Antimicrobial Photodynamic Therapy in Combination with Nystatin in the Treatment of Experimental Oral Candidiasis Induced by Candida albicans Resistant to Fluconazole

Abstract

Background: It has been demonstrated that azole-resistant strains of Candida albicans have a greater resistance to antimicrobial photodynamic therapy (aPDT) when compared to their more susceptible counterparts. For this reason, the present study evaluated the efficacy of aPDT, together with nystatin (NYS), in the treatment of oral candidiasis in vivo. Methods: Mice were infected with fluconazole-resistant C. albicans (ATCC 96901). To perform the combined therapy, aPDT, mediated by Photodithazine (PDZ) and LED light, was used together with NYS. The efficacy of the treatments was evaluated by microbiological, macroscopic, histopathological and Confocal Scanning Laser Microscopy analyses of the lesions. The expression of p21 and p53, proteins associated with cell death, from the tongues of mice, was also performed. Results: The combined therapy reduced the fungal viability by around 2.6 log10 and decreased the oral lesions and the inflammatory reaction. Additionally, it stimulated the production of p53 and p21. Conclusions: The combined therapy is a promising alternative treatment for oral candidiasis induced by C. albicans resistant to fluconazole.

RETRACTED: Sanguinarine Inhibits Mono- and Dual-Species Biofilm Formation by Candida albicans and Staphylococcus aureus and Induces Mature Hypha Transition of C. albicans

“…Candida albicans (C. albicans) is a frequent commensal colonizer of the human skin and mucosal flora [1]. However, C. albicans is an opportunistic fungal pathogen, and can cause infections (candidiasis or thrush) in humans and other animals, where it is estimated that more than 70% of women experience Candida infection at least once in their lifetime [2,3]. C. albicans also readily develops biofilms on the surface on in-dwelling biomedical materials and mucosal tissues, which serve as a rich reservoir of infection, and can result in severe systemic infections because of their heightened resistance to antibiotics [4].…”

Photosensitizers Mediated Photodynamic Inactivation against Fungi

“…Only 2.1 log reduction was obtained with the reversed order. Animals treated with PACT alone had a 1.3 log reduction in fungal cell counts, while nystatin alone had an effect of 1.1 log reduction, which shows a synergy between the therapies [223]. The activity of chlorins is summarized in Table 5.…”

“…Combination of chlorin with conventional antifungals has been studied as well. In one of the experiments, nystatin was included in the standard treatment with 38 [223]. This study was performed on mice infected with fluconazole-resistant C. albicans.…”

Photodynamic Therapy Review: Principles, Photosensitizers, Applications, and Future Directions

“…Light applied intravenously can be a solution during the clinical treatment of infections. Very recently, the use of the PDT procedure to treat patients with COVID-19 has also been discussed [ 8 , 57 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 ].…”