Synergistic Effects and Mechanisms of Budesonide in Combination with Fluconazole against Resistant Candida albicans

PLoS One. 2016 Dec 22;11(12):e0168936. doi: 10.1371/journal.pone.0168936. eCollection 2016.

Abstract

Candida albicans is an important opportunistic pathogen, causing both superficial mucosal infections and life-threatening systemic diseases in the clinic. The emergence of drug resistance in Candida albicans has become a noteworthy phenomenon due to the extensive use of antifungal agents and the development of biofilms. This study showed that budesonide potentiates the antifungal effect of fluconazole against fluconazole-resistant Candida albicans strains both in vitro and in vivo. In addition, our results demonstrated, for the first time, that the combination of fluconazole and budesonide can reverse the resistance of Candida albicans by inhibiting the function of drug transporters, reducing the formation of biofilms, promoting apoptosis and inhibiting the activity of extracellular phospholipases. This is the first study implicating the effects and mechanisms of budesonide against Candida albicans alone or in combination with fluconazole, which may ultimately lead to the identification of new potential antifungal targets.

MeSH terms

  • Antifungal Agents / administration & dosage
  • Antifungal Agents / pharmacology*
  • Apoptosis / drug effects
  • Biofilms / drug effects
  • Budesonide / administration & dosage
  • Budesonide / pharmacology*
  • Candida albicans / drug effects*
  • Drug Resistance, Fungal*
  • Drug Synergism
  • Drug Therapy, Combination
  • Fluconazole / administration & dosage
  • Fluconazole / pharmacology*
  • Microbial Sensitivity Tests
  • Phospholipases / antagonists & inhibitors

Substances

  • Antifungal Agents
  • Budesonide
  • Fluconazole
  • Phospholipases

Grants and funding

This work was supported by 2015GSF118022 from Finance Department of Shandong Province of China (http://www.sdcz.gov.cn/) and 2016GSF201187 from Finance Department of Shandong Province of China (http://www.sdcz.gov.cn/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.