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Boosting the Anti-Helicobacter Efficacy of Azithromycin through Natural Compounds: Insights From In Vitro, In Vivo, Histopathological, and Molecular Docking Investigations.
Bendary, Mahmoud M; Elmanakhly, Arwa R; Mosallam, Farag M; Alblwi, Noaf Abdullah N; Mosbah, Rasha A; Alshareef, Walaa A; Selim, Heba M R M; Alhomrani, Majid; Alamri, Abdulhakeem S; Safwat, Nesreen A; Hamdan, Ahmed M E; Elshimy, Rana.
Afiliação
  • Bendary MM; Department of Microbiology and Immunology, Faculty of Pharmacy, Port Said University, Port Said, Egypt.
  • Elmanakhly AR; Department of Microbiology and Immunology, Faculty of Pharmacy, Modern University of Technology and Information, Cairo, Egypt.
  • Mosallam FM; Drug Radiation Research Department, National Center for Radiation Research and Technology (NCRRT), Egyptian Atomic Energy Authority, Cairo, Egypt.
  • Alblwi NAN; Al Hadithah General Hospital Al-Qurayyat, Al Hadithah, Saudi Arabia.
  • Mosbah RA; Infection Control Unit, Zagazig University Hospital, Zagazig, Egypt.
  • Alshareef WA; Department of Microbiology and Immunology, Faculty of Pharmacy, 6th October University, Giza, Egypt.
  • Selim HMRM; Department of Pharmaceutical Science, College of Pharmacy, AlMaarefa University, Riyadh, Saudi Arabia.
  • Alhomrani M; Department of Clinical Laboratories Sciences, the Faculty of Applied Medical Science, Taif University, Taif, Saudi Arabia.
  • Alamri AS; Centre of Biomedical Science Research (CBSR), Deanship of Scientific Research, Taif University, Taif, Saudi Arabia.
  • Safwat NA; Department of Clinical Laboratories Sciences, the Faculty of Applied Medical Science, Taif University, Taif, Saudi Arabia.
  • Hamdan AME; Centre of Biomedical Science Research (CBSR), Deanship of Scientific Research, Taif University, Taif, Saudi Arabia.
  • Elshimy R; Department of Microbiology and Immunology, Faculty of Pharmacy, Modern University of Technology and Information, Cairo, Egypt.
Helicobacter ; 29(4): e13110, 2024.
Article em En | MEDLINE | ID: mdl-39001634
ABSTRACT

BACKGROUND:

Antimicrobial-resistant Helicobacter pylori (H. pylori) poses a significant public health concern, especially given the limited therapeutic options for azithromycin-resistant strains. Hence, there is a necessity for new studies to reconsider the use of azithromycin, which has diminished in effectiveness against numerous strains. Thus, we aimed to augment azithromycin's anti-Helicobacter properties by combining it with curcumin in different formulations, including curcumin in clove oil, curcumin nano-gold emulsion, and curcumin nanoemulsion.

METHODS:

The antimicrobial activities of the investigated compounds, both individually and in combination with other anti-Helicobacter drugs, were evaluated. Their antibiofilm and anti-virulence properties were assessed using both phenotypic and genotypic methods, alongside molecular docking studies. Our findings were further validated through mouse protection assays and histopathological analysis.

RESULTS:

We observed high anti-Helicobacter activities of curcumin, especially curcumin nanoemulsion. A synergistic effect was detected between curcumin nanoemulsion and azithromycin with fraction inhibitory concentration index (FICI) values <0.5. The curcumin nanoemulsion was the most active anti-biofilm and anti-virulence compound among the examined substances. The biofilm-correlated virulence genes (babA and hopQ) and ureA genes were downregulated (fold change <1) post-treatment with curcumin nanoemulsion. On the protein level, the anti-virulence activities of curcumin nanoemulsion were documented based on molecular docking studies. These findings aligned with histopathological scoring of challenge mice, affirming the superior efficacy of curcumin nanoemulsion/azithromycin combination.

CONCLUSION:

The anti-Helicobacter activities of all curcumin physical forms pose significant challenges due to their higher  minimum inhibitory concentration (MIC) values exceeding the maximum permissible level. However, using curcumin nanoemulsion at sub-MIC levels could enhance the anti-Helicobacter activity of azithromycin and exhibit anti-virulence properties, thereby improving patient outcomes and addressing resistant pathogens. Therefore, more extensive studies are necessary to assess the safety of incorporating curcumin nanoemulsion into H. pylori treatment.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Limite: Animals Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Limite: Animals Idioma: En Ano de publicação: 2024 Tipo de documento: Article