The aim of the present study was to evaluate the in vitro activity of baicalein, the flavone constituent of Scutellaria baicalensis, and synergism of the combination of baicalein and fluconazole against Candida albicans, Candida tropicalis and Candida parapsilosis. The MIC 50 (lowest concentration at which there was 50 % inhibition of growth) of baicalein alone against six Candida strains ranged from 13 to 104 mg ml "1 . For the three species tested, exposure to baicalein at the MIC 50 concentrations obtained for each strain resulted in a high loss of viability. The fluconazole plus baicalein combination markedly reduced the MICs of both drugs for all three strains analysed. In addition, a synergistic effect between baicalein and fluconazole was observed for C. parapsilosis in terms of MIC 50 (fractional inhibitory concentration index50.207). Scanning electron microscopy analysis revealed that yeast cells exposed to baicalein at MIC 50 produced a profusely flocculent extracellular material, resembling a biofilm-like structure. In conclusion, these results showed the antifungal capability of baicalein against Candida species and highlight a promising role of baicalein when used in combination with fluconazole against Candida infections. INTRODUCTIONCandidiasis is one of the most common fungal infections in humans caused by Candida species, most notably by Candida albicans. Currently, other species of this genus have been found to cause an increasing number of cases of candidiasis (Mokaddas et al., 2007;Pereira et al., 2010;Das et al., 2011).The therapy of invasive candidiasis remains a difficult medical problem. Despite the availability of extendedspectrum triazoles, the incidence of invasive infections and resistance to antifungal therapy continue to increase (Pfaller & Diekema, 2010). Widespread use of antifungal agents could be an explanation for the emergence of the more resistant non-albicans species of Candida, such as Candida glabrata (reviewed by Kothavade et al., 2010; Silva et al., 2012).The azole fluconazole is effective against most Candida species and is used currently as a first-line drug, although different degrees of susceptibility among species have been described. For instance, C. glabrata is inherently less susceptible to fluconazole. In addition, the emergence of fluconazole resistance has been reported in species typically susceptible to this agent, such as C. albicans, Candida tropicalis and Candida parapsilosis (Hajjeh et al., 2004;Yang et al., 2004;Lyon et al., 2010;Oxman et al., 2010; Arendrup et al., 2011), including that observed in Brazilian tertiarycare hospitals (Bruder-Nascimento et al., 2010;Favalessa et al., 2010;Pereira et al., 2010;Furlaneto et al., 2011).These factors present an urgent need to search for novel compounds with anticandidal activity. To this end, efforts have been made in the search for novel antifungal agents from various natural sources. In this regard, baicalein (5,6,7-trihydroxyflavone; Fig. 1) is a flavonoid originally isolated from the roots of the Chine...

Heat-shock proteins (Hsps) are chaperones required for the maintenance of cellular homeostasis in different fungal pathogens, playing an important role in the infectious process. This study investigated the effect of pharmacological inhibition of Hsp90 by radicicol on the Cryptococcus neoformans/Cryptococcus gattii species complex -agents of the most common life-threatening fungal infection amongst immunocompromised patients. The influence of Hsp90 inhibition was investigated regarding in vitro susceptibility to antifungal agents of planktonic and sessile cells, ergosterol concentration, cell membrane integrity, growth at 37 8C, production of virulence factors in vitro, and experimental infection in Caenorhabditis elegans. Hsp90 inhibition inhibited the in vitro growth of planktonic cells of Cryptococcus spp. at concentrations ranging from 0.5 to 2 mg ml 21 and increased the in vitro inhibitory effect of azoles, especially fluconazole (FLC) (P,0.05). Inhibition of Hsp90 also increased the antifungal activity of azoles against biofilm formation and mature biofilms of Cryptococcus spp., notably for Cryptococcus gattii. Furthermore, Hsp90 inhibition compromised the permeability of the cell membrane, and reduced planktonic growth at 37 8C and the capsular size of Cryptococcus spp. In addition, Hsp90 inhibition enhanced the antifungal activity of FLC during experimental infection using Caenorhabditis elegans. Therefore, our results indicate that Hsp90 inhibition can be an important strategy in the development of new antifungal drugs.

Sporotrichosis, caused by species of Sporothrix schenckii complex, is the most prevalent subcutaneous mycosis in many areas of Latin America. The aim of this study was to evaluate the ability of Sporothrix spp. to form biofilms in vitro and to characterize the growth kinetics, morphology, and antifungal susceptibility of biofilms against classical antifungals. We investigated the ability of strains to produce biofilms in vitro and determined the effects of exposure to amphotericin B, itraconazole, caspofungin, ketoconazole, voriconazole, and fluconazole at minimum inhibitory concentration (MIC) against planktonic form and at 10× MIC and 50× MIC on the biomass and metabolic activity of these biofilms. Biofilm structure was analyzed by optical microscopy using Congo-red staining, confocal and scanning electron microscopy. Strains were classified for biofilm-forming ability, through the analysis of absorbance of crystal violet retained by biomass of mature biofilms. We found that all S. brasiliensis (n = 10), S. schenckii sensu stricto (n = 2), S. globosa (n = 2), and S. mexicana (n = 4) strains were strong biofilm-producers. The analyzed biofilms had dense network of hyphae and conidia immersed in extracellular matrix, with presence of water channels. Antifungal drugs at the three tested concentrations showed different effects on biomass and metabolic activity of biofilms. However, the best inhibitory response was observed with 50× MIC of amphotericin B and caspofungin, which reduced these parameters. Furthermore, high drug concentrations, especially amphotericin B and caspofungin, showed antifungal activity against these biofilms, probably because they damaged the architecture and extracellular matrix, allowing diffusion of the drugs.

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Non-albicans Candida species were more frequently isolated in the hospital. Fluconazole resistance was a rare finding in our study.