Nanomedicines for the topical treatment of vulvovaginal infections: Addressing the challenges of antimicrobial resistance

Vanić, Željka; Jøraholmen, May Wenche; Škalko‐Basnet, Nataša

doi:10.1016/j.addr.2021.113855

Cited by 19 publications

(20 citation statements)

References 241 publications

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“…Vulvovaginal candidiasis, bacterial vaginosis, and aerobic vaginitis are the most common endogenous infections. Alarmingly, in an era of AMR, the incidence of sexually transmitted infections (STIs) such as gonorrhoea, mycoplasma, chlamydia, and trichomoniasis are continuously on the rise [10].…”

Section: Common Vaginal Infectionsmentioning

confidence: 99%

“…Bacterial vaginosis is one of the most widespread vaginal infections [10]. An infection originates from the overgrowth of anaerobic bacteria that are a natural part of the vaginal microflora.…”

Section: Common Vaginal Infectionsmentioning

confidence: 99%

“…These anaerobic bacteria include Bacteroides fragilis, Gardnerella vaginalis, and Atopobium vaginae, of which B. fragilis is the most resistant strain [265]. Both oral (metronidazole and clindamycin, tinidazole and secnidazole) and topical (metronidazole and clindamycin) antibiotic treatments are currently available; however, they often fail to completely eradicate biofilms, thus, preventing successful antimicrobial therapy [8,10]. The persistent biofilm contributes to recurrent infections and might intensify the resistance to antimicrobial agents [24].…”

Section: Common Vaginal Infectionsmentioning

confidence: 99%

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The Expanded Role of Chitosan in Localized Antimicrobial Therapy

2021

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Chitosan is one of the most studied natural origin polymers for biomedical applications. This review focuses on the potential of chitosan in localized antimicrobial therapy to address the challenges of current rising antimicrobial resistance. Due to its mucoadhesiveness, chitosan offers the opportunity to prolong the formulation residence time at mucosal sites; its wound healing properties open possibilities to utilize chitosan as wound dressings with multitargeted activities and more. We provide an unbiased overview of the state-of-the-art chitosan-based delivery systems categorized by the administration site, addressing the site-related challenges and evaluating the representative formulations. Specifically, we offer an in-depth analysis of the current challenges of the chitosan-based novel delivery systems for skin and vaginal infections, including its formulations optimizations and limitations. A brief overview of chitosan’s potential in treating ocular, buccal and dental, and nasal infections is included. We close the review with remarks on toxicity issues and remaining challenges and perspectives.

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Section: Common Vaginal Infectionsmentioning

confidence: 99%

Section: Common Vaginal Infectionsmentioning

confidence: 99%

Section: Common Vaginal Infectionsmentioning

confidence: 99%

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The Expanded Role of Chitosan in Localized Antimicrobial Therapy

2021

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“…Widespread antibiotics are currently the most common treatment for chlamydial infection ( Murray and McKay, 2021 ), and this treatment can effectively alleviate the infection and ameliorate sperm quality ( Gallegos et al, 2008 ; Hamazah and Al-Dahmoshi, 2021 ). However, antibiotic resistance is one of the remaining challenges for this treatment, especially in patients with multidrug resistance ( Hamazah and Al-Dahmoshi, 2021 ; Vanić et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Mesenchymal Stem-Cell Derived Exosome Therapy as a Potential Future Approach for Treatment of Male Infertility Caused by Chlamydia Infection

et al. 2022

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Some microbial sexually transmitted infections (STIs) have adverse effects on the reproductive tract, sperm function, and male fertility. Given that STIs are often asymptomatic and cause major complications such as urogenital inflammation, fibrosis, and scarring, optimal treatments should be performed to prevent the noxious effect of STIs on male fertility. Among STIs, Chlamydia trachomatis is the most common asymptomatic preventable bacterial STI. C. trachomatis can affect both sperm and the male reproductive tract. Recently, mesenchymal stem cells (MSCs) derived exosomes have been considered as a new therapeutic medicine due to their immunomodulatory, anti-inflammatory, anti-oxidant, and regenerative effects without consequences through the stem cell transplantation based therapies. Inflammation of the genital tract and sperm dysfunction are the consequences of the microbial infections, especially Chlamydia trachomatis. Exosome therapy as a noninvasive approach has shown promising results on the ability to regenerate the damaged sperm and treating asthenozoospermia. Recent experimental methods may be helpful in the novel treatments of male infertility. Thus, it is demonstrated that exosomes play an important role in preventing the consequences of infection, and thereby preventing inflammation, reducing cell damage, inhibiting fibrogenesis, and reducing scar formation. This review aimed to overview the studies about the potential therapeutic roles of MSCs-derived exosomes on sperm abnormalities and male infertility caused by STIs.

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“…Liposomal encapsulation is a promising tool for improving antibiotic efficacy and overcoming microbial resistance, thus reducing treatment failures [8]. Liposomal antibiotics have been proven to enable prolonged and/or controlled release of the encapsulated drug permitting a higher local drug concentrations and a greater efficacy against extracellular and certain facultative intracellular bacteria, such as Listeria monocytogenes, Brucella melitensis, Francisella tularensis, Salmonella enterica serovar Typhimurium, Mycobacterium avium complex and Mycobacterium tuberculosis [9].…”

Section: Introductionmentioning

confidence: 99%

Liposomal Encapsulation Increases the Efficacy of Azithromycin against Chlamydia trachomatis

et al. 2021

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Chlamydia trachomatis (C. trachomatis) is an obligate intracellular bacterium linked to ocular and urogenital infections with potentially serious sequelae, including blindness and infertility. First-line antibiotics, such as azithromycin (AZT) and doxycycline, are effective, but treatment failures have also been reported. Encapsulation of antibiotics in liposomes is considered an effective approach for improving their local effects, bioavailability, biocompatibility and antimicrobial activity. To test whether liposomes could enhance the antichlamydial action of AZT, we encapsulated AZT in different surface-charged elastic liposomes (neutral, cationic and anionic elastic liposomes) and assessed their antibacterial potential against the C. trachomatis serovar D laboratory strain as well as the clinical isolate C. trachomatis serovar F. A direct quantitative polymerase chain reaction (qPCR) method was used to measure chlamydial genome content 48 h post infection and to determine the recoverable chlamydial growth. All the liposomes efficiently delivered AZT to HeLa 229 cells infected with the laboratory Chlamydia strain, exhibiting the minimal inhibitory concentrations (MIC) and the minimal bactericidal concentrations (MBC) of AZT even 4–8-fold lower than those achieved with the free AZT. The tested AZT-liposomes were also effective against the clinical Chlamydia strain by decreasing MIC values by 2-fold relative to the free AZT. Interestingly, the neutral AZT-liposomes had no effect on the MBC against the clinical strain, while cationic and anionic AZT-liposomes decreased the MBC 2-fold, hence proving the potential of the surface-charged elastic liposomes to improve the effectiveness of AZT against C. trachomatis.

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Nanomedicines for the topical treatment of vulvovaginal infections: Addressing the challenges of antimicrobial resistance

Cited by 19 publications

References 241 publications

The Expanded Role of Chitosan in Localized Antimicrobial Therapy

The Expanded Role of Chitosan in Localized Antimicrobial Therapy

Mesenchymal Stem-Cell Derived Exosome Therapy as a Potential Future Approach for Treatment of Male Infertility Caused by Chlamydia Infection

Liposomal Encapsulation Increases the Efficacy of Azithromycin against Chlamydia trachomatis

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