Mezoneuron benthamianum inhibits cell adherence, hyphae formation, and phospholipase production in Candida albicans.

The aim of this study was to evaluate the phytochemical constituents, antioxidant, antifungal, and anti-virulence activities of traditionally used Mezoneuron benthamianum leaves. Extracts were prepared using acetone and methanol, and the preliminary phytochemical screening was performed. The antioxidant activity was studied using the DPPH method. Anti-Candida albicans activity was established and the effect on the germ tube and phospholipase production, as well as on the host cell adherence was assessed. The extracts showed the presence of anthraquinones, cardiac glycosides, flavonoids, reducing sugars, saponins, steroids, tannins, and terpenoids. Gallic acid and trans-resveratrol were among the predominant phytochemicals found in M. benthamianum. The crude extracts presented significantly higher antioxidant activity than the ascorbic acid standard. At 0.39 mg/mL, acetone extract inhibited the growth of Candida albicans. At lower concentrations (200-50 µg/mL), it significantly inhibited the adherence ability (up to 51%), formation of hyphae (up to 65%), and the production of phospholipase. In conclusion, at high concentrations, M. benthamianum kills C. albicans, and at lower concentrations, it can inhibit the virulence properties of this pathogen. This study on crude extract validates the traditional use of this plant. However, further research is required to establish the anti-virulence activity of the two compounds and their therapeutic potential.

Dodonaea viscosa var angustifolia derived 5,6,8-trihydroxy-7,4' dimethoxy flavone inhibits ergosterol synthesis and the production of hyphae and biofilm in Candida albicans.

ETHNOPHARMACOLOGICAL RELEVANCE: Candida albicans is developing resistance to existing drugs increasing morbidity and mortality, which elevates an immediate need to explore new antifungal agents. Phytochemicals are an excellent source of therapeutic agents. We previously reported the antifungal activity of the crude extract of Dodonaea viscosa var. angustifolia Jacq. (DVA) from which a beneficial compound flavone: 5,6,8-trihydroxy-7,4' dimethoxy flavone (5,6,8-trihydroxy-7-methoxy-2-(4-methoxyphenyl)-4H-chromen-4-one) abbreviated as TMMC, was extracted. AIM OF THE STUDY: The present study evaluated the effect of a TMMC subfraction on biofilms, membrane stability, ergosterol biosynthesis and germ tube (GT) formation in Candida albicans. MATERIALS AND METHODS: Extracts were prepared and fractionated to obtain purified TMMC. Minimum inhibitory concentrations of TMMC were obtained and subinhibitory concentrations were selected for further studies. Confocal laser scanning microscopy (CLSM) was performed to assess the effect of TMMC on membrane permeability and sterol deposition using propidium iodide (PI) and filipin stains, respectively. RESULTS: Minimum inhibitory concentrations (MIC) and Minimum Fungicidal concentrations (MFC) of TMMC were 0.39 mg/mL and 1.56 mg/mL, respectively. TMMC inhibited biofilm formation and damaged mature biofilms at 0.39 mg/mL and 1.56 mg/mL, respectively. CLSM further confirmed the disruption and architectural changes in biofilms following treatment with TMMC. TMMC also inhibited GT formation and ergosterol biosynthesis in a concentration dependent manner, which was further confirmed by varying sterol distribution and membrane disruption in treated and untreated cells. CONCLUSIONS: With the multiple targets at different concentrations, TMMC warrants its potential use as antifungal drug against C. albicans. However further studies using animal models and more mechanistic approaches will be required.

Improved efficacy of antifungal drugs in combination with monoterpene phenols against Candida auris.

Emergence of Candida auris has been described as a global health threat due to its ability to cause invasive infections with high mortality rate and multidrug resistance. Novel drugs and therapies are required to target this organism and its pathogenicity. Anti-virulence approach and combination therapy have been proposed as alternatives in recent years. This study evaluated the virulence factors in C. auris, combination antifungal activity of phenolic compounds with antifungal drugs and determined effect of the most active compound on positive pathogenicity markers of C. auris. Antifungal susceptibility profile of 25 clinical isolates of C. auris against antifungal agents as well as against phenolic compounds was obtained using CLSI guidelines. Combination of the most active phenolic compound with antifungal drugs was determined. Effect of carvacrol on the virulence factors was also studied. Carvacrol was the most active phenol with median MIC of 125 µg/ml and its combination with fluconazole, amphotericin B, nystatin and caspofungin resulted synergistic and additive effects in 68%, 64%, 96% and 28%, respectively. Combination also reduced the MIC values of the drugs. All test strains showed adherence ability to epithelial cells and 96% of strains produced proteinase. None of the strains produced hyphae and phospholipase. At low concentrations, carvacrol significantly inhibited the adherence ability and proteinase production (both p < 0.01). Carvacrol has antifungal and anti-virulence activity against C. auris. It also showed an enhanced antifungal activity in combination with antifungal agents. Therefore it has potential to be developed into a novel antifungal agent.

Anti-acidogenic, anti-biofilm and slow release properties of Dodonaea viscosa var. angustifolia flavone stabilized polymeric nanoparticles.

OBJECTIVE: Dental caries is caused by plaque associated oral bacteria including a pioneer species Streptococcus mutans. It has ability to form biofilm and produce acids in the oral cavity. Many oral hygiene products containing plant derived compounds have been investigated for their anti-S. mutans activity. Dodonaea viscosa var. angustifolia (DVA), has been found to have this property. However, beneficial concentrations are difficult to maintain in the oral cavity due to continual saliva flow which can be overcome using nanotechnology. The aim of this study was to investigate the anti-acidogenic, anti-biofilm and slow release properties of DVA derived flavone stabilized polymeric nanoparticles. METHODS: Crude extract prepared from DVA leaves was fractionated to produce subfractions and the beneficial subfraction (F5.1) was obtained. Polymeric nanoparticles (PLGA-PEG) were prepared, stabilized with the DVA subfraction (F5.1/NPs) and characterized. Anti-S. mutans, anti-acidogenic and antibiofilm properties were determined. The subfraction release profile (substantivity) and cytotoxicity was determined. Results were analyzed using the Wilcoxon sum test (Mann-Whitney). RESULTS: F5.1/NPs showed anti-S. mutans property (MIC 1.56 mg/ml). Subinhibitory concentrations of these nanoparticles significantly reduced the acid production in S. mutans (p < 0.01) and also reduced the biofilm formation by 92%. The retention and slow release of the beneficial compound was detected up to 12 h, reaching 0.1 mg/ml concentration at pH 7.4 after 4 h and at pH 5.5 after 5 h. IC50 of F5.1/NPs was 62.5 µg/ml. CONCLUSION: the DVA flavone containing nanoparticles showed anticariogenic activity with improved substantivity. Therefore, they have potential for use to control dental caries.

Anti-acidogenic and anti-biofilm activity of 5,6,8-trihydroxy-7-methoxy-2-(4-methoxyphenyl)-4H-chromen-4-one.

OBJECTIVES: Crude extracts of Dodonaea viscosa var. angustifolia (DVA), has shown to have anticariogenic property. However the compound responsible for this activity has not been identified. The aim of this study was to investigate anti-acidogenic and anti-biofilm activity of a flavone 5,6,8-Trihydroxy-7-methoxy-2-(4-methoxyphenyl)-4H-chromen-4-one isolated from D. viscosa var. angustifolia (DVA) in cariogenic bacteria Streptococcus mutans. METHODS: The crude extract from DVA leaves was fractionated into six fractions (F1-F6) using chromatography. The Minimum Inhibitory Concentrations (MIC) and Minimum Bactericidal Concentration (MBC) were determined. The effect of the six fractions on biofilm formation and acid production were investigated. The most active fraction (F5) was further fractionated, purified, identified and elucidated using GC-MS and NMR. The anticariogenic property of this purified compound was established. Results were analyzed using Wilcoxon rank-sum test (Mann-Whitney). RESULTS: The MIC and MBC of the fractions (F1-F6) and crude extract ranged from 0.39 to 12.5 mg/ml. F5 showed the lowest MBC. At 0.2 mg/ml, F5 reduced biofilm formation by 93.3% and reduced acid production in S. mutans. Subfraction F5.1 showed higher antimicrobial activity compared to the crude extract and F5. Purified F5.1 was identified as 5,6,8-Trihydroxy-7-methoxy-2-(4-methoxyphenyl)-4H-chromen-4-one (TMMC). TMMC inhibited biofilm formation at both 6 h (94% reduction) and 24 h (99% reduction), which was higher compared to the crude extract (87% reduction at 0.78 mg/ml after 6 h). TMMC also exhibited a higher inhibitory effect on acid production compared to the crude extract. CONCLUSION: Flavone 5,6,8-Trihydroxy-7-methoxy-2-(4-methoxyphenyl)-4H-chromen-4-one derived from DVA has anti-S. mutans, anti-biofilm and anti-acidogenic activity therefore it has a potential for use in the oral cavity to prevent dental caries.

Effect of Punica granatum on the virulence factors of cariogenic bacteria Streptococcus mutans.

Dental caries is caused by acids produced by biofilm-forming Streptococcus mutans from fermentable carbohydrates and bacterial byproducts. Control of these bacteria is important in the prevention of dental caries. This study investigated the effect of the fruit peel of Punica granatum on biofilm formation, acid and extracellular polysaccharides production (EPS) by S. mutans. Pomegranate fruit peels crude extracts were prepared. The Minimum bactericidal concentrations (MBC) were determined against S. mutans. At 3 sub-bactericidal concentrations, the effect on the acid production, biofilm formation and EPS production was determined. The results were analysed using Kruskal-Wallis and Wilcoxon Rank Sum Tests. The lowest MBC was 6.25 mg/mL. Punica granatum significantly inhibited acid production (p < 0.01). After 6 and 24 h, it significantly reduced biofilm-formation by 91% and 65% respectively (p < 0.01). The plant extract did not inhibit the production of soluble EPS in either the biofilm or the planktonic growth. However, it significantly reduced the insoluble EPS in the biofilm and the plantktonic (p = < 0.01) form of S. mutans. The crude extract of P. granatum killed cariogenic S. mutans at high concentrations. At sub-bactericidal concentrations, it reduced biofilm formation, acid and EPS production. This suggests that P. granatum extract has the potential to prevent dental caries.

Influence of cancer treatment on the Candida albicans isolated from the oral cavities of cancer patients.

PURPOSE: Cancer treatment causes mucositis and the manifestation of oral candidiasis. This study investigated the virulence properties and antifungal susceptibilities of Candida albicans isolated from cancer patients undergoing therapy. METHODS: C. albicans were isolated from 49 patients on cancer treatment and 21 healthy individuals and their virulence attributes measured. A correlation was determined between the length of treatment and the fungal counts and their virulence factors. RESULTS: Although Candida carriage was similar in all the study groups, high quantities of C. albicans and variety of Candida were found in cancer patients. Germ tubes were produced by all the strains. Significantly high number of yeast isolated from radiotherapy and chemotherapy produced large quantities of phospholipase compared to healthy individuals (p < 0.01). The length of chemotherapy was associated with an increase in the phospholipase production (p = 0.03) by the C. albicans. Proteinase production was seen in a significant number of isolates from the radiotherapy group (p < 0.01). Type of cancer treatment had no effect. Resistance to antifungal agents was low. CONCLUSIONS: High quantities of phospholipase were produced by C. albicans in cancer patients on therapy which also increased with the length of chemotherapy suggesting enhanced risk of oral and systemic infection. Therefore, during treatment, prophylactic topical antifungal therapy may be considered.

Inhibitory Effect of Dodonaea viscosa var. angustifolia on the Virulence Properties of the Oral Pathogens Streptococcus mutans and Porphyromonas gingivalis.

Aim. This study investigated the effect of Dodonaea viscosa var. angustifolia (DVA) on the virulence properties of cariogenic Streptococcus mutans and Porphyromonas gingivalis implicated in periodontal diseases. Methods. S. mutans was cultured in tryptone broth containing a crude leaf extract of DVA for 16 hours, and the pH was measured after 10, 12, 14, and 16 h. Biofilms of S. mutans were grown on glass slides for 48 hours and exposed to plant extract for 30 minutes; the adherent cells were reincubated and the pH was measured at various time intervals. Minimum bactericidal concentration of the extracts against the four periodontal pathogens was determined. The effect of the subinhibitory concentration of plant extract on the production of proteinases by P. gingivalis was also evaluated. Results. DVA had no effect on acid production by S. mutans biofilms; however, it significantly inhibited acid production in planktonic cells. Periodontal pathogens were completely eliminated at low concentrations ranging from 0.09 to 0.02 mg/mL of crude plant extracts. At subinhibitory concentrations, DVA significantly reduced Arg-gingipain (24%) and Lys-gingipain (53%) production by P. gingivalis (P ≤ 0.01). Conclusions. These results suggest that DVA has the potential to be used to control oral infections including dental caries and periodontal diseases.

Dodonaea viscosa var. angustifolia Inhibits Germ Tube and Biofilm Formation by C. albicans.

The virulence factors of Candida albicans are germ tube and biofilm formation, adherence to host tissues, and production of hydrolytic enzymes. This study investigated the effect of Dodonaea viscosa var. angustifolia extract on the germ tube and biofilm formation of C. albicans. Serum containing the three subinhibitory concentrations of leaf extract was inoculated with C. albicans, incubated, and viewed under a light microscope. Number of cells with germ tube was recorded and the results were analysed using Scheffe test for pairwise comparison. Biofilms were grown on coverslips in the presence of plant extracts and processed for scanning electron microscopy (SEM). Planktonic cells were grown in the presence of plant extract for 6 h and processed for electron microscopy (TEM). The crude plant extract significantly (P < 0.01) reduced the germ tube formation of C. albicans at 3.125 (85.36%), 1.56 (61.91%), and 0.78 mg/mL (26.27%) showing a concentration dependent effect. SEM results showed concentration dependent reduction in biofilm and hyphae formation. TEM results showed that the plant extract caused damage to the cell wall and cell membrane. DVA extract has ability to reduce virulence of C. albicans by inhibiting germ tube and biofilm formation through damage to the cell wall. Therefore, it has therapeutic potential.

Inhibitory activity of Dodonaea viscosa var. angustifolia extract against Streptococcus mutans and its biofilm.

ETHNOPHARMACOLOGICAL RELEVANCE: The leaves of Dodonaea viscosa var. angustifolia (DVA) are traditionally used for the treatment of fever, colds, oral thrush, toothaches and related problems. Streptococcus mutans is implicated in many oral infections. This study investigated the inhibitory activity of DVA extract against Streptococcus mutans and its biofilm. MATERIALS AND METHODS: Crude extract of the leaves was prepared using methanol. The time-kill curve for Streptococcus mutans at different concentrations of methanol extract after 6 and 24 h was determined. Biofilms of Streptococcus mutans were grown in the presence of subinhibitory concentration of extract (0.78 mg/ml) for 30 h and the bacterial counts were obtained after 6, 24 and 30 h. The chemical profile of the crude extract was obtained using gas chromatography-mass spectrometry (GC-MS). RESULTS: The reduction of Streptococcus mutans was concentration and exposure time dependent. The crude extract killed 48% of S. mutans at a lowest concentration of 0.1 mg/ml and 100% at 25 mg/ml after 6h. Biofilm formation was reduced by 95, 97 and 99% after 6, 24 and 30 h of exposure to the subinhibitory concentration of crude extract respectively. GC-MS analyses revealed the presence of polyphenols such as catechin or chromene groups, chalcones with trimethoxyphenyl group and tannin with 4-O-ß-D-xylopyranoside. At high concentration the crude extract was bactericidal to Streptococcus mutans but subinhibitory concentration significantly reduced the planktonic cells and biofilm formation. CONCLUSIONS: These results suggest that this plant has the potential to be used to control S. mutans and its biofilm which are responsible for oral infections.

The effect of Dodonaea viscosa var. angustifolia on Candida albicans proteinase and phospholipase production and adherence to oral epithelial cells.

AIM OF THE STUDY: This study investigated effect of a crude extract of Dodonaea viscosa on the proteinase and phospholipase production and adherence to epithelial cells by Candida albicans isolated from HIV positive and HIV negative patients. MATERIALS AND METHODS: Twenty Candida albicans strains isolated from HIV positive and 20 from HIV negative patients were investigated. The isolates were exposed to subinhibitory concentration of crude plant extract and adherence, proteinase and phospholipase production were assessed. The results were analysed using Student's t-test and a two-way ANOVA. RESULTS: Dodonaea viscosa var. angustifolia inhibited the adherence of Candida albicans to oral epithelial cells (p=<0.01) but no significant effect of the plant extract on proteinase and phospholipase production was observed. Results from Candida albicans strains isolated from HIV positive and HIV negative patients were similar. CONCLUSIONS: Dodonaea viscosa var. angustifolia inhibited the adherence of Candida albicans to oral epithelial cells, which is the initial step of colonization in the infection process. This plant has a therapeutic potential at subinhibitory concentration.

Antifungal activity of the plant Dodonaea viscosa var. angustifolia on Candida albicans from HIV-infected patients.

THE AIM OF THIS STUDY: was to determine the minimum inhibitory concentration (MIC) and the time taken by Dodonaea viscosa var. angustifolia (PLE) a South African medicinal plant, chlorhexidine gluconate (CHX) and triclosan (TRN) to kill Candida albicans. 41 strains of Candida albicans were investigated, 20 from HIV-positive patients, 20 from HIV-negative subjects and Candida albicans ATCC 90028. The MICs of an acetone extract of PLE, CHX and TRN were measured using a microtitre double dilution technique, and the time taken to kill 99.5% of the strains was determined. The MICs of PLE, CHX and TRN were 6.25-25, 0.008-0.16 and 0.0022-0.009 mg/ml, respectively. PLE killed all the test strains within 30s and CHX 40% of the isolates from HIV-positive patients and 20% of strains from HIV-negative subjects in 1 min. During the same time TRN killed 55% and 35% of isolates from HIV-positive and HIV-negative patients. Dodonaea viscosa var. angustifolia has antifungal properties and is more effective than commercially available mouthrinses.