INTRODUÇÃO: A frequência de Candida parapsilosistem apresentado considerável aumento em UTIs neonatais. Embora a taxa de resistência dessa espécie aos azólicos seja baixa, recentemente têm sido relatados surtos de candidemia por isolados resistentes. A capacidade de adesão e formação de biofilme por essa espécie confere maior potencial patogênico e resistência aos antifúngicos. Portanto, a vigilância epidemiológica, tanto da resistência aos antifúngicos como da virulência dos isolados, é fundamental para o controle e prevenção das infecções e surtoshospitalares. A técnica de MALDI-TOF MS pode ser uma ferramenta útil para realizar análises proteômicas das células planctônicas e sésseis de Candida parapsilosis,e identificar possíveis alvos terapêuticos ou biomarcadores, específicos do biofilme. MÉTODOS: Isolados clínicos do complexo Candida parapsilosis de dois hospitais universitários públicos brasileiros, foram submetidos à identificação por RAPD, RFLP e MALDI-TOF MS e aos testes de suscetibilidade aos antifúngicos. Ensaios de formação de biofilme foram realizados para quantificar a biomassa, a atividade metabólica e ainda, avaliar atividade in vitrodos antifúngicos contra as células sésseis dos isolados com alta formação de biofilme. A análise proteômica por MALDI-TOF MS das células planctônicas e sésseis dos isolados com alta formação de biofilme, foi realizada nas plataformas VITEK-MS(TM) e Microflex(TM). Isolados de Candida parapsilosis (sensu stricto) foram genotipados por PFGE e análise de microssatélites. Os genótipos foram correlacionados com dadosclínicos, para investigar a ocorrência de um surto em CTI adulto, e as sequências do gene ERG11dos isolados não suscetíveis aos azólicos (NSA) foram analisadas. RESULTADOS: Foram obtidos 38 isolados do complexo Candida parapsilosis, sendo Candida parapsilosis(sensu stricto) a espécie de maior frequência, superando 80% em ambos os hospitais, seguida de C. orthopsilosis e C. metapsilosis. Embora todos os isolados tenham sido suscetíveis à anfotericina B ( < 2 mg/L) e apresentado suscetibilidade intermediária à anidulafungina, caspofungina e micafungina ( > 0,002 mg/L), elevada frequência de não suscetibilidade (resistência ou suscetibilidade intermediária) ao fluconazol e voriconazol foi observada entre isolados de um dos hospitais. Alta formação de biofilme foi observada apenas entre os isolados da espécie Candida parapsilosis(sensu stricto). Por outro lado, a maioria dos isolados NSA, apresentou baixa formação de biofilme e baixa atividade metabólica. Apenas anfotericina B apresentou atividade contra os biofilmes de Candida parapsilosis. As duas plataformas de MALDI-TOF MS conseguiram diferenciar os perfis proteômicos das células planctônicas e sésseis dos isolados. A genotipagem de Candida parapsilosis(sensu stricto) revelou a persistência de isolados clonais NSA e a mutação A395T no gene ERG11foi identificada exclusivamente entre os isolados resistentes ao azólicos. O uso de corticosteroide foi associado, estatisticamente, com a ocorrência de isolados clonais NSA. CONCLUSÕES: Candida parapsilosis (sensu stricto) se mantém como a principal espécie do complexo em infecções sanguíneas. Isolados resistentes aos azólicos, com mutações no gene ERG11, ocorreram nos dois hospitais avaliados. A correlação dos genótipos com os dados clínicos evidenciou a ocorrência de um surto envolvendo isolados clonais NSA, com associação estatisticamente significativa, ao uso prévio de corticosteroides. Candida parapsilosis (sensu stricto) foi a única espécie que apresentou alta formação de biofilme, o qual demonstrou elevada resistência às equinocandinas. As duas plataformas de MALDI-TOF MS, diferenciaram os perfis proteômicos, das células planctônicas e sésseis de Candida parapsilosis, demonstrando o potencial emprego dessa tecnologia na identificação de possíveis alvos terapêuticos ou biomarcadores, específicos de biofilmes / INTRODUCTION: The frequency of Candida parapsilosis isolates has increased considerably in neonatal ICUs. Although resistance to azoles is usually low in this species, candidemia outbreaks by resistant isolates have been recently reported. Theability of adhesion and biofilm formation by this species confers higher pathogenic potential and resistance to antifungal agents. Therefore, establishment of profiles of antifungal susceptibility and virulence, besides the epidemiological surveillance ofC. parapsilosisisolates are essential for the control and prevention of nosocomial infections and outbreaks. The MALDI-TOF MS technique can be a useful tool to perform proteomic analyzes of the planktonic and sessile cells of Candida parapsilosis, identifying possible biofilm-specific therapeutic targets or biomarkers. METHODS: Candida parapsilosisclinical isolates from two Brazilian public university hospitals were identified by RAPD, RFLP and MALDI-TOF MS and submitted to antifungal susceptibility tests. Biofilm formation assays were carried out to quantify the biomass and metabolic activity, and to evaluate the in vitroactivity of antifungal drugs against the sessile cells of the isolates with high biofilm formation. Proteomic analysis of the planktonic and sessile cells of the isolates with high biofilm formation was performed in two MALDI-TOF MS platforms, VITEK-MS(TM) and Microflex(TM). Candida parapsilosis(sensu stricto) isolates were genotyped by PFGE and microsatellite analysis. The genotypes were correlated with clinical data to investigate the occurrence of an outbreak in the adult ICU andERG11gene sequences from non-susceptible to azoles (NSA) isolates were also analyzed. RESULTS: 38 clinical isolates of the Candida parapsilosiscomplex were obtained, with Candida parapsilosis(sensu stricto) being the most frequent species (exceeding 80% in both hospitals), followed by C. orthopsilosisand C. metapsilosis. Although all isolates were susceptible to amphotericin B ( < 2 mg/L) and showed intermediate susceptibility to anidulafungin, caspofungin e micafungin ( > 0,002 mg/L), high frequency of non-susceptibility (resistance or intermediate susceptibility) to fluconazole and voriconazole was observed among isolates from one of the hospitals. High biofilm formation was only observed among isolates of the Candida parapsilosis. (sensu stricto) species. On the other hand, most of the NSA isolates presented low biofilm formation and low metabolic activity. Only amphotericin B showed activity against Candida parapsilosisbiofilms. The two MALDI-TOF MS platforms were able to differentiate the proteomic profiles of planktonic and sessile cells of isolates. Candida parapsilosis(sensu stricto) genotyping revealed the persistence of clonal NSA isolates. The A395T mutation in the ERG11gene was identified exclusively among azole resistant isolates. The use of corticosteroid was statistically associated with the occurrence of clonal NSA isolates. CONCLUSIONS: Candida parapsilosis(sensu stricto) remains the main species of the complex in bloodstream infections. Azole-resistant isolates with mutations in the ERG11gene are emerging in the two hospitals evaluated. Additionally, the correlation between the genotypes and the clinical data showed the occurrence of an outbreak involving isolates resistant to azoles, with a statistically significant association with previous use of corticosteroids. Candida parapsilosis(sensu stricto) was the only species that presented high biofilm formation and resistance against echinocandins. The two MALDI-TOF MS platforms differentiated the proteomic profiles of the planktonic and sessile cells of Candida parapsilosis, demonstrating the potential use of this technology to identify possible biofilm-specific therapeutic targets or biomarkers

Infecções invasivas por Trichosporon spp. ocorrem com maior frequência em pacientes neutropênicos, principalmente portadores de doenças hematológicas malignas, e estão associadas a elevados índices de mortalidade devido às dificuldades na identificação do patógeno e à resistência aos fármacos mais empregados na terapêutica antifúngica. A identificação das espécies de Trichosporon é importante tanto para estudos epidemiológicos, como para associar aspectos clínicos com as espécies causadoras das infecções. Além disso, auxilia no tratamento da enfermidade, uma vez que a suscetibilidades aos fármacos antifúngicos pode variar de acordo com a espécie. Além disso, as leveduras do gênero Trichosporon sintetizam a glucuronoxilomanana (GXM) em sua parede celular, que pode estar envolvida no mecanismo de virulência do patógeno. Este estudo teve como objetivo determinar, por identificação fenotípica e molecular, espécies isoladas de pacientes internados em unidades hospitalares, comparando os resultados obtidos por ambos os métodos; avaliar diferenças na distribuição dessas espécies em relação às formas invasivas e não invasivas da infecção; determinar o perfil de suscetibilidade dessas leveduras aos antifúngicos, empregando um método de micro-diluição de referência e um método comercial; e avaliar a presença de GXM na parede celular dos isolados. Foram avaliados 74 isolados obtidos de amostras clínicas de pacientes do Hospital das Clinicas da FMUSP e de outras unidades hospitalares do Estado de São Paulo, no período de 2003 a 2011. Dezenove amostras foram isoladas de sítios estéreis do organismo (infecções invasivas) e 55 foram isoladas de urina e cateter (isolados não invasivos). Para a identificação das espécies, os isolados foram submetidos a análises fenotípicas, que incluíram estudo macro e micromorfológico, provas fisiológicas e avaliação do perfil bioquímico por sistema automatizado VITEK 2. A identificação molecular foi realizada pelo sequenciamento das regiões IGS e D1/D2 do DNA ribossomal. O perfil de suscetibilidade dos 74 isolados foi analisado pelo método de micro-diluição EUCAST (referência) com os fármacos fluconazol (FCZ), itraconazol (ITZ), voriconazol (VCZ), cetoconazol (CTZ), anfotericina B (AMB) e 5-fluocitosina (5FC); e pelo método de micro-diluição comercial Sensititre YeastOne, com os mesmos fármacos empregados no EUCAST, acrescidos do posaconazol (POS) e caspofungina (CAS). Os valores das concentrações inibitórias mínimas (CIM), erros categórico e essencial, bem como outros parâmetros foram comparados entre os dois métodos. A presença de GXM na parede celular dos 74 isolados foi determinada por citometria de fluxo, empregando anticorpo monoclonal anti-GXM. Os resultados dos estudos morfológicos e fisiológicos foram insuficientes para definir as espécies dos 74 isolados. Pela assimilação de carboidratos analisada pelo sistema VITEK 2, verificou-se que 71 isolados foram identificados como T. asahii (17 de infecção invasiva e 54 não invasivos), um isolado como T. mucoides (invasivo), e para dois isolados (um invasivo e um não invasivo), a identificação não foi conclusiva. Para estes últimos foi realizado o auxanograma (método manual), e a identificação permaneceu inconclusiva, pois pelo perfil de assimilação, os isolados poderiam ser identificados como T. asahii ou T. faecale. Pela técnica de sequenciamento, 62 dos 74 isolados foram identificados como T. asahii, demonstrando 82,4% de concordância com o sistema VITEK 2. Onze isolados com identificações discordantes pertenciam às espécies T. inkin (8), T. faecale (2) e T. dermatis (1), como determinado por sequenciamento. Dos dois isolados com identificação inconclusiva pelo VITEK 2, um foi identificado pela técnica molecular como T. asahii, enquanto para o outro isolado não foi possível definir a espécie. Portanto, dos 74 isolados do estudo, 62 foram identificados como T. asahii, 8 como T. inkin, 2 como T. faecale e 1 T. dermatis; dois isolados permaneceram sem identificação conclusiva. Os resultados dos testes de suscetibilidade in vitro mostraram que, em ambos os métodos, VCZ apresentou a melhor atividade antifúngica. Pelo método EUCAST, foram obtidos valores elevados de CIM para AMB, enquanto o mesmo não foi observado no teste comercial. Neste último, foram observados valores elevados de CIM para FCZ, POS e CAS. Em relação à 5FC, os valores de CIM 90% por ambos os testes foram elevados (16mg/L). Diferenças significantes foram observadas entre os valores de CIM obtidas pelos dois métodos, e percentuais relativamente elevados de erros categóricos graves quando o método comercial foi comparado ao de referência. Não houve diferença estatística significante de valores de CIM entre isolados de infecção invasiva e não invasiva, exceto para ITZ e 5FC. Cerca de 30% dos isolados obtidos de casos de infecção invasiva e não invasivos apresentaram resistência cruzada entre os azóis FCZ e VCZ, e uma pequena porcentagem apresentou multirresistência. Para a análise de GXM na parede celular dos 74 isolados do estudo, foi avaliada a intensidade de fluorescência emitida pela citometria de fluxo, não tendo sido observada diferença estatística significante entre isolados invasivos e não invasivos. O estudo permitiu concluir que T. asahii foi a espécie mais isolada das amostras clínicas obtidas de sítios estéreis e não estéreis. A metodologia clássica de identificação fenotípica não foi suficiente para definir as espécies do gênero Trichosporon, e o sistema VITEK 2 apresentou discordância quando comparado à técnica molecular para as espécies não T. asahii. Em relação aos testes de suscetibilidade in vitro, VCZ apresentou-se mais adequado para a inibição das leveduras, enquanto os fármacos AMB, FCZ e POS não foram eficazes para a maior parte dos isolados. As discordâncias encontradas entre o método de referência e o comercial sugerem que, para o segundo, são necessárias mais avaliações para seu emprego em rotina laboratorial para o gênero Trichosporon. A detecção de GXM não resultou em diferenças entre os isolados de ambos os grupos; no entanto, para se determinar o efeito protetor do polissacarídeo contra a ação de macrófagos, ensaios de fagocitose devem ser realizados / Invasive Trichosporon spp. infections occur more frequently in neutropenic patients, especially those with hematologic malignancies, and are associated with high mortality rates due to difficulties in identifying the pathogen and treating patients with drugs most currently employed in antifungal therapy. Trichosporon species identification is important for epidemiological studies and to better define eventual species-specific clinical association. Additionally, antifungal susceptibility may vary according to the species. Furthermore, glucuronoxylomannan (GXM) is a cell wall-associated polysaccharide produced by genus Trichosporon, which may be involved in virulence mechanisms of this pathogen. This study aimed (i) to identify Trichosporon species isolated from hospitalized patients by both phenotypic and molecular methods, comparing results; (ii) to verify the distribution of these species in invasive and non-invasive infection episodes; (iii) to determine the in vitro activities of various antifungals agents against the Trichosporon spp. isolates, employing a reference micro-dilution method and a commercial system; (iv) and to analyze the surface expression of GXM. Seventy-four Trichosporon spp. isolates obtained from clinical specimens of patients admitted to the Hospital das Clínicas-FMUSP and to other hospitals in the state of São Paulo, from 2003 to 2011, were included in the study. Nineteen samples were isolated from sterile deep sites (invasive infections) and 55 were isolated from catheter and urine samples (non-invasive isolates). All isolates were submitted to phenotypic analysis, which consisted in morphological features observation, physiological tests and determination of the biochemical profile by VITEK 2 system. Molecular identification was performed by sequencing of IGS1 and D1/D2 regions from the ribosomal DNA. The susceptibility antifungal profiles of the 74 isolates were analyzed by both the EUCAST micro-dilution method (reference) employing fluconazole (FCZ), itraconazole (ITZ), voriconazole (VCZ), ketoconazole (CTZ), amphotericin B (AMB) and 5 - flucytosine (5FC), and the commercial micro-dilution test Sensititre YeastOne, with the same drugs employed in EUCAST plus posaconazole (POS) and caspofungin (CAS). The minimum inhibitory concentration values (MIC), categorical and essential errors as well as other susceptibility parameters were compared between both methods. The cell wall expression of GXM of all isolates was measured by flow cytometry employing an anti-GXM monoclonal antibody. The morphological and physiological features of the Trichosporon spp. isolates were insufficientto define species. The carbohydrate assimilation analysis, performed by VITEK 2 system, has resulted in 71 isolates identified as T. asahii (17 from invasive infections and 54 non-invasive isolates) and one isolate as T. mucoides (invasive). The species identification for the two remaining isolates (one invasive and one non-invasive) was inconclusive. For this reason, a manual auxanogram was performed with these isolates, resulting again in non-conclusive species identification. By the automated sequencing method, 62 of the 74 isolates were identified as T. asahii, showing 82.4% of agreement with the VITEK 2 identification. Eleven isolates were identified by sequencing as T. inkin (8), T. faecale (2) and T. dermatis (1), showing disagreement identification with the VITEK 2 system. Regarding the two isolates with inconclusive results by the carbohydrate assimilation, the molecular technique identified one as T. asahii, whereas for the other isolate the sequencing was also unable to define species. Therefore, among the 74 studied isolates, 62 were identified as T. asahii, eight as T. inkin, two as T. faecale and one as T. dermatis; and two isolates remained with unconclusive identification. Almost all Trichosporon spp. isolates displayed susceptibility to VCZ with both methods. By the EUCAST method, high values of MIC were observed for AMB, while by the commercial test especially the invasive isolates showed susceptibility to this drug. Additionally, the Sensititre kit provided elevated MIC values for FCZ, POS and CAS. In regards to 5FC, the MIC 90% values were consistently high (16 mg/L) in both methodologies. The MIC values obtained by both EUCAST and commercial methods were compared, resulting in significant differences of MIC values for all tested antifungal drugs; major categorical errors occurred at relatively high percentage with the commercial method. No statistically significant differences in MIC values were verified when invasive and non-invasive isolates were compared. Around 30% of both invasive and non-invasive isolates showed cross-resistance to FCZ and VCZ, while a small number of isolates was multiresistant. The GXM analysis by cytometry demonstrated no significant differences between invasive and non- invasive isolates. This study demonstrated that T. asahii was the most frequently isolated species from both deep and non-sterile sites of the patients. The classical phenotypic methodology was not able to define Trichosporon species, and the VITEK 2 system identification showed disagreement with the sequencing technique for the non-T. asahii species. Regarding the in vitro susceptibility tests, VCZ was the most effective drug against the isolates, whereas most of them appear to be less susceptible to AMB, FCZ and POS. The discrepancies in the Trichosporon spp. susceptibility results between the reference and commercial methods suggest that the latter requires further evaluation tests before it can be used in routine laboratory. Although the GXM expression seemed to be equal in both invasive and non-invasive Trichosporon spp. isolates, phagocytic assays should be performed in order to determine the protective effect of the polysaccharide against phagocytosis

Plusieurs souches cliniques de Candida albicans résistantes aux médicaments antifongiques azolés surexpriment des gènes encodant des effecteurs de la résistance appartenant à deux classes fonctionnelles : i) des transporteurs expulsant les azoles, CDR1, CDR2 et MDR1 et ii) la cible des azoles 14-lanostérol déméthylase encodée par ERG11. La surexpression de ces gènes est due à la sélection de mutations activatrices dans des facteurs de transcription à doigts de zinc de la famille zinc cluster (Zn2Cys6) qui contrôlent leur expression : Tac1p (Transcriptional activator of CDR genes 1) contrôlant l’expression de CDR1 et CDR2, Mrr1p (Multidrug resistance regulator 1), régulant celle de MDR1 et Upc2p (Uptake control 2), contrôlant celle d’ERG11. Un autre effecteur de la résistance clinique aux azoles est PDR16, encodant une transférase de phospholipides, dont la surexpression accompagne souvent celle de CDR1 et CDR2, suggérant que les trois gènes appartiennent au même régulon, potentiellement celui de Tac1p. De plus, la régulation transcriptionnelle du gène MDR1 ne dépend pas seulement de Mrr1p, mais aussi du facteur de transcription de la famille basic-leucine zipper Cap1p (Candida activator protein 1), un régulateur majeur de la réponse au stress oxydatif chez C. albicans qui, lorsque muté, induit une surexpression constitutive de MDR1 conférant la résistance aux azoles. Ces observations suggèrent qu’un réseau de régulation transcriptionnelle complexe contrôle le processus de résistance aux antifongiques azolés chez C. albicans. L’objectif de mon projet au doctorat était d’identifier les cibles transcriptionnelles directes des facteurs de transcription Tac1p, Upc2p et Cap1p, en me servant d’approches génétiques et de génomique fonctionnelle, afin de i) caractériser leur réseau transcriptionnel et les modules transcriptionnels qui sont sous leur contrôle direct, et ii) d’inférer leurs fonctions biologiques et ainsi mieux comprendre leur rôle dans la résistance aux azoles. Dans un premier volet, j’ai démontré, par des expériences de génétique, que Tac1p contrôle non seulement la surexpression de CDR1 et CDR2 mais aussi celle de PDR16. Mes résultats ont identifié une nouvelle mutation activatrice de Tac1p (N972D) et ont révélé la participation d’un autre régulateur dans le contrôle transcriptionnel de CDR1 et PDR16 dont l’identité est encore inconnue. Une combinaison d’expériences de transcriptomique et d’immunoprécipitation de la chromatine couplée à l’hybridation sur des biopuces à ADN (ChIP-chip) m’a permis d’identifier plusieurs gènes dont l’expression est contrôlée in vivo et directement par Tac1p (PDR16, CDR1, CDR2, ERG2, autres), Upc2p (ERG11, ERG2, MDR1, CDR1, autres) et Cap1p (MDR1, GCY1, GLR1, autres). Ces expériences ont révélé qu’Upc2p ne contrôle pas seulement l’expression d’ERG11, mais aussi celle de MDR1 et CDR1. Plusieurs nouvelles propriétés fonctionnelles de ces régulateurs ont été caractérisées, notamment la liaison in vivo de Tac1p aux promoteurs de ses cibles de façon constitutive et indépendamment de son état d’activation, et la liaison de Cap1p non seulement à la région du promoteur de ses cibles, mais aussi celle couvrant le cadre de lecture ouvert et le terminateur transcriptionnel putatif, suggérant une interaction physique avec la machinerie de la transcription. La caractérisation du réseau transcriptionnel a révélé une interaction fonctionnnelle entre ces différents facteurs, notamment Cap1p et Mrr1p, et a permis d’inférer des fonctions biologiques potentielles pour Tac1p (trafic et la mobilisation des lipides, réponse au stress oxydatif et osmotique) et confirmer ou proposer d’autres fonctions pour Upc2p (métabolisme des stérols) et Cap1p (réponse au stress oxydatif, métabolisme des sources d’azote, transport des phospholipides). Mes études suggèrent que la résistance aux antifongiques azolés chez C. albicans est intimement liée au métabolisme des lipides membranaires et à la réponse au stress oxydatif. / Many azole resistant Candida albicans clinical isolates overexpress genes encoding azole resistance effectors that belong to two functional categories: i) CDR1, CDR2 and MDR1, encoding azole-efflux transporters and ii) ERG11, encoding the target of azoles 14-lanosterol demethylase. The constitutive overexpression of these genes is due to activating mutations in transcription factors of the zinc cluster family (Zn2Cys6) which control their expression. Tac1p (Transcriptional activator of CDR genes 1), controlling the expression of CDR1 and CDR2, Mrr1p (Multidrug resistance regulator 1), regulating MDR1 expression and Upc2p (Uptake control 2), controlling the expression of ERG11. Another determinant of clinical azole resistance is PDR16, encoding a phospholipid transferase, whose overexpression often accompanies that of CDR1 and CDR2 in clinical isolates, suggesting that the three genes belong to the same regulon, potentially that of Tac1p. Further, MDR1 expression is not only regulated by Mrr1p, but also by the basic-leucine zipper transcription factor Cap1p (Candida activator protein 1), which controls the oxidative stress response in C. albicans and whose mutation confers azole resistance via MDR1 overexpression. These observations suggest that a complex transcriptional regulatory network controls azole resistance in C. albicans. My Ph.D. studies are aimed at identifying the direct transcriptional targets of Tac1p, Upc2p and Cap1p using genetics and functional genomics approches in order to i) characterize their regulatory network and the transcriptional modules under their direct control and ii) infer their biological functions and better understand their roles in azole resistance. In the first part of my studies, I showed that Tac1p does not only control the expression of CDR1 and CDR2, but also that of PDR16. My results also identified a new activating mutation in Tac1p (N972D) and revealed that the expression of CDR1 and PDR16 is under the control of another yet unknown regulator. The combination of transcriptomics and genome-wide location (ChIP-chip) approaches allowed me to identify the in vivo direct targets of Tac1p (PDR16, CDR1, CDR2, ERG2, others), Upc2p (ERG11, ERG2, MDR1, CDR1, others) and Cap1p (MDR1, GCY1, GLR1, others). These results also revealed that Upc2p does not only control the expression of ERG11 but also that of MDR1 and CDR1. Many new functional features of these transcription factors were found, including the constitutive binding of Tac1p to its targets under both activating and non-activating conditions, and the binding of Cap1p which extends beyond the promoter region of its target genes, to cover the open reading frame and the putative transcription termination regions, suggesting a physical interaction with the transcriptional machinery. The characterization of the transcriptional regulatory network revealed a functional interaction between these factors, notably between Cap1p and Mrr1p, and inferred potential biological functions for Tac1p (lipid mobilization and traffic, response to oxidative and osmotic stress) and confirmed or suggested other functions for Upc2p (sterol metabolism) and Cap1p (oxidative stress response, regulation of nitrogen utilization and phospholipids transport). Taken together, my results suggest that azole resistance in C. albicans is tightly linked to membrane lipid metabolism and oxidative stress response.

M. Tech. (Department of Chemistry, Faculty of Applied and Computer Sciences), Vaal University of Technology / The present study includes the use of a green synthetic method to prepare copper and silver nanoparticles using chitosan, aqueous extracts of Camellia sinensis, Combretum molle and Melia azedarach linn leaves. This study aims to investigate the influence of capping and precursor concentration on the properties of silver nanoparticles with emphasis on the medicinal plants chosen. The effect of capping agent on the properties of copper nanoparticles is also investigated. The phytochemical properties of plant extracts and the antimicrobial activity of the synthesized particles were also studied; this was achieved by using microdilution bioassay. Decoction method was used to extract secondary metabolites from plant leaves. Preliminary phytochemical screening carried out on the aqueous extracts of the plant leaves showed the presence of tannins, proteins, flavonoids, phenols, and carbohydrates. The total phenolic and flavonoids content of the aqueous extract was determined using spectroscopic methods. The highest phenolic content was found in the aqueous extract of Combretum molle (135 mg/g), and the highest flavonoid content was found in the aqueous extract of Camellia sinensis (0.4 mg/g). Characterization was done by a combination of spectroscopic, microscopy and XRD techniques. Both the size and shape of the synthesized silver nanoparticles were dependent on the identity of the capping molecule, precursor and capping agent concentration as depicted from their TEM and XRD results. Silver nanoparticles were found to be predominantly spherical. The capping agent concentration was also found to influence the degree of agglomeration, with an increase in capping agent concentration giving lesser agglomeration. FTIR spectral analysis showed that silver nanoparticles interact with bioactive compounds found in the plants through the hydroxyl functional group. Other shapes including diamond were observed for the effect of precursor concentration. The XRD micrographs revealed a face-centered cubic geometry and the phase remained the same with an increase in precursor concentration. The synthesized silver nanoparticles were all blue shifted compared to the bulk material. The TEM results revealed that copper nanoparticles with different sizes and shapes were successfully synthesized. All the prepared copper and silver nanoparticles showed satisfactory antifungal and antibacterial activity against Candida albicans, Cryptococcus neoformans, Staphylococcus aureus, Enterococcus faecalis, Klebsiella pneumonia and Pseudomonas aeruginosa. The capping molecules used in this study also showed some antibacterial and antifungal activity against the selected strains. However nanoparticles performed better than these capping molecules. Both silver and copper nanoparticles were found to be more active against gram-negative bacteria compared to gram-positive bacteria. Amongst all the prepared silver nanoparticles Combretum molle capped nanoparticles were found to be the most active nanoparticles. Also with copper nanoparticles, it was found that Combretum molle capped nanoparticles were the most active nanoparticles. Between the two metal nanoparticles, silver nanoparticles showed high antibacterial and antifungal activity compared to copper nanoparticles. The antioxidant activity of silver nanoparticles was assessed using 2.2-diphenyl-1-picrylhydrazyl. Silver nanoparticles were found to have some antioxidant activity. However, the capping molecules were found to be more active than the synthesized nanoparticles. This observation is attributed to the presence of some bioactive compounds in the plant extracts.

Compte tenu de ses aspects multiples, de sa dangerosité potentielle et du taux de<p>survie considérablement bas qui lui est associé dans ses formes les plus graves, l’aspergillose<p>pulmonaire est encore à l’heure actuelle dévastatrice sur le plan clinique. L’approche<p>médicamenteuse conventionnelle consiste en l’administration par voie orale ou<p>intraveineuse (IV) d’agents antifongiques. Ces voies classiques requièrent l’administration de<p>doses très élevées qui sont nécessaires à l’obtention de concentrations systémiques<p>suffisantes pour obtenir un effet thérapeutique au niveau pulmonaire. Cependant, ces<p>concentrations systémiques sont également la cause d’effets secondaires indésirables et<p>d’interactions médicamenteuses importantes. Une alternative thérapeutique à ces voies<p>classiques serait de localiser ces antifongiques dans le poumon, en utilisant la voie inhalée.<p>Cela permettrait d’augmenter le taux de succès thérapeutique en déposant et en<p>concentrant directement la dose au niveau du site d’infection tout en minimisant les<p>concentrations systémiques.<p>Pour ce faire, nous avons choisi de développer des poudres sèches pour inhalation à<p>base d’itraconazole (ITZ), un antifongique actif à l’égard des souches d’aspergillus. Celles-ci<p>sont administrable via un inhalateur à poudre sèche pour les avantages que présente ce<p>mode d’administration comparativement aux nébuliseurs et aux inhalateurs pressurisés. Le<p>développement des formulations implique entre autres l’obtention de caractéristiques<p>aérodynamiques appropriées, c’est-à-dire, ayant, après décharge à partir d’un dispositif<p>d’inhalation, un profil de déposition pulmonaire permettant d’atteindre des doses<p>pulmonaires pharmacologiquement efficaces. Toutefois, l’ITZ présente une solubilité<p>aqueuse extrêmement faible (solubilité aqueuse à pH 7 ~ 4 ng/ml à 25°C). Or, une fois<p>déposée dans le poumon, la dose inhalée doit se solubiliser pour exercer son action<p>pharmacologique. Nous avons donc inclus dans les concepts de formulation, une stratégie<p>permettant l’amélioration du profil de dissolution et l’augmentation de la solubilité de l’ITZ.<p>Cela permettrait en effet d’en potentialiser au maximum l’action pharmacologique au sein<p>des lésions fongiques avant qu'il ne soit éliminé sous sa forme non dissoute par les<p>mécanismes de clairance non absorptifs du poumon. De plus, le poumon étant un organe ne<p>tolérant qu’un nombre limité de substances administrables par inhalation, nous nous<p>sommes focalisés sur l’utilisation d’excipients présentant un faible potentiel toxique ou bien<p>tolérés après inhalation. Enfin, nous avons gardé à l’esprit lors du développement des procédés de fabrication qu’ils pouvaient être sujets à la mise à l’échelle industrielle. Nous<p>avons donc privilégié des procédés de fabrication simples incluant des technologies<p>transposables telles que l’atomisation par la chaleur et l’homogénéisation à haute pression.<p>Une attention particulière lors de la caractérisation des poudres a été portée sur les<p>propriétés d’écoulement des formulations, toujours dans l’optique de faciliter une<p>potentielle future manutention à plus grande échelle.<p>Pour répondre à ces critères, durant la première partie de ce travail, nous avons<p>imaginé deux concepts de formulation qui ont pour but de former des microparticules de<p>mannitol dans lesquelles est dispersé l’ITZ sous forme « modifiée ».<p>Le premier concept de formulation qui a été développé consistait à former une<p>dispersion solide (DS) entre l’ITZ, si possible amorphe pour en augmenter la solubilité, et un<p>agent matriciel en utilisant le procédé d’atomisation par la chaleur d’une solution contenant<p>tous les ingrédients sous forme dissoute. Lors de tests préliminaires, nous avons évalué trois<p>types d’agents matriciels, deux agents hydrophiles (le mannitol et le lactose) et un agent<p>hydrophobe (le cholestérol). Sur base de la faisabilité, des résultats préliminaires de<p>solubilité, de dissolution et de déposition pulmonaire in vitro, le mannitol a été retenu.<p>Après une optimisation des conditions d’atomisation, les formulations ont été produites en<p>vue d’être caractérisées. Il a été observé, par diffraction de rayons X sur poudre (PXRD) et<p>par calorimétrie différentielle à balayage (DSC), qu’après atomisation, l’ITZ était obtenu sous<p>forme amorphe et le mannitol sous forme cristalline. Les tests d’évaluation des propriétés<p>aérodynamiques ont été réalisés à l’aide d’un impacteur liquide multi-étages (MsLI) en<p>suivant les recommandations pratiques de la Pharmacopée européenne. Ce type de<p>compositions, atomisées dans les conditions optimales, permettait d’obtenir des poudres<p>sèches présentant les caractéristiques de taille (diamètre médian < 5 μm, mesuré par<p>diffraction laser) et les propriétés aérodynamiques appropriées à l’administration<p>pulmonaire (fraction de particules fines (FPF) déterminées lors des tests d’impaction<p>comprises entre 40 % et 70 %). La formation d’une DS avec le mannitol était nécessaire afin<p>d’augmenter la solubilité et d’accélérer la cinétique de dissolution de l’ITZ comparativement<p>à son homologue micronisé sous forme cristalline ou encore à sa forme amorphe atomisée<p>sans mannitol. Par exemple, dans sa configuration amorphe atomisée sans excipient ou sous<p>sa forme cristalline initiale, l’ITZ présentait une solubilité à saturation (mesurée dans un tampon phosphate contenant 0,02% de dipalmytoyl phosphatidyl choline) inférieure à 10<p>ng/ml. Après formation d’une DS avec le mannitol suivant notre procédé de formulation,<p>nous sommes parvenus à des valeurs de solubilité atteignant 450 ng/ml. Il s’est avéré que<p>l’ajout à la composition d’un surfactant, le tocopherol polyethylène glycol 1000 succinate<p>(TPGS), permettait d’accélérer la cinétique de dissolution du principe actif. Toutefois,<p>l’utilisation du TPGS induisait une diminution des performances aérodynamiques des<p>formulations. Etant donné que cette augmentation de la cinétique de dissolution pouvait<p>être un avantage après administration pulmonaire, nous avons considéré un autre type de<p>surfactant, les phospholipides (PL). L’utilisation de la lécithine de soja hydrogéné s’est<p>révélée être très efficace. Les performances aérodynamiques des formulations ont été<p>préservées et même améliorées. Leur incorporation à la DS permettait également d’obtenir<p>une accélération du profil de dissolution de l’ITZ. De plus, l’augmentation de la quantité de<p>PL dans nos formulations, dans la gamme des concentrations utilisées, était corrélée avec<p>une amélioration d’autant plus marquée du profil de dissolution de l’ITZ. En outre, les<p>solubilités de l’ITZ en présence de PL furent considérablement améliorées avec, par<p>exemple, des concentrations mesurées de 870 ng/ml et 1342 ng/ml pour les formulations<p>contenant respectivement 10 % (m/mpoudre) et 35 % (m/mpoudre) d’ITZ, ainsi que 10 % de PL<p>exprimés par rapport à la quantité d’ITZ.<p>Le deuxième concept de formulation développé consistait à produire des<p>microparticules de mannitol dans lesquelles étaient dispersées des nanoparticules (NP)<p>cristallines d’ITZ. Le procédé de fabrication était le suivant. Une suspension de nanocristaux<p>d’ITZ produite par homogénéisation à haute pression (HPH) était re-suspendue dans une<p>solution de mannitol qui était par la suite atomisée pour obtenir les microparticules de<p>poudres sèches. Après optimisation des conditions d’homogénéisation, nous sommes<p>parvenus à produire des nanosuspensions d’ITZ dont les particules présentaient un diamètre<p>médian inférieur à 250 nm. Nous avons alors évalué l’influence qu’avait l’ajout du mannitol<p>et du taurocholate sodique sur l’état d’agrégation des NP avant l’étape d’atomisation et sur<p>les performances des formulations sous forme sèche. Il a été observé que l’ajout de<p>mannitol était nécessaire à la production de solutions sursaturées en ITZ avec une solubilité<p>maximale d’ITZ mesurées à 96 ng/ml dans le tampon phosphate précédemment cité. L’ajout<p>de mannitol s’est avéré nécessaire afin de minimiser le phénomène d’agrégation des NP durant l’étape d’atomisation. De plus, l’ajout de taurocholate de sodium permettait<p>également d’inhiber leur agrégation. La cristallinité des NP d’ITZ a été confirmée par PXRD et<p>DSC. Ce type de formulation présentait des tailles et des performances aérodynamiques<p>compatibles à l’administration pulmonaire (tailles des particules < 5 μm et FPF entre 35 % et<p>46 %). Néanmoins, comparativement aux DS précédemment décrites, ces formulations à<p>base de NP s’avèrent sensiblement moins performantes. En effet, au niveau des<p>caractéristiques aérodynamiques, les formulations à base de NP présentent des FPF<p>nettement inférieures à celles obtenues pour les DS (FPF de ~40 % pour les formulations<p>nanoparticulaires contre ~70 % pour les DS d’ITZ amorphe). De plus, à partir des<p>formulations à bases de NP, les taux de sursaturation en ITZ atteints étaient nettement<p>inférieurs à ceux obtenus avec les DS (~100 ng/ml Vs > 1000 ng/ml pour les meilleurs DS). En<p>outre, la production des nanosuspensions nécessitait l’étape supplémentaire d’un minimum<p>de 300 cycles d’homogénéisation, ce qui représente un désavantage considérable en termes<p>de rendement économique en cas de transposition à échelle industrielle comparativement à<p>l’étape unique nécessaire pour la fabrication des DS. Pour ces raisons, seules les DS ont été<p>évaluées in vivo.<p>Après la mise au point des formulations, la seconde partie de ce projet consistait à<p>évaluer les DS développés dans un système biologique complet, la souris. Nous avons en<p>premier lieu réalisé une pharmacocinétique (PK) après administration pulmonaire pour<p>déterminer l’effet de l’augmentation de la solubilité observée in vitro et de l’ajout de PL dans<p>la formulation. Ensuite, nous avons entrepris une étude d’activité sur un modèle murin<p>d’aspergillose pulmonaire invasive (API) permettant de comparer l’efficacité thérapeutique<p>ou prophylactique de nos formulations comparativement à une thérapie standard par voie<p>orale. Pour effectuer ces deux études, nous avons préalablement validé une méthode<p>d’administration des poudres sèches chez la souris à l’aide d’un insufflateur (DP-4M®, Penn<p>Century, Wyndmoor, USA) en utilisant la voie endotrachéale. Le premier point de cette<p>investigation avait pour objet de déterminer si l’intervalle de taille particulaire généré lors de<p>la décharge de nos formulations au sortir de l’insufflateur permettait une répartition<p>homogène dans les poumons ainsi qu’une pénétration profonde des particules jusqu’aux<p>alvéoles pulmonaires. Le deuxième point sur lequel nous nous sommes également attardés était la reproductibilité des doses pulmonaires générées après insufflation, facteur<p>déterminant lors de la réalisation d’une étude PK.<p>Sur base des observations constatées durant la validation du dispositif<p>d’administration, nous avons entrepris une étude PK après administration pulmonaire d’une<p>dose de 0,5 mg/kg d’ITZ, représentant une quantité inhalable par l’homme et pouvant<p>garantir des taux pulmonaires en antifongiques théoriquement adéquats. Cette étude a<p>permis de comparer les concentrations pulmonaires et plasmatiques en ITZ après<p>l’administration de poudres sèches à base d’une DS de mannitol et d’ITZ qui était soit<p>cristallin soit amorphe, avec ou sans PL. Après administration de la DS à base d’ITZ sous sa<p>forme amorphe, une augmentation de la quantité d’ITZ absorbée vers le compartiment<p>systémique a été observée. En effet, il a été observé une augmentation d’un facteur 2,7 de<p>l’aire sous la courbe des concentrations plasmatiques en ITZ de 0 à 24 heures (AUC0-24h)<p>comparativement à celle obtenue après administration de la DS à base d’ITZ sous sa forme<p>cristalline. Le temps pour atteindre la concentration plasmatique maximale (tmax) était<p>également plus court pour la formulation à base ITZ sous sa forme amorphe (tmax de 10 min<p>vs 30 min pour la formulation cristalline). De plus, dans cette configuration amorphe, les<p>temps de rétention pulmonaire en ITZ étaient considérablement plus élevés (t1/2<p>d’élimination de 6,5 h pour l'ITZ cristallin vs 14 ,7 h pour l’ITZ amorphe) permettant de<p>maintenir une concentration pulmonaire en ITZ supérieure à la CMI de la souche<p>d’aspergillus la plus fréquente (A. fumigatus ;2 μg/gpoumon) pendant plus de 24h. L’ajout de<p>PL dans un rapport ITZ:PL:mannitol (1:3:97) dans la DS influençait le profil PK de l’ITZ<p>amorphe en accentuant et accélérant d’avantage la phase d’absorption initiale de l’ITZ<p>observée (Cmax et tmax plasmatique supérieur et inférieur à ceux obtenus pour l’ITZ amorphe,<p>respectivement). Toutefois, cette formulation a été éliminée plus rapidement des poumons<p>(t1/2 d’élimination pulmonaire de l’ITZ de 4,1h pour les formulations avec PL vs 14,7h sans<p>PL). Pour cette raison, nous avons décidé d’évaluer l’efficacité des formulations à base d’ITZ<p>sous forme amorphe sans phospholipides dans un modèle murin d’aspergillose pulmonaire<p>invasive (API) que nous avons développé.<p>Nous ne sommes pas parvenus à mettre en évidence un effet thérapeutique de<p>l’administration des poudres sèches administrées dans ce modèle murin neutropénique<p>d’API. Nous justifions ce manque d’activité par une agressivité du modèle trop prononcée et par l’impossibilité de pouvoir administrer de manière plus fréquente le traitement par<p>inhalation en raison de l’anesthésie nécessaire pour la procédure d’administration<p>endotrachéale. Toutefois, des essais complémentaires vont être envisagés (modification de<p>la charge fongique, administration des poudres par une tour d’inhalation, optimisation du<p>dosage et de la fréquence d’administration). En revanche, il a été mis en évidence que<p>l’administration prophylactique (début des administrations 2 jours avant l’infection) d’une<p>dose de 5 mg/kg/48h d’une DS d’ITZ amorphe augmentait significativement le taux de survie<p>de 12 jours après l’infection par A. fumigatus comparativement aux animaux non traités<p>(taux de survivants :50 % vs 0 %). A titre de comparaison, le pourcentage de survie obtenu<p>après prophylaxie quotidienne d’une dose de 12,5 mg/kg/12h de solution orale de VCZ (la<p>thérapie recommandée pour l’API) n’était que de 25 %.<p>En conclusion, les DS d’ITZ destinées à être administrées par inhalation constituent<p>une approche thérapeutique prometteuse dans le cadre de la prévention et du traitement<p>de l’aspergillose pulmonaire. / Doctorat en Sciences biomédicales et pharmaceutiques / info:eu-repo/semantics/nonPublished

Discovery of new antifungal chemo-therapeutics for humans is limited by the large degree of conservation among eukaryotic organisms. In recent years, the histone acetyl-transferase Rtt109 was identified as the sole enzyme responsible for an abundant and important histone modification, histone H3 lysine 56 (H3K56) acetylation. In the absence of Rtt109, the lack of acetylated H3K56 renders yeast cells extremely sensitive to genotoxic agents. Consequently, the ability to sustain genotoxic stress from the host immune system is crucial for pathogens to perpetuate an infection. Because Rtt109 is conserved only within the fungal kingdom, I reasoned that Rtt109 could be a novel drug target. My dissertation first establishes that genome stability provided by Rtt109 and H3K56 acetylation is required for Candida albicans pathogenesis. I demonstrate that mice infected with rtt109 -/- cells experience a significant reduction in organ pathology and mortality rate. I hypothesized that the avirulent phenotype of rtt109 -/- cells is due to their intrinsic hypersensitivity to the genotoxic effects of reactive oxygen species (ROS), which are utilized by phagocytic cells of the immune system to kill pathogens. Indeed, C. albicans rtt109 -/- cells are more efficiently killed by macrophages in vitro than are wild-type cells. However, inhibition of ROS generation in macrophages renders rtt109 -/- and wild-type yeast cells equally resilient to killing. These findings support the concept that ability to resist genotoxic stress conferred by Rtt109 and H3K56 acetylation is a virulence factor for fungal pathogens and establish Rtt109 as an opportune drug- target for novel antifungal therapeutics. Second, I report the discovery of a specific chemical inhibitor of Rtt109 catalysis as the initial step in the development of a novel antifungal agent. We established a collaboration with the Broad Institute (Cambridge, MA) to perform a high-throughput screen of 300,000 compounds. From these, I identified a single chemical, termed KB7, which specifically inhibits Rtt109 catalysis, with no effect on other HAT enzymes tested. KB7 has an IC50 value of approximately 60 nM and displays noncompetitive inhibition regarding both acetyl-coenzyme A and histone substrates. With the genotoxic agent camptothecin, KB7 causes a synergistic decrease in C. albicans growth rate. However, this effect is only observed in an efflux-pump mutant, suggesting that this compound would be more effective if it were better retained intracellularly. Further studies through structure-activity relationship (SAR) modifications will be conducted on KB7 to improve its effective cellular concentration.

<p>Nesavesna upotreba antibiotika izazvala je razvoj antimikrobne rezistencije zabrinjavajućih razmera. Porast rezistencije prema konvencionalnim antimikrobicima nametnuo je potrebu pronalaska novih supstanci, koje će biti delotvorne protiv otpornih sojeva. U poslednje četiri decenije, dominira trend da se lekovi i lekovita sredstava prave na bazi prirodnih proizvoda, a naročito biljnog materijala. Hemijski sastav plodova porodice ruža (Rosaceae) upućuje na to da bi određene vrste ove porodice biljaka mogle ispoljavati antimikrobno dejstvo. Plodovi voća porodice Rosaceae istraživani u okviru ove disertacije su: malina (Rubus idaeus), kupina (Rubus fruticosus), tre&scaron;nja (Prunus avium), vi&scaron;nja (Prunus cerasus) i aronija (Aronia prunifolia). Predmet istraživanja ove doktorske disertacije je antimikrobno tj. antibakterijsko, antigljivično, antialgalno i antivirusno dejstvo sokova i ekstrakata plodova odabranog voća porodice Rosaceae gajenog i prikupljenog na teritoriji Srbije na &scaron;irok spektar humanih i animalnih patogenih mikroorganizama.Sokovi su dobijeni ceđenjem svežih plodova voća. Ekstrakti su dobijeni iz ostataka voća nakon ceđenja (tropa) metodom dvostruke etanolne ekstrakcije. Nakon ceđenja i ekstrakcije sprovođeno je uparavanje do suva sokova i ekstrakata. HPLC metodom je ispitano prisutstvo 23 hemijske komponente u svakom od sokova i ekstrakata. Antimikrobna analiza je sprovedena na 21 mikroorganizmu, od čega su 15 bile bakterije, 2 gljivice, 2 alge i 2 virusi. Od navedenih mikroorganizama 14 je bilo autohtonih izolata, a 7 referentnih sojeva. Ispitivanje antibakterijskog, antifungalnog i antialgalnog dejstva plodova odabranog voća je sprovedeno difuzionom i mikrodilucionom metodom. Analiza antivirusne aktivnosti plodova odabranog voća je sprovedena posmatranjem inhibicije citopatogenog efekta (CPE) virusnih čestica na ćelijsku kulturu. Sve studije su sprovedene u triplikatu. Rezultati hemijske analize su obrađeni statistikom metodom srednje vrednosti, uz računanje standardne devijacije. Eksperimentalno dobijeni podaci u okviru ispitivanja antibakterijskog, antigljivičnog i antialgalnog dejstva su uvr&scaron;teni u statističku analizu. Metodom aproksimacije je utvrđena tačna koncentracija soka ili ekstrakta koja daje željeni efekat na ispitivani mikroorganizam. Rezultati analize antivirusnog dejstva su statistički obrađeni metodom srednje vrednosti. Kako bi se utvrdio stepen povezanosti rezultata dobijenih u okviru antimikrobnih analiza sa hemijskim supstancama prisutnim u plodovima odabranog voća sprovedena je regresiona analiza za vaki pojedinačni slučaj. Antibakterisjko, antiungalno i antialgalno dejstvo sokova i ekstrakata je upoređeno sa istim dejstvima konvencionalnih antimikrobnih lekova. Najveću ukupnu količinu ispitivanih supstanci je sadržao ekstrakt kupine (3965,56 mg/ml), a najmanju ekstrakt tre&scaron;nje (161,44 mg/ml). Od svih ispitivanih hemijskih supstanci, samo su: antocijani, katehin, galna kiselina i vitamin C, prisutni u svim ispitivanim sokovima i ekstraktima. Sve ispitivane biljke sadrže veću količinu supstanci u ekstraktu, osim kod tre&scaron;nje, kod koje se veća količina supstanci nalazi u soku. U najvećoj meri su u sokovima i ekstraktima plodova biljaka prisutni antocijani i to najvi&scaron;e kod kupine od ekstrakata, a kod maline od sokova. Antimikrobno (antibakterijsko, antifungalno, antialgalno i antivirusno) dejstvo je dokazano za svaki od sokova i/ili ekstrakata plodova odabranog voća. Po prosečnim vrednostima rezultata dilucione analize antimikrobnog i dejstva na MDBK ćelije, protiv najvećeg broja mikroorganizama najdelotvorniji je bio ekstrakt kupine, a neaktivan ili najslabije aktivan (aktivan u najvećoj koncentraciji) sok tre&scaron;nje. Prosečne vrednosti antimikrobnog i dejstva na MDBK ćelije su bile u opsegu od 0,71 mg/ml do 100 mg/ml. Sve ispitivane supstance su pokazale antibakterijsku aktivnost u ispitivanim koncentracijama na sve ispitivane bakterije, osim soka maline na Escherichia-u coli i soka aronije na Klebsiella-u pneumoniae. Ekstrakti su bolje delovali u većini slučajeva, uz nekoliko izuzetaka. Sve ispitivane supstance su pokazale antfiungalnu aktivnost na Candida-u albicans ATCC 24433, osim soka aronije. Na autohtoni soj Candida-e albicans su delovali samo ekstrakti kupine i tre&scaron;nje. Ekstrakti su bolje delovali u većini slučajeva, osim kupine na Candida-u albicans ATCC 24433, u kojem je dejstvo soka bilo jednako sa dejstvom ekstrakta. Iako su skoro svi ispitivani sokvi i ekstrakti ispoljili antialgalno dejstvo, na Prototheca-u wickerhamii nisu delovali vi&scaron;nja i sok maline, dok sok aronije nije delovao antialgalno ni na jednu od ispitivanih Prototheca. Ekstrakti su bolje delovali u većini slučajeva, osim maline kod koje je, u oba slučaja, bolje delovao sok. Sve ispitivane supstance su pokazale antivirusnu aktivnost na Bovine herpesvirus i Bovine viral diarrhea virus, kao i toksičnost na MDBK ćelije, osim sokova maline i tre&scaron;nje, koji su bili neaktivni protiv Bovine herpesvirus-a. Ekstrakti su bolje delovali u većini slučajeva, osim tre&scaron;nje na MDBK ćelije i Bovine viral diarrhea virus, na koje je jače delovao sok. U potpunosti jednako delovanje soka i ekstrakta je uočeno kod aronije za sva tri dejstva i maline za toksičnost na MDBK ćelije. Pri ispitivanju difuzionom metodom antibiotik je ispoljio jače dejstvo u odnosu na sokove i ekstrakte, osim ekstrakata kupine, maline i vi&scaron;nje na Trueperella-u pyogenes. Pri ispitivanju dilucionom metodom, dejstvo ekstrakata i sokova na Gram pozitivne bakterije je bilo uporedivo sa dejstvom Streptomicina, dok je dejstvo antibiotika na Gram negativne bakterije bilo jače u odnosu na sokove i ekstrakte, izuzetev jačeg dejstva ekstrakta maline protiv Escherichia-e coli. Nistatin je sve antifungalne i antialgalne efekte na gljivice i alge obuhvaćene istraživanjem ispoljio u manjim koncentracijama u odnosu na ispitivane sokove i ekstrakte.Najpovezanije sa antibakterijskim dejstvom sokova i ekstrakata na odgovarajuće mikroorganizme su bile: kumarinska, ferulna i galna kiselina, katehin. Najveći procenat povezanosti sa antimikrobnom aktivnosti ploda imali su antocijani na Enterococcus faecalis (71,94%). Najmanje povezani sa antimikrobnom aktivnosti na odgovarajuće mikroorganizme su bili: hlorogenska kiselina, kempferol, kumarinska i siringinska kiselina, vitamin C, vanilinska kiselina, epikatehin, katehin, rutin, krisin, elaginska i p-hidroksibenzoeva kiselina. Saznanja dobijena u okviru ove disertacije pro&scaron;iruju obim znanja o antimikrobnom dejtvu voća i predstavljaju osnovicu za svrsishodniju primenu voća kako u ishrani tako i u terapiji. Međutim, dalja istraživanja u smislu pro&scaron;irenja spektra ispitivanih mikroorganizama, antimikrobnih studija pojedinačnih komponenti iz plodova i mehanizama dejstva su potrebna.</p> / <p>Nonconscientious use of antibiotics has caused the development of antimicrobial resistance of worrying proportions. The increase in resistance to conventional antimicrobials has imposed a need to find new substances that will be effective against resistant strains. Over the last four decades, the trend is to medicines and medicinal products be made on the basis of natural products, and especially plant material. The chemical composition of the Rose family (Rosaceae) fruits suggests that certain species of this family of plants may exhibit an antimicrobial effect. The fruits of the Rosaceae family studied in the framework of this dissertation are: Raspberry (Rubus idaeus), Blackberry (Rubus fruticosus), Cherry (Prunus avium), Cherry (Prunus cerasus) and Aronia (Aronia prunifolia). The subject of the research of this doctoral dissertation is antimicrobial ie. antibacterial, antifungal, antialgal and antiviral effects of juices and fruit extracts, of the selected fruit of the Rosaceae family collected on the territory of Serbia, on a wide range of human and animal pathogenic microorganisms. Juices were obtained by the process of squeezing fresh fruits. The extracts were obtained from residues of fruits after extraction (pomace) by the double ethanol extraction method. After squeezing and extraction, evaporation to dryness of juices and extracts was carried out. The presence of 23 chemical components in each of the juices and extracts was examined by the HPLC method. Antimicrobial analysis was carried out on 21 microorganisms, of which 15 were bacteria, 2 fungi, 2 algae and 2 viruses. 14 of these microorganisms were autochthonous isolates and 7 reference strains. The antibacterial, antifungal and antialgal effect of the selected fruit was tested by the diffusion and microdilution method. The analysis of the fruits antiviral activity was carried out by observing the inhibition of cytopathogenic effect (CPE) of viral particles per cell culture. All studies were conducted in triplicate. The results of the chemical analysis were processed by means of a mean value method, with calculation of the standard deviation. The experimentally obtained data within the antibacterial, antifungal and antialgal examination were included in the statistical analysis. The method of approximation was used in order to determine the exact concentration of the juice or extract, which gives the desired effect on the examined microorganisms. The results of the antiviral analysis were statistically processed using the mean value method. In order to determine the degree of correlation of the results obtained in the framework of antimicrobial analysis with the chemical substances present in the fruits of the selected fruit, regression analysis was carried out for each individual case. Antibacterial, antifungal and antialgic effects of juices and extracts are compared with he same effects of conventional antimicrobial drugs, Streptomycin and Nystatin. The largest total amount of test substances was contained by blackberry extract (3965.56 mg/ ml), and the smallest by extract of sweet cherry (161.44 mg/ ml). Of all the investigated chemicals, only: anthocyanins, catechins, gallic acids and vitamin C were present in all examined juices and extracts. All investigated plants contain a higher amount of substances in the extract, except for sweet cherries, in which a greater amount of substances is present in the juice. In the juices and extracts of fruits anthocyanins are present to the greatest extent, mostly in the blackberry extract, and in raspberry juices. According to the average values of the results of the dilution analysis of the antimicrobial and the effect on the MDBK cell, the most effective was the blackberry extract and the most active inactive (active in the highest concentration) cherry juice against the most numerous microorganisms. The average antimicrobial values and effects on the MDBK cells were in the range of 0.71 mg/ ml to 100 mg/ ml. All investigated substances showed antibacterial activity in the tested concentrations on all examined bacteria, except raspberry juice on Escherichia coli and aronia juice on Klebsiella pneumoniae. Extracts acted better in most cases, with few exceptions. All investigated substances showed antifungal activity on Candida albicans ATCC 24433, except aronia juice. On the autochthonous Candida albicans, only blackberry and sweet cherry extracts were active. Extracts worked better in most cases, except for blackberry on Candida albicans ATCC 24433, in which the effect of the juice was equally efficient as the extract. Although almost all of the examined juices and extracts exhibited an antialgal effect, the sour cherry and raspberry juice did not work on the Prototheca wickerhamii, while the aronia juice did not express antialgal activity to any of tested Prototheca isolates. Extracts worked better in most cases, apart from raspberries, wich juice was stronger in both cases. All investigated substances showed antiviral activity on Bovine herpesvirus and Bovine viral diarrhea virus, as well as the toxicity to MDBK cells, except for raspberry and cherry juices, that were inactive against Bovine herpesvirus. The extracts worked better in most cases, except sweet cherries on MDBK cells and Bovine viral diarrhea virus, whose juice had stronger effect. The equally effective action of juice and extract was observed in aronia for all three effects and raspberries for toxicity to MDBK cells. In the diffusion test, antibiotic showed a stronger effect than juices and extracts, except for extracts of blackberry, raspberry and sour cherries on Trueperella pyogenes. In a dilution study, the effect of extracts and juices on Gram-positive bacteria was comparable to that of Streptomycin, while the effect of the antibiotic on Gram negative bacteria was stronger than juices and extracts, with exception of the stronger effect of raspberry extract against Escherichia coli. Nystatin has expressed its all antifungal and antialgal effects on fungi and algae included in the study in smaller concentrations compared to the examined juices and extracts. The most consistent with the antibacterial effect of juices and extracts on the appropriate microorganisms were: coumarin, ferulan and gallic acid, catechin. The highest percentage of association with antimicrobial activity of the fruits was given by anthocyanins to Enterococcus faecalis (71.94%). The least related to the antimicrobial activity on the appropriate microorganisms were: chlorogenic acid, champferol, coumarin and saringic acid, vitamin C, vanillic acid, epicatechin, catechin, rutin, chrysin, elaginic and p-hydroxybenzoic acid. The knowledge gained through this dissertation expands the scope of knowledge on antimicrobial activity of fruits and forms the basis for more effective use of fruits in both therapy and nutrition. However, further research in terms of extending the range of examined microorganisms, antimicrobial studies of individual fruits components and mechanisms of action are required.</p>

Cetoconazol é um fármaco antimicótico largamente utilizado e veiculado por diversas formas farmacêuticas. Apesar de ser comprovadamente eficaz, é uma substância muito hepatotóxica quando administrado por via oral. Por esse motivo justifica-se o seu emprego em preparações tópicas e sistemas transdérmicos. Essa substância apresenta razoáveis níveis de penetração elou permeação cutânea, mas esses níveis podem ser melhorados através da incorporação, às formulações, de substâncias denominadas promotores de permeação/penetração (enhancers). Essas substâncias têm a função de modificar a difusão dos fármacos através da pele. Neste trabalho, foi estudada a liberação/permeação do cetoconazol de cremes O/A contendo os promotores de permeação/penetração, propilenoglicol e uma solução alcóolica de mentol, empregados em associação e isoladamente na concentração de 0 a 5% p/p. O estudo foi conduzido in vitro, utilizando célula de Franz modificada com o emprego de membrana sintética de acetato de celulose. Foram preparadas e testadas dez formulações, a partir de uma fórmula de creme O/A não-iônico. Dentre as dez formulações estudadas aquela que apresentou melhores resultados quanto aos parâmetros de fluxo e coeficiente de permeabilidade, após uma hora do início do experimento, foi uma formulação que apresenta 1% p/p de propilenoglicol e 1% p/p de solução alcoólica de mentol. / Ketoconazole is an antifungal drug and is largely employed in many delivery systems and dosage forms. Oral administration is not recommended because of its hepatotoxic effects, so topical preparations are employed. This drug shows skin penetration and/or permeation levels, but these levels may be enhanced by the addition of enhancers. These substances modify the diffusion of drugs through skin. In this work, the liberation/permeation of ketoconazole from, O/W creams was studied. These creams have propylene glycol and na alcoholic menthol solution as enhancers, in a range from 0 to 5%w/w. It was an in-vitro experiment, employing Franz modified cells and synthetic cellulose membrane Ten nonionic O/W creams were made and tested. Among the ten tested formulations the one which showed best results in flux and permeability coefficient, after 1 hour, was a formulation which has 1 % w/w of menthol alcoholic solution concentrations.

Cetoconazol é um fármaco antimicótico largamente utilizado e veiculado por diversas formas farmacêuticas. Apesar de ser comprovadamente eficaz, é uma substância muito hepatotóxica quando administrado por via oral. Por esse motivo justifica-se o seu emprego em preparações tópicas e sistemas transdérmicos. Essa substância apresenta razoáveis níveis de penetração elou permeação cutânea, mas esses níveis podem ser melhorados através da incorporação, às formulações, de substâncias denominadas promotores de permeação/penetração (enhancers). Essas substâncias têm a função de modificar a difusão dos fármacos através da pele. Neste trabalho, foi estudada a liberação/permeação do cetoconazol de cremes O/A contendo os promotores de permeação/penetração, propilenoglicol e uma solução alcóolica de mentol, empregados em associação e isoladamente na concentração de 0 a 5% p/p. O estudo foi conduzido in vitro, utilizando célula de Franz modificada com o emprego de membrana sintética de acetato de celulose. Foram preparadas e testadas dez formulações, a partir de uma fórmula de creme O/A não-iônico. Dentre as dez formulações estudadas aquela que apresentou melhores resultados quanto aos parâmetros de fluxo e coeficiente de permeabilidade, após uma hora do início do experimento, foi uma formulação que apresenta 1% p/p de propilenoglicol e 1% p/p de solução alcoólica de mentol. / Ketoconazole is an antifungal drug and is largely employed in many delivery systems and dosage forms. Oral administration is not recommended because of its hepatotoxic effects, so topical preparations are employed. This drug shows skin penetration and/or permeation levels, but these levels may be enhanced by the addition of enhancers. These substances modify the diffusion of drugs through skin. In this work, the liberation/permeation of ketoconazole from, O/W creams was studied. These creams have propylene glycol and na alcoholic menthol solution as enhancers, in a range from 0 to 5%w/w. It was an in-vitro experiment, employing Franz modified cells and synthetic cellulose membrane Ten nonionic O/W creams were made and tested. Among the ten tested formulations the one which showed best results in flux and permeability coefficient, after 1 hour, was a formulation which has 1 % w/w of menthol alcoholic solution concentrations.