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"We have read for you": Candida Albicans resistant to medicines: if you can't beat it, let's make it

How to fight a fungal infection with Candida Albicans that becomes increasingly resistant to medicines? Making it starve!

The discovery was made by a team of researchers from the University of Buffalo and Temple University.

This week, I read for you an article entitled "Iron Chelator Deferasirox Reduces Candida albicans Invasion of Oral Epithelial Cells and Infection Levels in Murine Oropharyngeal Candidiasis" by Dr. Puri and his team.

Candida albicans is the agent that causes various infections: oral thrush (a mouth infection identified by a white film that covers tongue and throat, causing painful swallowing); stomatitis (a fungal infection that affects almost two thirds of dental prosthesis wearers causing inflammation, redness and swelling in the mouth); vaginal candida (an infection that affects the genitals and causes redness, itching, burning and whitish leakage).

This fungus is also the fourth leading cause of hospital-acquired blood infections, which often have high mortality rates.

Candida albicans is the most abundant fungus in the oral microbiome and relies on saliva as a source of essential elements and nourishment. Iron, the second most abundant metal in saliva, is an indispensable nutrient used by the fungus in various cellular processes, including energy production and DNA repair.

To treat Candida albicans, the researchers in this study limited the access of the fungus to iron, a crucial element for its survival in the body.

They did it using Deferasirox, a drug used to treat certain blood disorders. The drug was tested on mice and the results were really promising: scientists reduced the levels of iron by four times in saliva, this altered the expression of over 100 genes by the fungus, decreased its ability to infect the oral tissue and mucous membranes and caused a double reduction in the survival rate of the fungus in the body.

In this study, Deferasirox was administered together with drinking water to mice to lower iron levels in saliva and reduce the availability of iron needed to nourish and support an infection.

The researchers found that Candida albicans in the mice receiving the treatment had a 12% survival rate compared to 25% in mice that had not received treatment.

Other researches have shown that treatment with Deferasirox does not cause iron deficiency in adults with normal iron levels. This makes it a potential preventive treatment for those who are vulnerable to mucosal infections.

The study is the first to show that, if we let Candida albicans die of hunger (or iron!), we can limit its growth and its reappearance.

In the absence of new drugs, the use of existing “off-label” drugs for the treatment of other diseases is a promising strategy.

Currently there are only three main classes of clinical antifungal drugs. However, resistance to fungal drugs has steadily increased and no new classes of antifungals have emerged for decades.

As an alternative to drugs, we can use a natural product: Lactoferrin.

Lactoferrin is a glycoprotein with antimicrobial and iron-transporter action, in mucous secretions it modulates the activity and the aggregative capacity of bacteria and viruses towards cell membranes.

We have seen that some pathogens require iron to be able to perform cell replication, lactoferrin removes free iron from the surrounding environment thus preventing the proliferation and growth of bacteria or fungi.

Obstetrician Sara Furno

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