The incidence of fungal infections and, in particular, the incidence of fungal antibiotic resistance, which is associated with biofilm formation, have significantly increased, contributing to morbidity and mortality. Thus, new therapeutic strategies need to be developed. In this context, natural products have emerged as a major source of possible antifungal agents. Berberine is a protoberberine-type isoquinoline alkaloid isolated from the roots, rhizomes, and stem bark of natural herbs, such as Berberis aquifolium, Berberis vulgaris, Berberis aristata, and Hydrastis canadensis, and of Phellodendron amurense. Berberine has been proven to have broad antibacterial and antifungal activity. In the present study, the potential antifungal effect of berberine against fluconazole-resistant Candida and Cryptococcus neoformans strains, as well as against the biofilm form of Candida spp., was assessed. The antifungal effect of berberine was determined by a broth microdilution method (the M27-A3 method of the Clinical and Laboratory Standards Institute) and flow cytometry techniques, in which the probable mechanism of action of the compound was also assessed. For biofilm assessment, a colorimetric 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay was used to determine the susceptibility of sessile cells. The isolates used in the study belonged to the Laboratory of Bioprospection and Experiments in Yeast (LABEL) of the Federal University of Ceará. After 24 and 72 h, fluconazole-resistant Candida and Cryptococcus neoformans strains showed berberine MICs equal to 8 μg/ml and 16 μg/ml, respectively. Cytometric analysis showed that treatment with berberine caused alterations to the integrity of the plasma and mitochondrial membranes and DNA damage, which led to cell death, probably by apoptosis. Assessment of biofilm-forming isolates after treatment showed statistically significant reductions in biofilm cell activity (P < 0.001).

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Recent research has shown broad antifungal activity of the classic antidepressants selective serotonin reuptake inhibitors (SSRIs). This fact, combined with the increased cross-resistance frequency of the genre Candida regarding the main treatment today, fluconazole, requires the development of novel therapeutic strategies. In that context, this study aimed to assess the antifungal potential of fluoxetine, sertraline, and paroxetine against fluconazole-resistant Candida spp. planktonic cells, as well as to assess the mechanism of action and the viability of biofilms treated with fluoxetine. After 24 h, the fluconazole-resistant Candida spp. strains showed minimum inhibitory concentration (MIC) in the ranges of 20-160 μg/mL for fluoxetine, 10-20 μg/mL for sertraline, and 10-100.8 μg/mL for paroxetine by the broth microdilution method (M27-A3). According to our data by flow cytometry, each of the SSRIs cause fungal death after damaging the plasma and mitochondrial membrane, which activates apoptotic signaling pathways and leads to dose-dependant cell viability loss. Regarding biofilm-forming isolates, the fluoxetine reduce mature biofilm of all the species tested. Therefore, it is concluded that SSRIs are capable of inhibit the growth in vitro of Candida spp., both in planktonic form, as biofilm, inducing cellular death by apoptosis.

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A síndrome da demência relaciona-se com a depressão de diversas maneiras e apresenta como características principais o prejuízo da memória, perda de habilidades, além de problemas de comportamento. Sabendo que a doença de Alzheimer (DA) é o tipo mais comum de demência, o presente trabalho objetivou associar depressão e demência, com enfoque na DA e para tal foi realizada uma análise teórica sobre o tema. As causas genéticas, neurobiológicas e sociais estão citadas como principais fatores de risco para o surgimento de depressão concomitante à DA. Cumpre destacar o papel dos familiares no cuidado aos portadores dessa patologia, no entanto, como consequência negativa desse processo, a dinâmica familiar pode sofrer profundas alterações. Foi também percebido que esses pacientes dependem da família no processo de reabilitação e, dessa forma, as abordagens terapêuticas devem atentar para inclusão da família e dos profissionais que assistem esse público. Palavras-chaves: Depressão. Demência. Doença de Alzheimer. Introdução A Demência é uma síndrome, ou seja, é composta por um conjunto de sinais e sintomas que os pacientes manifestam, sendo caracterizada, principalmente, por prejuízo da memória, problemas de comportamento e perda das habilidades. Segundo Balloni (2005), os sintomas mais comuns são o déficit de memória, o qual costuma ser o relato principal ou único na primeira consulta médica, além de problemas com o vocabulário, alterações de humor e de comportamento, dificuldade de executar tarefas domésticas incapacidade de julgar situações, alterações de personalidade e desorientação no tempo e espaço. A relação entre depressão e demência pode manifestar-se das seguintes maneiras principais: