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Antifungal Activity of ZnO Nanoparticles and Nystatin and Downregulation of SAP1-3 Genes Expression in Fluconazole-Resistant Candida albicans Isolates from Vulvovaginal Candidiasis

Authors Hosseini SS, Joshaghani H, Shokohi T, Ahmadi A, Mehrbakhsh Z

Received 6 August 2019

Accepted for publication 17 December 2019

Published 13 February 2020 Volume 2020:13 Pages 385—394

DOI https://doi.org/10.2147/IDR.S226154

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Sahil Khanna


Seyededeh Sedigheh Hosseini,1,2 Hamidreza Joshaghani,3 Tahereh Shokohi,4 Alireza Ahmadi,1 Zahra Mehrbakhsh5

1Laboratory Sciences Research Center, Golestan University of Medical Sciences, Gorgan, Iran; 2Department of Laboratory Sciences, Faculty of Paramedicine, Gorgan University of Medical Sciences, Gorgan, Iran; 3Department of Clinical Biochemistry, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran; 4Department of Medical Mycology and Parasitology, Mazandaran University of Medical Sciences, Sari, Iran; 5Department of Biostatistics and Epidemiology, School of Health, Golestan University of Medical Sciences, Gorgan, Iran

Correspondence: Seyededeh Sedigheh Hosseini
Laboratory Sciences Research Center, Golestan University of Medical Sciences, Gorgan 4934174515, Iran
Tel +9891137571228
Fax +9832423630
Email Hosseini.s@goums.ac.ir

Purpose: Antifungal resistance and virulence properties of Candida albicans (C. albicans) are growing health problems worldwide. The present study aims to investigate the effect of Zinc Oxide (ZnO) nanoparticles and Nystatin on SAP1-3 genes expression in C. albicans isolates of females with Vulvovaginal Candidiasis (VVC) isolated from Sayad Shirazi Obstetrics and Gynecology Hospital in Northeastern Iran during 2017– 2018.
Patients and Methods: In this descriptive-analytic study, vaginal samples were collected from 280 VVC women. 196 (70%) of C. albicans isolates were identified by phenotypic and ITS genotypic methods. Susceptibility to Fluconazole C. albicans isolates was determined by the disk diffusion method. Detection of ERG11 gene was done by RT-PCR technique.
Results: It was revealed that PCR amplified the ERG11 gene in all of the Fluconazole-resistant isolates. Real-time PCR was used to survey the effects of 3± 1.7μg/mL concentrations of ZnO nanoparticles and Nystatin on expression of SAP1-3 genes before and after treatment. 186 (95%) susceptible C. albicans and 10 (5%) Fluconazole-resistant C. albicans isolates from VVC were exposed to sub-minimum inhibitory concentrations (Sub-MIC) of ZnO-np (range=0.02– 12 μg/mL). Sub-MIC concentration was used for each strain, which reduced the expression of SAP1-3 genes to 1.8 MIC in the vaginal swabs. The observed reduction in gene expression was significant for both ZnO nanoparticles and Nystatin (P=0.01 and P=0.07, respectively).
Conclusion: ZnO as antifungal agent can well reduce the growth and gene expression of SAP1-3 in the pathogenesis of VVC.

Keywords: ZnO, gene expression, pathogenesis, vulvovaginal candidiasis

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