Abstract
Candida albicans is a common microorganism of human’s microbiota and can be easily found in both respiratory and gastrointestinal tracts as well as in the genitourinary tract. Approximately 30% of people will be infected by C. albicans during their lifetime. Due to its easy adaptation, this microorganism started to present high resistance to antifungal agents which is associated with their indiscriminate use. There are several reports of adaptive mechanisms that this species can present. Some of them are intrinsic alteration in drug targets, secretion of extracellular enzymes to promote host protein degradation and efflux receptors that lead to a diminished action of common antifungal and host’s innate immune response. The current review aims to bring promising alternatives for the treatment of candidiasis caused mainly by C. albicans. One of these alternatives is the use of antifungal peptides (AFPs) from the Histatin family, like histatin-5. Besides that, our focus is to show how nanotechnology can allow the application of these peptides for treatment of this microorganism. In addition, our intention is to show the importance of nanoparticles (NPs) for this purpose, which may be essential in the near future.
Highlights
Candida spp. are reported as the most common fungal pathogens with the ability to cause superficial infections to progress to systemic infections in human hosts, especially those who are immunocompromised [1]
The SAPs secreted by C. albicans have the ability to degrade a broad-range of host proteins: Sap2p and Sap5p are related to degradation of E-cadherin and mucins present in the gastrointestinal epithelium, facilitating hyphae penetration [33,34]
The prevalence of fluconazole resistance in C. albicans is low, but higher rates are observed for Candida glabrata with rates up to 13%, for Candida auris which rates near 93% resistance, and Candida krusei, which has shown innate resistance [76,77,78]
Summary
Candida spp. are reported as the most common fungal pathogens with the ability to cause superficial infections to progress to systemic infections in human hosts, especially those who are immunocompromised [1]. C. albicans is able to change its morphology from yeast to hyphae and become more infectious depending on the host’s immune response This set of characteristics has a direct influence on the virulence of this species, which has been increasing progressively over the years [5]. There are several reports of adaptive mechanisms that this species can present when exposed to conventional antifungal agents, such as fluconazole Some of these mechanisms are related to stress responses, intrinsic alteration in drug target and enzymatic degradation that permit this microorganism to survive even during antibiotic treatment [7]. For this reason, candidiasis caused by C. albicans is currently prevalent, especially in hospitalized patients. The use of nanotechnology and drug delivery systems can lead to a step forward in the field of antifungal therapy to allow its use without the risk of enzymatic degradation, increasing its time of residence at the site of action and providing a prolonged and non-cytotoxic treatment
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