Synergic effect of combination of glycyrol and fluconazole against experimental cutaneous candidiasis due to Candida albicans.

In this study, we investigated the anti-fungal activity of glycyrol, a coumarine isolated from licorice (Glycyrrhizae Radix), in a murine model of cutaneous candidiasis caused by Candida albicans. Compared to the infected sites, located on the mice's back, of the untreated control mice, the infected sites treated with glycyrol had reduced CFU (colony forming unit) values up to 60 and 85.5 % at 20 and 40 µg/mouse of glycyrol, respectively (P < 0.01). The antifungal activity of glycyrol was synergistically increased when glycyrol (10 µg/mouse) was combined with fluconazole (10 µg/mouse), demonstrating that the combination therapy is approximately 4 times more effective than fluconazole alone at 20 µg/mouse (P < 0.01). Additionally, the combination activity was 1.65 times greater than the antifungal activity of fluconazole alone at 40 µg/mouse (P < 0.05). In seeking glycyrol's antifungal mechanism, we determined that glycyrol inhibited hyphal induction and cell wall adherence of C. albicans. Thus, it is very likely that, by damaging the cell wall, glycyrol helps fluconazole invade C. albicans more readily and attack fluconazole's target in the fungus membrane. In summary, our data indicate that glycyrol may contribute to the development of a novel agent that possesses antifungal activity against cutaneous candidiasis.

The identification of surface interaction of apotransferrin with Candida albicans.

Our recent data indicate that apotransferrin, an iron-chelating protein, has anti-candidal activity by binding to the Candida albicans surface rather than just simple iron-chelation. Following that study, in this present study, we investigated the nature of the candidal surface substance that is responsible for the anticandidal activity by using (59)Fe(3+)-apotransferrin and biological assay methods. Data resulting from the binding studies showed that the yeast cells had one class of binding sites as analyzed by the Scatchard equation, and the binding was specific as determined by competitive binding assay with unlabeled and labeled transferrin. All these observations indicate that there is a substance(s) that mediates the binding. Thus, a mannoprotein-like substance was extracted from C. albicans surface using hot water-treatment. Radioisotope binding study revealed that the substance blocked the transferrin binding. At 25 µg of IHS (inhibitory substance) addition, there was 65 % inhibition of the transferrin binding to C. albicans (5 × 10(7) cells/ml) (P < 0.05). The blockage of the transferrin binding disrupted the anticandidal activity of transferrin, resulting in a full recovery from growth inhibition. These results explain our previous observation that there is partial growth inhibition when C. albicans interacts directly with iron-saturated transferrin (100 %). Thus, it was concluded that a candidate for transferrin receptor is involved in the anticandidal activity of transferrin when in direct contact with C. albicans.

Apotransferrin has a second mechanism for anticandidal activity through binding of Candida albicans.

It has been reported that transferrin has antibacterial and antifungal activities via iron chelation in the environment surrounding the microbes. In the present study, we investigated whether the binding of transferrin to Candida albicans mediates growth inhibition. By using cultures that contained iron-free (apo)transferrin glycoprotein either in contact with candidal cells or separated from candidal cells by a dialysis membrane, we distinguished the growth inhibition by transferrin-cell interaction from that of simple iron chelation. Maximal growth inhibition always occurred when the apotransferrin interacted directly with the cells. Additionally, there was partial inhibition even when candidal cells were in contact with iron-saturated transferrin. Binding studies with (59)Fe(3+) radiolabeled-transferrin indicated that the apo-protein can bind to the candidal cell surface. The binding sites were saturable and it was dose dependent. Chemicals (hydrogen peroxide, dithiothreitol, sodium dodecyl sulfate) blocked transferrin binding to C. albicans, and among the three, hydrogen peroxide (HP) was the most effective for the blocking. When HP-treated yeast cells were added to the culture that was pretreated with apotransferrin, candidal cell growth increased by 5-fold as compared to the growth of HP-untreated candidal cells under apotransferrin-regulation (P < 0.05). Combined all data together, it was concluded that transferrin has a second mechanism of anticandidal activity that is mediated by binding to the surface of C. albicans yeast cells.

Ginsenoside Rd induces protective anti-Candida albicans antibody through immunological adjuvant activity.

The role of an antibody against candidiasis is controversial. However, a certain Candida albicans surface epitope produces a protective antibody. Yet, its isolation is difficult. In this study, we investigated if ginsenoside Rd from Panax ginseng has an immunoadjuvant ability to induce surface mannan extract (CASM) to produce a protective antibody. Mice were immunized twice i.p. with an emulsion form of CASM mixed with one of the following: IFA [CASM/IFA], or CFA [CASM/CFA] or Rd with IFA [CASM/Rd/IFA]. One week after the booster, these mice were challenged i.v. with live C. albicans and their survivability was measured. Results showed that four of five CASM/Rd/IFA-vaccinated mice survived during the entire 110 day-observation period, whereas CASM/IFA- or CASM/CFA-vaccinated mice died within 19 and 23 days (P<0.05). The antiserum from CASM/Rd/IFA-immunized mice transferred the protection to naïve mice, whereas antiserum from CASM/CFA-given mice was not protective although CASM/CFA induced an antibody four times greater than CASM/Rd/IFA. IgG isotyping revealed that CASM/Rd/IFA-vaccine produced the most abundant IgG and IgG2a-resulting in the highest ratio (1.32) of IgG2a to IgG, which is helpful in treating Th2-oriented candidiasis. In contrast, the formulae lacking Rd had these ratios less than 1. This strongly indicates that Rd could enhance Th1 immunity. Cytokine profiles and DTH further confirmed the Th1 dominance. Rd caused no hemolysis. Combining all of these data together, Rd can enhance Th1-response to CASM in mice. This protects mice against disseminated candidiasis by eliciting higher titers of Th1 type antibody and a Th1-dominant immune response.

18ß-glycyrrhetinic acid induces immunological adjuvant activity of Th1 against Candida albicans surface mannan extract.

The aim of this study was to determine the immunological adjuvant effect of 18ß-glycyrrhetinic acid (GA) isolated from Glycyrrhizae radix. In the experiments, BALB/c mice were immunized on days 1 and 22 intraperitoneally (i.p.) with an emulsion form of Candida albicans surface mannan extract (SM) mixed with either Incomplete Freund's Adjuvant [SM/IFA], or Complete Freund's Adjuvant [SM/CFA] or GA mixed with IFA [SM/GA/IFA]. One week after the second immunization, polyclonal sera were collected from these animals in order to determine IgG isotypes and cytokine profiles in the sera. After the collection, the spleen samples were collected to determine the degree of T cell proliferation. Additionally, the DTH (delayed type hypersensitivity) response was examined by measuring the footpad swelling of immunized mice. Data resulting from the T cell proliferation test showed that SM/GA/IFA enhanced the proliferation the most. The enhancement was about 85% more compared to SM/IFA (p<0.05). IgG isotypes and cytokine profiles displayed that SM/GA/IFA induced the most abundant production of total IgG with the highest IgG2a/IgG1 ratio (1.31) and greatest IFN-γ secretion. In contrast, SM/CFA resulted in an IgG2a/IgG1 ratio less than 1 and SM/IFA produced a dominant induction of IL-4, but almost no IFN-γ secretion. Together, these observations revealed that GA developed a greater Th1 immune response than Th2 response. The DTH determination confirmed that GA-addition induced dominant Th1 immunity - displaying the highest footpad-swelling followed by SM/CFA and BSA/IFA, respectively. All of this data indicates that GA has a Th1-immunological adjuvant activity, which would be beneficial in the treatment of Th1-disordered disease due to C. albicans.

Comparison of two Candida mannan vaccines: the role of complement in protection against disseminated candidiasis.

We have previously shown that Candida albicans mannan extract encapsulated in liposomes [Lipo-mann] or conjugated to a protein (bovine serum albumin) [Conju-mann] induces the production of antibody in BALB/c mice with normal complement system that protect against disseminated candidiasis. In this present study, we determined the protective abilities of two formulae in a C5-deficient mouse model of disseminated candidiasis. It is known that the lack of C5 is known to aggravate candidal infection. In experiments, BALB/c or C5-deficient mice-DBA/2J and AKR mice, were immunized with one of the formulae before intravenous challenge with live C. albicans yeast cells and their degrees of survivability were measured. Results showed that Conju-mann was 100% protective in BALB/c mice against disseminated candidiasis, whereas only 60% of Lipo-mann immunized mice survived the entire 50 day observation period (p < 0.05). With the DBA/2J strain, Conju-mann resulted in a partial protection, but Lipo-mann had no protection. The conjugate vaccine enhanced the resistance of AKR mice, which resulted in three survivors of the five Conju-immunized AKR mice until the end of 50 day observation period (p < 0.05). Lipo-mann showed little protection in AKR mice. By agglutination analyses, it was determined that there was the same level of production of polyclonal antisera specific to the mannan regardless of the mouse strains. All data indicate that both formulations require complement in the protection. However, Conju-mann appears to be superior to Lipo-mann because the conjugate vaccine is protective even in the absence of C5. These observations suggest that the conjugate vaccine can be an excellent vaccine formulation against C. alibicans infections.

Immunoadjuvant activity of icariin that induces Th1-type antibody in mice.

The adjuvant effect of icariin from Epimedium koreanum on the immune responses to bovine serum albumin (BSA) in mice was examined. Mice were immunized on days 1 and 22 intraperitoneally (i.p.) with one of the following: an emulsion form of BSA mixed with Incomplete Freund's Adjuvant (BSA/IFA) or with Complete Freund's Adjuvant (BSA/CFA) or BSA plus icariin mixed with IFA (BSA/Icariin/IFA). One week after the booster, polyclonal sera were collected from these animals to determine IgG isotypes specific for BSA in the sera and then spleens of these animals were harvested to evaluate IFN-γ and IL-4 produced in the splenocyte cultures. In order to determine the DTH (delayed type hypersensitivity) response, BSA was administered into the footpads of mice that were immunized as described above and the degree of footpad-swelling was measured. Data from these experiments showed that the icariin combined with BSA (BSA/Icariin/IFA) provoked the most abundant of IgG production in mice and enhanced the Th1-lineage development of IgG2a and IFN-γ productions (p < 0.05), whereas BSA/IFA resulted in a highest ratio of IgG1 to IgG2 and most dominant IL-4 production, indicating a Th2 response. This pattern of immunity was confirmed by the DTH determination revealing that icariin-containing formula caused the highest footpad-swelling followed by BSA/CFA and BSA/IFA, respectively. In addition, hemolytic assay showed that icariin at a dose of 1000 µg/mL caused no hemolysis when compared with a water-treated mouse. All of these data indicate that icariin has the immunoadjuvant effect which may enhance Th1-immune response, suggesting that icariin as an adjuvant would be beneficial in the treatment of Th1-disordered diseases.

Th1 immunity induction by ginsenoside Re involves in protection of mice against disseminated candidiasis due to Candida albicans.

Type-1 and -2 responses of T helper lymphocytes demonstrate essentially different and opposite effector functions. In the present study, we determined the immunoregulatory effect of ginsenoside Re against disseminated candidiasis due to Candida albicans. This fungus may be one of the most problematic fungi for humans. Results showed that Re had no growth-inhibitory effect on C. albicans. In contrast, mice groups given Re intraperitoneally before intravenous challenge with live C. albicans survived longer against disseminated candidiasis than Re-untreated mice. All of the ten control mice died by day 15, whereas seven out of ten Re-treated mice survived during the entire duration of the 40 day-observation resulting in mean survival times (MST) of 32.7 ± 13.4 (MST ± S.E.) days. These survival values were almost the same as the values obtained from Rg1-treated mice used for a positive control. Through determining the kidneys' candidal colony forming unit, we found that the disease severity of Re-treated mice was far less than that of Re-untreated animals. This protection was transferable by the CD4+T cells (RECD4T) from Re-treated mice similar to (RGCD4T) CD4+T cells from Rg1-treated animals. A cytokine profile revealed the Th1- lineage development of dominant IFNg and IL-2 from RECD4T. However, the protection was abolished when mice were treated with anti-mouse IFNg. In addition, a hemolytic assay showed that Re at 1000 µg/ml caused no hemolysis. All of these data indicate that Re has the immunoregulatory effect of CD4+T cell-mediated immune response that is led from a Type 1-dominant immunity.

Induction of apoptosis by ginsenoside Rk1 in SK-MEL-2-human melanoma.

Ginsenosides are active compounds isolated from Panax ginseng Meyer. Among these ginsenosides, less polar ginsenosides such as ginsenoside Rg3 and ginsenoside Rh2 have been demonstrated to have tumor inhibitory effects because of their cytotoxicity. In this study, we evaluated the apoptotic effects of ginsenoside Rk1 in SK-MEL-2 human melanoma. Ginsenoside Rk1 isolated from red ginseng is one of the novel ginsenosides that shows strong cytotoxicity compared to ginsenoside Rg3 in dose- and time-dependent manners. The results of DNA fragmentation, 4',6-diamidino-2-phenylindole staining, and flow cytometric analysis are corroborated that ginsenoside Rk1 induced apoptosis in SK-MEL-2 cells. Western blot analysis revealed up-regulation of Fas, FasL, and Bax protein expression and down-regulation of procaspase-8, procaspase-3, mutant p53 and Bcl-2 protein expression. These findings suggest that ginsenoside Rk1 might be a promising compound to induce apoptosis through both extrinsic and intrinsic pathways in SK-MEL-2 cells.

Antiarthritic effect of lonicerin on Candida albicans arthritis in mice.

Fungal arthritis is a potentially serious disease resulting in rapid destruction of the joint. Among the various Candida species, Candida albicans is the most commonly associated with fungal arthritis. In the present study, we examined the effect of lonicerin, a flavonoid isolated from Lonicerae Flos, on an arthritis caused by C. albicans cell wall (CACW) in mice. To examine the effect, an emulsified mixture of CACW and complete Freund's adjuvant (CACW/CFA) was injected into BALB/c mice via hind footpad route on days -3, -2, and -1. On Day 0, mice with the swollen footpad received lonicerin at 1 or 2 mg/dose/time intraperitoneally 3 times every other day. The footpad-swelling was measured for 20 days. Results showed that the lonicerin treatment reduced the edema at all dose levels, and, furthermore, there was app. 54% edema reduction in animals given the 2 mg-dose at the peak (day 10) of septic arthritis (p < 0.05). Since the peak, the edema was reduced in similar rates. This antiarthritic activity appeared to be mediated by lonicerin's ability to suppress T cell proliferation, nitric oxide production from macrophages, and shift of cellular immunity from Th1- toward Th2-type responses, all of which are beneficial to treat arthritis. In addition, the flavonoid had anticandidal activity (p < 0.01). These data suggest that lonicerin alone, which has both anti-arthritic and antifungal activities, can result in a combination therapy for the treatment of fungal arthritis due to C. albicans infection.

Combination immunotherapy of MAb B6.1 with fluconazole augments therapeutic effect to disseminated candidiasis.

We recently reported that IgM MAb B6.1, specific for ß-1, 2-mannotriose on the cell wall of Candida albicans, is therapeutic to disseminated candidiasis due to C. albicans. In the current study, we examined if MAbB6.1 enhances therapeutic effect of fluconazole (FLC) to the disseminated disease. To assess the combination effect, determination by the kidneys-colony forming unit and survival times were used. Results showed that the therapeutic effect of FLC on mice with disseminated candidiasis was dose-dependent, but a FLC dose at 0.8 mg/kg body weight of mice was ineffective. To determine combination effect, mice treated intraperitoneally with a combination of FLC plus MAb B6.1 at 1 h post-infection - a condition of developing partial therapeutic activity - enhanced survival times beyond the effect by only antibody (p < 0.05). The resulting MST (mean survival times) value from the combination-received mice was almost the same as MST value from 3.2 mg FLC dose-given animals (p < 0.05). Another combination of 1.6 mg FLC dose and B6.1 reduced severity of the disseminated disease at almost the same rate as combination efficacy of 0.8 mg FLC dose plus B6.1. This data indicates that B6.1 acts in concert with FLC and that this combination therapy augments protection, which suggests a possibility of reducing FLC dose. The augmentation response was specific because an irrelevant IgM MAb S9 was not effective to the disseminated disease. Thus, our present studies demonstrate that this combination immunotherapy may be a way of solving the problem of limited antifungal drug choices caused by drug-resistant C. albicans.

Efficacy of combination immunotherapy of IgM MAb B6.1 and amphotericin B against disseminated candidiasis.

We previously reported that the IgM MAb B6.1, specific for ß-1,2-mannotriose on the surface of the cell wall of Candida albicans, prevents mice from disseminated candidiasis. The preventive activity of the antibody is mediated by enhanced phagocytosis that caused killing of the fungus and involvement of the complement system. In the present study, MAb B6.1 was tested if the antibody enhances therapeutic efficacy of amphotericin B (Amp B) in a murine model of disseminated candidiasis due to C. albicans. Determination by the kidneys-cfu (colony forming unit) and survival times was used to assess treatment. Mice treated intraperitoneally with MAb B6.1 at 1h post-infection with C. albicans (5 x 105 yeast cells/mouse) developed fewer 28%cfu and prolonged survival rates than negative controls, whereas administration of B6.1 to mice at 2h post-infection was ineffective. Therapeutic effect of Amp B on mice with the disseminated disease was dose-dependent, but dosage of Amp B (0.5mg/kg body weight of mice) was not effective. A combination of MAb B6.1 given at 1h post-infection plus Amp B (0.5mg dose) enhanced survival times beyond the effect due to only antibody (P<0.05). The MST (mean survival times) value resulted from the combination therapy-received mice was as almost the same as MST value from 2mg dose of Amp B-given animals (P<0.05). In case mice given a combination of Amp B (0.5mg dose) plus MAb B6.1 at 2h post-infection - a condition of developing no therapeutic efficacy, the combination also reduced disease severity. All these data indicate that MAb B6.1 acts in concert with Amp B, the antibody enhances therapeutic efficacy of Amp B, and this combination therapy augments protection which implies a possibility of reducing Amp B dose. The augmentation of the response appeared to be specific because an irrelevant IgM carbohydrate-specific MAb was not protective. In conclusion, these studies show that Amp B combined with MAb B6.1 may be an option of solving the problem of limited antifungal drug choices due to drug-resistant C. albicans.

Liquiritigenin, a licorice flavonoid, helps mice resist disseminated candidiasis due to Candida albicans by Th1 immune response, whereas liquiritin, its glycoside form, does not.

Licorice (the root of Glycyrrhizae plant) has been used as an oriental herbal medicine for thousands of years. The licorice flavonoid components are reported to possess immunomodulatory activities. In this present study, we investigated the immunomodulatory effects of liquiritigenin (LG) and liquiritin (LQ), licorice flavonoid components, against disseminated candidiasis due to Candida albicans, a dimorphic fungus, that causes severe disease via hematogenous dissemination and local diseases such as vaginitis and thrush. Results showed that direct interaction of LG or LQ with C. albicans yeast cells resulted in no growth-inhibition, in vitro. When tested in a murine model of disseminated candidiasis, mice given LQ intraperitoneally before intravenous challenge with live C. albicans yeast cells had similar mean survival times (MST) as untreated mice groups. On the contrary, mice given LG in the same manner as LQ above had longer MST than the untreated mice groups (P < 0.05). In one experiment, 3 out of 5 LG-treated mice survived during the entire period of the 55-day observation. Furthermore, the 3 survivors were cured -- shown by a lack of CFU (colony forming unit) in the kidneys. This protection was nulled when mice were pretreated with anti-CD4+ antibody before LG-treatment and challenge with the yeast. However, the protection was transferable by the CD4+ T cells isolated from LG-treated mice not infected with the yeast. In addition, mice given CD4+ T cells that were pre-treated with LG, in vitro were also protected against disseminated candidiasis. ELISA analysis revealed that in LG-treated mice IFNgamma and IL-2 were dominantly produced compared to IL-4 and IL-10. When LG-given mice were treated with anti-mouse IFNgamma, the protection was again nulled. Combined together, these results indicate that LG protects mice against disseminated candidiasis by the CD4+ Th1 immune response.

Rutin has therapeutic effect on septic arthritis caused by Candida albicans.

As of late, numerous reports have demonstrated the multiple biological activities of polyphenolic flavonoids. Amongst these reports, some indicate that the flavonoids play an important role in inflammation therapy. In this present study, we investigated the effect of rutin, a polyphenolic flavonoid, on septic arthritis due to Candida albicans, a major etiological agent that causes fungal arthritis. To induce septic arthritis, an emulsified mixture of C. albicans cell wall and Complete Freund's Adjuvant (CACW/CFA) was injected into BALB/c mice via hind footpad route once a day, everyday, for three days. In order to determine the effect of rutin, twenty-four hours after the final injection, mice having the swollen footpad were given the flavonoid (1 mg/dose/mouse) intraperitoneally every other day for three times. The footpad-edema was measured for a period of 17 days. Results showed that the rutin treatment reduced app. 45% of the edema at the peak day (day 11) of septic arthritis (P<0.05). In addition, 6 days after the peak, there was an app. 35% additional reduction of the edema (P<0.05). We found that this anti-arthritic activity was mediated by rutin's ability to inhibit nitric oxide production from macrophages and T-cells proliferation. Furthermore, this flavonoid also inhibited the growth of C. albicans yeast cells (P<0.01) and resulted in no hemolysis. These data indicate that rutin, which has both anti-arthritic and antifungal effects, can safely be administered into the blood circulation for treatment of septic arthritis caused by C. albicans. Ultimately, it can be suggested that the dual effects of rutin, anti-arthritic and anti-candidal may be helpful as an all-in-one treatment for septic arthritis.

Chlorogenic acid, a polyphenolic compound, treats mice with septic arthritis caused by Candida albicans.

There has been an increasing number of studies concerning the multiple biological activities of polyphenolic compounds. In this present study, we determined the effect of chlorogenic acid (CRA), a polyphenolic compound, on septic arthritis caused by Candida albicans, a major etiological agent that causes fungal arthritis. To induce septic arthritis, an emulsified mixture of C. albicans cell wall and Complete Freund's Adjuvant (CACW/CFA) was injected into BALB/c mice via hind footpad route once a day for 3 days. Twenty-four hours after the final injection, in order to determine CRA effect, mice having the swollen footpad were given CRA (1 mg/dose/mouse) intraperitoneally every other day three times. The footpad edema was measured for 15 days. Results showed that the CRA treatment reduced approximately 40% of the edema at the peak of septic arthritis (P<0.05). This anti-arthritic activity appeared to be mediated by a complete inhibition of nitric oxide (NO) production from macrophages and suppression of T-cells proliferation. Furthermore, CRA also inhibited growth of C. albicans yeast cells (P<0.01) and caused no hemolysis. These data indicate that CRA, which has antifungal and anti-arthritic effects, can safely be administered into the blood circulation for treatment of septic arthritis due to C. albicans. In addition, in respect to antiseptic arthritis, it can be suggested that the anti-candidal effect of CRA may be helpful as an all-in-one treatment of the candidal arthritis.

Effects of sugar additives on protein stability of recombinant human serum albumin during lyophilization and storage.

Few researches on the protein stabilization of recombinant human serum albumin (rHSA) have been done. In the present study, we assessed the impact of sugar lyoprotectants on the protein stability of lyophilized rHSA (65 KDa) in the solid state. For the assessment, rHSA was formulated with sucrose and trehalose, respectively, alone or in combination with mannitol, which were lyophilized and stored at 35 degrees C. Degradation and aggregation of the resulting lyophilized formulations was analyzed by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). Induction of amorphous state by the lyophilactants with rHSA was determined by differential scanning calorimetry (DSC). The protein secondary structure of the rHSA in the formulations was analyzed by Fourier transform infrared spectroscopy (FT-IR). Results from SDS-PAGE analysis displayed that mannitol formulation caused aggregation resulting in a few bands that were greater than 65 KDa, whereas sucrose and trehalose formulations revealed no such aggregation. However, the aggregation of the protein decreased when mannitol was combined with sucrose or trehalose. DSC measurement supported the electrophoresis data showing that sucrose and trehalose formed complete amorphous state, but mannitol induced a partial amorphous state. These data indicate during lyophilization the most effective protein protection against aggregation was provided by sucrose and trehalose. The protection lasted during 4 months storage at 35 degrees C. FT-IR analysis displayed that the sucrose formulation inhibited deamidation. In conclusion, our data suggest that sucrose and trehalose as additives seems to be sufficient to protect from lyophilization of rHSA protein and also maintain its stability in the solid state during storage.

Synergic effect of grape seed extract with amphotericin B against disseminated candidiasis due to Candida albicans.

Amphotericin B (Amp B) is considered as a drug of choice for treatment of fungal infections, but it causes severe side effects such as renal damage. To lessen the severity, it is often combined with the azole, but data reporting resistance of Candida albicans to the azole have been recently increasing. Thus, finding a new product that can reduce Amp B dose by combination seems to be important. In the present study, we investigated a synergic effect of grape seed extract (GSE) combined with Amp B against the fungus. Our results showed that the GSE alone inhibited growth of C. albicans yeast cells, and that in a murine model of disseminated candidiasis mice groups given GSE before intravenous inoculation with the yeast cells survived longer than diluent-received (control) mice groups (P<0.05). This GSE antifungal effect was dose-dependent. Upon combination of GSE plus Amp B, the combination therapy strikingly retarded the yeast growth as determined by the broth susceptibility method. Against the disseminated disease, mice given diluent (negative control), Amp B (0.5mg/kg of body weight), or GSE (2mg/kg of body weight) had mean survival times (MSTs) of approximately 11.4, 14.4, and 17.6 days, respectively. However, mice treated with the combination of the doses of Amp B and GSE had a MST value of 38.4 days, surviving an average of 24 days longer than Amp B alone-treated mice groups. This MST value from the combination-received mice group was greater than the MST value from the mice group given four times the Amp B dose (2mg/kg of body weight). All these data indicate that the combination therapy can reduce more than 75% of Amp B dose, implying that GSE has a synergic effect with Amp B.

Synergic anticandidal effect of epigallocatechin-O-gallate combined with amphotericin B in a murine model of disseminated candidiasis and its anticandidal mechanism.

In the present study, we investigated synergic anticandidal effect of epigallocatechin-O-gallate (EGCG) in a murine model of disseminated candidiasis caused by Candida albicans. In addition, its mechanism was examined. In the animal system, EGCG-given BALB/c mice group intraperitoneally (i.p.) before intravenous (i.v.) inoculation with viable C. albicans yeast cells survived longer than diluent-received (control) mice group (p<0.05). EGCG treatment inhibited the hyphal formation from the yeast form of C. albicans, causing growth-inhibition of the candidal cells. In experiments determining synergic effect, mice given diluent (control), Amp B (amphotericin B; 0.5 mg/kg of body weight), or EGCG (2 mg/kg) had mean survival times (MST) of approximately 10.9, 11.7, and 13.9 d, respectively. However, mice administered combination of Amp B (0.5 mg/kg) plus EGCG (2 mg/kg) had a MST value of 42.1 d, surviving an average of app. 30 d longer than the Amp B alone-received mice groups. The MST value from the combination-treated mice groups was much greater than MST value from mice groups that received four times the Amp B dose. These results indicate that EGCG, which has anticandidal activity causing blockage of the hyphal formation, has the synergism combined with Amp B against disseminated candidiasis.

Immunoregulatory activity by daucosterol, a beta-sitosterol glycoside, induces protective Th1 immune response against disseminated Candidiasis in mice.

In the present study, we investigated immunomodulatory effect of daucosterol, a beta-sitosterol glycoside, against disseminated candidiasis caused by Candida albicans. Results showed that direct interaction of daucosterol with C. albicans yeast cells resulted in no growth-inhibition by in vitro susceptibility analysis. In contrast, mice given daucosterol (DS) intraperitoneally before intravenous challenge with live C. albicans yeast cells survived longer than DS-untreated control mice against disseminated candidiasis (P<0.05). By assessment of the fungal CFU in kidneys, DS-treated mice before the challenge developed about 81% fewer kidney CFU than untreated controls. This protection was removable by pretreatment of mice with anti-CD4+ antibody before the DS-treatment and challenge with the yeast. However, the protection was transferable by the CD4+ T cells from DS-treated mice not infected with the yeast. ELISA analysis revealed there were predominant production of IFNgamma and IL-2 cytokines as compared to IL-4, and IL-10 productions in DS-treated mice. By treatment of DS-given mice with anti-mouse IFNgamma, the protection was also abolished. Our studies show that DS protects mice against disseminated candidiasis by the CD4+ Th1 immune response.

Ginsenoside Rg1 helps mice resist to disseminated candidiasis by Th1 type differentiation of CD4+ T cell.

Ginsenosides, the most important component isolated from Panax ginseng, exhibits a variety of biological activities. Particularly, ginsenoside Rg1 is known to have various immune-modulating activities such as increase of immune activity of T helper (Th) cells. In this present work, we investigated the effect of the Rg1 on Candida albicans growth. Results showed that direct interaction of the Rg1 to C. albicans yeast cells resulted in no growth inhibition as tested by agar diffusion susceptibility method. Reversely, mice given the Rg1 intraperitoneally (i.p.) before intravenous (i.v.) challenge with live C. albicans yeast cells protected the mice to experimental disseminated candidiasis. By kidney candidal CFU (colony forming unit) determination, the disease severity of the Rg1-treated mice was confirmed far less than Rg1-untreated control mice. The protection was transferable by CD4+ T cells (RGCD4T) isolated from Rg1-treated mice. ELISA analysis revealed that there were cytokine inductions of IFNgamma, IL-2, IL-4 and IL-10 from the RGCD4T, demonstrating the Th1-lineage development of predominant IFNgamma and IL-2 production. Anti-mouse IFNgamma antibody treatment of Rg1-treated mice abolished the protection to disseminated disease. Our studies show that ginsenoside Rg1 helps the host resists disseminated candidiasis by the CD4(+) T cell-mediated immune response led from a Th1-dominant cytokine response.