In vivo activity of Sapindus saponaria against azole-susceptible and -resistant human vaginal Candida species

Edílson Damke,Márcia R Batista,Thâmara A Bertoni,Izabel CP Ferreira,Terezinha IE Svidzinski,Lucélia Donati,Márcia EL Consolaro,Joyce K Tsuzuki,Diógenes AG Cortez

doi:10.1186/1472-6882-11-35

Abstract

BackgroundStudy of in vivo antifungal activity of the hydroalcoholic extract (HE) and n-BuOH extract (BUTE) of Sapindus saponaria against azole-susceptible and -resistant human vaginal Candida spp.MethodsThe in vitro antifungal activity of HE, BUTE, fluconazole (FLU), and itraconazole (ITRA) was determined by the broth microdilution method. We obtained values of minimal inhibitory concentration (MIC) and minimum fungicide concentration (MFC) for 46 strains of C. albicans and 10 of C. glabrata isolated from patients with vulvovaginal candidiasis (VVC). VVC was induced in hyperestrogenic Wistar rats with azole-susceptible C. albicans (SCA), azole-resistant C. albicans (RCA), and azole-resistant C. glabrata (RCG). The rats were treated intravaginally with 0.1 mL of HE or BUTE at concentrations of 1%, 2.5% and 5%; 100 μg/mL of FLU (treatment positive control); or distilled water (negative control) at 1, 24, and 48 h after induction of the infection, and the progress of VVC was monitored by culturing and scanning electron microscopy (SEM). The toxicity was evaluated in cervical cells of the HeLa cell line.ResultsThe extracts showed in vitro inhibitory and fungicidal activity against all the isolates, and the MIC and MFC values for the C. glabrata isolates were slightly higher. In vivo, the SCA, RCA, and RCG infections were eliminated by 21 days post-infection, with up to 5% HE and BUTE, comparable to the activity of FLU. No cytotoxic action was observed for either extract.ConclusionsOur results demonstrated that HE and BUTE from S. saponaria show inhibitory and fungicidal activity in vitro, in addition to in vivo activity against azole-resistant vaginal isolates of C. glabrata and azole-susceptible and resistant isolates of C. albicans. Also considering the lack of cytotoxicity and the low concentrations of the extracts necessary to eliminate the infection in vivo, HE and BUTE show promise for continued studies with purified antifungal substances in VVC yeast isolates.

Highlights

Study of in vivo antifungal activity of the hydroalcoholic extract (HE) and n-BuOH extract (BUTE) of Sapindus saponaria against azole-susceptible and -resistant human vaginal Candida spp
Determination of in vitro minimum inhibitory and fungicidal concentrations The majority of the C. albicans isolates proved to be susceptible in vitro to FLU and ITRA simultaneously (n = 38) and a few were resistant to ITRA (n = 3), but there was no resistance to FLU
The values of MIC50 and MIC90 were higher for FLU, ITRA, HE, and n-BuOH extract of Sapindus saponaria (BUTE) in the isolates of C. glabrata

Summary

Introduction

Study of in vivo antifungal activity of the hydroalcoholic extract (HE) and n-BuOH extract (BUTE) of Sapindus saponaria against azole-susceptible and -resistant human vaginal Candida spp. The same group demonstrated excellent inhibitory action in vitro of the wateralcohol extract (HE) and BUTE against the yeasts Candida albicans and non- C. albicans isolated from patients with vulvovaginal candidiasis (VVC)[5], signaling the possibility of using this plant as an antifungal agent in this pathology. In spite of these recent investigations of the constituents and biological properties of S. saponaria, few in vivo studies have yet been carried out to establish a correlation with the in vitro results. In view of the need for new therapeutic options for VVC and the promising in vitro inhibitory activity of S. saponaria L. against yeasts, we conducted a study of antifungal activity in vivo of HE and BUTE against azole-susceptible and -resistant human vaginal Candida spp., and of the cell toxicity of these extracts

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