Preclinical approaches in vulvovaginal candidiasis treatment with mucoadhesive thermoresponsive systems containing propolis

Abstract

Vulvovaginal candidiasis (VVC) is a common vaginitis that affects women, especially in childbearing age, caused by Candida albicans in almost 80% of cases. Considering the limited drug arsenal available and the increasing fungal resistance profile, the search for new therapeutic sources with low toxicity and easy administration should be supported. Propolis has been used as a traditional medicine for multiple diseases, considering its particular composition and pharmaceutical properties that permits its wide applicability; it has also emerged as a potential antifungal agent. Thus, this study performed an in vitro and in vivo investigation into the efficacy of a new mucoadhesive thermoresponsive platform for propolis delivery (MTS-PRPe) in a preclinical murine model of VVC treatment caused by C. albicans. The methodologies involved chemical analysis, an assessment of the rheological and mucoadhesive properties of propolis formulations, in vitro and in vivo antifungal evaluations, histological evaluations and electron microscopy of the vaginal mucosa. The results demonstrated the antifungal activity of propolis extract and MTS-PRP against the standard strain and a fluconazole-resistant clinical isolate of C. albicans, in both in vitro and in vivo assays. These results were similar and even better, depending on the propolis concentration, when compared to nystatin. Thus, the formulation containing propolis exhibited good performance against C. albicans in a vulvovaginal candidiasis experimental model, representing a promising opportunity for the treatment of this infection.

Antifungal Properties of Chemically Defined Propolis from Various Geographical Regions

“…Therapy of various candidiasis should be based on complementary methods, including natural products such as not only tea tree and garlic but also propolis [71]. It should be emphasized that the number of studies on the evaluation of the effects of propolis in vulvovaginal candidiasis (opportunistic fungal infection) is increasing [25,27,71,72]. New trends in antifungal research of propolis include also assessment of anti-candidal activities i.e., in orthodontic materials (green propolis) [73], dental surface (red propolis) [61,74], in treatment of chronic periodontitis (red propolis) [75], in caries (Brazilian and European propolis) [53].…”

Antiviral, Antibacterial, Antifungal, and Antiparasitic Properties of Propolis: A Review

“…The authors observed antifungal activity of propolis extract and MTS-PRPe against the standard strain and a fluconazole-resistant clinical isolate of C.albicans, in vitro and in vivo. They demonstrated that the MTS-PRPe did not negatively affect the efficacy of propolis [156].…”

“…Among all the extracts, PEE was the most potent and was followed by PSDE, PM, and PWE. Bonfim et al (2020) conducted an in vitro and in vivo study to assess efficacy of a new mucoadhesive thermoresponsive platform for propolis delivery (MTS-PRPe) in a preclinical murine model of vulvovaginal candidiasis treatment caused by C.albicans [156]. They carried out chemical analysis, an assessment of the rheological and mucoadhesive properties of propolis formulations, in vitro and in vivo antifungal evaluations, histological evaluations, and electron microscopy of the vaginal mucosa.…”

Perspectives for Uses of Propolis in Therapy against Infectious Diseases

“…Other genera of fungi studied have been Aspergillus , Microsporon , Trichophyton , and Trichosporon . One in vivo preclinical study was carried out about effects against a vulvovaginal standard and fluconazol-resistant isolates of C. albicans [ 118 ]. The main propolis components responsible for antifungal activity have been suggested to be flavonoids.…”