Oral Candidiasis Research Articles

Unlocking the potential of capsaicin in oral health (Review).

Capsaicin is a bioactive compound found prominently in Capsicum annuum L. plants and takes on a pivotal role in their characteristic spiciness. Previous studies have delved into the potential analgesic effect of capsaicin in various oral conditions, such as oral neuropathic pain, trigeminal neuralgia, oral mucositis, temporomandibular joint disorders and burning mouth syndrome. Capsaicin has also demonstrated promise in inhibiting the proliferation of different oral cancer cell lines. Its antimicrobial properties have also been shown to inhibit the growth of oral pathogens associated with dental caries, periodontitis and oral candidiasis. However, to harness its benefits effectively, more studies are required to establish optimal dosages for pain relief while minimizing adverse effects. In addition, investigation of the effect of capsaicin on nonpathogenic oral bacteria and viruses is warranted. Human-based research is crucial for elucidating the biomolecular mechanisms underlying the properties of capsaicin, potentially leading to the development of more effective interventions for oral health problems.

Prevalence of oral diseases in patients under palliative care: a systematic review and meta-analysis.

Oral alterations are frequently observed in patients undergoing palliative care and are linked to the direct or indirect effects of the primary medical condition, comorbidities and medical management, leading to oral pain, impacting oral intake, and affecting quality of life. This systematic review aims to assess the prevalence of oral disease in palliative care patients. The protocol was registered at the PROSPERO database, and a systematic review of the literature was performed based on the PRISMA statement. A thorough evaluation of studies from five databases and gray literature was conducted. The risk of bias in each study was assessed using the Joanna Briggs Institute checklist for cross-sectional and case-control studies. A quantitative analysis was conducted on five studies using meta-analysis, and the degree of certainty in the evidence was determined using the GRADE tool. The sample consisted of 2,502 patients, with a slight male predominance (50.43%). The average age was 66.92years. The prevalence of oral diseases among palliative care patients was as follows: caries 32% (95% CI, 0.11-0.56; I2 = 93%), and oral candidiasis 17% (95% CI,0.11-0.25; I2 = 74%). Gingivitis and stomatitis were also reported, but with less frequency. Dental intervention should take place as early as possible, ideally from the time of the patient's initial admission to palliative care, with regular monitoring of oral health. This approach can enhance the patient's comfort and quality of life and help prevent more severe complications in the future.

Tailored Sticky Solutions: 3D-Printed Miconazole Buccal Films for Pediatric Oral Candidiasis.

In this research, 3D-printed antifungal buccal films (BFs) were manufactured as a potential alternative to commercially available antifungal oral gels addressing key considerations such as ease of manufacturing, convenience of administration, enhanced drug efficacy and suitability of paediatric patients. The fabrication process involved the use of a semi-solid extrusion method to create BFs from zein-Poly-Vinyl-Pyrrolidone (zein-PVP) polymer blend, which served as a carrier for drug (miconazole) and taste enhancers. After manufacturing, it was determined that the disintegration time for all films was less than 10min. However, these films are designed to adhere to buccal tissue, ensuring sustained drug release. Approximately 80% of the miconazole was released gradually over 2h from the zein/PVP matrix of the 3D printed films. Moreover, a detailed physicochemical characterization including spectroscopic and thermal methods was conducted to assess solid state and thermal stability of film constituents. Mucoadhesive properties and mechanical evaluation were also studied, while permeability studies revealed the extent to which film-loaded miconazole permeates through buccal tissue compared to commercially available oral gel formulation. Histological evaluation of the treated tissues was followed. Furthermore, in vitro antifungal activity was assessed for the developed films and the commercial oral gel. Finally, films underwent a two-month drug stability test to ascertain the suitability of the BFs for clinical application. The results demonstrate that 3D-printed films are a promising alternative for local administration of miconazole in the oral cavity.

Opportunistic infections among people living with HIV/AIDS attending antiretroviral therapy clinics in Gedeo Zone, Southern Ethiopia

IntroductionOpportunistic infections (OIs) are more common and severe among people with suppressed immunity like those living with HIV/AIDS (PLWH). This study aimed to assess the prevalence of OIs and associated factors among PLWH attending antiretroviral therapy (ART) clinics in the Gedeo zone, Southern Ethiopia.MethodsA facility based retrospective cohort study was conducted from April to June 2018 among PLWH attending ART clinics in Gedeo zone, Ethiopia from November 2016 – November 2017. A simple random sampling method was used to select the both paper based and electronic study participants’ charts. Adjusted odds ratios were calculated using multivariable logistic regression analysis for variables statistically significant at 95% confidence interval under bivariable logistic regression analysis, and significance was declared at P < 0.05.Resultsa total of 266 PLWH attended the selected ART clinics of Gedeo zone during the one year period were participated in the current study. The majority 104(39.1%) were within the age group 30–39, 106(60.2%) male, 184(69.2%) married, and 167(62.9%) urban residents. The study revealed the prevalence of OIs was 113(42.5%) with oral candidiasis 28(24.5%) the most prevalent followed by pulmonary tuberculosis 22(19.5%) and herpes zoster 15(13.4%). Further, study participants with ambulatory [AOR = 2.40(95% CI: 1.14, 5.03)], and bedridden [AOR = 3.27(95% CI:1.64, 6.52)] working functional status; with lower CD4 count: less than 200cells/mm3 [AOR = 9.14(95% CI: 2.75, 30.39)], 200–350cells/mm3 [AOR = 9.45(95% CI: 2.70,33.06)], 351-500cells/mm3 [AOR = 5.76(95% CI: 1.71, 19.39)]; being poor in ART adherence level [AOR = 10.05(95% CI: 4.31,23.46)]; being in stage III/IV WHO clinical stage of HIV/AIDS [AOR = 2.72(95% CI: 1.42, 5.20)]; and being chewing khat [AOR = 2.84(95% CI: 1.21, 6.65)] were found positively predicting the occurrence of OIs.ConclusionThis study speckled a high prevalence of OIs with several predicting factors. Therefore, the study acmes there should be interventional means which tackles the higher prevalence of OIs with focus to the predicting factors like lower CD4 count level, less/bedridden working functional status, poor ART adherence level, advanced stage of HIV/AIDS stage and chewing khat.

Design of Experiments and Optimization of Monacolin K Green Extraction from Red Yeast Rice by Ultra-High-Performance Liquid Chromatography.

Monacolin K (MK), in red yeast rice (RYR) in the forms of lactone (LMK) and hydroxy acid (AMK), is known for its anti-hypercholesterolemic activity. Under the rising demand for natural bioactive molecules, we present a green ultrasound-assisted extraction (UAE) optimization study for MK in RYR. The development and validation of a fast, sensitive, selective, reproducible, and accurate ultra-high-performance liquid chromatography (UHPLC) method coupled to diode array detection for LMK and AMK allowed us to evaluate the MK recovery in different extract media. Firstly, the ethanol comparability to acetonitrile was assessed (recovery of 80.7 ± 0.1% for ethanol and 85.5 ± 0.2% for acetonitrile). Then, water/ethanol mixtures, with decreasing percentages of organic solvent, were tested by modulating temperature and extraction times. Water extractions at 80 °C for 10 min produced MK yield > 85%. Thus, UAE conditions were optimized by a DOE study using a water-based formulation (mouthwash). The optimal total MK extraction yield (86.6 ± 0.4%) was found under the following conditions: 80 °C, 45 min, 5 mg mL-1 (RYR powder/solvent). Therefore, the new single-process green approach allowed the simultaneous direct extraction of MK and mouthwash enrichment (MK concentration = 130.0 ± 0.6 µg mL-1), which might be tested for the prevention and treatment of periodontitis or oral candidiasis.

Chronic nonspecific cheilitis associated with tislelizumab treatment in a patient with a history of tongue squamous cell carcinoma: a case report

BackgroundChronic nonspecific cheilitis is a complex condition characterized by persistent lip peeling and discomfort. This case report explores the clinical progression of a patient with history of tongue squamous cell carcinoma and subsequent Tislelizumab treatment, presenting with persistent lip peeling.Case presentationA patient with a history of tongue squamous cell carcinoma (T2N0M0), treated with chemotherapy, surgery, and Tislelizumab, presented with six months of persistent lip peeling. Clinical examination revealed distinct features of chronic nonspecific cheilitis with infectious angular cheilitis (Oral Candidiasis). A tailored treatment plan, emphasizing oral hygiene practices and local treatments with Sodium Bicarbonate, Tacrolimus ointment, and Chlortetracycline ointment. Follow-up visits demonstrated sustained improvement, highlighting the significance of individualized approaches.ConclusionsThis case underscores the importance of recognizing and managing oral manifestations in patients with a history of cancer and immunotherapy. The patient’s response to treatment suggests that a multifaceted approach, combining local therapy with lifestyle modifications, can be effective in managing chronic nonspecific cheilitis associated with immunotherapy. Routine follow-up appointments, guided by personalized medicine principles, contribute to sustained patient well-being.

Evaluation of therapeutic response to algorithm assisted improvement of oral mucosa damage in male AIDS patients

HIV/AIDS is now the biggest cause of mortality in Africa and the fourth highest cause of death globally. Half or more of HIV-infected individuals and as many as 80% of AIDS patients develop oral lesions. People living with HIV/AIDS may benefit from early testing, diagnosis, and treatment if oral lesions are detected, as they are the initial clinical characteristics of the infection and strong indicators of immunodeficiency. Oral candidiasis (OPC), oral hairy leukoplakia (OHL), oral Kaposi’s sarcoma (OKS), and HIV-associated periodontal diseases were the subjects of this comprehensive review designed to assess the available data for the management of these and other common oral mucosa damage that are linked to HIV. Further exacerbating the condition are host variables such as xerostomia, smoking, dental caries, oral prosthesis, diabetes, and cancer treatments. A separate portion of this Worldwide Workshop discusses the treatment of salivary gland illness linked with HIV. Oral mucosa injury in AIDS patients does not have a reliable diagnostic approach. Improving the early diagnosis of Oral Mucosa damage in male AIDS patients was the primary goal of this work, which sought to construct an Artificial Intelligence (AI) diagnostic model with high sensitivity. To demonstrate a Gradient Boosting Regression (GBR) based method for assessing the efficacy of treatments for oral mucosa damage in AIDS patients. Both investigation and diagnostic applications may benefit from this predictor. Results show that, compared to existing models, the suggested AI and GBR methods can accurately predict oral mucosa deterioration in AIDS patients. This study significantly contributes to the profession by improving the accuracy of diagnoses and providing useful information for treatment options.

The therapeutic effects of Juglans regia Linn (Walnut) extracts on oral Candida infection

The difficulties associated with oral Candida infection management necessitate the development of novel antifungal medicines in order to widen the spectrum of activity against Candida albicans. The aim of this work is to study the oral anticandidal activity of Juglans regia L. cultivated in Algeria. This plant was chosen due to its traditional use for the treatment of oral infections. Methanolic, ethanolic, butanolic, ethylic acetate and acetonic extracts of the bark of J. regia L. were extracted in a Soxhlet device and screened for in vitro activity against C. albicans. Plant preparations were screened for antifungal activity using a standard agar well diffusion assay. Following a study of the antimicrobial activity of plant extracts, their minimal inhibitory concentration (MIC) and minimal fungicidal concentration (MFC) values were determined using a broth microdilution assay. Among J. regia L. extracts, ethylic acetate extract had potent antifungal activity against Candida strain with diameters of inhibition ranging from 15.16±0.76 to 20.83±0.76 mm, followed by acetonic extract with diameters of inhibition ranging from 14.83±0.76 to 19.33±0.28 mm. The J. regia L. demonstrated MIC values ranging from 0.46875 to 3.75 mg mL-1 and the lowest MIC was recorded for ethylic acetate, acetonic extracts and AMB at 0.46875 mg mL-1. The ethylic acetate extract showed the lowest MFC value (0.9375 mg mL-1), followed by butanolic extract (3.125 mg mL-1). These results indicate that J. regia L. bark extracts can contain compounds with therapeutic potential against oral C. albicans and, hence, their possible use as therapeutic agents for oral candidiasis.

Early Candida colonisation impact on patients and healthcare professionals in an intensive care unit.

Candida spp. is an opportunistic pathogen that causes superficial and invasive infections with nosocomial outbreaks without strict hygiene protocols. Herein, we assessed oral colonisation by Candida spp. in 209 Intensive Care Unit (ICU) patients between July 2021 and April 2022, conducting clinical, epidemiological, and microbiological characterisation of those developing oral or invasive candidiasis. Initial oral swabs were collected within 24 h of admission in the ICU, followed by collections on Days 2, 4, 6 and 8. Swabs from denture-wearing patients, abiotic surfaces, healthcare professionals' hands, and retroauricular regions were also obtained. Recovered yeasts and filamentous fungi were identified using MALDI-TOF MS and morphological characteristics, respectively. Genetic similarity of Candida spp. isolates was evaluated using Amplified fragment length polymorphism (AFLP), and the antifungal susceptibility profile was determined by broth microdilution. In the study, 64.11% of patients were orally colonised by Candida spp. Of these, 80.59% were colonised within the first 24 h. Oral colonisation also occurred on subsequent days: 50%/Day 2, 26.92%/Day 4, and 11.53%/Days 6 and 8. Of the patients, 8.61% had oral candidiasis, mainly pseudomembranous. Among orally colonised patients, 2.23% developed invasive candidiasis. Besides, 89.47% of healthcare professionals evaluated were colonised. MALDI-TOF MS identified different yeast species, and C. albicans (45.34%), C. tropicalis (15.7%), and C. parapsilosis sensu stricto (9.88%) were the most prevalent. AFLP analysis indicated a high genetic correlation (≥97%) between C. parapsilosis sensu stricto isolates from patients and professionals. Three resistant C. albicans isolates were also found. This study reported a diversity of yeast and filamentous fungi species in ICU patients and highlighted early Candida spp. colonisation risks for invasive candidiasis, as well as the potential horizontal transmission in the nosocomial setting, emphasising the need for effective infection control measures.

Safety of Bimekizumab for Plaque Psoriasis: An Expert Consensus Panel.

Plaque psoriasis is a chronic, relapsing systemic illness that has a significant effect on quality of life. Bimekizumab is the first monoclonal antibody to target both interleukin (IL)-17A and IL-17F, and recently received Food and Drug Administration (FDA) approval for moderate to severe plaque psoriasis. Guidance is necessary regarding the safety of bimekizumab. A comprehensive literature search of PubMed, Scopus, and Google Scholar was completed for English-language original research articles on the safety of bimekizumab for moderate to severe psoriasis. A panel of 9 dermatologists and 1 rheumatologist with significant expertise in the treatment of psoriasis gathered to review the articles and create consensus statements on this new medication. A modified Delphi process was used to approve each statement, and strength of recommendation was assigned using the Strength of Recommendation Taxonomy criteria. The literature search produced 110 articles that met the criteria. A thorough screening of the studies for relevance to the research question resulted in 15 articles. These were distributed to all panelists for review prior to a roundtable discussion. The panel unanimously voted to adopt 5 consensus statements and recommendations, all of which were given a strength of "A". Bimekizumab has a safety profile consistent with other biologics, except for a higher risk of oral candidiasis. Its hepatic safety profile is comparable with other currently FDA-approved biologics for plaque psoriasis. In addition, the data do not support an association of bimekizumab with suicide, and the incidence of inflammatory bowel disease is not greater than the incidence of other IL-17 blockers. J Drugs Dermatol. 2024;23(8):592-599. doi:10.36849/JDD.8246.

Effect of saliva pH on Candida albicans activity in the oral cavity

Background: Low saliva pH is supposed to increase Candida sp activity because low saliva pH can cause immunocompromising. Objective: To determine the effect of saliva pH on the activity of Candida albicans. Methods: Secondary data from literature studies were analyzed descriptively by presenting the results of research on the effect of saliva pH on the activity of Candida albicans. Results: The results of the study reveal that decreasing salivary pH can increase the activity of Candida albicans in the oral cavity, which is characterized by the growth of hyphae and colonization of the microbiota itself as well as manifestations that can be seen clinically, such as oral candidiasis. Conclusion: Salivary pH levels can influence the activity of Candida albicans in the oral cavity.

Effect of inhalation therapy on oral health in patients with chronic airway disease

The primary treatment for both chronic obstructive pulmonary disease (COPD) and asthma is inhalation therapy. When utilized over an extended period of time, inhalation treatment serves as both a controller and a relief therapy. Oral adverse effects can result from inhaled medications, particularly bronchodilators and corticosteroids that are deposited in the oropharyngeal region. Reduced saliva flow rate, periodontal disease, oral thrush, dental caries, and dental erosion are just a few of the side effects and difficulties associated with using inhaler therapy that are frequently discovered in the oral region. This problem may arise from improper inhaler use, concomitant diseases and conditions of the patient, inadequate education, and inadequate assessment of oral health during inhalation medication. In order to prevent side effects and complications from inhaler therapy, it is essential to comprehend the different types of inhaler drugs and the pathophysiology associated with oral health complications. This will enable clinicians to modify the components of the drug type, the type of inhaler therapy device, and the appropriate method of use based on the unique characteristics of each patient.

Are Mouthwashes Really Effective against Candida spp.?

Oral candidiasis is an opportunistic infection caused by fungi of the genus Candida. Nystatin, fluconazole, and miconazole are the most widely used antifungal drugs in dentistry, but in recent years, they have been shown to be less effective due to the increase in the resistance to antifungal drugs. The growing challenge of antifungal resistance emphasizes the importance of exploring not only alternative strategies in the fight against Candida spp. infections but also supportive treatment for pharmacological treatment for oral candidiasis. This review aims to evaluate and compare the in vitro reports on antifungal efficacy against Candida spp. exhibited by mouthwashes distributed on the European market. The research question was elaborated through the PEO framework recommended by PRISMA 2020. A bibliographic search strategy was developed for the scientific online databases Pubmed and ScienceDirect. According to the eligibility criteria, 21 papers were included in this study over a 27-year period. Mouthwashes containing chlorhexidine digluconate, cetylpyridinium chloride, hexetidine, and fluorine compounds among others, and natural antimicrobials, such as menthol, thymol, eucalyptol, and Glycyrrhiza glabra extracts, have demonstrated antifungal effectiveness. Nonetheless, the methodological variance introduces ambiguity concerning the comparative efficacy of distinct molecules or mouthwash formulations and complicates the evaluation and the comparison of results between studies. Some mouthwashes commercially available in Europe have the potential to be used in anti-Candida therapy and prevention since they have shown antifungal effect.

Antifungal recombinant psoriasin of human origin effectively inhibits fungal growth on denture base.

To evaluate the efficacy of recombinant psoriasin as a novel treatment for oral candidiasis by eliminating Candida albicans growth on polymethyl methacrylate denture base. Recombinant psoriasin protein was expressed and purified from E. coli, and Candida growth was monitored invitro with varying concentrations of psoriasin. Subsequently, denture-base polymethyl methacrylate was immersed in psoriasin's solution or voriconazole, and fungal growth on the acrylic base and in the medium was examined by scanning electron microscopy and optical density, respectively. Cellular viability of HeLa and human gingival fibroblast cells treated with psoriasin was measured by methylene blue assay. The findings reveal an effective antifungal activity of psoriasin, completely inhibiting Candida albicans growth in RPMI at a protein concentration above 400 nM. Immersing the polymethyl methacrylate with 50 μM psoriasin completely eradicates fungal growth. Psoriasin has low cytotoxicity in HeLa cells at a concentration higher than 12 μM and no toxic effect on human gingival fibroblasts. This study marks psoriasin as an effective alternative to conventional antifungal treatments for denture stomatitis and a safe alternative to chemical antifungals in dental medicine and beyond.

Candida albicans Mannosidases, Dfg5 and Dcw1, Are Required for Cell Wall Integrity and Pathogenesis.

Candida albicans is an oral mucosal commensal fungus that transforms into an opportunistic pathogen under specific conditions, including immunosuppression. It causes oral and systemic candidiasis, which results in a significant health burden. Furthermore, an alarming rise in antifungal drug resistance in Candida species raises the urgent need for novel drugs and drug targets. C. albicans Dfg5 and Dcw1 are homologous cell wall alpha-1,6-mannosidases with critical functions and represent potential new drug targets. Our past studies have shown that Dfg5 and Dcw1 function in cell wall biogenesis through the cross-linking of glycoproteins into the cell wall, thus playing a key role in cell wall integrity. Additionally, Dfg5 and Dcw1 are required for hyphal morphogenesis. However, the exact functions of Dfg5 and Dcw1 in cell wall integrity, hyphal morphogenesis, and pathogenesis are not known. In this study, we determined the relation of Dfg5 and Dcw1 with Hog1 MAPK, which plays a key role in cell wall integrity via the regulation of chitin synthesis in C. albicans. Additionally, we also determined the effects of dfg5 and dcw1 mutations on the gene expression of transcriptional regulators of hyphal morphogenesis. Furthermore, we determined the effects of dfg5 and dcw1 mutations on pathogenesis in a mouse model of oral candidiasis. Our results demonstrate that dfg5 and dcw1 mutations, as well as a hog1 knockout mutation, result in the dysregulation of chitin synthesis, resulting in a cell separation defect. Heterozygous and conditional mutations in dfg5 and dcw1 resulted in decreased transcriptional levels of cst20, a positive regulator of hyphal morphogenesis. However, dfg5 and dcw1 mutations resulted in increased levels of all the five negative regulators of hyphal morphogenesis-Tup1, Nrg1, Mig1, Rbf1, and Rfg1. Additionally, Tup1 levels were significantly higher than other negative regulators, indicating that Dfg5 and Dcw1 function in hyphal morphogenesis by repressing Tup1. Finally, dfg5 and dcw1 mutations affected the ability of C. albicans to cause oral candidiasis in mice. Thus, the cell wall glycosidases Dfg5 and Dcw1 are required for virulence and pathogenesis and represent novel drug targets.

Effect of silver nanoparticles on different Candida species isolated from patients with oral candidiasis.

Effect of silver nanoparticles on different Candida species isolated from patients with oral candidiasis.

Candidiasis and Oral Health

Candidiasis, primarily caused by Candida albicans, poses significant oral health concerns. This review highlights its clinical manifestations, diagnostics, and management strategies. Predisposing factors include poor oral hygiene and systemic conditions like HIV/AIDS and diabetes. Clinical presentation varies from asymptomatic colonization to symptomatic mucosal infections, with complications such as denture stomatitis. Diagnostics encompass clinical examination and various laboratory methods, guiding tailored treatment with topical or systemic antifungals. Prevention strategies targeting modifiable risk factors are crucial. Despite challenges like antifungal resistance, interdisciplinary collaboration among healthcare providers is essential for the effective management of oral candidiasis and its impact on overall health. Keywords: Candidiasis; Candida albicans; Oral health; Diagnostics; Antifungals; Prevention strategies

A Study to evaluate Oral Candidal Colonization and Species Variation in Diabetes Patients

Introduction Diabetes mellitus is a clinical syndrome characterized by hyperglycemia due to absolute or relative deficiency of insulin. In the oral cavity, yeasts commonly colonize the tongue, palate, and buccal mucosa. Aside from oral mucosa, recent research have revealed the existence of C. albicans in other oral sites such as root canal, including persistent infection, carious lesions, and periodontal pockets5. The main aim of the study is to evaluate and compare Candidal colonization and species variation in healthy individuals and Diabetic patients. Material &amp; Methods Study includes 60 samples which are divided into Group –I consist of 30 Diabetic patients &amp; Group II consists of 30 healthy individuals. Blood samples were collected to estimate the glucose levels using Glucose Tolerance Test &amp; HbA1C. Saliva Sample was collected to estimate the candida using VITEK_2 Procedure. The absorbance values were measured on a digital calorimeter for Glucose Tolerance Test &amp; HbA1C levels using the standard protocol. Results Statistical Analysis was done using SPS software. Anova test &amp; Paired t –test were done to estimate the comparison of Candidal positivity to HbA1C and VITEK_2 Procedure showed a mean of 97.33 and SD of 11.02 and with that of HbA1C, showed a mean of 4.93 and SD of 1.00. Comparison of study &amp; control groups with VITEK2 status showed (46%) Candida albicans, followed by (16.67%) Candida famata and (10%) Candida tropicalis. Conclusion The patients with diabetes mellitus are at a higher risk of developing oral Candidiasis. These members of the normal flora probably acquire invasiveness and become pathogenic leading to change in disease progression and develop resistance to the existing drug regime. Key Words: Diabetes mellitus, Glucose, Hyperglycemia, Oral candidasis, Lesions etc.

Ethnobotanical survey and anti-candidal activity of plant species used for oral candidiasis

Background: Oral candidiasis is caused by Candida albicans, which is most prevalent in immunocompromised patients.Aim: The study aimed to investigate the antifungal activity of plant species used for oral candidiasis against C. albicans.Setting: The study was conducted in Aganang Local Municipality, Capricorn District, Limpopo province, South Africa.Methods: A survey was conducted using a semi-structured questionnaire supplemented with guided field walks with traditional health practitioners to gather information on medicinal plants used to treat oral candidiasis. Nine plant species (Artemisia afra Jacq. ex Willd., Blepharis subvolubilis subsp. subvolubilis C.B. Clarke, Enicostemma axillare [Lam.], Helichrysum caespititium [DC.] Harv., Solanum incanum L., Waltheria indica L., Ximenia caffra Sond. var. caffra, Ximenia caffra Sond. var. natalensis and Ziziphus mucronata Willd.) were investigated for antifungal activity. The plant material were extracted with solvents of varying polarities: acetone, dichloromethane, ethyl acetate, ethanol, hexane, methanol, and water. The Micro-dilution and bioautography assays were used to determine the antifungal activity of the plant extracts.Results: Leaf extracts of A. afra and S. incanum were more active against C. albicans with MIC values of 0.02 mg/mL. Bioautography assay demonstrated active compounds in S. incanum, W. indica and X. caffra var. caffra extracts developed in Benzene: Ethanol: Ammonia hydroxide (BEA).Conclusion: An ethnobotanical survey is a worthy starting point in selecting potential plant species for ethnopharmacological studies.Contribution: The effectiveness of oral administrations of the medicinal plants was confirmed by the excellent antifungal activity of the aqueous extracts.

Bimekizumab Safety and Tolerability in Moderate to Severe Plaque Psoriasis: Pooled Analysis from Up to 4 Years of Treatment in 5 Phase 3/3b Clinical Trials

Introduction: Psoriasis is a chronic condition requiring long-term management; evaluating long-term safety of treatments is important. We report the first 4-year (yr) safety data for bimekizumab (BKZ) in patients with moderate to severe plaque psoriasis. Methods: Data were pooled from 5 trials: BE SURE/BE VIVID/BE READY, their open-label extension (OLE) BE BRIGHT (4‑yr data; cut-off 14Nov2022), and BE RADIANT (3‑yr data; cut‑off 6May2022).1-5 Patients received BKZ 320mg every 4 weeks (wks)(Q4W) or Q8W; all received Q8W from Wk64 (BE RADIANT)/OLE Wk48 (BE BRIGHT) or next scheduled visit. Treatment-emergent adverse events (TEAEs) are presented as exposure-adjusted incidence rates (EAIRs)/100 patient‑yrs (PY) for all patients who received ≥1 BKZ dose, and evaluated separately for Yr1/Yr2/Yr3/Yr4 (Wks0-52/52-104/104-156/156-208) of treatment. Results: Total BKZ exposure was 6,324.3PY (N=2,186) (Yr1: 2,053.3PY [n=2,186]; Yr2: 1,904.3PY [n=2,013]; Yr3: 1,521.1PY [n=1,803]; Yr4: 819.5PY [n=1,309]). Overall, TEAEs occurred at an EAIR of 170.5/100PY (Yr1, Yr2, Yr3, Yr4: 230.9/100PY, 137.7/100PY, 107.1/100PY, 99.9/100PY), serious TEAEs at 5.5/100PY (6.5/100PY, 5.9/100PY, 5.8/100PY; 5.6/100PY), and TEAEs leading to discontinuation at 2.9/100PY (4.6/100PY, 2.3/100PY, 2.3/100PY, 1.1/100PY). The most common TEAEs were nasopharyngitis at 12.7/100PY (25.8/100PY, 13.2/100PY, 5.4/100PY, 5.9/100PY), oral candidiasis at 8.9/100PY (18.9/100PY, 10.7/100PY, 6.8/100PY, 5.4/100PY), and upper respiratory tract infection at 5.7/100PY (10.4/100PY, 5.7/100PY, 3.7/100PY, 3.9/100PY). Throughout, fewer TEAEs occurred with BKZ Q8W vs Q4W (115.4/100PY vs 224.4/100PY), including for oral candidiasis (6.5/100PY vs 16.7/100PY). Conclusions: BKZ demonstrated good tolerability and a consistent safety profile over 4 yrs in patients with plaque psoriasis. EAIRs of TEAEs remained consistent/decreased with longer BKZ exposure; no new safety findings were identified.