title: Conditions influencing the in vitro antifungal activity of lactoferrin combined with antimycotics against clinical isolates of Candida. Impact on the development of buccal preparations of lactoferrin.
abstract: Lactoferrin, an iron-binding glycoprotein, is a potential agent for the treatment of oropharyngeal Candidiasis. The aim of the present study was to test the capability of lactoferrin, combined or not combined with conventional antifungal agents, to inhibit the growth of different Candida species under various experimental conditions to be of guidance in the development of a suitable pharmaceutical formulation containing lactoferrin. The anti-Candida activities of lactoferrin were considerably higher using RPMI instead of SLM as assay medium. They were moreover increased by raising the medium pH from 5.6 to 7.5. With the 'standard' antifungal agent fluconazole similar results were found as for lactoferrin, but the medium type and pH did not affect MIC values of amphotericin B. The addition of saliva to medium did not reduce the antifungal activities of the individual compounds. Synergistic inhibitory effects on Candida growth were found for combinations of lactoferrin and fluconazole or amphotericin B, irrespective of the medium type and pH, or the addition of saliva. This indicates that for treatment of oral Candidiasis a formulation containing lactoferrin seems appropriate; results may be optimized if the formulation is provided with buffer capacity to attain pH 7.5 in the mucosal fluid. The synergistic effects between lactoferrin and 'standard' antifungals indicate that combinations should be considered in such a formulation.
authors.affiliation: Groningen University Institute for Drug Exploration (GUIDE), Dept. of Pharmacokinetics and Drug Delivery, University Center for Pharmacy, Groningen, The Netherlands.
authors.forename: M E
authors.initials: ME
authors.lastname: Kuipers
authors.forename: L
authors.initials: L
authors.lastname: Beljaars
authors.forename: N
authors.initials: N
authors.lastname: Van Beek
authors.forename: H G
authors.initials: HG
authors.lastname: De Vries
authors.forename: J
authors.initials: J
authors.lastname: Heegsma
authors.forename: J J M
authors.initials: JJ
authors.lastname: Van Den Berg
authors.forename: D K F
authors.initials: DK
authors.lastname: Meijer
authors.forename: P J
authors.initials: PJ
authors.lastname: Swart
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology*; D002175:Candida / Q000187:drug effects* / Q000254:growth & development; D002626:Chemistry, Pharmaceutical; D003470:Culture Media; D004357:Drug Synergism; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007781:Lactoferrin / Q000494:pharmacology*; D012471:Salivary Proteins and Peptides / Q000494:pharmacology
chemical_list: D000935:Antifungal Agents; D003470:Culture Media; D012471:Salivary Proteins and Peptides; D007781:Lactoferrin