Comparison of topical antifungal agents for oral candidiasis treatment: a systematic review and meta-analysis

Xiao, Yanxuan; Yuan, Peiyang; Sun, Yutong; Xu, Yiming; Deng, Xiaojuan; Wang, Xianwen; Li, Rui; Chen, Qianming; Jiang, Lu

doi:10.1016/j.oooo.2021.10.023

Cited by 16 publications

(11 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Fluconazole and amphotericin B demonstrated similar results in clinical response, mycological cure, the incidence of adverse reactions, and relapse rates. The authors also indicated that the results might be influenced by the reduced number of studies included, the differences in patient age, the dosage, the course, and the frequency of drug administration [ 34 ]. Drew and Perfect emphasized that published data regarding the administration of antifungals by alternative routes are scarce and restricted to uncontrolled case reports or studies with small sample sizes [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

“…The adverse effects of intravenously administered amphotericin B are vascular, respiratory, thoracic, mediastinal, renal, and urinary disorders [33]. Xiao et al (2022) evaluated the effectiveness of topical application of antifungals commonly used in treating oral candidiasis in a systematic review and meta-analysis. Among the studies included, the topical formulations of amphotericin B analyzed comprised oral suspension (0.5 g, three times a day, for 14 days) and lozenges (10 mg, four times a day, for 30 days).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Resistance profiles to antifungal agents in Candida albicans isolated from human oral cavities: systematic review and meta-analysis

Kessler

Lang²,

Dal-Pizzol

et al. 2022

Clin Oral Invest

View full text Add to dashboard Cite

Aim To identify the antifungal susceptibility profile of Candida spp . isolated from the human oral cavity was assessed with meta-analyses of observational studies that collected samples from the oral cavity of human subjects. Material and methods Isolated Candida albicans tested by E-test®; disk diffusion test; microdilution and macrodilution; Sensititre YeastOne; and/or FungiTest. Search strategies were conducted on the MEDLINE, Embase, CINAHL, Dentistry, and Oral Sciences, Central, Scopus, and LILACS databases, and gray literature sources. Articles were initially screened by title and then their abstracts. Articles that met the conditions for inclusion were read in full, followed by data extraction. A descriptive analysis was conducted of each study, and the data were tabulated. A first meta-analysis was conducted to assess the resistance of antifungals regardless of systemic comorbidities. An additional stratified analysis was conducted by systemic comorbidity groups for the outcome “resistance” to the antifungals. Results When not grouping Candida albicans isolates by systemic conditions, the lowest resistance rates to the antifungals tested were observed for amphotericin B, nystatin, flucytosine, and caspofungin. In contrast, the highest resistance rates were observed for miconazole and econazole. There was a high degree of heterogeneity and low resistance in general in all analyses, except for the “several associated comorbidities” group, which had high resistance rates. Conclusions Clinical C. albicans isolates had low antifungal resistance. Clinical relevance The presence of concomitant systemic comorbidities appears to be an essential factor that should be considered when evaluating resistance to antifungals for oral isolates. Supplementary Information The online version contains supplementary material available at 10.1007/s00784-022-04716-2.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Resistance profiles to antifungal agents in Candida albicans isolated from human oral cavities: systematic review and meta-analysis

Kessler

Lang²,

Dal-Pizzol

et al. 2022

Clin Oral Invest

View full text Add to dashboard Cite

show abstract

“…Nystatin (Nys) 2 was the first macrolide polyene antimycotic to be discovered [ 22 ]; it was first called fungicidin [ 36 ] and is synthesized by Streptomyces noursei . Due to a slightly higher toxicity, Nys is used topically [ 37 , 38 , 39 , 40 ] to treat, for example, oral candidiasis [ 41 ]. Toxicity is a major problem when it comes to the clinical use of polyenes and remains an obstacle when addressing an increasing number of multidrug-resistant fungal pathogens such as Candida albicans , Candida lusitaniae [ 42 ], and Candida auris [ 43 ].…”

Section: Introductionmentioning

confidence: 99%

Polyene Antibiotics Physical Chemistry and Their Effect on Lipid Membranes; Impacting Biological Processes and Medical Applications

et al. 2022

View full text Add to dashboard Cite

This review examined a collection of studies regarding the molecular properties of some polyene antibiotic molecules as well as their properties in solution and in particular environmental conditions. We also looked into the proposed mechanism of action of polyenes, where membrane properties play a crucial role. Given the interest in polyene antibiotics as therapeutic agents, we looked into alternative ways of reducing their collateral toxicity, including semi-synthesis of derivatives and new formulations. We follow with studies on the role of membrane structure and, finally, recent developments regarding the most important clinical applications of these compounds.

show abstract

“…The widespread use of traditional antifungal drugs, including azoles, echinocandins, and polyenes, has led to increasingly severe antifungal resistance (Berman and Krysan, 2020). In addition, traditional antifungal agents may induce severe adverse reactions, such as hepatotoxicity, nephrotoxicity, and gastrointestinal reactions (Housť ̌et al, 2020;Xiao et al, 2022). The total incidence of adverse reactions of topical antifungal agents for oral candidiasis in immunocompetent patients with fluconazole can even reach 39.5% (Xiao et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

“…In addition, traditional antifungal agents may induce severe adverse reactions, such as hepatotoxicity, nephrotoxicity, and gastrointestinal reactions (Housť ̌et al, 2020;Xiao et al, 2022). The total incidence of adverse reactions of topical antifungal agents for oral candidiasis in immunocompetent patients with fluconazole can even reach 39.5% (Xiao et al, 2022). Therefore, Candida infections have become one of the crucial hidden dangers to human health, and the development of safer and more effective antifungal agents is urgently required to address this problem.…”

Section: Introductionmentioning

confidence: 99%

Magnolol as a potent antifungal agent inhibits Candida albicans virulence factors via the PKC and Cek1 MAPK signaling pathways

Xie

Hua

Zhou

2022

Front. Cell. Infect. Microbiol.

View full text Add to dashboard Cite

Magnolol, a lignin compound extracted from Magnolia officinalis Cortex, has been found to have prominent antifungal effects against Candida albicans. However, the specific mechanism still remains unclear. Therefore, this study aimed to further explore the inhibition mechanism of magnolol against Candida albicans virulence factors and the related signaling pathways. By an XTT reduction assay, a hyphal formation assay, confocal laser scanning microscopy, transmission electron microscopy, a calcofluor white staining assay, and a cell wall β-glucan quantitative detection assay, we evaluated the inhibitory effects of magnolol against the adhesion, hyphal formation, biofilm viability, biofilm spatial structure, and cell wall ultrastructure of Candida albicans. Moreover, by RNA sequencing and qRT-PCR, we confirmed the effects of magnolol in inhibiting the gene expression of Candida albicans virulence factors and the related signaling pathways. The results revealed that the adhesion and hyphal formation of Candida albicans were inhibited significantly by magnolol. The viability and spatial structures of Candida albicans biofilms were further weakened. Candida albicans ultrastructure showed partial thinning of cell walls and even rupture, with cytoplasmic leakage. The cell wall intergrity and β-glucan content were also radically reduced. Moreover, magnolol caused significant inhibition of the expression of Candida albicans adhesion, invasion, hyphal formation, biofilm formation, β-1,3-glucan synthesis, and hydrolase secretion-related genes, including ALS1, ALS3, EFG1, EAP1, FKS1, FKS2, PLB2, and SAP2. Furthermore, the PKC pathway-related genes (RHO1, PKC1, BCK1, MKK2, MKC1) and Cek1 pathway-related genes (CDC42, CST20, STE11, HST7, CEK1) were also significantly downregulated, indicating that the inhibition of magnolol against Candida albicans virulence factors might be related to PKC and Cek1 MAPK signaling pathways. In conclusion, the findings of this study confirmed the inhibition mechanism of magnolol against Candida albicans virulence factors, which might be related to PKC and Cek1 MAPK pathways, thus laying the theoretical foundation for its clinical antifungal applications.

show abstract

Comparison of topical antifungal agents for oral candidiasis treatment: a systematic review and meta-analysis

Cited by 16 publications

References 33 publications

Resistance profiles to antifungal agents in Candida albicans isolated from human oral cavities: systematic review and meta-analysis

Resistance profiles to antifungal agents in Candida albicans isolated from human oral cavities: systematic review and meta-analysis

Polyene Antibiotics Physical Chemistry and Their Effect on Lipid Membranes; Impacting Biological Processes and Medical Applications

Magnolol as a potent antifungal agent inhibits Candida albicans virulence factors via the PKC and Cek1 MAPK signaling pathways

Contact Info

Product

Resources

About