Progress and promise of alternative animal and non-animal methods in biomedical research.

Cell culture and invertebrate animal models reflect a significant evolution in scientific research by providing reliable evidence on the physiopathology of diseases, screening for new drugs, and toxicological tests while reducing the need for mammals. In this review, we discuss the progress and promise of alternative animal and non-animal methods in biomedical research, with a special focus on drug toxicity.

Antimicrobial, anti-adherence and antibiofilm activity against Staphylococcus aureus of a 4-phenyl coumarin derivative isolated from Brazilian geopropolis.

The discovery of new drug candidates, especially from natural products, remains a promising approach to overcome the alarmingly high microbial resistance rates. A major 4-phenyl coumarin named cinnamoyloxy-mammeisin (CNM) isolated from stingless bee geopropolis showed interesting biological properties; however, its antimicrobial activity against Staphylococcus aureus has never been investigated. In order to clarify these properties, CNM isolated from geopropolis was initially tested against methicillin-susceptible and -resistant S. aureus strains. Further, the effects of CNM were assessed on the microbial adherence to human cells, biofilm formation and mature biofilm. Then, the acute toxicity of the compound was determined in Galleria mellonella. CNM showed bacteriostatic activity against methicillin-susceptible and -resistant S. aureus strains, with MIC of 11.3 µM. In addition, CNM at 5.7 µM reduced bacterial adherence to human keratinocytes from 1 to 3 h and disrupted biofilm formation by reducing cell viability and architecture, as evidenced by scanning electron microscopy. The acute toxicity assay indicated no significant harmful effects. Based on these findings, CNM can be considered a promising compound with anti-S. aureus properties and predicted low toxicity. Thus, it may be used as a drug candidate or lead compound for structure/activity optimization.

Diacetylcurcumin: a new photosensitizer for antimicrobial photodynamic therapy in Streptococcus mutans biofilms.

This study evaluated the effect of antimicrobial photodynamic therapy (aPDT) on S. mutans using diacetylcurcumin (DAC) and verified DAC toxicity. In vitro, S. mutans biofilms were exposed to curcumin (CUR) and DAC and were light-irradiated. Biofilms were collected, plated and incubated for colony counts. DAC and CUR toxicity assays were conducted with Human Gingival Fibroblast cells (HGF). In vivo, G. mellonella larvae were injected with S. mutans and treated with DAC, CUR and aPDT. The hemolymph was plated and incubated for colony counts. Significant reductions were observed when DAC and CUR alone were used and when aPDT was applied. HGF assays demonstrated no differences in cell viability for most groups. DAC and CUR reduced the S. mutans load in G. mellonella larvae both alone and with aPDT. Systematic toxicity assays on G. mellonella demonstrated no effect of DAC and CUR or aPDT on the survival curve.

Isoflavonoids from Brazilian red propolis down-regulate the expression of cancer-related target proteins: A pharmacogenomic analysis.

Vestitol and neovestitol are bioactive isoflavonoids isolated from Brazilian red propolis, a unique Apis melifera type of propolis botanically originated from Dalbergia ecastophyllum. Although these molecules have relevant biological effects, including anticancer and immunomodulatory activities, their mechanism(s) of action and the affected pathways remain largely unknown. Here, we carried out a pharmacogenomic analysis to investigate the effects of vestitol and neovestitol on the whole-genome expression in human tumor cells, particularly cancer-related target proteins. HeLa cells were exposed to the compounds at IC20 and genomic information of treated cells was analyzed using the Illumina transcriptome system and GeneGo MetaCore software. Our results showed that vestitol (IC20  = 214.7 µM) reduced the expression of genes enrolled with the alpha tubulin (fold -3.7), tubulin in microtubules (fold -3.7), and histone h3 (fold = -3.03), and that treatment with neovestitol (IC20  = 102.91 µM) downregulated prostaglandin E synthase gene (fold = -3.12), which are considered ideal targets for anticancer therapy. These data open avenues for the study of vestitol and neovestitol as potential promising candidates for anticancer therapy. Toxicological, non-clinical, and clinical validation of the findings presented herein is needed.

Unexplored endemic fruit species from Brazil: Antibiofilm properties, insights into mode of action, and systemic toxicity of four Eugenia spp.

Brazilian endemic fruit species have aroused attention due to their highly valuable, yet unexplored, agro-industrial, food and therapeutic potential. Herein, we describe the antifungal activity of four Eugenia spp. against Candida albicans biofilms, and further demonstrate insights into their potential mode(s) of action and toxicity in vitro and in vivo. Extracts from different parts (seeds, pulps, leaves) of E. leitonii (EL), E. brasiliensis (EB), E. myrcianthes (EM) and E. involucrata (EI) were obtained (S23°23',W45°39') and chemically characterized by GC/MS. The active extracts were tested against C. albicans biofilm viability and architecture, as well as mode of action, and toxicology using RAW 264.7 macrophages and Galleria mellonella larvae. The MIC values ranged from 15.62 to >2000 µg/mL. The most active extracts were EL (seed, 15.62 µg/mL) and EB (leaf and seeds, 31.25 and 15.62 µg/mL, respectively). Treatment with these extracts at 10xMIC reduced biofilm viability by 54-55% (P < 0.0001) as compared to 42% by nystatin. At 10xMIC, all extracts caused damages to biofilm architecture and integrity, and fewer hyphae remained attached to treated biofilms. None of them was found to interfere with cell wall biosynthesis or complexation with ergosterol. The extracts had low toxicity against macrophages in vitro (P > 0.05) and G. mellonella larvae, with mean in vivo LD50 of 1500 mg/kg (EL, seeds); 2500 mg/kg (EB, seeds); and 1250 mg/kg (EB, leaf). The phenolic compounds epicatechin and gallic acid were the major constituents in the extracts. Our findings may open avenues for the application of these yet unexplored native fruits in the food and pharmaceutical industry.

Alternative Animal and Non-Animal Models for Drug Discovery and Development: Bonus or Burden?

Mammalian models have served as a basis for R&D over the past decades. Nevertheless, these models are expensive, laborious, may yield results that cannot always be translated into the human in vivo situation and, more recently, have reverberated great social and ethical dilemmas. Hence, the prospect of changes in the global scientific scenario and the Three Rs principle (Reduction, Replacement and Refinement) have encouraged the development of alternative methods to the use of mammals. Despite the efforts, suitable alternative tests are not available in all areas of biomedical research, as regulatory acceptance requires time, prior validation and robust financial and scientific investment. In this perspective, we aim to shed light on the concepts, challenges and perspectives for implementation of innovative alternative animal and non-animal methods in scientific research. The applicability and meaningfulness of invertebrate animal models, in silico analysis and reverse pharmacology are discussed, among other aspects of relevance in today's scenario. Overall, the use of alternative models, including Artemia salina (brine shrimp), Caenorhabditis elegans (roundworm), Danio rerio (zebra fish), Drosophila melanogaster (fruit fly), Galleria mellonella (greater waxmoth) and in silico modelling, increased 909% from 1990 to 2015, as compared to 154% of conventional mammals in the same period. Thus, technological and scientific advancements in the fields of toxicology and drug development seem to have diminished the need for mammalian models. Today, however, mammals still remain critically indispensable to provide - in most cases -reliable data subsidizing and validating translation into the clinical setting.

Efficiency of bimaxillary advancement surgery in increasing the volume of the upper airways: a systematic review of observational studies and meta-analysis.

Postsurgical changes of the airways have become a great point of interest because it has been reported that maxillomandibular advancement surgery can improve or eliminate obstructive sleep apnea; however, its treatment effectiveness is still controversial. The purpose of this systematic review and meta-analysis was to assess the effectiveness of maxillomandibular advancement surgery to increase upper airway volume in adults, comparing before and after treatment. Bibliographic searches of observational studies with no restriction of year or language were performed in the electronic databases PubMed, Scopus, ScienceDirect and SciELO for articles published up to April 2015. After verification of duplicate records, 1860 articles were examined. Of these, ten met the eligibility criteria, of which three were excluded for having poor methodological quality. The other seven articles were included in the systematic review and six in the meta-analysis, representing 83 patients. One study whose data were not given in absolute values was excluded from the meta-analysis. The meta-analysis showed a statistically significant difference between the averages of upper airway volume before and after surgery {7.86 cm3 [95 % CI (6.22, 9.49), p = 1.00)}. Clinical evidence suggests that the upper airway volume is increased after maxillomandibular advancement surgery.

Antibiofilm Activity and Mechanism of Action of the Disinfectant Chloramine T on Candida spp., and Its Toxicity against Human Cells.

We evaluated the antifungal and anti-biofilm activity, mechanism of action and cytotoxicity of chloramine T trihydrate (CAT) against Candida spp. The Minimum Inhibitory and Fungicidal Concentrations (MIC/MFC) of CAT were determined. Changes in CAT-treated C. albicans growth kinetics and micromorphology were evaluated, as well as the mechanism of action, and its effects on biofilm. Cytotoxicity was assessed by the hemolysis method. The data were analyzed by inferential statistics (p ≤ 0.05). CAT showed antifungal activity against all strains, with MIC values ranging between 1.38 and 5.54 mmol/L (MIC75%: 2.77 mmol/L). CAT demonstrated an immediate and sustained action on C. albicans growth kinetics, particularly at 2 × MIC. This compound likely acts on the cell wall and membrane permeability simultaneously and was found to cause changes in C. albicans micromorphology. Tha antibiofilm activity of CAT was similar to that of sodium hypochlorite (p > 0.05) against mature biofilms. CAT was more effective than NaOCl in reducing mature biofilm upon 1-min exposure at 2 × MIC (24 h) and 4 × MIC (48 h) (p < 0.05). Toxicological analysis revealed that CAT had hemolytic activity between 61 and 67.7% as compared to 100% by NaOCl. CAT has antifungal and anti-biofilm properties, probably acting on both cell wall and membrane permeability, and showed low toxicity in vitro.

How Natural Product Research has Contributed to Oral Care Product Development? A Critical View.

PURPOSES: Despite the high number of studies on the biological effects of natural products (NP) and molecules isolated therefrom, only a small part of them reach the clinical phase and become commercially available. In this perspective we make an analysis on how plant research has impacted oral health care over the last 15 years. METHODS: Sixteen major clinical trial registry databases across the globe were searched for completed randomized clinical trials of herbal/natural product interventions (RCTHI) in theperiod 2000-2015. RESULTS: There was a considerable increase in the number of RCTHI, which points out an interest of academia and industry in the development of novel NP-based therapeutics. There is a trendfor greater heterogeneity of targeted dental conditions, mostly oral mucositis, periodontitis and dental caries. Topical application rather than systemic use predominated in the dental scope as mouthwashes, toothpastes, oral patches and gels have been the most commonly tested pharmaceutical forms. Today, despite the high number of in vitro, in vivo and clinical studies testing NP and/or NP-isolated molecules, only 11% (n = 9) of them are phase IV clinical trials assessing commercially available herbal products. This may be a result of poorly designed, superficial basic research that does not provide evidence to support the clinical testing of NP and derived molecules. CONCLUSION: As of now, plant research is promising although still accounts for a modest participation in the oral health care industry due to limited investment and incomplete or inconsistent information from preclinical and clinical testing.

Antifungal potential of Sideroxylon obtusifolium and Syzygium cumini and their mode of action against Candida albicans.

Context The emergence of resistant pathogens and toxicity of antifungals have encouraged an active search for novel candidates to manage Candida biofilms. Objective In this study, the little known species Sideroxylon obtusifolium T.D. Penn (Sapotacea) and Syzygium cumini (L.) Skeels (Myrtaceae), from the Caatinga biome in Brazil were chemically characterized and explored for their antifungal potential against C. albicans. Materials and methods We determined the effects of hydroalcoholic extracts/fractions upon fungal growth (minimum inhibitory and fungicidal concentrations, MIC/MFC), biofilm morphology (scanning electron microscopy) and viability (confocal laser scanning microscopy), proposed their mode of action (sorbitol and ergosterol assays), and finally investigated their effects against macrophage and keratinocyte cells in a cell-based assay. Data were analysed using one-way analysis of variance with Tukey-Kramer post-test (α = 0.05). Results The n-butanol (Nb) fraction from S. obtusifolium and S. cumini extract (Sc) showed flavonoids (39.11 ± 6.62 mg/g) and saponins (820.35 ± 225.38 mg/g), respectively, in their chemical composition and demonstrated antifungal activity, with MICs of 62.5 and 125 µg/mL, respectively. Nb and Sc may complex with ergosterol as there was a 4-16-fold increase in MICs in the presence of exogenous ergosterol, leading to disrupted permeability of cell membrane. Deleterious effects were observed on morphology and viability of treated biofilms from concentrations as low as their MICs and higher. Sc was not toxic to macrophages and keratinocytes at these concentrations (p > 0.05), unlike Nb. Conclusions Nb and Sc demonstrated considerable antifungal activity and should be further investigated as potential alternative candidates to treat Candida biofilms.

Antibacterial Activity of Essential Oils and Their Isolated Constituents against Cariogenic Bacteria: A Systematic Review.

Dental caries remains the most prevalent and costly oral infectious disease worldwide. Several methods have been employed to prevent this biofilm-dependent disease, including the use of essential oils (EOs). In this systematic review, we discuss the antibacterial activity of EOs and their isolated constituents in view of a potential applicability in novel dental formulations. Seven databases were systematically searched for clinical trials, in situ, in vivo and in vitro studies addressing the topic published up to date. Most of the knowledge in the literature is based on in vitro studies assessing the effects of EOs on caries-related streptococci (mainly Streptococcus mutans) and lactobacilli, and on a limited number of clinical trials. The most promising species with antibacterial potential against cariogenic bacteria are: Achillea ligustica, Baccharis dracunculifolia, Croton cajucara, Cryptomeria japonica, Coriandrum sativum, Eugenia caryophyllata, Lippia sidoides, Ocimum americanum, and Rosmarinus officinalis. In some cases, the major phytochemical compounds determine the biological properties of EOs. Menthol and eugenol were considered outstanding compounds demonstrating an antibacterial potential. Only L. sidoides mouthwash (1%) has shown clinical antimicrobial effects against oral pathogens thus far. This review suggests avenues for further non-clinical and clinical studies with the most promising EOs and their isolated constituents bioprospected worldwide.

Phytochemistry, antifungal and antioxidant activity, and cytotoxicity of byrsonima gardneriana (A. Juss) extract.

OBJECTIVE: To determine the phytochemical composition of Byrsonima gardneriana (A. Juss) leaf extract (BGE) and its antifungal activity against Candida spp., antioxidant potential and in vitro cytotoxicity. MATERIAL AND METHODS: BGE was obtained and submitted to Gas Chromatography Coupled to Mass Spectrometry for phytochemical analysis. The ethanolic extract was tested for its antifungal activity against C. albicans and non-albicans reference strains and clinical isolates in addition to inhibition of C. albicans growth kinetics. It was also tested for antioxidant potential in the presence of phenylhydrazine and reactive oxygen species (ROS). And cytoxicity in human erythrocytes. The data were analyzed by one-way Analysis of Variance (ANOVA) followed by Tukey's or Dunnett's post-hoc test, with α = 0.05. RESULTS: Pyroglutamic acid (90.77 %), eucalyptol (89.61 %) and octanoic acid (76.22 %) were the major compounds detected in BGE, P (%) is the percent probability of compound identification, according to the mass spectra library. The extract showed fungistatic activity, with MIC of 125 µg/mL against most tested strains. While BGE showed low hemolytic activity on all blood types tested herein, it could not prevent osmotic stress in human erythrocytes. The extract did not have oxidizing effects in the presence of phenylhydrazine, but it showed antioxidant potential against ROS when tested at 31 µg/mL and 62 µg/mL. CONCLUSION: B. gardneriana extract showed antifungal activity against Candida spp., demonstrated low hemolytic potential, no oxidant activity in human erythrocytes and antioxidant activity against ROS. This study opens avenues for the study of BGE as a promising biocompatible antifungal agent.

In silico approaches for screening molecular targets in Candida albicans: A proteomic insight into drug discovery and development.

Candida species are opportunistic pathogens which can cause conditions ranging from simple mucocutaneous infections to fungemia and death in immunosuppressed and hospitalized patients. Candida albicans is considered to be the species mostly associated with fungal infections in humans and, therefore, the mostly studied yeast. This microorganism has survival and virulence factors which, allied to a decreased host immunity response, make infection more difficult to control. Today, the current limited antifungal arsenal and a dramatic increase in fungal resistance have driven the need for the synthesis of drugs with novel mechanisms of action. However, the development of a new drug from discovery to marketing takes a long time and is highly costly. The objective of this review is to show that with advances in biotechnology and biofinformatics, in silico tools such as molecular docking can optimize such a timeline and reduce costs, while contributing to the design and development of targeted drugs. Here we highlight the most promising protein targets in Candida albicans for the development of drugs with new mechanisms of action.

Fusogenic Liposomes Increase the Antimicrobial Activity of Vancomycin Against Staphylococcus aureus Biofilm.

Objective: The aim of the present study was to encapsulate vancomycin in different liposomal formulations and compare the in vitro antimicrobial activity against Staphylococcus aureus biofilms. Methods: Large unilamellar vesicles of conventional (LUV VAN), fusogenic (LUVfuso VAN), and cationic (LUVcat VAN) liposomes encapsulating VAN were characterized in terms of size, polydispersity index, zeta potential, morphology, encapsulation efficiency (%EE) and in vitro release kinetics. The formulations were tested for their Minimum Inhibitory Concentration (MIC) and inhibitory activity on biofilm formation and viability, using methicillin-susceptible S. aureus ATCC 29213 and methicillin-resistant S. aureus ATCC 43300 strains. Key Findings: LUV VAN showed better %EE (32.5%) and sustained release than LUVfuso VAN, LUVcat VAN, and free VAN. The formulations were stable over 180 days at 4°C, except for LUV VAN, which was stable up to 120 days. The MIC values for liposomal formulations and free VAN ranged from 0.78 to 1.56 µg/ml against both tested strains, with no difference in the inhibition of biofilm formation as compared to free VAN. However, when treating mature biofilm, encapsulated LUVfuso VAN increased the antimicrobial efficacy as compared to the other liposomal formulations and to free VAN, demonstrating a better ability to penetrate the biofilm. Conclusion: Vancomycin encapsulated in fusogenic liposomes demonstrated enhanced antimicrobial activity against mature S. aureus biofilms.

Anadenanthera Colubrina vell Brenan: anti-Candida and antibiofilm activities, toxicity and therapeutical action.

We evaluated the antifungal and antibiofilm potential of the hydroalcoholic extract of bark from Anadenanthera colubrina (vell.) Brenan, known as Angico, against Candida spp. Antifungal activity was evaluated using the microdilution technique through the Minimum Inhibitory and Fungicide Concentrations (MIC and MFC). The antibiofilm potential was tested in mature biofilms formed by Candida species and analyzed through the counting of CFU/mL and scanning electron micrograph (SEM). In vivo toxicity and therapeutic action was evaluated in the Galleria mellonella model. The treatment with the extract, in low doses, was able to reduce the growth of planktonic cells of Candida species. MIC values range between 19.5 and 39 µg/mL and MFC values range between 79 and 625 µg/mL. In addition was able to reduce the number of CFU/mL in biofilms and to cause structural alteration and cellular destruction, observed via SEM. A. colubrina showed low toxicity in the in vivo assay, having not affected the viability of the larvae at doses below 100mg/kg and high potential in the treatment of C. albicans infection. Considering its high antifungal potential, its low toxicity and potential to treatment of infections in in vivo model, A. colubrina extract is a strong candidate for development of a new agent for the treatment of oral candidiasis.

The alveolar bone protective effects of natural products: A systematic review.

OBJECTIVES: This systematic review was carried out to identify which naturally-occurring agents and constituents isolated therefrom have effects in preventing bone loss in a ligature-induced periodontitis model. MATERIALS AND METHODS: Eight databases were systematically searched for studies of experimental periodontitis. The data were extracted, analyzed, and the treatment outcomes were given scores based on the level of bone destruction as compared to their untreated induced-periodontitis control. RESULTS: 294 articles were found, of which 15 met the inclusion criteria. The selected studies tested a multi-herbal formulation; extracts (leaves, barks or fruit) of different plant species; and propolis. The most usual dosing protocol consisted of 3-times-a-day, 11-day treatment. The combined gel of Myracrodruon urundeuva (5%) and Lippia sidoides (0.5%) was the most active treatment, reducing 45-65% bone loss in the region of molars as compared to 73.4% of doxycycline (gold-standard). Ginkgo biloba extract (28-56 mg/kg) and propolis (100-200 mg/kg) prevented bone destruction by 50% and 40-44%, respectively. The other tested samples showed intermediate/weak activity in modulating bone resorption. CONCLUSIONS: The gel of M. urundeuva and L. sidoides, and G. biloba and propolis extracts showed strong alveolar bone protective effectiveness in induced-periodontitis in rats. Further translational research should bridge the gap between the rat study outcomes and the clinical efficacy and long-term toxicity of these formulations in humans. The compilation of the vast literature database presented herein may drive further in vivo and clinical studies with the selected efficacious formulations to subsidize their pharmaceutical application.

The use of Brazilian propolis for discovery and development of novel anti-inflammatory drugs.

Anti-Inflammatory drugs have been routinely used in the management of acute and chronic inflammatory conditions. Nevertheless, their undesirable side and adverse effects have encouraged the development of more selective, tolerable and efficacious drugs able to modulate the inflammatory process through distinct mechanisms than those of drugs currently available in the market, for instance, inhibition of leukocyte recruitment (chemotaxis, rolling, adhesion and transmigration). Natural products, including Brazilian propolis, have been considered a rich source of anti-inflammatory molecules due to a very complex phytochemical diversity. Brazil has at least thirteen distinct types of propolis and many bioactive compounds have been isolated therefrom, such as apigenin, artepillin C, vestitol, neovestitol, among others. These molecules were proven to play a significant immunomodulatory role through (i) inhibition of inflammatory cytokines (e.g. TNF-α) and chemokines (CXCL1/KC and CXCL2/MIP2); (ii) inhibition of IκBα, ERK1/2, JNK and p38MAPK phosphorylation; (iii) inhibition of NF-κB activation; and (iv) inhibition of neutrophil adhesion and transmigration (ICAM-1, VCAM-1 and E-selectin expression). In this review, we shed light on the new advances in the research of compounds isolated from Brazilian propolis from Apis mellifera bees as potentially novel anti-inflammatory drugs. The compilation of data and insights presented herein may open further avenues for the pharmacological management of oral and systemic inflammatory conditions. Further research should focus on clinical and acute/chronic toxicological validation of the most promising compounds described in this review.

Antifungal Activity, Mode of Action, Docking Prediction and Anti-biofilm Effects of (+)-ß-pinene Enantiomers against Candida spp.

AIMS: The objective of this study was to investigate the effectiveness of (+)-ß-pinene inhibition on Candida spp. growth, aiming at elucidation of the mechanism of action; to determine fungal cell enzyme binding activity (through molecular docking simulations) and its effects on biofilm reduction. METHODS: Candida strains (n=25) from referenced and clinical origins, either susceptible or resistant to standard clinical antifungals, were tested for determination of Minimum Inhibitory Concentration (MIC); Minimum Fungicidal Concentration (MFC); and microbial death curves upon treatment with (+)-ß-pinene; the effects of (+)-ß-pinene on the cell wall (sorbitol assay), membrane ergosterol binding, and effects on biofilm were evaluated by microdilution techniques. We also evaluated the interactions between (+)-ß-pinene and cell wall and membrane enzymes of interest. RESULTS: The MIC values of (+)-ß-pinene ranged from <56.25 to 1800 µmol/L. The MIC of (+)-ß-pinene did not increase when ergosterol was added to the medium, however it did increase in the presence of sorbitol, leading to a doubled MIC for C. tropicalis and C. krusei. The results of the molecular docking simulations indicated better interaction with delta-14-sterol reductase (-51 kcal/mol). (+)-ß-pinene presents anti-biofilm activity against multiples species of Candida. CONCLUSION: (+)-ß-pinene has antifungal activity and most likely acts through interference with the cell wall; through molecular interaction with Delta-14-sterol reductase and, to a lesser extent, with the 1,3-ß- glucan synthase. This molecule was also found to effectively reduce Candida biofilm adhesion.