title: Antifungal effects of phytocompounds on Candida species alone and in combination with fluconazole.
abstract: Invasive fungal infections caused by Candida spp. remain the most predominant nosocomial fungal infections. Owing to the increased use of antifungal agents, resistance of Candida spp. to antimycotics has emerged frequently, especially to fluconazole (FLC). To cope with this issue, new efforts have been dedicated to discovering novel antimycotics or new agents that can enhance the susceptibility of Candida spp. to existing antimycotics. The secondary metabolites of plants represent a large library of compounds that are important sources for new drugs or compounds suitable for further modification. Research on the anti-Candida activities of phytocompounds has been carried out in recent years and the results showed that a series of phytocompounds have anti-Candida properties, such as phenylpropanoids, flavonoids, terpenoids and alkaloids. Among these phytocompounds, some displayed potent antifungal activity, with minimum inhibitory concentrations (MICs) of ≤8 µg/mL, and several compounds were even more effective against drug-resistant Candida spp. than FLC or itraconazole (e.g. honokiol, magnolol and shikonin). Interestingly, quite a few phytocompounds not only displayed anti-Candida activity alone but also synergised with FLC against Candida spp., even leading to a reversal of FLC resistance. This review focuses on summarising the anti-Candida activities of phytocompounds as well as the interactions of phytocompounds with FLC. In addition, we briefly overview the synergistic mechanisms and present the structure of the antimycotic phytocompounds. Hopefully, this analysis will provide insight into antifungal agent discovery and new approaches against antifungal drug resistance.
authors.affiliation: School of Pharmaceutical Sciences, Shandong University, Jinan, Shandong Province 250012, China.
authors.forename: Mengjiao
authors.initials: M
authors.lastname: Lu
authors.affiliation: Intensive Care Unit, Qianfoshan Hospital affiliated to Shandong University, Jinan, Shandong Province 250014, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Li
authors.affiliation: Department of Respiratory, Yucheng People's Hospital, Yucheng, Shandong Province 251200, China.
authors.forename: Jianjian
authors.initials: J
authors.lastname: Wan
authors.affiliation: School of Pharmaceutical Sciences, Shandong University, Jinan, Shandong Province 250012, China.
authors.forename: Xiuyun
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Pharmacy, Baodi District People's Hospital, Tianjin 301800, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Yuan
authors.affiliation: Department of Pharmacy, Qianfoshan Hospital Affiliated to Shandong University, Jinan, Shandong Province 250014, China. Electronic address: sunshujuan888@163.com.
authors.forename: Shujuan
authors.initials: S
authors.lastname: Sun
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology*; D002175:Candida / Q000187:drug effects*; D004347:Drug Interactions; D015725:Fluconazole / Q000494:pharmacology*; D008826:Microbial Sensitivity Tests; D064209:Phytochemicals / Q000494:pharmacology*
chemical_list: D000935:Antifungal Agents; D064209:Phytochemicals; D015725:Fluconazole
keywords: Antifungal activity; Candida spp; Fluconazole; Interaction; Phytocompounds