Echinocandins - structure, mechanism of action and use in antifungal therapy.

With increasing number of immunocompromised patients as well as drug resistance in fungi, the risk of fatal fungal infections in humans increases as well. The action of echinocandins is based on the inhibition of ß-(1,3)-d-glucan synthesis that builds the fungal cell wall. Caspofungin, micafungin, anidulafungin and rezafungin are semi-synthetic cyclic lipopeptides. Their specific chemical structure possess a potential to obtain novel derivatives with better pharmacological properties resulting in more effective treatment, especially in infections caused by Candida and Aspergillus species. In this review we summarise information about echinocandins with closer look on their chemical structure, mechanism of action, drug resistance and usage in clinical practice. We also introduce actual trends in modification of this antifungals as well as new methods of their administration, and additional use in viral and bacterial infections.

Prevention of artificial dental plaque formation in vitro by plant extracts.

AIMS: A number of previous studies have shown that plant extracts can inhibit formation of dental plaque. The ability of extracts of Rosmarinus officianalis L., Salvia officianalis L., unfermented cocoa, red grape seed and green tea to inhibit plaque bacteria, glucosyltransferase activity, glucan and plaque formation in an in vitro model using bovine teeth was examined. METHODS AND RESULTS: The antimicrobial activity of the plant extracts against oral bacteria was determined using a standard susceptibility agar dilution technique. Inhibition of growth and acid production from glucose and sucrose by Streptococcus mutans in liquid culture was investigated. Prevention of plaque formation on bovine teeth initiated by Strep. mutans was studied using an artificial mouth. The plant extracts inhibited the growth of oral bacteria and prevented acid production by Strep. mutans. Extracts inhibited glucosyltransferase activity and glucan production and inhibited adhesion to glass. Extracts of R. officianalis L. and S. officianalis L. at 0·25 mg ml(-1) reduced plaque growth by >80%. Green tea extract completely inhibited plaque formation but resulted in a greenish discolouration of the teeth which could not be removed by scrubbing. CONCLUSIONS: The plant extracts, particularly those from R. officianalis L. and S. officianalis L., inhibited glucosyltranferase activity, glucan production and plaque formation in vitro. SIGNIFICANCE AND IMPACT OF THE STUDY: The results suggest that the extracts of R. officianalis L. and S. officianalis L. may be useful as antiplaque agents in foods and dental preparations. Bovine teeth can be used as an alternative to hydroxyapatite for studies of plaque formation, but they need to be carefully sterilized before use.

In vitro anti-bacterial and anti-adherence effects of natural polyphenolic compounds on oral bacteria.

AIMS: To investigate the action of different polyphenolic compounds, extracted from red wine, grape marc and pine bark, on oral bacteria. METHODS AND RESULTS: The anti-microbial activity of extracts was examined by determining the Minimal Inhibitory Concentration and Minimal Bactericidal Concentration using the macro dilution broth technique. Their effect on the adherence was tested on growing cells of Streptococcus mutans on a glass surface and on a multi-species biofilm grown on saliva-coated hydroxyapatite discs. The effect on glucosyltransferase activity was analysed through the reductions in the overall reaction rate and the quantity of insoluble glucan (ISG) synthesized. Pine bark and grape marc extracts were the most effective inhibitors of the multi-species biofilm formation and of the ISG synthesis. CONCLUSION: The tested components showed an interesting anti-plaque activity in vitro. SIGNIFICANCE AND IMPACT OF THE STUDY: This is, to our knowledge, the first and the most complete report on the properties of wine and pine bark extracts that could be used for oral disease prevention purpose.

In vitro effect of Chinese herb extracts on caries-related bacteria and glucan.

The purpose of this study was to evaluate the inhibitory effects of herb extracts on caries-related bacteria and glucan of dental plaque in vitro. Bacterial sensitivity tests were done using broth dilution, and the phenol sulphate method was used to assess glucan inhibition. The results showed that tannic acid could inhibit bacterial growth more effectively than other herb extracts. Eugenol showed a 46.87 +/- 12.74 and 36.67 +/- 6.30% inhibitory effect on insoluble and soluble glucan synthesis, respectively. Cnidium, barbaloin, caryophyllin, and piperine had > 40.0% inhibitory effect on soluble glucan synthesis. Both insoluble and soluble glucan synthesis of S. sobrinus were inhibited by eugenol and piperine. Eugenol and piperine were efficacious in inhibiting glucan synthesis making them desirable agents for oral care products.

In vitro effects of crude khat extracts on the growth, colonization, and glucosyltransferases of Streptococcus mutans.

Millions of Yemenites, East Africans, and immigrants to Western countries chew khat daily for its amphetamine-like effects. There is little information in the literature concerning the possible effects of the habit on oral microbiota. Our objective was to study in vitro crude khat extract effects on Streptococcus mutans growth and sucrose-dependent colonization, and on its glucosyltransferase (GTF) activity and production. Three khat cultivars were used. Lyophilized crude aqueous khat extracts were applied to the different assays at concentrations of 0-1% (w/v). Sucrose-dependent colonization was assessed as the ability of Streptococcus mutans UA159 to form adherent biofilms in glass culture tubes. Colony forming units (CFUs) in the planktonic phase served as a measure of bacterial growth, while CFUs in the biofilm phase were used to quantify viability in the biofilms. GTFs activity was tested by incubating a crude GTFs preparation with sucrose and determining the amount of water-soluble and water-insoluble glucans formed. GTFs production was assayed by comparing intensities of GTF bands in Western blots of extracts from control and khat-containing cultures. The khat extracts effectively inhibited biofilm formation. The minimum biofilm inhibitory concentration (MBIC) varied among the cultivars (0.25-1%). The extracts also inhibited synthesis of both glucan types, particularly insoluble glucans (average 85% inhibition at 1%), with significant differences among the cultivars. However, khat increased bacterial growth and at sub-MBIC also viability within biofilms; there were no inter-cultivar differences. It is shown that khat leaves contain water-soluble constituents that inhibit some cariogenic properties of S. mutans in vitro.

Comparative evaluation of in-vitro effects of Brazilian green propolis and Baccharis dracunculifolia extracts on cariogenic factors of Streptococcus mutans.

Streptococcus mutans triggers dental caries establishment by two major factors: synthesis of organic acids, which demineralize dental enamel, and synthesis of glucans, which mediate the attachment of bacteria to the tooth surface. Propolis is a natural product that may prevent dental caries. Baccharis dracunculifolia DC (Asteraceae), a native plant from Brazil, is the most important botanical origin for the production of green propolis (Brazilian propolis) by honeybees. However, whether B. dracunculifolia (Bd) has an anticariogenic effect, like green propolis, remains unknown. Herein, we have made a comparative evaluation of the effects of extracts from green propolis and Bd on the glucan synthesis and acidogenic potential of S. mutans. The inhibitory effects of the extracts on bacterial acid production were evaluated through the potentiometric measurement of pH from bacterial suspensions treated with serial concentrations of both extracts. Besides presenting close inhibitory values at the same concentration range, Bd leaf rinse and green propolis extracts had similar IC(50) values (0.41 and 0.34 mg/ml, respectively). Both extracts produced a bacteriostatic effect on S. mutans cultures at a concentration of 0.40 mg/ml. Estimated inhibitory values of green propolis and Bd leaf rinse extracts on the synthesis of insoluble glucans (IC(50)=12.9 and 25.0 microg/ml, respectively) and soluble glucans (IC(50)=50.4 and 49.1 microg/ml, respectively) were not significantly different from each other at p<0.05. The results demonstrate that Bd leaf rinse and green propolis extracts have similar inhibitory effects on the S. mutans cariogenic factors evaluated herein, and allowed us to suggest that Bd leaves may be a potential source for pharmaceutical products employed for this purpose.

Identification of cariostatic substances in the cacao bean husk: their anti-glucosyltransferase and antibacterial activities.

The cacao bean husk has been shown to possess two types of cariostatic substances, one showing anti-glucosyltransferase (GTF) activity and the other antibacterial activity, and to inhibit experimental dental caries in rats infected with mutans streptococci. In the present study, chromatographic purification revealed high-molecular-weight polyphenolic compounds and unsaturated fatty acids as active components. The former, which showed strong anti-GTF activity, were polymeric epicatechins with C-4beta and C-8 intermolecular bonds estimated to be 4636 in molecular weight in an acetylated form. The latter, which showed bactericidal activity against Streptococcus mutans, were determined to be oleic and linoleic acids, and demonstrated a high level of activity at a concentration of 30 microgram/mL. The cariostatic activity of the cacao bean husk is likely caused by these biologically active constituents.

In vitro antimicrobial activity of propolis and Arnica montana against oral pathogens.

Arnica and propolis have been used for thousands of years in folk medicine for several purposes. They possess several biological activities such as anti-inflammatory, antifungal, antiviral and tissue regenerative, among others. Although the antibacterial activity of propolis has already been demonstrated, very few studies have been done on bacteria of clinical relevance in dentistry. Also, the antimicrobial activity of Arnica has not been extensively investigated. Therefore the aim here was to evaluate in vitro the antimicrobial activity, inhibition of adherence of mutans streptococci and inhibition of formation of water-insoluble glucan by Arnica and propolis extracts. Arnica montana (10%, w/v) and propolis (10%, w/v) extracts from Minas Gerais State were compared with controls. Fifteen microorganisms were used as follows: Candida albicans--NTCC 3736, F72; Staphylococcus aureus--ATCC 25923; Enterococcus faecalis--ATCC 29212; Streptococcus sobrinus 6715; Strep. sanguis--ATCC 10556; Strep. cricetus--HS-6; Strep. mutans--Ingbritt 1600; Strep. mutans--OMZ 175; Actinomyces naeslundii--ATCC 12104, W 1053; Act. viscosus OMZ 105; Porphyromonas gingivalis; Porph. endodontalis and Prevotella denticola (the last three were clinical isolates). Antimicrobial activity was determined by the agar diffusion method and the zones of growth inhibition were measured. To assess cell adherence to a glass surface, the organisms were grown for 18 h at 37 degrees C in test-tubes at a 30 degree angle. To assay water-insoluble glucan formation, a mixture of crude glucosyltransferase and 0.125 M sucrose was incubated for 18 h at 37 degrees C in test-tubes at a 30 degree angle. Arnica and propolis extracts (20 microl) were added to these tubes to evaluate the % of inhibition of cell adherence and water-insoluble glucan formation. The propolis extract significantly inhibited all the microorganisms tested (p < 0.05), showing the largest inhibitory zone for Actinomyces spp. The Arnica extract did not demonstrate significant antimicrobial activity. Cell adherence and water-insoluble glucan formation were almost completely inhibited by the propolis extract at a final concentration of 400 microg/ml and 500 microg/ml, respectively. The Arnica extract showed slight inhibition of the adherence of the growing cells (19% for Strep. mutans and 15% for Strep. sobrinus) and of water-insoluble glucan formation (29%) at these same concentrations. Thus, the propolis extract showed in vitro antibacterial activity, inhibition of cell adherence and inhibition of water-insoluble glucan formation, while the Arnica extract was only slightly active in those three conditions.

Anticaries effect of a component from shiitake (an edible mushroom).

The caries-inhibiting effect of the extract from shiitake (Lentinus edodes), the most popular edible mushroom in Japan, was studied both in vitro and in vivo. Shiitake extract showed an inhibitory effect on water-insoluble glucan formation from sucrose by crude glucosyltransferases of Streptococcus mutans JC-2 and Streptococcus sobrinus OMZ-176. The firmly adherent plaque in the artificial plaque formation test was strongly inhibited by shiitake extract. The reduction of firmly adherent plaque caused an increase in the incidence of non- and loosely adherent plaque and a decrease in total plaque formation. A significantly lower caries score was observed in specific pathogen-free rats infected with S. mutans JC-2 and fed with a cariogenic diet containing 0.25% shiitake extract as compared with controls fed the cariogenic diet without shiitake extract.

Oolong tea polyphenols inhibit experimental dental caries in SPF rats infected with mutans streptococci.

An extract of oolong tea (semifermented tea leaves of Camellia sinensis) and its chromatographically isolated polyphenolic compound was examined for in vitro inhibitory effects on glucosyltransferases (GTases) of mutans streptococci and on caries development in Sprague-Dawley rats infected with mutans streptococci. The samples showed no detectable effect on the growth of mutans streptococci. However, insoluble glucan synthesis from sucrose by the GTases of Streptococcus mutans MT8148R and Streptococcus sobrinus 6715 was markedly inhibited, as was sucrose-dependent cell adherence of these mutans streptococci. The administration of the oolong tea extract and the isolated polyphenol compound into diet 2000 and drinking water resulted in significant reductions in caries development and plaque accumulation in the rats infected with mutans streptococci. The active components in the oolong tea extract were presumptively identified as polymeric polyphenols which were specific for oolong tea leaves. These results indicate that the oolong tea polyphenolic compounds could be useful for controlling dental caries.

Anticaries effects of polyphenolic compounds from Japanese green tea.

The dental caries inhibiting effect of the extract from Japanese green tea, one of the most popular drinks in Japan, was studied both in vitro and in vivo. The crude tea polyphenolic compounds (designated Sunphenon) from the leaf of Camellia sinensis were found to effectively inhibit the attachment of Streptococcus mutans strain JC-2 (serotype c) to saliva-coated hydroxyapatide discs. Sunphenon was also inhibitory to water-insoluble glucan formation from sucrose by crude glucosyltransferase of S. mutans JC-2 (c). Among the tea catechins tested, (-)-epigallocatechin gallate and (-)-epicatechin gallate showed the most potent inhibition of the glucosyltransferase activity. Finally, significantly lower caries scores were observed in specific pathogen free rats infected with S. mutans JC-2 (c) and fed a cariogenic diet and/or drinking water containing 0.05% Sunphenon as compared with control rats not receiving polyphenolic compounds.

Gallotannins inhibit growth, water-insoluble glucan synthesis, and aggregation of mutans streptococci.

During screening for anti-plaque agents of plant origin, ethanolic extracts from Melaphis chinensis (Bell), the Chinese Nutgall, exhibited strong inhibition of glucosyltransferase (GTF), in vitro adherence and glucan-induced agglutination of Streptococcus mutans 3209 and S. sobrinus B13. More than 91% inhibition of water-insoluble glucan synthesis from sucrose by GTF was noted at a concentration as low as 7.8 micrograms/mL. Bactericidal effects on other mutans streptococci, S. salivarius, and Actinomyces viscosus were also evident. Through chemical fractionation and analyses, along with bioassays, the active components were identified as gallotannins.