Elucidating the Anti Candida Potential and Mechanistic Insights of Phenolic Monoterpenoids in Candida Glabrata

Abstract

Fungal infection is a global public health concern, particularly due to its high morbidity and mortality rates. These infections can range from superficial skin conditions to severe, life-threatening systemic diseases, particularly in immunocompromised individuals. Members of the genus Candida are among the major human fungal pathogens like black mucor, Cryptococcus, and Aspergillus etc. According to the Global Action Fund for Fungal Infections (GAFFI-2020), fungal infection affects over 1 billion people globally and causes over 2 million deaths annually. Candidiasis, caused by Candida species, can manifest as oral thrush, genital yeast infections, or invasive candidiasis affecting internal organs in immunocompromised individuals. Vulvovaginal candidiasis (VVC) and bloodstream infections caused by fungal pathogens are a significant health concern. VVC is mainly caused by C. albicans followed by C. glabrata (non-albicans Candida) which affects 50-75% of women once in life leading to symptoms like itching, discharge, and irritation, and can severely impact quality of life. The growing resistance to antifungal medications exacerbates these issues, making infections harder to treat and control. According to a report by the World Health Organization (2022), resistance to azole drugs in non-albicans Candida species (NACS) cautiously rising, particularly for fluconazole. Addressing this issue requires improved stewardship of antifungal medications, the development of new antifungal agents, and enhanced diagnostic techniques to detect resistance early. In ancient times, people depended on natural remedies for fungal infections. Monoterpenoids have been reported to have significant antimicrobial properties such as terpinen-4-ol from tea tree oil, phenolic compounds like thymol and carvacrol from thyme, and eugenol from cloves. The limitations of existing antifungal drugs, rising antifungal resistance, and shift in the epidemiology to NACS, have encouraged us to explore the alternative drugs of plant origin against NACS