Low-intensity pulsed ultrasound combined with nystatin treatment synergistically inhibits vaginal Candida albicans biofilm infection in rabbits.
10.12122/j.issn.1673-4254.2025.02.10
- Author:
Mengyao XIE
1
;
Min YANG
1
;
Xin LI
1
;
Yonghong DU
1
Author Information
1. State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing 400016, China.
- Publication Type:Journal Article
- Keywords:
Candida albicans;
biofilm;
low-intensity pulsed ultrasound;
nystatin;
vaginitis
- MeSH:
Animals;
Rabbits;
Female;
Biofilms/drug effects*;
Candida albicans/physiology*;
Nystatin/therapeutic use*;
Candidiasis, Vulvovaginal/microbiology*;
Ultrasonic Waves;
Antifungal Agents/therapeutic use*;
Vagina/microbiology*;
Ultrasonic Therapy;
Microbial Sensitivity Tests;
Combined Modality Therapy
- From:
Journal of Southern Medical University
2025;45(2):296-303
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVES:To explore the efficacy of low-intensity pulsed ultrasound (LIPUS) combined with nystatin for treatment of vaginal Candida albicans biofilm infection.
METHODS:In vitro cultured Candida albicans biofilm were treated with LIPUS, nystatin, or both, and the minimum inhibitory concentration (MIC) of nystatin was determined. Crystal violet staining, confocal laser microscopy (CLSM) and scanning electron microscopy were used to quantify the biofilm and observe the activity and morphological changes of the biofilms; DCFH-DA was used to detect the changes in reactive oxygen species (ROS). Twenty female New Zealand White rabbits with vaginal inoculation of Candida albicans biofilm were randomized into 4 groups for treatment with normal saline, LIPUS, nystatin, or both LIPUS and nystatin. The changes in vulvar symptoms of the rabbits were observed, and the histopathological and ultrastructural changes of the vagina before and after treatment were observed using HE staining and transmission electron microscopy.
RESULTS:In the combined treatment group, the MIC50 and MIC80 of nystatin in Candida albicans biofilms were both reduced by 50% compared with those in nystatin group, and the biofilm clearance rate increased by 26% and 68% compared with nystatin and LIPUS groups, respectively. Compared with nystatin and LIPUS treatment alone, the combined treatment produced stronger effects for inhibiting biofilm activity, causing structural disruption and promoting ROS production. In the rabbit models, the combined treatment more effectively improved vulvar symptoms and inflammatory infiltration, reduced residual vaginal hyphae/strains, and improved ultrastructure of the vaginal epithelium than LIPUS and nystatin treatment alone.
CONCLUSIONS:LIPUS combined with nystatin produces a significant synergistic antifungal effect against Candida albicans biofilm both in vitro and in vivo.
