Investigation of Hungarian mushrooms for antibacterial activity and synergistic effects with standard antibiotics against resistant bacterial strains

Abstract This study aimed to screen the antibacterial activity of 160 extracts of 40 mushroom species, collected in Hungary, against 11 standard bacterial strains and 9 clinical isolates. The further objective of this work was to evaluate the capacity of active fungal extracts to potentiate the action of antibiotics against resistant pathogens. Disc-diffusion method was applied for screening of antibacterial activity of extracts. Microdilution method was used to determine minimum inhibitory concentrations. The active extracts were applied to different resistant micro-organisms (multiresistant Acinetobacter baumannii and Pseudomonas aeruginosa, vancomycin-resistant Enterococcus faecium and MRSA), combined with commercial drugs. The synergism between extracts and antibiotics was assessed by double-disc synergy assay and determination of fractional inhibitory concentration (FIC) with checkerboard technique. From 40 mushrooms included in this experiment, 16 species exhibited antibacterial effects with moderate to high potential. In general the chloroform extracts proved to be most active, while the aqueous and aqueous-methanolic extracts demonstrated low or no activity. Fistulina hepatica, Tapinella atrotomentosa (syn. Paxillus atrotomentosus) and Rhodocybe popinalis were the most active species; moreover, they can potentiate the action of cefuroxime against MRSA. Significance and Impact of the Study In this study, 160 organic (n-hexane, chloroform and 50% methanol) and aqueous extracts of 40 mushroom species were submitted to antibacterial screening assay. The antibacterial capacity of 18 species has been examined for the first time. Nineteen extracts of 16 species showed antibacterial effects with moderate to high potential. The extracts of Fistulina hepatica, Tapinella atrotomentosa and Rhodocybe popinalis exhibited not only broad antibacterial spectrum, but also synergistic activity with cefuroxime against MRSA. Our screening study proved that mushroom species are promising sources of potential antimicrobial molecules. The results serve as good starting point for selection of fungal species for detailed pharmacological and chemical investigation. </jats:sec

Real-life effectiveness of dupilumab in chronic rhinosinusitis with nasal polyps: results from eight Hungarian centres with 12-month follow-up

Background: Research on the immune mechanism behind chronic rhinosinusitis (CRS) has revealed various new endotypes, leading to targeted therapies, especially for severe uncontrolled CRS. Biologics are novel therapeutic strategies providing targeted treatment for the difficult-to-treat recalcitrant CRSwNP patients. Dupilumab is a fully human-derived monoclonal antibody that binds to IL4Rα, inhibiting the signalling of both IL-4 and IL-13. In Hungary, it is approved for the treatment of uncontrolled CRSwNP according to criteria based on the EPOS2020 and the Hungarian guidelines. Methodology: This study aimed to collect and evaluate real-world therapeutic data of CRSwNP patients treated with dupilumab. One hundred thirty-five patients from eight different referral centres have been enrolled in this study, who received dupilumab since 2020. All subjects were adult patients (>18 years) with uncontrolled CRSwNP. Baseline data collection included demographics, medical history, previous surgeries, related comorbidities, total endoscopic nasal polyp score (NPS), SNOT22, nasal congestion parameters measured with visual analogue scale (VAS) and nasal obstruction evaluation scale (NOSE), loss of smell score (LSS) and eosinophil count. 300 mg dupilumab was administered subcutaneously every second week. Follow up visits were performed after 6 and 12 months. Results: After 6 and 12 months of treatment significant improvement was detected in all clinical parameters. Safety was proved, no severe side effects occurred, and no rescue treatment was necessary. Conclusions: Our real-life findings show that continuous dupilumab treatment is effective and safe in daily clinical practice in CRSwNP and other type 2 comorbidities such as bronchial asthma and NERD