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Antifungal Activity of Brazilian Propolis Microparticles against Yeasts Isolated from Vulvovaginal Candidiasis
Antifungal Activity of Brazilian Propolis Microparticles against Yeasts Isolated from Vulvovaginal Candidiasis
Abstract
Propolis, a resinous compound produced by Apis mellifera L. bees, is known to possess a variety of biological activities and is applied in the therapy of various infectious diseases. The aim of this study was to evaluate the in vitro antifungal activity of propolis ethanol extract (PE) and propolis microparticles (PMs) obtained from a sample of Brazilian propolis against clinical yeast isolates of importance in the vulvovaginal candidiasis (VVC). PE was used to prepare the microparticles. Yeast isolates (n = 8 9 ), obtained from vaginal exudates of patients with VVC, were exposed to the PE and the PMs. Moreover, the main antifungal drugs used in the treatment of VVC (Fluconazole, Voriconazole, Itraconazole, Ketoconazole, Miconazole and Amphotericin B) were also tested. Minimum inhibitory concentration (MIC) was determined according to the standard broth microdilution method. Some Candida albicans isolates showed resistance or dose-dependent susceptibility for the azolic drugs and Amphotericin B. Non-C. albicans isolates showed more resistance and dose-dependent susceptibility for the azolic drugs than C. albicans. However, all of them were sensitive or dose-dependent susceptible for Amphotericin B. All yeasts were inhibited by PE and PMs, with small variation, independent of the species of yeast. The overall results provided important information for the potential application of PMs in the therapy of VVC and the possible prevention of the occurrence of new symptomatic episodes.
1. Introduction
Vulvovaginal candidiasis (VVC) is a disease caused by abnormal growth of yeast-like fungi in the mucosa of the female genital tract, classified by the World Health Organization as a sexually transmitted disease of frequent sexual transmission [1]. VVC is caused mainly by the genus Candida, the major agent being Candida albicans, and the prevalence of this yeast can reach 85–95% [2]. Moreover, studies have shown the increasing infections by non-C. albicans species (C. tropicalis, C. glabrata, C. krusei, C. parapsilosis, C. pseudotropicalis, C. lusitaniae) in VVC [3, 4]. Because the disease strikes millions of women annually, leading to great discomfort, interfering with sexual and affective relations and impairing work performance, it has been considered an important worldwide public health concern [2]. VVC is the first cause of vulvovaginitis in Europe and the second in the USA and Brazil. It represents 20–25% of the vaginal discharges of infectious nature. It is estimated that about 75% of the adult women show at least one episode of VVC during their lifetimes, 40–50% of those will experience new surges and 5% will reach the recurrent character (RVVC), defined as the occurrence of four or more symptomatic episodes in a one year interval [4].
In recent years, drug-resistance to antifungal agents and optimizing therapy of Candida infections have been broadly focused [5]. Moreover, the therapeutic arsenal available for the treatment of fungal infections is quite restricted...
Conclusion
Considering the antifungal activity showed by PMs and that the high ethanol concentration is a disadvantage of PE, this report clearly showed that PMs arises as a possible agent for the treatment and especially the prevention of the new symptomatic episode the VVC. Moreover PMs have the advantage of to be incorporated in some dosage forms, like vaginal ointments, and to be administered into the vaginal mucosa more easily and safely.
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