Estudo da fototerapia antimicrobiana mediada por curcumina contra biofilmes de leveduras do gênero Candida

Abstract

In the current public health scenario and due to the problems generated by fungal infections andantimicrobial resistance, Antimicrobial Photodynamic Therapy (aPDT) is emerging as apromising alternative. This technology is based on the production of reactive oxygen species,when light-absorbing compounds (photosensitizers) are activated with light. However, for theextensive use of this technology in the clinical context, more studies are needed to identify theexisting gaps in knowledge. In this context, the present study aimed to evaluate the effect ofcurcumin-mediated phototherapy against biofilms of yeasts of the genus Candida spp. bysearching for evidence with a systematic review of the current literature, evaluating the activity ofphotoactivated curcumin against biofilms of Candida krusei Ck7 and Candida albicans ATCC10231 adhered to toothbrushes, evaluating the efficacy of the combination of chlorhexidine andphotoactivated curcumin in inhibiting the formation of biofilm of Candida spp. isolated from theoral cavity and evaluating the efficacy of curcumin-mediated phototherapy in inhibiting theformation and combating mature biofilms of Candida albicans ATCC 10231, Candidametapsilosis ATCC 96143, Candida dubliniensis ATCC MYA-646, Candida orthopsilosis ATCC96141 and Candida parapsilosis ATCC 22019. The systematic review was carried out on theRayyan Systematic Review platform, in the Virtual Health Library (VHL), PubMed, Web ofScience and Scopus databases, resulting in 24 publications, but after screening, five studies wereselected that addressed different species of Candida spp. and concentrations of curcumin. Theactivity of photoactivated curcumin against Candida krusei Ck7 and Candida albicans ATCC10231 biofilms adhered to toothbrushes was evaluated using blue LED light with a wavelength of450 nm. In addition, tests were carried out to determine the total biofilm biomass by the crystalviolet method, the minimum inhibitory concentration (MIC), the minimum fungicidalconcentration (MFC) and the minimum biofilm inhibitory concentration (MICB50) to verify theefficacy of the combination of chlorhexidine and curcumin, with and without photoactivation,against clinical isolates of Candida spp. Tests were also carried out to verify the efficacy ofcurcumin-mediated phototherapy in inhibiting the formation and eradication of mature biofilms ofdifferent Candida species by determining the total biofilm biomass using the crystal violetmethod. The systematic review showed that curcumin-mediated aPDT significantly reduced theviability of biofilms and has an antimicrobial effect against yeasts of the genus Candida spp. Thestudy of the effect of curcumin against biofilms adhered to toothbrushes found that photoactivatedcurcumin provided a strong reduction in the number of viable yeasts associated with the biofilm.The combination of chlorhexidine and photoactivated curcumin inhibited the formation ofbiofilms by yeasts. The test to inhibit the formation and eradication of mature biofilms showedthat CUR-mediated aPDT was able to inhibit and eradicate the mature biofilm with betterpercentages of reduction in biofilm inhibition. Therefore, the systematic review found thatcurcumin-mediated phototherapy has activity against biofilms of yeasts of the genus Candida spp,and the experimental studies showed that curcumin has activity against biofilms of clinicalisolates of C. albicans, C. krusei and against the formation and eradication of biofilms of differentCandida species. In this sense, curcumin-mediated phototherapy can be considered acomplementary alternative therapy to conventional antimicrobials.