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Dysbiosis in the female genital tract (FGT) is characterized by the overgrowth of pathogenic bacterial, fungal, or protozoan members of the microbiota, leading to symptomatic or asymptomatic infections. In this review, we discuss recent advances in studies dealing with molecular mechanisms of pathogenicity factors of Gardnerella vaginalis, Mycoplasma genitalium, Mycoplasma hominis, Neisseria gonorrhoeae, Streptococcus agalactiae, Chlamydia trachomatis, Trichomonas vaginalis, and Candida spp., as well as their interactions with the host and microbiota in the various niches of the FGT. Taking a holistic approach to identifying fundamental commonalities and differences during these infections could help us to better understand reproductive tract health and improve current prevention and treatment strategies.

Albumin is abundant in serum but is also excreted at mucosal surfaces and enters tissues when inflammation increases vascular permeability. Host-associated opportunistic pathogens encounter albumin during commensalism and when causing infections. Considering the ubiquitous presence of albumin, we investigated its role in the pathogenesis of infections with the model human fungal pathogen, Candida albicans. Albumin was introduced in various in vitro models that mimic different stages of systemic or mucosal candidiasis, where it reduced the ability of C. albicans to damage host cells. The amphipathic toxin candidalysin mediates necrotic host cell damage induced by C. albicans. Using cellular and biophysical assays, we determined that albumin functions by neutralizing candidalysin through hydrophobic interactions. We discovered that albumin, similarly, can neutralize a variety of fungal (α-amanitin), bacterial (streptolysin O and staurosporin), and insect (melittin) hydrophobic toxins. These data suggest albumin as a defense mechanism against toxins, which can play a role in the pathogenesis of microbial infections. IMPORTANCE Albumin is the most abundant serum protein in humans. During inflammation, serum albumin levels decrease drastically, and low albumin levels are associated with poor patient outcome. Thus, albumin may have specific functions during infection. Here, we describe the ability of albumin to neutralize hydrophobic microbial toxins. We show that albumin can protect against damage induced by the pathogenic yeast C. albicans by neutralizing its cytolytic toxin candidalysin. These findings suggest that albumin is a toxin-neutralizing protein that may play a role during infections with toxin-producing microorganisms.

The opportunistic pathogen Candida glabrata is the second most frequent causative agent of vulvovaginal candidiasis (VVC), a disease that affects 70–75% of women at least once during their life. However, C. glabrata is almost avirulent in mice and normally incapable of inflicting damage to vaginal epithelial cells in vitro. We thus proposed that host factors present in vivo may influence C. glabrata pathogenicity. We, therefore, analyzed the impact of albumin, one of the most abundant proteins of the vaginal fluid. The presence of human, but not murine, albumin dramatically increased the potential of C. glabrata to damage vaginal epithelial cells. This effect depended on macropinocytosis-mediated epithelial uptake of albumin and subsequent proteolytic processing. The enhanced pathogenicity of C. glabrata can be explained by a combination of beneficial effects for the fungus, which includes an increased access to iron, accelerated growth, and increased adhesion. Screening of C. glabrata deletion mutants revealed that Hap5, a key regulator of iron homeostasis, is essential for the albumin-augmented damage potential. The albumin-augmented pathogenicity was reversed by the addition of iron chelators and a similar increase in pathogenicity was shown by increasing the iron availability, confirming a key role of iron. Accelerated growth not only led to higher cell numbers, but also to increased fungal metabolic activity and oxidative stress resistance. Finally, the albumin-driven enhanced damage potential was associated with the expression of distinct C. glabrata virulence genes. Transcriptional responses of the epithelial cells suggested an unfolded protein response (UPR) and ER-stress responses combined with glucose starvation induced by fast growing C. glabrata cells as potential mechanisms by which cytotoxicity is mediated.Collectively, we demonstrate that albumin augments the pathogenic potential of C. glabrata during interaction with vaginal epithelial cells. This suggests a role for albumin as a key player in the pathogenesis of VVC., Author summary Candida glabrata is the overall second causative species of candidiasis in humans, but little is known about the pathogenicity mechanisms of this yeast. C. glabrata is capable of causing lethal systemic candidiasis mostly in elderly immunocompromised patients, but is also a frequent cause of vulvovaginal candidiasis. These clinical insights suggest that C. glabrata has a high virulence potential, yet little pathogenicity is observed in both in vitro and in vivo infection models. The finding that human albumin, the most abundant protein in the human body, is boosting C. glabrata pathogenicity in vitro provides novel insights into C. glabrata pathogenicity mechanisms and shows that the presence of distinct human factors can have a significant influence on the virulence potential of a pathogenic microbe.

Graphical abstract, Candidiasis, aspergillosis, and mucormycosis cause the majority of nosocomial fungal infections in immunocompromised patients. Using an unbiased transcriptional profiling in PBMCs exposed to the fungal species causing these infections, we found a core host response in healthy individuals that may govern effective fungal clearance: it consists of 156 transcripts, involving canonical and non-canonical immune pathways. Systematic investigation of key steps in antifungal host defense revealed fungal-specific signatures. As previously demonstrated, Candida albicans induced type I and Type II interferon-related pathways. In contrast, central pattern recognition receptor, reactive oxygen species production, and host glycolytic pathways were down-regulated in response to Rhizopus oryzae, which was associated with an ER-stress response. TLR5 was identified to be uniquely regulated by Aspergillus fumigatus and to control cytokine release in response to this fungus. In conclusion, our data reveals the transcriptional profiles induced by C. albicans, A. fumigatus, and R. oryzae, and describes both the common and specific antifungal host responses that could be exploited for novel therapeutic strategies.

Candida species are commensal yeasts but are also responsible of life-threatening infection in at-risk populations, like new-born or immunocompromised patients. Candida albicans is the most common causative species, and the most studied. Moreover, non-albicans Candida species as Candida glabrata, Candida parapsilosis and Candida tropicalis cause a large proportion of infections. In our study we investigated the interaction between four Candida species and human vaginal epithelial cells A431 by using a dual RNA-seq method. Our aim is to identify the different transcriptomic response of each yeast, and of the host, during the infection of human cells. Gene Ontology analysis of up-regulated genes in the yeasts during infection implicated the ergosterol (ERG) pathway in C. parapsilosis only. We therefore investigated the role of the ERG pathway in the three Candida species in which it is currently possible to generate gene knockouts. The transcriptional factor Upc2 is the main regulator of ERG gene expression in C. albicans and C. parapsilosis. C. glabrata has two UPC2 orthologs, called CgUPC2A and CgUPC2B. We found that deleting CgUPC2A or CgUPC2B or both together does not reduce the damage inflicted by C. glabrata on host cells. However, deleting UPC2in C. albicans greatly reduces damage. Deleting UPC2 in C. parapsilosis appears to reduce damage of host cells; however further investigation is required. Our results show the that the role of ergosterol pathway in the host pathogen interaction differs between Candida species.

A series of new thiophene-based guanylhydrazones (iminoguanidines) were synthesized in high yields using a straightforward two-step procedure. The antifungal activity of compounds was evaluated against a wide range of medicaly important fungal strains including yeasts, molds, and dermatophytes in comparison to clinically used drug voriconazole. Cytotoxic properties of compounds were also determined using human lung fibroblast cell line and hemolysis assay. All guanylhydrazones showed significant activity against broad spectrum of clinically important species of Candida spp., Aspergillus fumigatus, Fusarium oxysporum, Microsporum canis and Trichophyton mentagrophytes, which was in some cases comparable or better than activity of voriconazole. More importantly, compounds 10, 11, 13, 14, 18 and 21 exhibited excellent activity against voriconazole-resistant Candida albicans CA5 with very low minimal inhibitory concentration (MIC) values lt 2 mu g mL(-1). Derivative 14, bearing bromine on the phenyl ring, was the most effective compound with MICs ranging from 0.25 to 6.25 g mL(-1). However, bis-guanylhydrazone 18 showed better selectivity in terms of therapeutic index values. In vivo embryotoxicity on zebrafish (Danio rerio) showed improved toxicity profile of 11, 14 and 18 in comparison to that of voriconazole. Most guanylhydrazones also inhibited C albicans yeast to hyphal transition, essential for its biofilm formation, while 11 and 18 were able to disperse preformed Candida biofilms. All guanylhydrazones showed the equal potential to interact with genomic DNA of C albicans in vitro, thus indicating a possible mechanism of their action, as well as possible mechanism of observed cytotoxic effects. Tested compounds did not have significant hemolytic effect and caused low liposome leakage, which excluded the cell membrane as a primary target. On the basis of computational docking experiments using both human and cytochrome P450 from Candida it was concluded that the most active guanylhydrazones had minimal structural prerequisites to interact with the cytochrome P450 14a-demethylase (CYP51). Promising guanylhydrazone derivatives also showed satisfactory pharmacokinetic profile based on molecular calculations. (C) 2016 Elsevier Ltd. All rights reserved. This is peer-reviewed version of the following article: Ajdačić, V.; Senerovic, L.; Vranić, M.; Pekmezovic, M.; Arsic-Arsnijevic, V.; Veselinovic, A.; Veselinovic, J.; Šolaja, B. A.; Nikodinovic-Runic, J.; Opsenica, I. M. Synthesis and Evaluation of Thiophene-Based Guanylhydrazones (Iminoguanidines) Efficient against Panel of Voriconazole-Resistant Fungal Isolates. Bioorganic and Medicinal Chemistry 2016, 24 (6), 1277–1291. [https://doi.org/10.1016/j.bmc.2016.01.058] Supplementary material: [http://cherry.chem.bg.ac.rs/handle/123456789/3628]

The antifungal effect of essential oils (EOs) of Thymus vulgaris L. (EOT. vulgaris) and Cinnamomum cassia L. (EOC. cassia) against Aspergillus flavus spores was evaluated by determining minimum inhibitory concentration, minimum fungicidal concentrations and fungicidal kinetics. Kinetic model of fungicidal activity of individual EOT. vulgaris and EOC. cassia was developed and its parameters were used to make EO mixture with optimal ratio of individual EOs. Synergism and speed of fungicidal effect of EO mixtures against A. flavus spores were evaluated. Kinetic model revealed optimal ratio EOT. vulgaris: EOC. cassia as 14:1 in mixture. Observed result was validated by comparing fungicidal effect of this mixture to commonly used ratio 1:1 and intermediate 7:1 EO mixtures. All three mixtures showed partial fungicidal synergism, but the time point of fungicidal effect was different. The fastest fungicidal effect was observed in 14:1 EO mixture (after 90 min), followed by 7:1 (110 min) and 1:1 (180 min). The difference in the speed of fungicidal effect could not be detected using standard microdilution susceptibility tests, which demonstrated the importance and usefulness of developed kinetic model for further investigations.

Cryptococcosis is a major fungal disease caused by members of the Cryptococcus gattii and Cryptococcus neoformans species complexes. After more than 15 years of molecular genetic and phenotypic studies and much debate, a proposal for a taxonomic revision was made., Cryptococcosis is a major fungal disease caused by members of the Cryptococcus gattii and Cryptococcus neoformans species complexes. After more than 15 years of molecular genetic and phenotypic studies and much debate, a proposal for a taxonomic revision was made. The two varieties within C. neoformans were raised to species level, and the same was done for five genotypes within C. gattii. In a recent perspective (K. J. Kwon-Chung et al., mSphere 2:e00357-16, 2017, https://doi.org/10.1128/mSphere.00357-16), it was argued that this taxonomic proposal was premature and without consensus in the community. Although the authors of the perspective recognized the existence of genetic diversity, they preferred the use of the informal nomenclature “C. neoformans species complex” and “C. gattii species complex.” Here we highlight the advantage of recognizing these seven species, as ignoring these species will impede deciphering further biologically and clinically relevant differences between them, which may in turn delay future clinical advances.

The fatality rate of invasive aspergillosis (IA) is still very high, especially in prolonged and untreated pulmonary cases. Aspergillus fumigatus is the main causative agent of IA and investigation of its metabolites could provide valuable insight into virulence factor(s) associated with this organism. We evaluated the A. fumigatus culture filtrate (CF) products generated during short- and long-term aerated and non-aerated conditions and tested for (i) inhibition of cysteine or serine proteases and (ii) cytotoxicity. In addition, the mathematical model was determined using response surface methodology (RSM) to estimate the influence of different fermentation conditions on A. fumigatus CF characteristics, predict enzyme inhibition and make possible correlations with in vivo conditions. Biosynthesis of A. fumigatus low molecular weight proteinaceous products (from 6.4 to 15.4 kDa) was observed after 6 days of growth under aerated and alkaline conditions. Also, only these CFs showed significant reduction in cell lines survival (Caco-2 and WISH 35.6% and 54.6%, respectively). Obtained results provide solid starting point for further studies that would include: (i) detailed chemical characterization of A. fumigatus CF, (ii) activity relationships and in vivo correlation with pathogenicity of prolonged pulmonary IA and (iii) possible use of biomolecules as diagnostic or therapeutic markers.

Candida spp. form a part of human and animal oral cavity flora. However Candida spp. is the main cause of dental related stomatitis in humans and stomatitis in dogs. Stomatitis treatment implies the use of azoles and polyenes to which yeasts build up resistance. The research is directed to the use of natural compounds such as essential oils. The aim of this paper is to define the antifungal activity of thyme oil on 15 clinical strains of Candida spp., isolated from humans and dogs and to determine if there is a difference in susceptibility between human and dog isolates. Sampling in patients with stomatitis was done by swabbing the denture or oral mucosa swab while sampling in dogs was done by swabbing the oral cavity mucosa after stomatitis has been diagnosed. In order to investigate the antifungal activity of thyme oil in vitro, microdilution method was used. Thyme oil expressed antifungal effects on all investigated strains. Also, our data show that the values of minimum fungicide concentration (MFC) and minimum inhibitory concentration (MIC) are lower in human strains. Explanation is that in most cases, stomatitis in humans is asymptomatic and thus not treated, so Candida strains have not developed resistance. On the other hand, stomatitis in dogs is followed by a marked clinical picture and treated is by antimicotics (mostly by azoles), therefore resistant Candida strains are more likely to occur., Candida spp. je sastavni deo mikrobioma usne duplje čoveka i psa. Međutim Candida spp. predstavlja glavni uzročnik proteznog stomatitisa kod čoveka i stomatitisa kod psa. Terapija stomatitisa podrazumeva korišćenje azola i poliena na koje poslednjih godina gljivice razvijaju otpornost. Istrživanja se usmeravaju ka primeni prirodnih preparata kao što su etarska ulja. Cilj rada je utvrdi antifungalnu aktivnost ulja timijana na kliničke izolate Candida spp. čoveka i psa, i utvrdi da li postoji razlika u osetljivosti sojeva Candide spp. izolovanih kod čoveka i psa. Uzorkovanje kod pacijenata sa stomatitisom je vršeno brisom proteze ili brisom sluzokože. Kod pasa je uzrokovanje vršeno brisom sluzokože usne duplje kada je dijagnostikovan stomatitis. Zasejani sojevi su in vitro tretirani korišćenjem mikrodilucione metode da bi se utvrdilo da li ulje timijana deluje na kliničke izolate Candida spp. čoveka i psa. Rezultati pokazuju da su vrednosti minimalne fungicidne koncentracije (MFC) i minimalne inhibitorne koncentracije (MIC) manje kod čoveka. Stomatitis je kod ljudi najčešće je asimptomatski, pacijenti se ne podvrgavaju lečenju, pa sojevi Candida spp. nisu razvili rezistenciju na antifungicidne preparate. Kod pasa stomatitis je praćen burnijom kliničkom slikom, leči se antimikoticima (uglavnom azolima) pa je verovatnoća pojave rezistentnih sojeva Candida spp. veća.

Recently, geographic variations in resistance to agents commonly used in the treatment of cryptococcosis have been reported. Therefore, the antifungal susceptibilities of 31 clinical isolates of Cryptococcus neoformans, collected in Serbia during 10-year period, were investigated. Strains were isolated from cerebrospinal fluid (n = 28) and blood (n = 3), from patients with AIDS (n = 26), lymphoma (n = 4) and kidney transplant recipient (n = 1). The minimal inhibitory concentrations (MICs) of amphotericin B, 5-fluorocytosine, fluconazole and itraconazole were determined by the E-test (R) method. The isolates were highly susceptible to amphotericin B (100% susceptibility at MIC LT 0.5 mu g/mL) and 5-fluorocytosine (87.1% susceptibility at MIC LT = 4 mu g/mL). Geometric mean MIC of amphotericin B and 5-fluorocytosine were 0.102 mu g/mL and 0.396 mu g/mL, respectively. Fluconazole exhibited the lowest activity in vitro (48.4% susceptibility at MIC LT = 8 mu g/mL) with a significant resistance rate. The activity of itraconazole was also decreased (48.4% susceptibility at MIC LT = 0.25 mu g/mL). The geometric mean MIC of fiuconazole stood at 15.14 mu g/mL and of itraconazole was 0.144 mu g/mL. Cross-resistance among azoles was not common (3.2%), but the parallel increase in fluconazole and itraconazole MIC has been observed (P LT 0.01). The low rate of susceptibility to fluconazole stresses the need for active antifungal surveillance of C. neoformans and of the corresponding data from different geographic regions. (C) 2012 Elsevier Masson SAS. All rights reserved.

Despite the increasing of onychomycosis caused by Candida spp., in referent literature, there is still data insufficiency about this nail infection. The objectives of this retrospective study were to determine epidemiological characteristics of Candida onychomycosis, the antifungal susceptibility of isolated species in vitro, and to compare the results of antifungal susceptibility testing with conducted treatment in period from 2011 to the end of March 2015. Out of 761 patients who were underwent clinical and mycological examinations, 137 had Candida species isolated from nails. The dominant species was Candida albicans (C. albicans) (36.59%) followed by C. parapsilosis (23.78%), C. krusei (9.76%), and C. guilliermondii (6.71%). Antifungal susceptibility in vitro testing showed good susceptibility to antimycotics, except C. krusei, which was resistance to fluconazole (FCZ) and isolates of C. tropicalis and C. glabrata which were dose dependent to itraconazole (ITZ) and fluconazole. Evaluation of medical histories determined that combined therapy, which included pulsed systemic regimen of ITZ with topical application of clotrimazole, had better clinical outcomes regarding the proscribed only topical application of clotrimazole. Multidisciplinary approach of dermatologists and mycologists is required in solving the problem of onychomycosis, which is the dominant nail disease.

A series of novel 3-substituted isocoumarins was prepared via Pd-catalysed coupling processes and screened in vitro for antifungal activity against Candida species. The study revealed antifungal potential of isocoumarins possessing the azole substituents, which, in some cases, showed biological properties equal to those of clinically used voriconazole. Selected compounds were also screened against voriconazole resistant Candida krusei 6258 and a clinical isolate Candida parapsilosis CA-27. Although the activity against these targets needs to be improved further, the results emphasise additional potential of this new class of antifungal compounds. (C) 2015 Elsevier Ltd. All rights reserved.

Summary Malassezia yeast belongs to the normal cutaneous flora and under certain conditions it causes seborrhoeic dermatitis (SD). There is no culture-based study about the presence and density of the Malassezia in SD patients in Serbia. Aim was to show the presence, species distribution and density of Malassezia in patients with SD on lesional skin (LS) and non-lesional skin (NLS) and healthy controls (HC) and to compare data between Serbia and other countries. The study included 70 HC and 60 patients with SD in the study group (SG). Isolation, identification and examination of density of Malassezia colony-forming units from LS and NLS were performed. Malassezia was found more frequently in the SG than in HC, 90% and 60%, respectively (P

Antifungal effect of individual thyme (Thymus vulgaris L.) and cinnamon (Cinnamomum cassia L.) essential oils (EOs) and mixture of thereof on Aspergillus flavus spores was investigated. In order to optimize the process variables (time of action, concentration of individual or mixture EOs and their mass ratio) for the antifungal effect of EO mixture, two models were developed: the response surface methodology (RSM) and artificial neural network (ANN) combined with genetic algorithm (GA). In RSM model, three factors were involved in Box–Behnken design that was applied for the experiment. Based on the mean relative percent deviation (MRPD), both models provided a good quality prediction for the antifungal effect in terms of all three process variables. RSM and ANN–GA techniques predicted the 0.5% as an optimum percentage concentration of EO mixture in EOs mass ratio T. vulgaris:C. cassia 1:1, ensuring the highest antifungal effect of 95.8% and 96.4% after 65 min. Both models were found useful for the optimization of the antifungal effect in vitro. ANN–GA was found more accurate in comparison to RSM due to its lower value of MRPD. Therefore, ANN–GA can be generally used for optimization and prediction of antimicrobial effects of EOs and their mixtures.

In recent years fungi are favoured as origin of chronic rhinosinusitis (CRS), especially with nasal polyps (wNP). Sensitive methods for fungal detection are still absent, therefore we used NP tissue single-cell suspension for mycology investigations in patients with recalcitrant NP (rNP) that underwent functional endoscopic sinus sur- gery (FESS). A prospective case-series study and culture- based mycological examination were conducted in patients who underwent FESS for the first time (ft-FESS) and those with repeated FESS (re-FESS). The study was conducted in a tertiary Otorhinolaryngology Unit of Clinical Centre of Serbia. A total of 43 consecutive patients with CRSwNP underwent FESS. Culture-based mycological examination of single-cell suspension was done on 55 NPs samples. Patient's co-morbidity data were collected. Repeated FESS was observed in 19/43 (44 %) patients (re-FESS group). Asthma and aspirin intolerance were more frequent in re- FESS than in ft-FESS group (p = 0.000, p = 0.002; respectively). Fungi were detected (wF) in 10/43 (23.3 %) patients (FESSwF group), representing 13/55 culture positive NP tissue (23.6 %). Fungal presence was higher in re-FESS than in ft-FESS group (42 and 8 %, respectively; p = 0.01). Significantly longer duration of CRS was observed in FESSwF than in fungal negative patients (p = 0.033). Predominate strain was Aspergillus flavus detected in 6/10 patients. This is the first study which analysed association of fungi in single-cell suspension of NP tissue and rNP. We demonstrate significantly higher percentage of positive fungal finding in re-FESSwF than in ft-FESSwF group. The most commonly isolated species in our patients was A. flavus.

Item does not contain fulltext Molecular typing and antifungal susceptibility testing of 34 clinical Serbian Cryptococcus neoformans isolates from 25 patients was retrospectively performed. Amplified fragment length polymorphism (AFLP) fingerprinting was used for genotyping, whereas a novel real-time PCR was used to determine the mating- and serotype. The antifungals amphotericin B, 5-fluorocytosine, fluconazole, voriconazole, itraconazole and posaconazole were used to determine the antifungal susceptibility profiles. The majority of isolates belonged to genotype AFLP1/VNI (n = 20; 58.8%), followed by AFLP2/VNIV (n = 10; 29.4%), AFLP3/VNIII (n = 3; 8.8%) and AFLP1B/VNII (n = 1; 2.9%). All AFLP1/VNI isolates were mating-serotype alphaA, the sole AFLP1B/VNII isolate was found to be aA, whereas AFLP2/VNIV harboured serotype D isolates with either the a (n = 2; 5.9%) or alpha (n = 8; 23.5%) mating-type allele. The isolates (n = 3; 8.8%) that were found to be genotype AFLP3/VNIII had the hybrid mating- and serotype combination aA-alphaD. In vitro antifungal susceptibility testing showed that all isolates were susceptible to amphotericin B, voriconazole and posaconazole. Low resistance level was observed for fluconazole (n = 1; 2.9%) and 5-fluorocytosine. (n = 2; 5.8%). A large percentage of isolates was found to be susceptible dose dependent to itraconazole (n = 16; 47.1%). AFLP1/VNI was the most common genotype among clinical C. neoformans isolates from immunocompromised patients in Serbia. C. neoformans from HIV-negative patients were significantly less susceptible to 5-fluorocytosine (P < 0.01). Correlation between genotypes and antifungal susceptibility was not observed.

Mixed microbial infections caused by Pseudomonas aeruginosa and pathogenic fungi are commonly found in patients with chronic infections and constitute a significant health care burden. The aim of this study was to address the potential polymicrobial antibiofilm activity of pompia and grapefruit essential oils (EOs). The mechanism of antimicrobial activity of EOs was analysed. EOs of pompia and grapefruit inhibited fungal growth with MIC concentrations between 50 and 250 mg L−1, whereas no effect on P. aeruginosa growth was observed. Both citrus EOs inhibited formation of bacterial and fungal monomicrobial biofilms in concentrations of 50 mg L−1 and were efficient in potentiating the activity of clinically used antimicrobials in vitro . The concentration of 10 mg L−1 EOs inhibited mixed biofilm formation composed of P. aeruginosa and Aspergillus fumigatus or Scedosporium apiospermum . Citrus EOs affected quorum sensing in P. aeruginosa and caused fast permeabilisation of Candida albicans membrane. Pompia and grapefruit EOs potently inhibited biofilm formation and could be used for the control of common polymicrobial infections.

The glucocorticoid betamethasone (BM) is frequently employed in clinical practice because of its anti-inflammatory and immunosuppressive properties. In this study, we investigated the effect of BM (1 and 2 mM) on the ability of Candida albicans to adhere to, invade and damage oral, intestinal or vaginal epithelial cells, as well as to elicit cytokine and chemokine release. BM at 2 mM concentration stimulated adherence of C. albicans to vaginal cells and facilitated the invasion of intestinal and vaginal epithelia without influencing the growth rate of invading C. albicans hyphae at any type of epithelia and BM concentrations tested. In addition, BM at 2 mM concentration also augmented C. albicans-initiated cell damage of oral and intestinal cells. Furthermore, BM exposure decreased IL-6 cytokine and IL-8 chemokine release from oral and vaginal epithelial cells and also IL-6 release from intestinal epithelium after infection with C. albicans. These observations suggest that high-dose applications of BM may predispose patients to various epithelial C. albicans infections.

Novel biodegradable and biocompatible formulations of “old” but “gold” drugs such as nystatin (Nys) and amphotericin B (AmB) were made using a biopolymer as a matrix. Medium chain length polyhydroxyalkanoates (mcl-PHA) were used to formulate both polyenes (Nys and AmB) in the form of films (~50 µm). Thermal properties and stability of the materials were not significantly altered by the incorporation of polyenes in mcl-PHA, but polyene containing materials were more hydrophobic. These formulations were tested in vitro against a panel of pathogenic fungi and for antibiofilm properties. The films containing 0.1 to 2 weight % polyenes showed good activity and sustained polyene release for up to 4 days. A PHA monomer, namely 3-hydroxydecanoic acid (C10-OH), was added to the films to achieve an enhanced synergistic effect with polyenes against fungal growth. Mcl-PHA based polyene formulations showed excellent growth inhibitory activity against both Candida yeasts (C. albicans ATCC 1023, C. albicans SC5314 (ATCC MYA-2876), C. parapsilosis ATCC 22019) and filamentous fungi (Aspergillus fumigatus ATCC 13073, Trichophyton mentagrophytes ATCC 9533, Microsporum gypseum ATCC 24102). All antifungal PHA film preparations prevented the formation of a C. albicans biofilm, while they were not efficient in eradication of mature biofilms, rendering them suitable for the transdermal application or as coatings of implants.