Curcumin nanoparticles: the topical antimycotic suspension treating oral candidiasis

Abstract

Phytotherapeutics is widely used nowadays as an alternative to the current antifungal drugs to reduce their side effects. Curcumin, with its wide therapeutic array as antioxidant and anti-inflammatory agent, is one of the natural compounds that ha..s an antifungal effect, especially when being used at nanoscale to increase its bioavailability. Our research aimed to evaluate clinically and microbiologically the effect of using topical nanocurcumin suspension to treat oral candidiasis. After 4 days from induction of oral candidiasis (baseline), we randomly divided 39 female BALB/c mice into three groups of 13 animals; nanocurcumin, nystatin, and sham groups. All animals in nanocurcumin and nystatin groups received topical treatment twice daily for 10 days. Then, we performed clinical and microbiological evaluations at baseline, day 5, and day 10. By the end of treatment, our results revealed that nanocurcumin promoted a significant reduction in the number of candida colonies. There was no statistically significant difference neither clinically nor microbiologically between nanocurcumin and nystatin groups. In conclusion, nanocurcumin has a good antifungal effect as nystatin, however, its therapeutic efficacy takes a longer time to appear than nystatin. The enhanced bioavailability of curcumin at the nanoscale qualifies this nano-herb as a promising alternative therapy for oral candidiasis, evading nystatin-associated morbidity.

Keywords: Nanocurcumin; Nanotechnology; Nystatin; Oral candidiasis.

Fig. 1

Photograph showing characterization of nanocurcumin: a, b the UV–Vis spectrophotometer characterization results for average particles’ size and Zeta potential. c curcumin nano particles examination with transmission electron microscope

Fig. 2

A bar chart showing the comparison between the three studied groups according to clinical scores. Significance is denoted by * for p < 0.05 and ** for p < 0.001, while ns denotes non-statistically significant

Fig. 3

A representative graph showing a comparison between the three studied groups according to colony counts (CFU/ML) in each period. Significance is denoted by * for p < 0.05 and ** for p < 0.001, while ns denotes non-statistically significant

Fig. 4

Histopathological assessment and scoring of the three different treatment modalities. a Photomicrographs of PAS-stained tongue specimens at the end of treatment period (× 400 with a scale bar of 50 µm). The untreated negative controlled tongue mucosae range in their scores from mild to severe. In mild score 1, the upper third of mucosa reveals candida (green arrow). While mild neutrophil infiltrations are noted in score 2 resulting in the formation of micro abscess (red arrow), which become more evident throughout the mucosal surface with Munro’s macro abscesses (arrowheads) in score 3. Red asterisks denote the neutrophils infiltration in the underlying connective tissue, while black arrows mark the mitotic activity in untreated candida infected tongue mucosa. Nystatin and nanocurcumin topical treatment restore the normal tongue architecture, with a scoring range from absent (0) to mild (1) revealing candida hyphae restricted to the keratinized epithelial layer (yellow arrows). b A heatmap of histopathological candida scoring system after 10-days treatment protocols showing the comparable significant drops in the scores to almost absent 0 grade in both nystatin and nanocurcumin treated groups (ns; p > 0.05), compared with the significant high histological candida count scoring mainly 2 and 3 (***; p < 0.0001)