An in Vitro Study on the Effect of Combined Treatment with Photodynamic and Chemical Therapies on Candida albicans

Int J Mol Sci. 2018 Jan 24;19(2):337. doi: 10.3390/ijms19020337.

Abstract

Candida albicans is the most commonly encountered human fungal pathogen, and it is traditionally treated with antimicrobial chemical agents. The antimicrobial effect of these agents is largely weakened by drug resistance and biofilm-associated virulence. Enhancement of the antimicrobial activity of existing agents is needed for effective candidiasis treatment. Our aim was to develop a therapy that combined biofilm disruption with existing antimicrobial agents. Photodynamic therapy (PDT) utilizing curcumin and blue light was tested as an independent therapy and in combination with fluconazole treatment. Viability assays and morphology analysis were used to assess the effectiveness of C. albicans treatment. Results showed that fluconazole treatment decreased the viability of planktonic C. albicans, but the decrease was not as pronounced in adherent C. albicans because its biofilm form was markedly more resistant to the antimicrobiotic. PDT effectively eradicated C. albicans biofilms, and when combined with fluconazole, PDT significantly inhibited C. albicans to a greater extent. This study suggests that the addition of PDT to fluconazole to treat C. albicans infection enhances its effectiveness and can potentially be used clinically.

Keywords: Candida albicans; biofilm; curcumin; fluconazole; photodynamic therapy.

MeSH terms

  • Antifungal Agents / pharmacology*
  • Antifungal Agents / therapeutic use
  • Biofilms / drug effects
  • Candida albicans / drug effects*
  • Candida albicans / growth & development
  • Candida albicans / radiation effects*
  • Candidiasis / microbiology
  • Candidiasis / therapy
  • Cell Membrane / drug effects
  • Cell Membrane / metabolism
  • Cell Membrane / radiation effects
  • Combined Modality Therapy
  • Curcumin / pharmacology
  • Curcumin / therapeutic use
  • Fluconazole / pharmacology
  • Fluconazole / therapeutic use
  • Free Radicals / metabolism
  • Humans
  • Microbial Viability / drug effects
  • Microbial Viability / radiation effects
  • Photochemotherapy*
  • Singlet Oxygen / metabolism

Substances

  • Antifungal Agents
  • Free Radicals
  • Singlet Oxygen
  • Fluconazole
  • Curcumin