Ellagic Acid-Cyclodextrin Complexes for the Treatment of Oral Candidiasis.

The increase in the prevalence of fungal infections worldwide and the rise in the occurrence of antifungal resistance suggest that new research to discover antifungal molecules is needed. The aim of this study was to evaluate the potential use of ellagic acid-cyclodextrin complexes (EA/HP-ß-CD) for the treatment of oral candidiasis. First, the effect of EA/HP-ß-CD on C. albicans planktonic cells and biofilms was evaluated. Then, the cytotoxicity of the effective concentration was studied to ensure safety of in vivo testing. Finally, the in vivo effectiveness was determined by using a murine model of induced oral candidiasis. Data was statistically analyzed. The minimal inhibitory concentration of EA/HP-ß-CD was 25 µg/mL and a concentration of 10 times MIC (250 µg/mL) showed an inhibitory effect on C. albicans 48 h-biofilms. The complex at concentration 250 µg/mL was classified as slightly cytotoxic. In vivo experiments showed a reduction in fungal epithelial invasion after treatment with EA/HP-ß-CD for 24 h and 96 h when compared to the negative control. In conclusion, the results demonstrated that EA/HP-ß-CD has antifungal and anti-inflammatory effects, reducing the invasive capacity of C. albicans, which suggests that EA/HP-ß-CD may be a promising alternative for the treatment of oral candidiasis.

Oral prevalence and antifungal susceptibility of Candida species in cystic fibrosis patients.

OBJECTIVE: This study aimed at assessing the oral prevalence ofCandida species in cystic fibrosis patients and the antifungal susceptibility of the isolates. DESIGN: One hundred patients aged 3-20 years old were included in the study and were divided into three groups: G1 (low severity disease): 25 cystic fibrosis patients with Shwachman-Kulczycki score (SK) between 100 and 71; G2 (high severity disease): 25 cystic fibrosis patients with SK score under 40; and G3 (control): 50 healthy patients age- and gender-matched to cystic fibrosis patients. Stimulated saliva samples were collected and the oral fungal concentrations were assessed. Isolates were identified by phenotypic and genotypic tests. Antifungal susceptibilities to amphotericin B, flucytosine and fluconazole were determined by CLSI methodology. Fungal counts were compared by Kruskal Wallis and Dunn's test (5%). RESULTS: A total of 68 % of Group 1, 80 % of Group 2, and 44 % of controls yielded positive Candida cultures. Oral concentrations of fungi were significantly higher in cystic fibrosis patients in relation to the control group (p < 0.0005). No significant difference was observed between low and high severity cystic fibrosis groups (p > 0.05). C. albicans was most frequently isolated species in all groups. Higher variability of Candida species was observed in the control group. C. dubliniensis and C. tropicalis were only detected among cystic fibrosis groups. All the isolates were susceptible to flucytosine and fluconazole. CONCLUSIONS: Patients with cystic fibrosis were more frequently colonized by Candida species and showed higher oral fungal burden. No antifungal resistant isolates were detected.

Efeitos da fibrose cística sobre o microbioma bucal e o proteoma salivar / Effects of cystic fibrosis on oral microbiome and salivary proteome

A Fibrose Cística (FC) é uma doença genética de elevada prevalência global e que causa função anormal das glândulas exócrinas. As alterações nas funções das glândulas salivares podem impactar a saúde bucal que por sua vez podem influenciar a saúde geral. A boca pode representar um reservatório microbiano de potenciais patógenos e colonizadores das vias aéreas, causando infecções crônicas pulmonares. O objetivo deste estudo foi avaliar os impactos da FC na cavidade bucal, saliva e microbioma bucal. Foram incluídos no estudo 50 pacientes com diagnóstico de FC com idades de 3 a 20 anos, divididos em 2 grupos de acordo com o grau de severidade da doença determinado pelo escore de Shwachman-Kulczycki: G1 (baixa severidade) e G2 (alta severidade). Foi também incluído grupo controle pareado ao grupo de estudo quanto ao gênero e idade (G3, n=50). A presença de lesões de cárie foi avaliada. O impacto da FC sobre a saúde bucal foi avaliado por questionário preenchido pelos pais ou responsáveis. Amostra de saliva estimulada foi coletada de todos os pacientes. O microbioma bucal foi avaliado por Human Oral Microbe Identification using Next Generation Sequencing (HOMINGS) e metodologias de cultivo, para análise da microbiota potencialmente oportunista e cariogênica. Realizouse ainda a análise proteômica da saliva e quantificação de imunoglobulinas salivares. Os resultados foram analisados e, de acordo com a distribuição dos dados e avaliação desejada, foram aplicados os testes estatísticos apropriados, sendo adotado o nível de significância de 5%. O questionário aplicado apontou que os pais consideraram que a saúde bucal não impacta negativamente a saúde geral dos seus filhos em todos os grupos estudados Os grupos de pacientes com FC apresentaram menores índices de Ceo-d, CPO-D, taxa de fluxo salivar e pH inicial em relação ao grupo controle. As contagens de estafilococos e leveduras foram significativamente mais elevadas nos grupos FC. Todos os isolados fúngicos foram suscetíveis aos antifúngicos testados. Alta incidência de resistência foi observada dentre as cepas bacterianas. Os níveis de IgA foram mais altos nos grupos com FC em relação ao controle. Pseudomonas aeruginosa foi detectada apenas nos grupos com FC. A análise proteômica identificou 7 potenciais biomarcadores para a fibrose cística. Conclui-se que o monitoramento do microbioma oral de pacientes com fibrose cística pode ser uma ferramenta importante na prevenção da colonização pulmonar por potenciais patógenos. O estudo de biomarcadores salivares pode contribuir para o desenvolvimento de novos métodos de diagnóstico alternativos ao teste do suor para a fibrose cística(AU)

Cystic Fibrosis (CF) is a genetic disease with high global prevalence that causes abnormal function of the exocrine glands. The functional alterations of salivary glands and saliva can impact the oral health and influence general health. Oral cavity may represent a microbial reservoir of potential pathogens that can colonize the airways and cause chronic pulmonary infections. The aim of this study is to evaluate the impact of cystic fibrosis on the oral cavity, saliva and oral microbiome. Fifty CF patients aged from 3 to 20 years were divided into two groups according to the disease severity determined by the Shwachman-Kulczycki score: G1 (low severity) and G2 (high severity). Also, age and gender paired control group was included in the study (G3, n = 50). The occurrence of caries was evaluated. The impact of CF on oral health was evaluated by a questionnaire filled by parents or responsible person. Stimulated whole saliva (WS) samples were collected from all patients. The oral microbiome was analyzed by Human Oral Microbe Identification using Next Generation Sequencing (HOMINGS) and by microbiological culture methodologies to evaluate the potential opportunistic and cariogenic microbiota. The proteomic analysis of saliva and quantification of salivary immunoglobulins were carried out. Statistical analysis was performed according to the normality of the data at a significance level of 5%. The applied questionnaire pointed out that oral health did not impact systemic health negatively, according to the parents in all groups. The groups of patients with CF had lower rates of dmft, DMFT, salivary flow rate and initial pH in comparison to the control group. The counts of staphylococcal and yeast from CF groups were significant higher than the controls. All fungal isolates were susceptible to the antifungal agents. Higher incidence of bacterial resistance was observed. The IgA levels were higher in both CF groups than in the control group. Pseudomonas aeruginosa were detected only in the CF groups. The proteomic analysis identified 7 potential biomarkers for cystic fibrosis. The effects of CF in saliva and oral microbiome must be considered to establishment of therapeutic and preventives multidisciplinary protocols aiming overall health and quality of life of these patients. In conclusion, monitoring the oral microbiome of CF patients may be an important tool in the prevention of pulmonary colonization by potential pathogens. The study of salivary biomarkers may contribute to the development of new diagnostics methods alternative to sweat test for CF(AU)

Enterococcus Species in the Oral Cavity: Prevalence, Virulence Factors and Antimicrobial Susceptibility.

Enterococci are considered as transient constituent components of the oral microbiome that may cause a variety of oral and systemic infections. As there is sparse data on the oral enterococcal prevalence, we evaluated the Enterococcus spp. and their virulence attributes including antimicrobial resistance in a healthy Brazilian cohort. A total of 240 individuals in different age groups were studied (children 4-11 yrs, adolescents 12-17 yrs, young adults 18-29 yrs, adults 30-59 yrs, elderly over 60 yrs). Oral rinses were collected and isolates were identified by API 20 Strep and confirmed by 16S rDNA sequencing. E. faecalis isolates, in particular, were evaluated for virulence attributes such as their biofilm formation potential, and susceptibility to antimicrobials and an antiseptic, chlorhexidine gluconate. A total of 40 individuals (16.6%) and 10% children, 4% adolescents, 14% young adults, 30% adults, and 25% elderly carried oral enterococci. The oral enterococcal burden in adolescents was significantly lower than in the adults (p = 0.000) and elderly (p = 0.004). The proportion of carriers was higher among females (p = 0.001). E. faecalis was the most frequent isolate in all the age groups (p = 0.000), followed by E. durans and E. faecium. Whilst all the clinical isolates were able to form biofilms, only a proportion of them were able to produce lipase (92%), hemolysin (38%), and gelatinase (39%). Of all the isolates 53.8% were resistant to tetracycline, 12.3% to amoxicillin, 16.0% to ampicillin, 20.8% to chloramphenicol and 43.4% to erythromycin. None of the isolates were resistant to vancomycin. Our data suggest that in this Brazilian cohort the oral cavity may act as a significant reservoir of rather virulent and antibiotic resistant enterococci, with an increasing degree of carriage in the adults and elderly. Hence clinicians should be cognizant of this silent reservoir of virulent enterococci that may pose a particular threat of nosocomial infection.

Efeito do recobrimento de filmes de carbono tipo diamante depositados a plasma na manutenção do torque de parafusos protéticos / Effects of diamond-like carbon films deposited in abutment screws the measurement of the loosening torque

Objetivo: Avaliar os valores de torque reverso RT(%) de parafusos protéticos de liga de titânio recobertos com um filme de carbono amorfo tipo diamante (DLC) e filme dopado com partículas de diamante(CD-DLC) comparando-os com parafusos sem tratamento (controle). Método: Foram utilizados 60 implantes de plataforma regular, divididos de acordo com o tipo de conexão (hexágono externo e hexágono interno) e o tratamento do parafuso protético (n=10): Grupo A1: hexágono externo/parafuso controle; Grupo A2: hexágono externo/parafuso com DLC; Grupo A3: hexágono externo/parafuso com CD-DLC; Grupo B1: hexágono interno/parafuso controle; Grupo B2: hexágono interno/parafuso com DLC; Grupo B3: hexágono interno/parafuso com CD-DLC. Os filmes de DLC e CD-DLC foram depositados pelo processo conhecido como PECVD (Plasma Enhanced Chemical Vapour Deposition). Os implantes foram inseridos em blocos de poliuretano e as coroas protéticas cimentadas sobre os pilares que foram parafusados aos implantes. O torque reverso foi mensurado após ciclagem mecânica (1.106 ciclos). A análise estatística foi realizada pelo teste Anova 1 fator e Teste de Tukey e Teste t-student com nível de significância de 5%. Resultados: A análise dos resultados mostraram que após a ciclagem mecânica o torque reverso RT(%) do grupo sem tratamento (A1) foi significativamente maior que a dos grupos DLC (A2) e CD-DLC (A3) (p=0,0001), para os parafusos das conexões HE. Entretanto não houve diferença estatística entre os grupos com e sem tratamento na manutenção do torque para os parafusos dos grupos de conexão HI (p= 0.5476). Conclusão: Nas condições estudadas, concluiu-se que os parafusos revestidos com filmes DLC não foram efetivos na manutenção do torque reverso em relação aos parafusos sem tratamento para ambas as as conexões avaliadas

Objective: To evaluate the values of reverse torque RT ( % ) of prosthetic screws titanium alloy coated with a film of diamond-like carbon (DLC) and DLC film doped with diamond particles (CD- DLC) comparing them with screws without treatment (control). Method: Sixty implants were divided into six groups according to the type of connection (external or internal hex) and type of abutment screw (n = 10 ): Group A1: external hexagon / screw control , Group A2: external hexagon / screw with DLC; group A3: external hexagon / screw with CD- DLC; group B1: internal hex / screw control; group B2: internal hex / screw with DLC; group B3: internal hex / screw with CD- DLC. The DLC films and CD - DLC were deposited by PECVD process (Plasma Enhanced Chemical Vapour Deposition). The implants were inserted into polyurethane resin, and crowns of nickel chrome cast were cimented and the abutments screwed into the implants. The reverse torque was measured after the mechanical cycling (1.106 cycles). Statistical analysis was performed by one factor ANOVA and Tukey's test, with significance level of 5%. Analysis was performed screws through scanning electron microscopy (SEM) before and after loading . Results: The results showed that after mechanical reverse torque RT (%) for the untreated group (A1) was significantly higher than the one of the DLC groups (A2) and CD -DLC (A3) (p = 0.0001). However, there was no statistical difference for the groups with and without coating in maintaining torque for the screws’ internal hex connections (p = 0.5476). Conclusion: After mechanical cycling, the diamond-like carbon with and without doping of diamond on the screws for abutments, showed no improvement in maintaining the torque in external and internal hex connections