Recurrent vulvovaginal candidiasis (RVVC) affects women worldwide and has far-reaching implications for a patient's quality of life. For decades, maintenance treatment using the azole antifungal fluconazole was the preferred treatment. Although efficient in controlling the symptoms, the development of azole resistance and high rates of recurrence after therapy cessation have emerged as significant limitations. Nevertheless, persistent efforts have delivered novel treatment options. Oteseconazole (VT-1161), marketed as VIVJOA, is an oral, tetrazole antifungal with unprecedented specificity toward the fungal lanosterol 14α-demethylase. We reviewed literature data on oteseconazole with a focus on the management of RVVC. Therapeutic options for RVVC are limited, and novel, innovative approaches are needed to treat this debilitating condition. These therapies need to be well-tolerated and prevent RVVC recurrence. The available clinical data show excellent safety and efficacy, with an unprecedentedly low recurrence rate. However, we believe health-care providers should be mindful to monitor for the development of resistance, as this may result in treatment failure. Further, the availability and cost may, like for most novel drugs, affect the widespread clinical implementation of VIVJOA. Altogether, we are convinced that VIVJOA is a significant advance in RVVC management.

Mycelium-based composites (MBCs) are highly valued for their ability to transform low-value organic materials into sustainable building materials, offering significant potential for decarbonizing the construction sector. The properties of MBCs are influenced by factors such as the mycelium species, substrate materials, fabrication growth parameters, and post-processing. Traditional fabrication methods involve combining grain spawn with loose substrates in a mold to achieve specific single functional properties, such as strength, acoustic absorption, or thermal insulation. However, recent advancements have focused on digital biofabrication to optimize MBC properties and expand their application scope. Despite these developments, existing research predominantly explores the use of grain spawn inoculation, with little focus on liquid spawn. Liquid spawn, however, holds significant potential, particularly in digital biofabrication, due to its ease of deposition and greater precision compared with grains. This paper, part of a digital biofabrication framework, investigates the growth kinetics of Ganoderma lucidum and Pleurotus ostreatus on hemp non-woven mats, offering flexibility and mold-free fabrication using liquid inoculation. By integrating mycelium growth kinetics into digital biofabricated materials, researchers can develop more sustainable, efficient, and specialized solutions using fewer resources, enhancing the adaptability and functionality of MBCs. The experiment involved pre-cultivating P. ostreatus and G. lucidum in yeast peptone dextrose (YPD) and complete yeast media (CYM) under static (ST) and shaking (SH) conditions. Four dilutions (1:10, 1:2, 1:1, and 2:1) were prepared and analyzed through imagery to assess growth kinetics. Results showed that lower dilutions promoted faster growth with full coverage, while higher dilutions offered slower growth with partial coverage. SH conditions resulted in slightly higher coverage and faster growth. To optimize the control of material properties within the digital biofabrication system, it is recommended to use CYM ST for P. ostreatus and YPD SH for G. lucidum, as their growth curves show clear separation between dilutions, reflecting distinct growth efficiencies and speeds that can be selected for desired outcomes.

Vulvovaginal candidiasis (VVC) affects millions of women globally and is characterized by multifactorial immunopathology, with Candida albicans virulence driving disease progression through epithelial tissue damage and neutrophil hyperactivation and dysfunction contributing to disease severity. Here, we explored the multifaceted nature of S. cerevisiae as a live-biotherapeutic to attenuate C. albicans virulence and modulate host immune responses during VVC. We identified an S. cerevisiae isolate (Sc3458) that targets multiple aspects of C. albicans virulence, including fungal proliferation, adhesion, and hyphal morphogenesis, collectively impairing biofilm formation and disrupting pathogenic potential. These effects were linked to transcriptional reprogramming in C. albicans, marked by metabolic stress and downregulation of virulence- and biofilm-related genes. Additionally, S. cerevisiae (Sc3458) reduced inflammatory responses and neutrophil hyperactivation, while preserving neutrophil antimicrobial functionality. Altogether, this translated to an improved control of infection and dampened VVC-associated hyperinflammation in a murine VVC model. These findings position S. cerevisiae strain Sc3458 as a promising candidate live biotherapeutic for VVC treatment. Further clinical validation in human cohorts is essential to confirm its therapeutic efficacy and to assess how Sc3458 performs relative to established market-standard formulations.

Vulvovaginal candidiasis (VVC) is a widespread fungal infection of the vaginal mucosa caused by Candida species, most notably C. albicans. Despite its high global prevalence and considerable impact on women’s health and well-being, VVC remains under-recognized and often sidelined due to the stigma surrounding intimate health and persistent gender disparities in medical research and care. Epidemiological data estimate that up to 75% of women will experience at least one episode of VVC during their lifetime, with 7-9% suffering from recurrent VVC (RVVC), defined as three or more episodes annually. This equates to an estimated 138 million cases per year worldwide. Clinically, VVC presents with distressing symptoms and signs including clumpy white discharge, burning, pruritus, erythema, and dyspareunia, which significantly impair both physical comfort and psychological well-being. Alarmingly, around 20% of affected women report inadequate relief with currently available antifungal therapies, underscoring a critical gap in treatment efficacy. Traditionally, VVC has long been treated with a singular focus on eradicating fungal load. However, growing consensus now recognizes VVC as a classic example of mucosal immunopathology. In C. albicans-driven VVC, disease pathology is not solely attributable to fungal proliferation but arises from a dysfunctional host immune response. Neutrophils, key players in antifungal immunity, are abundantly recruited to the site of infection but fail to resolve the fungal burden. Instead, they contribute to epithelial damage and perpetuate inflammatory signaling, establishing a cycle of tissue destruction and symptom persistence. This dissertation investigates Saccharomyces cerevisiae as a novel, host-compatible, live biotherapeutic product (LBP) for the treatment of VVC. S. cerevisiae strain Sc3458 was established as a scientifically validated, microbiome-compatible, and therapeutically versatile live biotherapeutic for the treatment of VVC. By simultaneously attenuating fungal virulence and recalibrating host immune responses, Sc3458 addresses both arms of the disease process. Its compatibility with endogenous lactobacilli and efficacy against multiple Candida species further reinforces its translational value. In an era marked by rising antifungal resistance and persistent gaps in women’s health, Sc3458 offers a compelling alternative to conventional therapies, one that is both mechanistically grounded and ecologically compatible.

Mycelium-based composites (MBC) are valued for converting low-value organic materials into high-performance building materials, offering significant potential for decarbonizing the construction sector. MBC properties are influenced by mycelium species, substrate materials, and fabrication growth parameters. In traditional applications, grain spawn is combined with loose particle substrates to achieve specific functional properties, such as strength, acoustic absorption, or thermal insulation, tailored to a single purpose. However, recent advancements have shifted toward creating graded materials—materials in which properties vary gradually throughout the structure. This approach allows for multiple local optimized properties to be incorporated within a single material. As a result, graded materials can support applications that require complex, multifunctional performance, making them ideal for fields like construction where multiple properties are often needed within a single component. This study, part of a digital biofabrication framework, explores controlling mycelium growth via liquid spawn. While liquid spawn has improved mechanical properties, its effects on growth performance have not been fully studied. Non-woven mats, offering flexibility and mold-free fabrication, are proposed as substrates. This paper investigates the growth kinetics of Ganoderma lucidum and Pleurotus ostreatus on hemp non-woven mats using liquid inoculation, comparing it to traditional grain spawn inoculation. By integrating graded properties into digital biofabricated materials, researchers can develop more sustainable, efficient, and specialized solutions using fewer resources, enhancing the adaptability and functionality of MBC.The experiment involved pre-cultivating P. ostreatus and G. lucidum in yeast peptone dextrose (YPD) and complete yeast (CYM) media under static (ST) and shaking (SH) conditions. Four mycelium dilutions (1:10, 1:2, 1:1, and 2:1) were prepared and analyzed through imagery to assess growth kinetics, aesthetics, and potential material properties. Results showed that lower dilutions promoted faster growth with full coverage, while higher dilutions offered slower growth with partial coverage, providing more control during incubation. Shaking conditions resulted in slightly higher coverage and faster growth. CYM medium resulted in G. lucidum and P. ostreatus closely matching the grain spawn growth curve across all dilutions, compared to YPD medium. To optimize the control of material properties within the digital biofabrication system, it is recommended to use CYM ST for P. ostreatus and YPD SH for G. lucidum, as their growth curves show clear separation between dilutions, reflecting distinct growth efficiencies and speeds that can be selected for desired outcomes. P. ostreatus should be preferred for acoustic absorption qualities due to its thin, fibrous growth, while G. lucidum is ideal for strength and aesthetic properties, thanks to its dense growth and color-changing characteristics.

Mycelium-based composites (MBC) are valued for their ability to convert low-value organic materials into sustainable building resources, making them a promising solution for decarbonizing the construction sector [1-5]. MBC performance is influencing by various factors including mycelium species, substrate composition, growth conditions, and post-processing techniques [1,6]. Conventional fabrication methods involve combining grain spawn with loose organic material to achieve specific functional properties, such as strength, acoustic absorption, or thermal insulation [7,8]. Recent advancements have increasingly focused on digital biofabrication methods to enhance growth, improve material properties, and shape mycelium materials with a primary focus on additive manufacturing (AM) [9-14]. This approach integrates lignocellulosic substrates with fungal inoculation to create complex composite structures. Most experiments use an extrudable paste to construct scaffolds, with studies investigating the effects of inoculating the paste either before or after fabrication [15-20]. Liquid spawn, however, holds significant potential, particularly in AM, due to its ease of deposition and greater precision compared to grain spawn. Combining liquid spawn and AM has the potential to control localized growth within MBC, enabling more precise material customization. I propose a new digital biofabrication framework that consists of three key components: (1) computational design, which analyzes material functionalities and generates robotic actions; (2) robotic fabrication, which executes inoculation and time-dependent actions; and (3) biological material selection, encompassing mycelium species and substrate composition.