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Efficacy of Flavonoids in Combating Fluconazole Resistant Oral Candidiasis
Dipti Srivastava1, Aarti Yadav1, Salma Naqvi2
1Amity Institute of Pharmacy, Lucknow, Amity University Uttar Pradesh, Sector 125, Noida, 201313, India.
Background:
Candida is an opportunistic fungus often present in the oral mucosa. In the compromised immune system, it may become pathogenic and cause oral candidiasis. This infection is more common with Candida albicans; though, non-albicans Candida spp also have significant relevance. Current treatment guidelines include polyenes, azoles and echinocandins, where fluconazole is the primary therapeutic option. However, both inherited and acquired resistance to fluconazole is exhaustively reported. The development of resistance has resulted in the worsening of the original and re-emergence of new fungal diseases. Thus, the development of an anti-candidiasis therapy with a satisfactory outcome is the urgent need of the hour.
Objective:
This review article aims to stimulate research in establishing the synergistic efficacy of various flavonoids with fluconazole to combat the resistance and develop an effective pharmacotherapy for the treatment of oral candidiasis. Further, in this article, we discuss in detail the mechanisms of action of fluconazole, along with the molecular basis of the development of resistance in Candida species.
Methods:
PubMed and other databases were used for literature search.
Results:
The designing of natural drugs from the plant-derived phytochemicals are the promising alternatives in modern medicine. The challenge today is the development of alternative anti-oral candidiasis drugs with increased efficacy, bioavailability and better outcome which can combat azole resistance. Identifying the flavonoids with potential antifungal action at low concentrations seems to meet the challenges.
Conclusion:
Phyto-active constituents, either alone or in combination with conventional antibiotics may be an effective approach to deal with global antimicrobial resistance. The efficacy of herbal therapy for decades suggests that bacteria, fungi, and viruses may have a reduced ability to adapt and resistance to these natural antimicrobial regimes.
Insights
Flavonoids show promise as natural antifungal agents to combat fluconazole-resistant oral candidiasis. Research into synergistic combinations could lead to new, effective treatments for this common fungal infection.
Area of Science:
- Mycology
- Pharmacology
- Natural Product Chemistry
Background:
- Candida species are opportunistic fungi causing oral candidiasis, particularly in immunocompromised individuals.
- Fluconazole is a primary treatment, but rising resistance necessitates alternative therapies.
- Non-albicans Candida species also contribute significantly to oral candidiasis.
Purpose of the Study:
- To review the potential of flavonoids as synergistic agents with fluconazole against Candida.
- To explore the mechanisms of action and resistance of fluconazole in Candida species.
- To stimulate research into novel pharmacotherapies for oral candidiasis.
Main Methods:
- Literature search conducted using PubMed and other databases.
- Review of existing research on Candida, fluconazole resistance, and flavonoids.
- Analysis of mechanisms of action and resistance pathways.
Main Results:
- Flavonoids are promising natural drug candidates for treating oral candidiasis.
- Identifying flavonoids with potent antifungal activity at low concentrations addresses azole resistance.
- Plant-derived phytochemicals offer alternatives with potential for increased efficacy and bioavailability.
Conclusions:
- Flavonoids, alone or combined with conventional drugs, can combat antimicrobial resistance.
- Herbal therapies demonstrate reduced microbial adaptability, suggesting efficacy against fungi.
- Developing flavonoid-based therapies is a viable strategy against resistant Candida infections.
