Candidiasis is caused by Candida parapsilosis and Candida tropicalis emerges due to antifungal resistance and limited therapies. We aim to assess the antifungal activity of Hedychium spicatum essential oil (HSEO), followed by computational analyses to identify potential lead phytochemicals, targeting lanosterol 14α-demethylase (CYP51), a key enzyme in ergosterol biosynthesis. GC-MS identified 29 phytoconstituents, with τ-cadinol (17.94%) as the major component. Disc diffusion demonstrated concentration-dependent antifungal activity against C. parapsilosis and C. tropicalis, with inhibition zones of 11.00 ± 0.53 and 10.40 ± 0.36 mm, respectively, at 100% (v/v). Homology models of CYP51 exhibited structural reliability based on Ramachandran and validation metrics. Molecular docking identified cis-γ-bisabolene with the lowest binding energies (-7.6 and -7.9 kcal/mol) against haem-free CYP51 models of C. parapsilosis and C. tropicalis, respectively, through hydrophobic interactions. ADMET predictions indicated favorable oral absorption, Lipinski compliance, minimal CYP450 inhibition risk, and no hepatotoxicity or mutagenicity. MD simulations confirmed stable complexes using RMSD, RMSF, Rg, and SASA profiles. MM-PBSA showed favorable binding energies of -6.02 and -8.05 kJ/mol compared to fluconazole (0.98 and 0.66 kJ/mol). DFT showed comparable HOMO-LUMO gaps (6.216 and 6.176 eV) and global hardness (3.108 and 3.088 eV). Overall, HSEO shows promising antifungal potential, with cis-γ-bisabolene as a lead candidate.

Esophagitis dissecans superficialis (EDS), also known as sloughing esophagitis, is a rare, benign disorder characterized by superficial sloughing of the esophageal mucosa. Its pathogenesis remains incompletely understood, with several underlying conditions and medication exposures described as potential predisposing factors. We present the case of a 41-year-old woman with an extensive surgical history, including subtotal gastrectomy with Roux-en-Y reconstruction, who presented with chronic upper abdominal pain and bloating. Esophagogastroduodenoscopy demonstrated superficial sloughing of the esophageal mucosa consistent with EDS. Subsequent histopathologic examination confirmed the diagnosis and showed no evidence of fungal infection. Because esophageal candidiasis was initially suspected based on the endoscopic appearance, the patient was empirically treated with fluconazole and continued proton pump inhibitor therapy. Repeat endoscopy six months later demonstrated complete resolution of the esophageal abnormalities. This case highlights EDS in a patient with extensively altered foregut anatomy and illustrates its potential to mimic infectious esophagitis. Although a causal relationship between prior gastric reconstruction and EDS cannot be established, recognizing this entity and correlating endoscopic and histopathologic findings are important for accurate diagnosis.

The emergence of antifungal resistance among diverse Candida species highlights the need for a more efficient and effective approach to address this issue. Nanotechnology has emerged as a transformative approach with great promise to counter antifungal resistance, a global concern that has surged over the past two decades. Antifungal activity of zinc oxide nanoparticles (ZnO NPs), their green synthesis approaches, and mechanisms of action are promising characteristics that warrant systematic investigation. This review discusses the current literature available on ZnO NPs focusing on the approaches used in the synthesis of these nanoparticles, characterization, antifungal efficacy of these nanoparticles against Candida species, mechanisms of action, and effects on biofilm formation, potential synergistic effects with antifungal compounds, as well as their biocompatibility. From 324 PubMed and 688 Scopus records, 44 and 66 articles, respectively, were screened; after exclusions, 33 original studies (20 from Scopus and 13 from PubMed) were included in this review. Based on reviewed studies, ZnO NPs demonstrate antifungal activity against several Candida species, such as Candida albicans, C. glabrata, C. auris, C. tropicalis, C. parapsilosis, C. krusei, and C. famata, and the possible mechanisms of action of ZnO NPs are reactive oxygen species production, release of Zn²+ ions, cell membrane disruption, oxidative stress induction, inhibition of biofilm formation, and suppression of virulence genes. The green synthesis of ZnO NPs exhibited all but one of the traits required for biocompatibility. Their combination with standard antifungals enhanced antifungal activity. ZnO NPs therefore represent a promising antifungal strategy for the treatment of candidiasis. To ensure safety and therapeutic applicability, however, additional validation through standardized research, pharmacokinetic and toxicological evaluations, and well-designed clinical trials is necessary.

Nakaseomyces glabratus is an opportunistic pathogen of humans, causing invasive candidiasis (IC). Among the risk factors that favor IC are various host-specific factors. Although drugs are available to treat candidiasis, their clinical application remains limited. Therefore, it is necessary to identify therapeutic targets that will enable the development of new antifungals. In this regard, our research group has identified enzymes as potential therapeutic targets in N. glabratus, including fructose-1,6-bisphosphate aldolase (Fba1) and pyruvate kinase (Pk). Enzyme activity studies on these two enzymes have shown that they are important therapeutic targets against this pathogen. However, their three-dimensional structure has not yet been elucidated, an essential requirement for designating an enzyme as a therapeutic target. To propose Fba1 and Pk of N. glabratus as potential therapeutic targets, we investigated the solution structure and oligomeric state of N. glabratus Fba1 and Pk for the first time by combining Small-Angle X-ray Scattering (SAXS) with AlphaFold3 modeling. SAXS data were collected on the B21 beamline at Diamond Light Source (Didcot, UK), providing solution-scattering profiles, molecular-weight estimates, and low-resolution molecular envelopes. These data indicate that Pk is monomeric and Fba1 homodimeric in solution were used to evaluate and refine the corresponding AlphaFold3 atomic models by molecular dynamics. These structural findings for Fba1 and Pk from N. glabratus open the door to understanding these enzymes as potential therapeutic targets against this pathogen and, at the same time, a basis for future comparative studies.

Background/Objectives: Cutaneous fungal infections remain a major therapeutic challenge due to poor skin penetration and emerging antifungal resistance of current treatments. Drug repurposing offers a promising strategy to expand antifungal therapy, with ketoprofen (KPN) recently demonstrating antifungal activity. Methods: In this study, KPN-cationic aspasomes (Ca-ASPMs) were developed using a Quality by Design (QbD) approach to enhance topical delivery and maximize the therapeutic potential of repurposed KPN. A D-optimal experimental design was implemented to investigate the influence of ascorbyl palmitate amount (X1), ethanol concentration (X2), and cationic SAA type (X3) on the critical quality attributes of KPN-Ca-ASPMs, namely entrapment efficiency, particle size, and zeta potential. Results: Numerical optimization identified an optimum formulation comprising 10 mg ascorbyl palmitate, 5% ethanol, and didodecyldimethylammonium bromide (DDAB) as cationic SAA, with an overall desirability of 0.815. The optimal KPN-Ca-ASPM (F9) exhibited nanosized vesicles (213.24 ± 2.20 nm) and 91.30 ± 10.01% entrapment efficiency. TEM confirmed the spherical morphology of the vesicles, while DSC demonstrated successful incorporation of KPN within the aspasomal matrix. F9 exhibited enhanced in vitro drug release (68% after 6 h) and excellent storage stability. Confocal laser scanning microscopy demonstrated enhanced skin penetration of F9. In a murine cutaneous candidiasis model, F9 significantly enhanced the antifungal efficacy of KPN, producing a 2.989-log reduction in fungal burden compared with the untreated group and significantly outperforming the free drug (p = 0.0005). Histopathological examination confirmed restoration of normal skin architecture. Conclusions: Collectively, the QbD-guided development of KPN-Ca-ASPM provided a reproducible nanocarrier that significantly enhanced the topical antifungal efficacy of repurposed KPN, highlighting its potential for the treatment of cutaneous candidiasis.

Background: Spontaneous abortion is a complex multifactorial disease. Recently, vaginal microbiota has become a research hotspot for understanding the etiology of spontaneous abortion. Here, we aimed to explore associations of first-trimester vaginal microecology with adverse pregnancy outcomes. Methods: A retrospective cohort study included 786 pregnant women receiving prenatal care at Fujian Maternity and Child Health Hospital between 2023 and 2025. All participants underwent vaginal microecological examinations. Study outcomes included abortion, preterm birth (PTB), prelabor rupture of the membranes (PROM), intrapartum fever, meconium-stained amniotic fluid, etc. The logistic regression analysis was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between vaginal microecological parameters and these outcomes. Results: Of 786 participants, 160 (20.4%) had spontaneous abortion, and 626 (79.6%) delivered. The mean vaginal Lactobacillus proportion was significantly lower in the spontaneous abortion group (42.5 ± 35.85%) than in the non-abortion group (61.6 ± 26.72%; p < 0.001). After age adjustment, vulvovaginal candidiasis (VVC) (OR = 2.17, 95% CI = 1.34-3.52, p = 0.001), bacterial vaginosis (BV) (OR = 3.19, 95% CI = 1.89-5.38, p < 0.001), and moderate-to-severe aerobic vaginitis (AV) (OR = 2.71, 95% CI = 1.08-6.82, p = 0.034) were associated with elevated spontaneous abortion risk. Among enzymatic markers, inflammation-related leukocyte esterase was also associated with higher spontaneous abortion risk (OR = 2.22, 95% CI = 1.39-3.61, p < 0.001). In addition, BV was significantly associated with PROM (OR = 2.95, 95% CI = 1.50-5.79, p = 0.002). Conclusion: Reduced Lactobacillus abundance and pathogenic proliferation linked to BV and VVC constitute a risk factor for spontaneous abortion. These findings suggest the potential clinical value of vaginal microecological monitoring in early-trimester pregnancy.

Vulvovaginal candidiasis (VVC) is one of the most common superficial fungal infections affecting women. A particularly challenging issue is the treatment of recurrent vulvovaginal candidiasis (RVVC)-defined as ≥4 episodes of VVC within 12 months-which affects 5-8% of women with VVC. The development of VVC is influenced by many risk factors related to the host organism and behaviour, including disturbances in the vaginal microflora, hormonal fluctuations, diabetes, hygiene and sexual behaviour. Although C. albicans remains the primary species causing this infection, infections caused by other species, such as Nakaseomyces glabratus and Pichia kudriavzevii, are becoming increasingly common, partly due to the widespread use of azole antifungal drugs and growing drug resistance. Therefore, this publication focuses on a review of the newest literature concerning the epidemiology, diagnosis, current approaches to antifungal susceptibility testing and treatment according to global guidelines. According to the literature, precise species identification and drug susceptibility testing are crucial to avoid therapeutic errors and drug resistance. Moreover, new antifungal drugs such as tetrazoles (oteseconazole) and triterpenoids (ibrexafungerp) are entering clinical practice, offering high efficacy against resistant strains. Probiotics used as adjuvant therapy help restore the homeostasis of the vaginal microbiome; however, due to inconsistent evidence, they are currently not included in treatment recommendations.

Background and Objectives: Pregnancy is accompanied by physiological, hormonal, immunological, and metabolic changes that may increase susceptibility to infections and adverse maternal or fetal outcomes. This study aimed to evaluate hygiene- and nutrition-related behaviors among pregnant or previously pregnant women and to assess their associations with infections, pregnancy complications, and pregnancy outcomes. Materials and Methods: An observational, descriptive, and analytical cross-sectional study was conducted using an anonymous questionnaire administered to women aged 18-40 years from Timiș County, Romania, who were currently pregnant or had experienced at least one previous pregnancy. A total of 361 participants were included in the final analysis. Descriptive and bivariate analyses were performed, followed by multivariable binary logistic regression. Multicollinearity was assessed using variance inflation factors, and Firth's penalized logistic regression was performed as a sensitivity analysis. Results: In multivariable analyses, occasional intimate hygiene, compared with twice-daily intimate hygiene, was associated with higher odds of vaginal candidiasis (aOR = 6.63; 95% CI: 2.29-19.17) and urinary tract infection (aOR = 4.36; 95% CI: 1.73-10.99). An unbalanced diet was associated with higher odds of pregnancy complications compared with a balanced diet (aOR = 2.33; 95% CI: 1.26-4.30). Compared with women reporting three or more supplements, women reporting no supplementation had markedly higher odds of an adverse pregnancy outcome (aOR = 46.15; 95% CI: 20.45-104.15), while each additional previous abortion was associated with higher odds of an adverse outcome (aOR = 2.25; 95% CI: 1.41-3.59). Firth sensitivity analysis attenuated the estimate for no supplementation (OR = 37.54; 95% CI: 17.89-85.32) but did not materially change the principal findings. Conclusions: Intimate hygiene frequency, nutritional supplementation, perceived diet quality, and reproductive history were associated with pregnancy-related outcomes in this study. These findings support structured prenatal assessment and counselling regarding nutrition, evidence-based supplementation, reproductive history, and appropriate hygiene practices. Because of the cross-sectional observational design and potential residual confounding, the findings should be interpreted as associations rather than causal effects.

The vaginal ecosystem undergoes profound physiological adaptations during pregnancy and the puerperium through dynamic interactions among the vaginal microbiota, epithelial barrier, local immune system, and hormonal milieu. Disruption of this homeostasis may lead to vaginal dysbiosis and infection, with potential consequences for maternal, fetal, and neonatal health. This narrative review aimed to provide a comprehensive and updated overview of the vaginal ecosystem throughout pregnancy and the puerperium, integrating current evidence on physiological changes in the vaginal microbiota, mechanisms of dysbiosis, major vaginal infections, diagnostic approaches, therapeutic management, and maternal-fetal implications. A structured literature search was conducted in PubMed/MEDLINE and Scopus through July 2026. Priority was given to recent systematic reviews, meta-analyses, international clinical guidelines, randomized clinical trials, and observational studies addressing the vaginal microbiota, dysbiosis, bacterial vaginosis, vulvovaginal candidiasis, trichomoniasis, aerobic vaginitis, pregnancy, and the puerperium. Pregnancy is generally characterized by a stable, low-diversity, Lactobacillus-dominated vaginal microbiota, whereas the postpartum period is associated with reduced Lactobacillus abundance, increased microbial diversity, and gradual restoration of eubiosis. Disruption of this ecosystem promotes biofilm formation, microbial persistence, inflammation, and ascending infection. Bacterial vaginosis, vulvovaginal candidiasis, trichomoniasis, and aerobic vaginitis represent the major vaginal infections during pregnancy and the puerperium and have varying associations with adverse outcomes, including preterm birth, preterm premature rupture of membranes, chorioamnionitis, postpartum infection, and neonatal morbidity. Molecular diagnostics and microbiome profiling have improved etiological characterization, while emerging microbiome-directed interventions offer potential strategies for restoring vaginal homeostasis. Current evidence supports an increasingly ecosystem-centered approach to vaginal health during pregnancy and the puerperium. Accurate etiological diagnosis and evidence-based treatment remain essential, while preservation and restoration of vaginal homeostasis may represent important complementary objectives for improving maternal, fetal, and neonatal outcomes.

Background/Objectives: Dedicator of cytokinesis 8 (DOCK8) deficiency is an autosomal recessive combined immunodeficiency and an actin cytoskeleton-related inborn error of immunity characterized by severe atopy, recurrent infections, and broad immune dysregulation. We aimed to describe the clinical, immunological, genetic, treatment-related, and outcome features of children with genetically confirmed DOCK8 deficiency, emphasizing immune dysregulation and systemic involvement. Methods: We retrospectively reviewed 17 pediatric patients from 14 unrelated kindreds with genetically confirmed DOCK8 deficiency followed at a tertiary pediatric immunology center between 2005 and 2026. Demographic data, infectious and allergic manifestations, autoimmune and hematological findings, organ involvement, malignancy, laboratory parameters, genetic findings, hematopoietic stem cell transplantation (HSCT) status, and survival outcomes were analyzed descriptively. Results: Twelve patients were male (70.6%), and parental consanguinity was present in 13 patients (76.5%). The median age at symptom onset was 5 months (IQR, 3-10), whereas the median age at diagnosis was 44 months (IQR, 23-56). A history of eczema was documented in all patients. Recurrent skin infections occurred in 16 patients (94.1%), recurrent pneumonia in 13 (76.5%), mucocutaneous candidiasis in 10 (58.8%), and cytomegalovirus infection in four (23.5%). Confirmed autoimmune manifestations were documented in two patients, including autoimmune hepatitis and autoimmune hemolytic anemia. Malignancy occurred in two patients: gastrointestinal stromal tumor and cutaneous squamous cell carcinoma. Additional uncommon systemic manifestations included sclerosing cholangitis, giant aortic aneurysm, and chronic pancreatitis. HSCT was performed in 12 patients (70.6%); complete clinical recovery was achieved in 11, whereas one patient died after transplantation. Four of five non-transplanted patients died during follow-up. Conclusions: Pediatric DOCK8 deficiency showed an early-onset, severe, multisystem phenotype. Beyond infections and atopy, immune dysregulation-related and systemic manifestations were clinically important. Favorable HSCT outcomes were consistent with previous evidence supporting early molecular diagnosis and timely transplant evaluation.

Dental infections continue to pose a major health concern worldwide, driven by persistent microbial biofilms, dysregulated host responses, and suboptimal efficacy of conventional antimicrobial therapies. The emergence of nanotechnology has facilitated the development of therapeutic approaches that offer spatiotemporal, minimally invasive, and resistance-preventing alternatives for treating complex dental infections. This review critically assesses novel nanomaterial-based therapies designed to directly eradicate pathogenic microorganisms involved in periodontal disease, dental caries, oral candidiasis and endodontic infections. We first explore the roles of microbial dysbiosis and biofilm-associated pathogenicity as key factors in disease progression, thereby providing a biological rationale for targeted therapies. Particular emphasis is placed on pathogen-directed modalities such as photodynamic, photothermal, sonodynamic, chemodynamic, and nanozyme-based therapies, which allow localized microbial eradication while reducing antibiotic resistance. The design and effectiveness of multifunctional nanomaterials, ranging from bioactive nanoparticles and polymeric hydrogels to microsphere-based delivery systems and implant surface modifications, are analysed in the context of antimicrobial efficacy, biofilm disruption, and compatibility with regenerative processes. Meanwhile, recent advances in integration with tissue regeneration and the potential of artificial intelligence in diagnosis, treatment strategies and materials design are explored as complementary strategies that could improve therapeutic outcomes. By consolidating mechanistic and translational insights, this review highlights how pathogen-targeted nanotherapeutics are revolutionizing the treatment of dental infections with more effective and clinically viable solutions.

Background: Respiratory tract candidiasis, primarily caused by Candida species, is a prevalent opportunistic fungal infection in individuals with HIV/AIDS. A high HIV viral load is considered a significant risk factor for developing respiratory fungal infection. This study aimed to identify the yeast species isolated from sputum samples of HIV-positive and HIV-negative adults, determine their antifungal susceptibility patterns, and investigate associated risk factors. Methods: A hospital-based comparative cross-sectional study was conducted from March to May 2022. Sputum samples were collected from 190 HIV-positive and 190 HIV-negative participants. Candida and other yeast species were isolated and identified, followed by antifungal sensitivity testing. Results: Of the 190 specimens from each group, 77 (40.53%) from HIV patients and 12 (6.31%) from HIV-negative participants tested positive for yeasts. Candida albicans was the most prevalent species, found in 52 (67.53%) HIV-positive patients and 12 (100%) HIV-negative patients. This was followed by Nakaseomyces glabratus (15.58%), Pichia kudriavzevii (9.09%), Candida tropicalis (6.49%), and Candida parapsilosis (1.29%) in HIV-positive patients. Notably, all 12 isolates from HIV-negative participants demonstrated 100% sensitivity to all ten tested antifungal drugs. In contrast, isolates from HIV patients showed significant resistance to fluconazole and ketoconazole (32.5% each). High viral load (p < 0.001), dermatophyte infection (p < 0.001), and antiretroviral (ARV) regimen (p = 0.030) were significantly associated with respiratory tract fungal infections in HIV patients. Conclusions: Based on this exploratory study, respiratory mycosis is frequent in HIV-positive patients in Cameroon, and identified fungi show increased resistance to azoles. While these results must be interpreted with care due to the sample size relative to the high national HIV prevalence, they suggest that public health education is needed to improve awareness. These preliminary findings prompt a review by health authorities concerning the use of fluconazole for prophylaxis in HIV-positive patients in Cameroon.

Background: The vaginal microbiota of healthy women is predominantly composed of lactic acid bacteria (LAB), particularly species from the lactobacilli group, which contribute to the maintenance of vaginal health through multiple protective mechanisms. Objectives: In the present study, vaginal LAB isolated from healthy premenopausal Algerian women were evaluated for their probiotic potential. Methods: A total of 259 LAB isolates were initially screened for antimicrobial activity against vaginal pathogens, among which 164 strains exhibited inhibitory effects. Based on antimicrobial capacity and biofilm formation ability, 38 strains were selected for further characterization. A refined subset of 15 strains belonging to Lactiplantibacillus (Lpb.) plantarum, Limosilactobacillus (Lmb.) fermentum, and Ligilactobacillus (Lgb.) salivarius were subsequently identified according to their superior antimicrobial and probiotic-related properties. The selected strains were evaluated for several functional and safety characteristics, including antimicrobial activity, production of lactic acid and hydrogen peroxide (H2O2), biofilm formation, auto-aggregation, cell surface hydrophobicity, antibiotic susceptibility, hemolytic activity, and tolerance to acidic conditions. These studies were complemented with comparative genomics using the complete genome sequences of selected strains. Results: The isolates demonstrated significant inhibitory activity against vaginal pathogens associated with aerobic vaginitis, and vulvovaginal candidiasis. In addition, strong correlations were observed between metabolite production and antimicrobial activity. Several strains also exhibited enhanced biofilm formation, aggregation capacity, and favorable safety profiles. Among the tested isolates, Lmb. fermentum 70BJ2, Lpb. plantarum 87JG8, and Lpb.plantarum N17 emerged as particularly promising probiotic candidates due to their combined antimicrobial, metabolic, and adhesion-related properties. Conclusions: Overall, these findings demonstrate that the vaginal microbiota of healthy Algerian women represents a valuable source of potential probiotic strains and provide a strong basis for future in vivo validation and clinical application in the prevention and management of vaginal infections.