Antifungal, anti-inflammatory and antioxidant activity of bi-herbal mixtures with medicinal plants from Argentinean highlands.

ETHNOPHARMACOLOGICAL RELEVANCE: Argentinean medicinal plants such as Larrea divaricata Cav., Larrea cuneifolia Cav., Larrea nitida Cav., Zuccagnia punctata Cav. and Tetraglochin andina Ciald. are used alone and in combination in traditional medicine by inhabitants from northwestern Argentina to solve mycosis, vaginal infections, gastrointestinal, respiratory, and inflammatory processes. AIM OF THE STUDY: To assess the effect of interactions between hydroalcoholic extracts of these five species of medicinal plants against yeast strains isolated from vaginal infections, select the most active mixtures and evaluate anti-inflammatory and antioxidant activities. MATERIAL AND METHODS: Synergy between the plant extracts was studied by using a broth microdilution assay by means of the checkerboard method against Saccharomyces cerevisiae, Candida albicans, and non albicans strains. The inhibitory effect on lipoxygenase and the antioxidant capacity in cell-free and cell systems were studied. The chemical profile was evaluated by qualitative and quantitative screening, whereas chemical markers were quantified by HPLC-DAD. RESULTS: A synergistic antifungal effect was observed in some binary combinations. Z. punctata/L. divaricata, Z. punctata/L. cuneifolia, and Z. punctata/L. nitida were the most active mixtures. Nordihydroguaiaretic acid and 2',4'-dihydroxychalcone, two antifungal compounds, present in these extracts, were identified and quantified by HPLC-DAD. Both single extracts and bi-herbal mixtures showed antioxidant activity (in cellular and in cell-free systems) and were active on pro-inflammatory enzymes (LOX). CONCLUSIONS: Our results indicated that the most active combinations of these species extracts could be useful in the treatment of vaginal infectious diseases caused by Saccharomyces cerevisiae and Candida spp. strains and in associated oxidative and inflammatory processes, supporting its traditional use. In addition, the results highlighted the phyto-therapeutic potential of total phytochemical compounds present in these medicinal plants.

Antimicrobial Potential of Rosmarinus officinalis Commercial Essential Oil in the Treatment of Vaginal Infections in Pregnant Women.

Treating inflammatory conditions .such as vaginosis, vaginitis, and vulvovaginitis in pregnancy is- a special problem due to limitations. of available drugs. However, possible treatment options can be found also in naturally originated products, such as essential oils (EOs) of different plants. The aim of this study was to evaluate in -vitro antimicrobial and toxic activities of the commercial EO of Rosmiarinus officinalis L. (Lamiaceae) against five Gram-positive and Gram-negative bacterial strains and two Candida strains obtained from pregnant women with Vaginal infection. Gas chromatography-mass spectrometry of the tested EO revealed oxygenated monoterpenes to be the major ingredients, while microdilution assay showed the highest activity on Staphylococcus aureus II strain at 6.2 mg/mL. After 24 hours, toxicity was determined at 19.4 mg/mL on Artemia salina nauplii. The obtained results show this EO to be a promising alternative therapy for vaginal infections, although further toxicity and safety research is required.

Curcumin: a novel non-steroidal contraceptive with antimicrobial properties.

Women face unique pathologies and challenges related to the female genital tract (FGT), including vaginal infections and gynecologic cancers. Vaginal infections faced by women include bacterial vaginosis (BV), vulvovaginal candidiasis (VC), and sexually transmitted infections (STIs). Curcumin, a component of the dietary spice turmeric, has immense biological properties, including antioxidant, anti-inflammatory/immunomodulatory, and anticancer effects. It has no side effects and is well-tolerated, making it an ideal treatment modality highly desired by women. Recently, our laboratory showed, for the first time ever, that curcumin exhibits a spermicidal and broad-spectrum microbicidal activity against several species of bacteria and yeast involved in vaginal infections. Thus, it could provide a novel, non-steroidal contraceptive having both spermicidal and microbicidal properties and can be panacea in women for treatment of several FGT pathologies, including gynecologic cancers.

Alternative treatment of vaginal infections ­ in vitro antimicrobial and toxic effects of Coriandrum sativum L. and Thymus vulgaris L. essential oils.

AIMS: The aims of study were to examine the antibacterial potential of two commercial essential oils (EOs) from coriander (Coriandrum sativum L.) and thyme (Thymus vulgaris L.) against vaginal clinical strains of bacteria and yeast and their chemical composition. METHODS AND RESULTS: Antimicrobial activities of commercial essential oils were determined using macro-diffusion (disc, well) and micro-dilution method in 96-well micro plates against twelve clinical strains of bacteria: Escherichia coli, Proteus mirabilis, Staphylococcus aureus and Enterococcus sp., Staph. aureus ATCC 25923, ATCC 6538 and E. coli 25922 and two clinical Candida albicans strains, including ATTC 10231. Spectrophotometric method was used for determination on C. albicans growth. An antimicrobial effect of EOs was strain specific. Bactericidal activity was higher for coriander EO (minimal inhibitory concentration (MICs) 0·4-45·4 µl ml(-1)) against almost all tested bacteria, except multiple resistant strains of Eneterococcus sp. and Proteus sp. Thyme EO showed slightly better fungicidal activity reaching MIC at 0·11 mg ml(-1) for all C. albicans strains. The effect of EOs on biofilm-forming ability was tested for two strains of Staph. aureus and E. coli, as well as on C. albicans filamentation ability. Brine shrimp lethality bioassay revealed thymus oil total toxicity and coriander oil intoxicity (LC50 = 2·25 mg ml(-1)). The chemical composition of oils was analysed by gas chromatography mass spectrometry showing oxygenated monoterepenes as dominant constituents. CONCLUSIONS: The results provide in-vitro scientific support for the safety possible use of Coriander EO against E. coli, Staph. aureus and C. albicans vaginal infections in alternative gynaecological treatment. SIGNIFICANCE AND IMPACT OF STUDY: To examine EOs as possible constituent of naturally based antimicrobial agents in vaginaletes for safety gynaecological application.

Pyocolpos in a Pinscher bitch: a case report

Diseases related to the urogenital system in both males and females, are common in clinical routine of smallanimal and represents important causes of morbidity and mortality in dogs and cats. Pyocolpos is a cysticdilatation of the vagina due to the accumulation of pus resulting from the genital tract obstruction. The maincause of obstruction is imperforate hymen, transverse vaginal membrane, or vaginal atresia.We present a caseof a three-year-old female Pinscher with a history of constipation for four days, even after administration oflaxatives and enema, and estrus for ten days without a report of cover. Physical examinations were performed,which revealed increased abdominal size. Ultrasound confirmed the presence of large amounts of vaginal fluid.Exploratory laparotomy was performed, which confirmed the diagnosis of pyocolpos. Although pyocolposis a rare congenital malformation in female domestic animals, this report of its existence underscores theimportance of more accurate clinical research when increased abdominal size is noted by veterinarians.

The use of konjac glucomannan hydrolysates to recover healthy microbiota in infected vaginas treated with an antifungal agent.

The aim of this study was to evaluate how konjac glucomannan hydrolysates (GMH) could support the healthy re-colonisation of vaginal microflora post infections. A total of 26 female patients (12 controls and 14 treatments) aged 18 to 25 suffering from vaginal infection were recruited for this study. Patients were assigned randomly into two groups to receive a standard antifungal treatment or a standard antifungal treatment plus pessary capsules containing 200 mg GMH (twice a week for thirty days). Patients were assessed on day zero, sixteen and thirty of the trial. Several parameters were determined including yeast and bacterial counts, the KOH test, pH, Gram staining and wet mount microscopic observations. The results showed that the counts of Candida were diminished completely with antifungal treatment for both groups. However, the total bacterial counts increased with time in the GMH pessary group unlike the control. The normalised average KOH scores were reduced sharply with time in both groups although in the control group scores started to increase after sixteen days. The normalised average white blood cell scores also decreased with time for both groups. Epithelial cell scores decreased only for the GMH pessary group while clue cells and yeast-like fungi decreased with time for both control and GMH pessary groups. These results indicate the improvement of vaginal health recovery (post antifungal treatment for Candida infection) and especially the presence of healthy microflora due to the introduction of GMH in the vagina. The data indicate that it would be worth examining further the health benefits of GMH in a vaginal health format with a view to employing the material as a prophylactic or therapeutic agent. It provides an alternative approach to reducing vaginal infections and promoting consumer health.

In vitro and in vivo antifungal activities of the eight steroid saponins from Tribulus terrestris L. with potent activity against fluconazole-resistant fungal pathogens.

Antifungal activity of natural products is being studied widely. Saponins are known to be antifungal and antibacterial. We have isolated eight steroid saponins from Tribulus terrestris L., namely TTS-8, TTS-9, TTS-10, TTS-11, TTS-12, TTS-13, TTS-14 and TTS-15. TTS-12 and TTS-15 were identified as tigogenin-3-O-beta-D-xylopyranosyl(1-->2)-[beta-D-xylopyranosyl(1-->3)]-beta-D-glucopyranosyl(1-->4)-[alpha-L-rhamnopyranosyl(1-->2)]-beta-D-galactopyranoside and tigogenin-3-O-beta-D-glucopyranosyl(1-->2)-[beta-D-xylopyranosyl(1-->3)]-beta-D-glucopyranosyl(1-->4)-beta-D-galactopyranoside, respectively. The in vitro antifungal activities of the eight saponins against six fluconazole-resistant yeasts, Candida albicans, Candida glabrata, Candida parapsilosis, Candida tropicalis, Candida krusei, and Cryptococcus neoformans were studied using microbroth dilution assay. The results showed that TTS-12 and TTS-15 were very effective against several pathogenic candidal species and C. neoformans in vitro. It is noteworthy that TTS-12 and TTS-15 were very active against fluconazole-resistant C. albicans (MIC(80)=4.4, 9.4 microg/ml), C. neoformans (MIC(80)=10.7, 18.7 microg/ml) and inherently resistant C. krusei (MIC(80)=8.8, 18.4 microg/ml). So in vivo activity of TTS-12 in a vaginal infection model with fluconazole-resistant C. albicans was studied in particular. Our studies revealed TTS-12 also showed in vivo activities against fluconazole-resistant yeasts. In conclusion, steroid saponins TTS-12 and TTS-15 from Tribulus terrestris L. have significant in vitro antifungal activity against fluconazole-resistant fungi, especially TTS-12 also showed in vivo activity against fluconazole-resistant C. albicans.

A mucoadhesive, cyclodextrin-based vaginal cream formulation of itraconazole.

The development of vaginal medications, especially antifungal medications, requires that the drug is solubilized as well as retained at or near the mucosa for sufficient periods of time to ensure adequate bioavailability. Itraconazole is a broad-spectrum antifungal agent, which has been used for some time orally and intravenously but for which a vaginal formulation has not yet been developed. We present here a novel itraconazole formulation intended for vaginal use based on hydroxypropyl-beta-cyclodextrin (HPbetaCD), a functional excipient that increases drug solubility and generates a mucoadhesive system in the presence of other ingredients. An aqueous phase was prepared by solubilizing itraconazole with HCl in the presence of propylene glycol and then adding an aqueous solution of HPbetaCD. After pH adjustment, the itraconazole/HPbetaCD solution was added to the oil phase (paraffin oil, trihydroxystearate, and cetyl dimethicon copolyol) and the desired cream containing 1%, 2%, and 2.5% drug obtained by homogenization. Primary irritation studies and subchronic toxicity studies using a rabbit vaginal model indicated that the formulation was safe, well tolerated, and retained in the vaginal space. Clinical investigations indicated that application of 5 g of a 2% cream was very well tolerated and itraconazole was not systemically absorbed. Additional studies in women found that the itraconazole cream was highly effective in reducing or eliminating fungal cultures with few adverse effects. These studies suggested that an HPbetaCD-based, emulsified wax cream formulation was a useful and effective dosage form for treating vaginal candidiasis.

Hyperbaric oxygenation for rectovaginal fistula: a report of two cases.

A rectovaginal fistula after delivery is a rare complication, and its management can become difficult if infection occurs. In two such cases, we administered hyperbaric oxygenation (HBO) treatment against complicated infections, and we obtained a good outcome in each case.

Vitamin C status, cervico-vaginal infection and premature rupture of amniotic membranes.

A prospective study to evaluate the role of vitamin C and cervico-vaginal infection in the premature rupture of amniotic membranes (PROM) was designed. The leukocyte vitamin C levels of 44 pregnant women that did not consume vitamin supplements was evaluated at weeks 20, 28 and 32 of pregnancy. On each evaluation the presence of cervico-vaginal infection was diagnosed and treated. The leukocyte vitamin C level throughout gestation showed a decrease towards week 28 and then it recovered at the end of pregnancy. Six of every ten women had normal flora in their vaginal secretion cultures. Eleven cases had PROM (0.24), no association was found between cervico-vaginal infection and PROM. The leukocyte vitamin C levels on week 20 of gestation showed an association with PROM. (chi 2 = 6.34, p < 0.05, odds ratio 6.75 [CI 1.26-26.03]).