From plants to particles: herbal solutions and nanotechnology combating resistant vulvovaginal candidiasis

Abstract

Despite having current advanced therapy, vulvovaginal candidiasis (VVC) remains a common yet debated healthcare-associated topic worldwide due to multi-drug resistance Candida species. In our review, we outlined and highlighted upcoming values with scope of existing and emerging information regarding the possibility of using various natural molecules combined with modern technology that shows promising anti-candida activity in VVC. Furthermore, in this review, we compiled herbal drug molecules and their nanocarriers approach for enhancing the efficacy and stability of herbal molecules. We have also summarized the patent literature available on herbal drug molecules and their nanoformulation techniques that could alternatively become a new innovative era to combat resistance VVC.

Plain language summary

There is a type of fungi called Candida that is responsible for infections like vulvovaginal candidiasis in the human vagina. Due to resistance of currently available antifungal medicines, there are side effects on the body. Therefore, researchers are studying and preparing natural-based medicine from plants which may provide very good effects on human health. Also, herbal-based medicines have shown evidence based good antifungal activity. Combinations of herbal drugs with very small-sized particles called nanomaterials have added advantage as it helps herbs (drug) to reach their target. Its activity is enhanced as it stays for longer time in the body. So, in the future more research is needed to make sure plant medicines are safe and work well on vaginal infections and its uses should be promoted so that could be a good solution for treating vaginal candidiasis.

Graphical abstract

Executive summary

Background

• Vulvovaginal candiasis is mucosal infection of lower female reproductive tract. It is caused due to polymorphic Candida albicans, a fungus of yeast family. C. albicans exists in human microbiota and commonly colonizes lower female reproductive lumen (vaginal lumen) asymptomatically.

Major challenges in marketed antifungal medication

• Emergence and fast development of resistance.

• Adverse side effects.

• Patient non-compliance issues.

Objective toward using herbal medicine

• Design and development of herbal based medication is necessary to counteract resistance and also it has lesser side effects and notably they are well accepted in the masses.

• Herbal drug molecules alone or in combination with application of novel drug-delivery systems may be useful in combating bacterial resistance.

Importance of integration between nanomaterials & natural constituents

• Traditional herbal formulations and phytoconstituents have limitations like penetration to the target area, stability and compatibility.

• Nanocarriers-based approach could be beneficial to enhance the efficacy and to overcome challenges associated with delivery of herbal drugs.

• This review is focused on various nanocarrier delivery systems encapsulating herbal drug molecules or essential oils.

Keywords: :

• Candida albicans
• essential oil (EO)
• herbal combination
• nanoherbal formulation
• pathogenesis
• plants
• vulvovaginal candidiasis (VVC)

Author contributions

M Dalabehera: wrote the whole manuscript, draw figures and tables, C Rathore: study concept and design, A Rathee: draw chemical structure, UR Lal: investigation and visualization.

Financial disclosure

The authors have no financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Competing interests disclosure

The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, stock ownership or options and expert testimony.

Writing disclosure

No writing assistance was utilized in the production of this manuscript.

Present review provides required herbal molecule and combinations with recent advancement based formulation that shows promising anti candida activity in VVC as it embrace herbal activity and overcome challenges associated with delivery of herbal drug like penetrate to reach their target in active form, stability and compatibility. This offers potential alternatives with enhanced tolerance against candida. In this context numerous reported studies came up with either herbal formulation their implementation solely. But neither of them concerns regarding compilations of various summarized study regarding herbal and its combinations activities, comparison between herbal molecule and synthetic drug, novel nanoherbal formulations, clinical trials and patents. And their uses against candida that could be implement further towards benefits of mankind.