title: Synergistic Effects and Mechanisms of Budesonide in Combination with Fluconazole against Resistant Candida albicans.
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.
authors.affiliation: School of Pharmaceutical Sciences, Shandong University, Jinan, Shandong Province, People's Republic of China.
authors.forename: Xiuyun
authors.initials: X
authors.lastname: Li
authors.affiliation: Respiration Medicine, Qianfoshan Hospital Affiliated to Shandong University, Jinan, Shandong Province, People's Republic of China.
authors.forename: Cuixiang
authors.initials: C
authors.lastname: Yu
authors.affiliation: Pharmaceutical Department, Qianfoshan Hospital Affiliated to Shandong University, Jinan, Shandong Province, People's Republic of China.
authors.forename: Xin
authors.initials: X
authors.lastname: Huang
authors.affiliation: Pharmaceutical Department, Qianfoshan Hospital Affiliated to Shandong University, Jinan, Shandong Province, People's Republic of China.
authors.forename: Shujuan
authors.initials: S
authors.lastname: Sun
mesh_terms: D000935:Antifungal Agents / Q000008:administration & dosage / Q000494:pharmacology*; D017209:Apoptosis / Q000187:drug effects; D018441:Biofilms / Q000187:drug effects; D019819:Budesonide / Q000008:administration & dosage / Q000494:pharmacology*; D002176:Candida albicans / Q000187:drug effects*; D025141:Drug Resistance, Fungal; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D015725:Fluconazole / Q000008:administration & dosage / Q000494:pharmacology*; D008826:Microbial Sensitivity Tests; D010740:Phospholipases / Q000037:antagonists & inhibitors
chemical_list: D000935:Antifungal Agents; D019819:Budesonide; D015725:Fluconazole; D010740:Phospholipases