<p>Antifungal Activity of ZnO Nanoparticles and Nystatin and Downregulation of SAP1-3 Genes Expression in Fluconazole-Resistant <em>Candida albicans</em> Isolates from Vulvovaginal Candidiasis</p>

Abstract

Purpose: Antifungal resistance and virulence properties of Candida albicans (C. albicans) are growing health problems worldwide. The present study aims to investigate the effect of Zinc Oxide (ZnO) nanoparticles and Nystatin on SAP1-3 genes expression in C. albicans isolates of females with Vulvovaginal Candidiasis (VVC) isolated from Sayad Shirazi Obstetrics and Gynecology Hospital in Northeastern Iran during 2017-2018. Patients and Methods: In this descriptive-analytic study, vaginal samples were collected from 280 VVC women. 196 (70%) of C. albicans isolates were identified by phenotypic and ITS genotypic methods. Susceptibility to Fluconazole C. albicans isolates was determined by the disk diffusion method. Detection of ERG11 gene was done by RT-PCR technique. Results: It was revealed that PCR amplified the ERG11 gene in all of the Fluconazole-resistant isolates. Real-time PCR was used to survey the effects of 3±1.7µg/mL concentrations of ZnO nanoparticles and Nystatin on expression of SAP1-3 genes before and after treatment. 186 (95%) susceptible C. albicans and 10 (5%) Fluconazole-resistant C. albicans isolates from VVC were exposed to sub-minimum inhibitory concentrations (Sub-MIC) of ZnO-np (range=0.02-12 μg/ mL). Sub-MIC concentration was used for each strain, which reduced the expression of SAP1-3 genes to 1.8 MIC in the vaginal swabs. The observed reduction in gene expression was significant for both ZnO nanoparticles and Nystatin (P=0.01 and P=0.07, respectively). Conclusion: ZnO as antifungal agent can well reduce the growth and gene expression of SAP1-3 in the pathogenesis of VVC.

Vulvovaginal candidiasis: An overview of mycological, clinical, and immunological aspects

“…In addition to efflux pumps, Candida species use other mechanisms for drug resistance. Overexpression of the ERG genes involved in the ergosterol biosynthesis and biofilm formation are two instances that result in drug resistance among Candida species 84,86–89 . Antifungal susceptibility testing prior to treatment could provide useful data for prescribing the proper antifungal drug, especially in confirmed cases of RVVC.…”

Striking Back against Fungal Infections: The Utilization of Nanosystems for Antifungal Strategies

“…As with silver nanoparticles, zinc nanoparticles show significant anti-candida effects both as a monotherapy [ 144 , 145 ] and in combination with antifungal drugs such as fluconazole [ 146 ]. Thus far, the in vitro antifungal activities of zinc nanoparticles have been evaluated with various strains of C. albicans, C. krusei, C. aprapsilosis, and C. tropicalis [ 116 , 144 , 147 ]. However, the in vivo studies remain unconvincing; as a result, zinc nanoparticles are currently not indicated for the treatment of a specific candidiasis.…”

Nanoparticles of Bioactive Metals/Metal Oxides and Their Nanocomposites with Antibacterial Drugs for Biomedical Applications

“…ZnO INPs poses bactericidal activity against P. aeruginosa , E. coli , S. aureus , S. enterica , C. jejuni , and V. cholerae , antiviral activity against Herpes Simplex Virus Type 1 and hepatitis A virus, and antifungal activity against Botrytis cinerea , Penicillium expansum , Erythricium salmonicolor , and Candida albicans [ 91 , 92 , 93 , 94 , 95 , 96 , 97 ]. ZnO nanoparticles in different ratios inhibited the growth of antibiotic-resistant Mycobacterium tuberculosis strains, but did not lead to bacterial death [ 98 ].…”