Antifungal Effect and Inhibition of the Virulence Mechanism of D-Limonene against Candida parapsilosis.

Yeasts from the Candida parapsilosis complex are clinically relevant due to their high virulence and pathogenicity potential, such as adherence to epithelial cells and emission of filamentous structures, as well as their low susceptibility to antifungals. D-limonene, a natural compound, emerges as a promising alternative with previously described antibacterial, antiparasitic, and antifungal activity; however, its mechanisms of action and antivirulence activity against C. parapsilosis complex species have not been elucidated. Therefore, in the present study, we aimed to evaluate the antifungal and antivirulence action, as well as the mechanism of action of D-limonene against isolates from this complex. D-limonene exhibited relevant antifungal activity against C. parapsilosis complex yeasts, as well as excellent antivirulence activity by inhibiting yeast morphogenesis and adherence to the human epithelium. Furthermore, the apoptotic mechanism induced by this compound, which is not induced by oxidative stress, represents an important target for the development of new antifungal drugs.

Anti-biofilm effect by the combined action of fluconazole and acetylsalicylic acid against species of Candida parapsilosis complex.

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.

Use of the natural products from the leaves of the fruitfull tree Persea americana against Candida sp. biofilms using acrylic resin discs.

The search for natural substances such as plant extracts with antimicrobial properties has considerably increased, given that biofilms constitute a barrier against antifungal therapy, where these can be formed on any surface, such as acrylic resin prosthesis. The objective of this study was to identify the chemical composition of the Persea americana Mill. leaf ethanol extract (EEFPa) using the UPLC-QTOF-MS/MS technique, to verify its antifungal activity through a sensitivity test according to the conditions described in the documents in M27-A3 (CLSI, 2008) and M60 (CLSI, 2017), to induce biofilm formation in acrylic resin discs and quantify their formation using tetrazolium salt reduction (MTT), as well as to treat these with the extract and fluconazole. Ten of the twelve compounds present in the extract were identified. In the sensitivity test the lowest minimum inhibitory concentration observed was 512 µg/mL, while fluconazole concentrations ranged from 64 to 1 µg/mL. During biofilm induction, all the isolates were able to form biofilms within 48 h. During biofilm treatment, the extract was less effective at biofilm reduction than Fluconazole. The EEFPa showed significant antifungal activity against some of the strains in this study, however the extract showed lower effect when compared to fluconazole against the biofilm formation.

Evaluation of the Antifungal Activity of the Licania Rigida Leaf Ethanolic Extract against Biofilms Formed by Candida Sp. Isolates in Acrylic Resin Discs.

Candida sp. treatment has become a challenge due to the formation of biofilms which favor resistance to conventional antifungals, making the search for new compounds necessary. The objective of this study was to identify the composition of the Licania rigida Benth. leaf ethanolic extract and to verify its antifungal activity against Candida sp. and its biofilms. The composition identification was performed using the ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-QTOF-MS/MS) technique. The antifungal activity of extract and fluconazole against planktonic cells and biofilms was verified through the minimum inhibitory concentration (MIC) following biofilm induction and quantification in acrylic resin discs by reducing tetrazolic salt, with all isolates forming biofilms within 48 h. Six constituents were identified in the extract, and the compounds identified are derivatives from phenolic compounds such as flavonoids (epi) gallocatechin Dimer, epigallocatechin and gallocatechin, Myricetin-O-hexoside, Myricitrin, and Quercetin-O-rhamnoside. The extract reduced biofilm formation in some of the strains analyzed, namely C. tropicalis URM5732, C. krusei INCQS40042, and C. krusei URM6352. This reduction was also observed in the treatment with fluconazole with some of the analyzed strains. The extract showed significant antifungal and anti-biofilm activities with some of the strains tested.