s)
- Hiba Sahib Sadeq
- Biology Department, College of Science, University of Al-Muthanna, Iraq
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12
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Facile Green Synthesis of Zinc Oxide Nanoparticles with Potential Synergistic Activity with Common Antifungal Agents against Multidrug-Resistant Candidal Strains. CRYSTALS 2022. [DOI: 10.3390/cryst12060774] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The high incidence of fungal resistance to antifungal drugs represents a global concern, contributing to high levels of morbidity and mortality, especially among immunocompromised patients. Moreover, conventional antifungal medications have poor therapeutic outcomes, as well as possible toxicities resulting from long-term administration. Accordingly, the aim of the present study was to investigate the antifungal effectiveness of biogenic zinc oxide nanoparticles (ZnO NPs) against multidrug-resistant candidal strains. Biogenic ZnO NPs were characterized using physicochemical methods, such as UV-vis spectroscopy, transmission electron microscopy (TEM), energy-dispersive X ray (EDX) spectroscopy, FTIR (Fourier transform infrared) spectroscopy and X-ray powder diffraction (XRD) analysis. UV spectral analysis revealed the formation of two absorption peaks at 367 and 506 nm, which preliminarily indicated the successful synthesis of ZnO NPs, whereas TEM analysis showed that ZnO NPs exhibited an average particle size of 22.84 nm. The EDX spectrum confirmed the successful synthesis of ZnO nanoparticles free of impurities. The FTIR spectrum of the biosynthesized ZnO NPs showed different absorption peaks at 3427.99, 1707.86, 1621.50, 1424.16, 1325.22, 1224.67, 1178.22, 1067.69, 861.22, 752.97 and 574.11 cm−1, corresponding to various functional groups. The average zeta potential value of the ZnO NPs was −7.45 mV. XRD analysis revealed the presence of six diffraction peaks at 2θ = 31.94, 34.66, 36.42, 56.42, 69.54 and 76.94°. The biogenic ZnO NPs (100µg/disk) exhibited potent antifungal activity against C. albicans, C. glabrata and C. tropicalis strains, with suppressive zone diameters of 24.18 ± 0.32, 20.17 ± 0.56 and 26.35 ± 0.16 mm, respectively. The minimal inhibitory concentration (MIC) of ZnO NPs against C. tropicalis strain was found to be 10 μg/mL, whereas the minimal fungicidal concentration (MFC) was found to be 20 μg/mL. Moreover, ZnO NPs revealed a potential synergistic efficiency with fluconazole, nystatin and clotrimazole antifungal drugs against C. albicans strain, whereas terbinafine, nystatin and itraconazole antifungal drugs showed a potential synergism with ZnO NPs against C. glabrata as a multidrug-resistant strain. In conclusion, pomegranate peel extract mediated green synthesis of ZnO NPs with potential physicochemical features and antimicrobial activity. The biosynthesized ZnO NPs could be utilized for formulation of novel drug combinations to boost the antifungal efficiency of commonly used antifungal agents.
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13
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In Vitro Antidermatophytic and Biochemical Studies on Aqueous Extracts of Avicennia marina and Suaeda monoica Plants from the Yanbu Region. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2022. [DOI: 10.22207/jpam.16.2.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Many infectious diseases can be treated using herbal medicines. Therefore, plant materials play a major role in therapeutic medicine and are widely used in many developing countries. In this study, we analyzed the potential of Avicennia marina and Suaeda monoica leaf extracts as antidermatophytic agents. Molecular identification of the plant samples was performed via DNA sequencing of the internal transcribed spacer region using the primers ITS-u1 and ITS-u4. Leaf extracts of A. marina and S. monoica were prepared in cold and hot distilled water. Their antidermatophytic activities were evaluated against Trichophyton mentagrophytes, T. verrucosum, Microsporum gallinae, M. gypseum, M. canis, Epidermophyton floccosum, Candida albicans, and C. tropicalis using the dry weight method. E. floccosum was the most sensitive to both cold extracts of A. marina and S. monoica, whereas T. verrucosum was the most sensitive to the hot extract of A. marina. The minimum inhibitory concentrations of the hot extracts were determined. They ranged from 10 to 30 mg/ml, defining the anti-scavenging activity and total phenolic content of both plants. The hot extract of A. marina possessed the highest anti-scavenging activity (76%), whereas the cold extract of A. marina contained the highest phenolic content (40.06 mg/g dry weight). In addition, high-performance liquid chromatography was used to separate and estimate some of the bioactive compounds present in the plant extracts.
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14
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First detection of Trichophyton indotineae causing tinea corporis in Central Vietnam. Med Mycol Case Rep 2022; 36:37-41. [PMID: 35620657 PMCID: PMC9127533 DOI: 10.1016/j.mmcr.2022.05.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/24/2022] [Accepted: 05/02/2022] [Indexed: 12/21/2022] Open
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15
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Mohod B, Jain D, Kumar P, Chowdhuri S, Doshi H, Jain U, Beergouder S, Maganti K, Rani R, Jaiswal A. A retrospective analysis of real-world data to evaluate the safety and effectiveness of topical amorolfine in tinea infection. INDIAN JOURNAL OF DRUGS IN DERMATOLOGY 2022. [DOI: 10.4103/ijdd.ijdd_8_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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16
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Trifan A, Bostănaru AC, Luca SV, Temml V, Akram M, Herdlinger S, Kulinowski Ł, Skalicka-Woźniak K, Granica S, Czerwińska ME, Kruk A, Greige-Gerges H, Mareș M, Schuster D. Honokiol and Magnolol: Insights into Their Antidermatophytic Effects. PLANTS (BASEL, SWITZERLAND) 2021; 10:2522. [PMID: 34834886 PMCID: PMC8620735 DOI: 10.3390/plants10112522] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 05/15/2023]
Abstract
Dermatophyte infections represent a significant public health concern, with an alarming negative impact caused by unsuccessful therapeutic regimens. Natural products have been highlighted as a promising alternative, due to their long-standing traditional use and increasing scientific recognition. In this study, honokiol and magnolol, the main bioactives from Magnolia spp. bark, were investigated for their antidermatophytic activity. The antifungal screening was performed using dermatophyte standard strains and clinical isolates. The minimal inhibitory concentration (MIC) and the minimal fungicidal concentration (MFC) were determined in accordance with EUCAST-AFST guidelines, with minor modifications. The effects on ergosterol biosynthesis were assessed in Trichophyton rubrum cells by HPLC-DAD. Putative interactions with terbinafine against T. rubrum were evaluated by the checkerboard method. Their impact on cells' viability and pro-inflammatory cytokines (IL-1β, IL-8 and TNF-α) was shown using an ex vivo human neutrophils model. Honokiol and magnolol were highly active against tested dermatophytes, with MIC and MFC values of 8 and 16 mg/L, respectively. The mechanism of action involved the inhibition of ergosterol biosynthesis, with accumulation of squalene in T. rubrum cells. Synergy was assessed for binary mixtures of magnolol with terbinafine (FICI = 0.50), while honokiol-terbinafine combinations displayed only additive effects (FICI = 0.56). In addition, magnolol displayed inhibitory effects towards IL-1β, IL-8 and TNF-α released from lipopolysaccharide (LPS)-stimulated human neutrophils, while honokiol only decreased IL-1β secretion, compared to the untreated control. Overall, honokiol and magnolol acted as fungicidal agents against dermatophytes, with impairment of ergosterol biosynthesis.
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Affiliation(s)
- Adriana Trifan
- Department of Pharmacognosy, Faculty of Pharmacy, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania;
| | - Andra-Cristina Bostănaru
- Laboratory of Antimicrobial Chemotherapy, Faculty of Veterinary Medicine, “Ion Ionescu de la Brad” Iasi University of Life Sciences, 700489 Iasi, Romania;
| | - Simon Vlad Luca
- Department of Pharmacognosy, Faculty of Pharmacy, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania;
- Biothermodynamics, TUM School of Life and Food Sciences, Technical University of Munich, 85354 Freising, Germany
| | - Veronika Temml
- Department of Pharmaceutical Chemistry, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria; (V.T.); (M.A.); (S.H.); (D.S.)
| | - Muhammad Akram
- Department of Pharmaceutical Chemistry, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria; (V.T.); (M.A.); (S.H.); (D.S.)
| | - Sonja Herdlinger
- Department of Pharmaceutical Chemistry, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria; (V.T.); (M.A.); (S.H.); (D.S.)
| | - Łukasz Kulinowski
- Department of Natural Products Chemistry, Medical University of Lublin, 20-093 Lublin, Poland; (Ł.K.); (K.S.-W.)
| | - Krystyna Skalicka-Woźniak
- Department of Natural Products Chemistry, Medical University of Lublin, 20-093 Lublin, Poland; (Ł.K.); (K.S.-W.)
| | - Sebastian Granica
- Microbiota Lab, Centre for Preclinical Studies, Department of Pharmacognosy and Molecular Basis of Phytotherapy, Medical University of Warsaw, 02-097 Warsaw, Poland; (S.G.); (A.K.)
| | - Monika E. Czerwińska
- Department of Biochemistry and Pharmacogenomics, Faculty of Pharmacy, Medical University of Warsaw, 02-097 Warsaw, Poland;
- Centre for Preclinical Research, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Aleksandra Kruk
- Microbiota Lab, Centre for Preclinical Studies, Department of Pharmacognosy and Molecular Basis of Phytotherapy, Medical University of Warsaw, 02-097 Warsaw, Poland; (S.G.); (A.K.)
| | - Hélène Greige-Gerges
- Bioactive Molecules Research Laboratory, Department of Chemistry and Biochemistry, Faculty of Sciences, Section II, Lebanese University, Jdeidet el-Matn B.P. 90656, Lebanon;
| | - Mihai Mareș
- Laboratory of Antimicrobial Chemotherapy, Faculty of Veterinary Medicine, “Ion Ionescu de la Brad” Iasi University of Life Sciences, 700489 Iasi, Romania;
| | - Daniela Schuster
- Department of Pharmaceutical Chemistry, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria; (V.T.); (M.A.); (S.H.); (D.S.)
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17
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Trifan A, Luca SV, Bostănaru AC, Brebu M, Jităreanu A, Cristina RT, Skalicka-Woźniak K, Granica S, Czerwińska ME, Kruk A, Greige-Gerges H, Sieniawska E, Mareș M. Apiaceae Essential Oils: Boosters of Terbinafine Activity against Dermatophytes and Potent Anti-Inflammatory Effectors. PLANTS (BASEL, SWITZERLAND) 2021; 10:plants10112378. [PMID: 34834740 PMCID: PMC8623916 DOI: 10.3390/plants10112378] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 05/03/2023]
Abstract
Dermatophyte infections represent an important public health concern, affecting up to 25% of the world's population. Trichophyton rubrum and T. mentagrophytes are the predominant dermatophytes in cutaneous infections, with a prevalence accounting for 70% of dermatophytoses. Although terbinafine represents the preferred treatment, its clinical use is hampered by side effects, drug-drug interactions, and the emergence of resistant clinical isolates. Combination therapy, associating terbinafine and essential oils (EOs), represents a promising strategy in the treatment of dermatophytosis. In this study, we screened the potential of selected Apiaceae EOs (ajowan, coriander, caraway, and anise) to improve the antifungal activity of terbinafine against T. rubrum ATCC 28188 and T. mentagrophytes ATCC 9533. The chemical profile of EOs was analyzed by gas chromatography. The minimal inhibitory concentration (MIC) and minimal fungicidal concentration (MFC) of EOs/main compounds were determined according to EUCAST-AFST guidelines, with minor modifications. The checkerboard microtiter method was used to identify putative synergistic combinations of EOs/main constituents with terbinafine. The influence of EOs on the viability and pro-inflammatory cytokine production (IL-1β, IL-8 and TNF-α) was determined using an ex vivo human neutrophils model. The binary associations of tested EOs with terbinafine were found to be synergistic against T. rubrum, with FICI values of 0.26-0.31. At the tested concentrations (6.25-25 mg/L), EOs did not exert cytotoxic effects towards human neutrophils. Anise EO was the most potent inhibitor of IL-1β release (46.49% inhibition at 25 mg/L), while coriander EO displayed the highest inhibition towards IL-8 and TNF-α production (54.15% and 54.91%, respectively). In conclusion, the synergistic combinations of terbinafine and investigated Apiaceae EOs could be a starting point in the development of novel topical therapies against T. rubrum-related dermatophytosis.
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Affiliation(s)
- Adriana Trifan
- Department of Pharmacognosy, Faculty of Pharmacy, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
- Correspondence: (A.T.); (A.-C.B.)
| | - Simon Vlad Luca
- Department of Pharmacognosy, Faculty of Pharmacy, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
- Biothermodynamics, TUM School of Life and Food Sciences, Technical University of Munich, 85354 Freising, Germany;
| | - Andra-Cristina Bostănaru
- Laboratory of Antimicrobial Chemotherapy, Faculty of Veterinary Medicine, “Ion Ionescu de la Brad” Iasi University of Life Sciences, 700489 Iasi, Romania;
- Correspondence: (A.T.); (A.-C.B.)
| | - Mihai Brebu
- Physical Chemistry of Polymers Laboratory, Petru Poni Institute of Macromolecular Chemistry, 700481 Iasi, Romania;
| | - Alexandra Jităreanu
- Department of Toxicology, Faculty of Pharmacy, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania;
| | - Romeo-Teodor Cristina
- Department of Pharmacology, The Banat University of Agricultural Sciences and Veterinary Medicine, 300645 Timisoara, Romania;
| | - Krystyna Skalicka-Woźniak
- Department of Natural Products Chemistry, Medical University of Lublin, 20-093 Lublin, Poland; (K.S.-W.); (E.S.)
| | - Sebastian Granica
- Microbiota Lab, Centre for Preclinical Studies, Department of Pharmacognosy and Molecular Basis of Phytotherapy, Medical University of Warsaw, 02-097 Warsaw, Poland; (S.G.); (A.K.)
| | - Monika E. Czerwińska
- Department of Biochemistry and Pharmacogenomics, Faculty of Pharmacy, Medical University of Warsaw, 02-097 Warsaw, Poland;
- Centre for Preclinical Research, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Aleksandra Kruk
- Microbiota Lab, Centre for Preclinical Studies, Department of Pharmacognosy and Molecular Basis of Phytotherapy, Medical University of Warsaw, 02-097 Warsaw, Poland; (S.G.); (A.K.)
| | - Hélène Greige-Gerges
- Bioactive Molecules Research Laboratory, Department of Chemistry and Biochemistry, Faculty of Sciences, Section II, Lebanese University, Jdaidet el-Matn B.P. 90656, Lebanon;
| | - Elwira Sieniawska
- Department of Natural Products Chemistry, Medical University of Lublin, 20-093 Lublin, Poland; (K.S.-W.); (E.S.)
| | - Mihai Mareș
- Laboratory of Antimicrobial Chemotherapy, Faculty of Veterinary Medicine, “Ion Ionescu de la Brad” Iasi University of Life Sciences, 700489 Iasi, Romania;
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