Alireza Khodavandi, Fahimeh Alizadeh, Nedasadat Marashi,
Volume 20, Issue 11 (2-2018)
Abstract
Abstract
Background: Biofilm formation represents one of the major virulence factors of Candida albican. However, the number of antifungal drugs is limited for the treatment of candidiasis. Combination therapy is one of the most frequently used techniques to alleviate this problem. In this study, we aimed to evaluate the antifungal activity of fluconazole and terbinafine alone and in combination on C. albicans biofilm inhibition.
Materials and Methods: In this cross- sectional study, 10 clinical isolates of C. albicans were identified from the immunocompromised patients. Antifungal susceptibilities were performed using the CLSI standard reference method. The crystal violet colorimetric method, direct microscopic observation and expression of HWP1 gene at different concentrations based on MICs were carried out to investigate inhibition of biofilm formation in C. albicans treated alone and in combination with fluconazole and terbinafine.
Results: The data indicated that combination of fluconazole with terbinafine exerted synergistic effects with fractional inhibitory concentration index ranged from 0.375 to 1.5. The combination of fluconazole with terbinafine reduced the number of yeast form and inhibited the biofilm formation. Finally, the expression level of HWP1 was down regulated (p< 0.05).
Conclusion: These results suggest the possibility of fluconazole/ terbinafine to treat candidiasis with a higher efficiency. In addition, HWP1 gene could be probable target in synergistic interaction of fluconazole/ terbinafine against C. albicans biofilm.
Alireza Khodavandi, Fahimeh Alizadeh, Parisa Rastgo,
Volume 28, Issue 6 (1-2026)
Abstract
Introduction: The emergence of antifungal resistance in Candida albicans diseases poses a threat to global public health. New treatments are needed to target C. albicans and its ability to produce hyphae. The aim of this study was to investigate the potential synergistic effects and antifungal properties of Thymus vulgaris and Trigonella foenum-graecum extracts alone and in combination on C. albicans.
Methods: In this experimental study, extracts of Thymus vulgaris and Trigonella foenum-graecum were prepared using hot water (60 °C) and Soxhlet extraction with methanol (10%). Yeast susceptibility testing was performed according to the Clinical and Laboratory Standards Institute disk diffusion and broth microdilution guidelines. The hyphal model was created in the presence of alcoholic extracts of Thymus vulgaris and Trigonella foenum-graecum alone and in combination. Crystal violet staining, microscopic observation and gene expression analysis were used to evaluate the inhibition of hyphal growth.
Results: The results showed that 90% of the C. albicans isolates were resistant to fluconazole. Aqueous and alcoholic extracts of Thymus vulgaris in combination with Trigonella foenum-graecum showed synergistic, partially synergistic and additive effects. Alcoholic extracts of Thymus vulgaris with Trigonella foenum-graecum alone and in combination have anti-hyphae activity by reducing the percentage of hyphae, reducing the number of planktonic cells and the transition of planktonic cells to hyphae, and down-regulating the Secreted Aspartyl Proteinase 1 (SAP1) gene.
Conclusions: Taken together, these results indicate that extracts of Thymus vulgaris alone and in combination with Trigonella foenum-graecum may offer a potent alternative strategy to combat resistant C. albicans infections and their ability to reduce hyphae formation. Additionally, the SAP1 gene could be a likely target in the synergistic interaction of alcoholic extracts of Thymus vulgaris in combination with Trigonella foenum-graecum against the C. albicans hyphae model.
