Abstract Candida is becoming more resistant to conventional treatments, and causes persistent and severe infections. This study evaluates the antifungal and virulence activities of the hydroalcoholic extract of Phyllanthus niruri (HE-Pn) on Candida. HE-Pn was prepared by maceration technique. Chemical composition of HE-Pn was determined using Gas Chromatography-Mass Spectrometry (GS-MS). Antifungal screening was done using agar well diffusion. CLSI M27-A3 was used to determine the Minimum Inhibitory (MIC) and Fungicidal Concentrations (MFC). Effects of HE-Pn on adhesion and germ tube of C. albicans (ATCC MYA-2876) were determined using XTT assay and germ tube formation assay, respectively. Transmission Electron Microscopy (TEM) was performed to visualize the post-exposure cellular changes. HE-Pn cytotoxicity was determined using human keratinocyte cell line (HaCaT). Chlorhexidine digluconate (2 mg/mL) was used as the positive control. Linolenic acid ethyl ester was the most abundant chemical component of HE-Pn. All strains tested were sensitive to HE-Pn. MIC were 0.03 - 8 mg/mL and MFC were 0.5 - 64 mg/mL for all test strains. C. albicans (ATCC MYA-2876) showed 50% of adhesion reduction with > 4 mg/mL of HE-Pn and germ-tube formation was inhibited with 0.25 and 2 mg/mL. TEM exhibited cytoplasmic granulation, intracellular vacuoles, detachment of cell wall and plasma membrane and chromatin condensation of Candida. No toxicity of HE-Pn was noted on HaCaT cells. HE-Pn shows an anti-Candida activity and can be used as an inhibitory agent against adhesion and germ tube formation of Candida albicans (ATCC MYA-2876) without causing any toxicity to human cells.

Ethanolic crude extracts prepared from the arils and seeds, pericarp, peels and from the whole fruit of Punica granatum, known as pomegranate, had their antifungal activity tested against Candida spp. The ethanolic crude extracts were analyzed by Mass Spectrometry and yielded many compounds such as punicalagin and galladydilacton. The extracts from the pericarp and peel showed activity against Candida spp., with MICs of 125 µg/mL. The effect of pericarp and peel extracts upon the morphological and structure of C. albicans and C. krusei were examined by scanning and transmission electron microscopy, with the visualization of an irregular membrane and hyphae, formation of vacuoles and thickening of the cell wall. The data obtained revealed potential antimicrobial activity against yeasts cells of the Candida genus, and the bioactive compounds could be responsible for changes in cell morphology and structure. The data obtained open new perspectives for future research in continuation to this study, where information such as determination of the site of action of the compounds could contribute to an alternative therapy against these organisms.

Candida-associated denture stomatitis is the most common form of oral candidal infection, with Candida albicans being the principal etiological agent. Candida adheres directly or via an intermediary layer of plaque-forming bacteria to denture acrylic. Despite antifungal therapy to treat denture stomatitis, infection is reestablished soon after the treatment ceases. In addition, many predisposing factors have been identified as important in the development of oral candidiasis, including malnourishment, common endocrine disorders, such as diabetis mellitus, antibacterial drug therapy, corticosteroids, radiotherapy and other immunocompromised conditions, such as acquired immunodeficiency syndrome (AIDS). These often results in increased tolerance to the most commonly used antifungals. So this review suggests new therapies to oral candidiasis.