title: Combinatorial drug approaches to tackle Candida albicans biofilms.
abstract: The human fungal opportunistic pathogen Candida albicans resides in the human gut, genitourinary tract and on the skin. The majority of infections caused by C. albicans are biofilm-related. In the first part of this review, we discuss new insights into C. albicans biofilm characteristics, concentrating on the extracellular matrix, phenotypic switching, efflux pumps and persister cells. It is widely accepted that this multicellular lifestyle is more resistant to traditional antifungal treatment compared to free-living cells. Therefore, much effort is put in the search for combinations of drugs leading to synergistic interactions against microbial biofilms to achieve lower effective doses of the drugs. In the second part of this manuscript, we review all recently identified compounds that act synergistically with azoles, echinocandins and/or polyenes against C. albicans biofilms.
authors.affiliation: Centre of Microbial and Plant Genetics, KU Leuven, Kasteelpark Arenberg 20, box 2460, 3001 Leuven, Belgium.
authors.forename: Kaat
authors.initials: K
authors.lastname: De Cremer
authors.forename: Ines
authors.initials: I
authors.lastname: Staes
authors.forename: Nicolas
authors.initials: N
authors.lastname: Delattin
authors.forename: Bruno P A
authors.initials: BP
authors.lastname: Cammue
authors.forename: Karin
authors.initials: K
authors.lastname: Thevissen
authors.forename: Katrijn
authors.initials: K
authors.lastname: De Brucker
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D018441:Biofilms / Q000187:drug effects*; D002176:Candida albicans / Q000187:drug effects; D002177:Candidiasis / Q000188:drug therapy*; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D006801:Humans
chemical_list: D000935:Antifungal Agents
keywords: Candida albicans; azole; biofilm; combination therapy; echinocandin; efflux pump; extracellular matrix; persister; phenotypic switching; polyene; synergy