On the in vivo assessment of goblet cells of the human bulbar conjunctiva by confocal microscopy - A review
CONTACT LENS & ANTERIOR EYE
Authors: Doughty, Michael J.
Abstract
Background: In vivo confocal microscopy (IVCM) has been used for over 10 years to assess the goblet cell density (GCD) within the human conjunctiva, but the reported values have been variable with no obvious indications as to why. Methods: From publications between 2008 and 2019, representative GCD values were extracted, as well as on the image sampling strategy used. Results: Average GCD values for any particular group of individuals ranged from 7 to 979 goblet cells / sq. mm, and with one notable outlier removed, an overall group -mean value for GCD (+/ - SD) from single site locations was 207 +/ - 143 goblet cells / sq. mm from 15 data sets for those usually designated as control subjects, with a value of 190 +/ - 161 goblet cells / sq. mm calculated from 20 single site data sets from other (patient) groups. An overall analysis indicated that the reported average values for GCD from different groups of individuals increased according to the number of images assessed / individual (Spearman rho = 0.304), on the number of individuals evaluated to generate an averaged value for each group (rho = 0.367), and the total number of images assessed (rho = 0.346, multivariate analysis partial r = greater or = to 0.522). Conclusions: In the use of confocal microscopy to assess the number of goblet cells in the human bulbar con- junctiva, the substantial differences reported appear to be linked to the protocols used for image selection, and some type of standardization needs to be developed.
Anti-biofilm effect by the combined action of fluconazole and acetylsalicylic acid against species of Candida parapsilosis complex
INFECTION GENETICS AND EVOLUTION
Authors: Graciano dos Santos, Franz de Assis; Leite-Andrade, Melyna Chaves; Brandao, Ildnay de Sousa; da Silva Alves, Adryelle Idalina; Silva Buonafina, Maria Daniela; Nunes, Michellangelo; de Araujo-Neto, Luiz Nascimento; de Freitas, Maria Audilene; Brayner, Fabio Andre; Alves, Luiz Carlos; Melo Coutinho, Henrique Douglas; Neves, Rejane Pereira
Abstract
The Candida parapsilosis complex has been associated with highly refractory infections mainly due to the presence of biofilms. High glucose levels enable the development of this virulence factor which can aggravate the clinical condition of patients with diabetes mellitus, those using parenteral nutrition, with invasive medical device, including others. Combined antifungal therapy, such as azole and cyclooxygenase inhibitors, may be an alternative in such infections since they modulate prostaglandin production favoring the adhesion and development of biofilms. Thus, the present study aimed to evaluate the influence of glucose supplementation in the formation and detection of Candida parapsilosis complex biofilms and to treat them using fluconazole and a cyclooxygenase inhibitor in combination. Protein spectra evaluation allowed the differentiation between species from the complex (score > 2) in our studies. All isolates were able to form active biofilms at different glucose concentrations. In addition, a significant reduction in biofilm formation was observed when fluconazole and acetylsalicylic acid were combined. The ultrastructural analysis presented typical biofilm characteristics by species from the complex. These data support new combined therapies for the treatment of fungal infections, especially with those which are resistant and therapeutic failure is associated with virulence factors.