Chlorhexidine (CHX) is a commonly used antiseptic in oral healthcare, but its cytotoxic effects on host cells remain a significant concern. Oleuropein (OLE), a bioactive compound derived from olive leaves, has shown antimicrobial and cytoprotective properties. However, its potential to modulate CHX-induced toxicity and enhance antimicrobial efficacy remains largely unexplored.
This study investigated the antibacterial effects of CHX and OLE against resistant and susceptible bacterial strains and evaluated their effects on the viability and cell cycle of human gingival mesenchymal stem cells (GMSCs). Minimum inhibitory concentrations (MICs) of CHX and OLE were determined by evaluating 16 bacterial species. Checkerboard assays were used to assess their combined effects using fractional inhibitory concentration (FIC) indices. Cytotoxicity, apoptosis, and cell cycle distribution of GMSCs were analysed using flow cytometry. CHX exhibited strong antibacterial activity (MIC: 0.5–16 µg/mL), whereas OLE showed moderate effects (MIC: 256–2048 µg/mL). Checkerboard assays indicated a significant 64-fold reduction in the MIC of OLE, whereas the CHX MIC either increased or remained unchanged. Partial synergy was observed against only one isolate Pseudomonas aeruginosa (FIC index = 0.53125), whereas 11 strains showed indifference (1 ≤ FIC index <4) and remaining 4 of 16 isolates had possible antagonism (FIC index ≥ 4). OLE did not inhibit the bactericidal effect of CHX. However, it mitigated the CHX-induced dose-dependent reduction in GMSC viability by reducing necrosis, G0/G1 phase arrest, and enhancing DNA synthesis. CHX and OLE possess antibacterial potential, and OLE mitigates CHX-induced cytotoxicity in GMSCs. When combined, these two compounds offer considerable therapeutic benefits, particularly in dentistry. Further research is needed to optimise the concentration ratios for enhanced synergy and elucidate the underlying molecular mechanisms.
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