eISSN: 1732-2707
ISSN: 1730-1270
HIV & AIDS Review. International Journal of HIV-Related Problems
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3/2020
vol. 19
 
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abstract:
Review paper

Ellagic acid: an alternative for antifungal drugs resistance in HIV/AIDS patients with oropharyngeal candidiasis

Satutya Wicaksono
1
,
Fianza Rezkita
1
,
Fadhilah N. Wijaya
1
,
Alexander P. Nugraha
2
,
Saka Winias
3

1.
Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
2.
Dental and Biomaterial Research Group, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
3.
Department of Oral Medicine, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
HIV AIDS Rev 2020; 19, 3: 153-156
Online publish date: 2020/10/02
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Oropharyngeal candidiasis (OPC) is considered the most common fungal infection in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients. Antifungal drug, azole group, is the preferred treatment. However, the long-term use of antifungal drug as prophylaxis and therapy for OPC may lead to a compromised side effects and drug resistance. Nowadays, the prevalence of antifungal Candida albicans resistance is approximately 56.7%. Ellagic acid (EA) presents broad spectrum of antifungal activities. Based on previous studies, EA can act as natural antifungal agent. It also helps enhancing oral mucosal innate immunity. This review explores the anti­fungal activity of EA as an alternative for antifungal drugs resistance in HIV/AIDS patients with OPC. A web-based search was conducted via PubMed, NCBI, Scopus, ScienceDirect, and ResearchGate databases, with “antifungal resistance”, “ellagic acid”, “HIV/AIDS”, and “OPC” as the keywords. EA is a dimeric derivative of gallic acid that is found in several plants. EA can induce the expression of hBD2 and SLPI in the oral mucosa. Those proteins play a pivotal role in immunomodulation and anti-inflammation of oral microenvironment innate immunity, which inhibit several opportunistic pathogens and microbes, including Candida. Furthermore, EA also inhibits ergosterol biosynthesis (EB), which is the primary component of fungi cell membrane. EA breakdown fungal membrane permeability and enzyme activity, leading to cessation of fungal growth. EA presents antifungal activity in HIV/AIDS patients with OPC; thus, it can be used as an alternative in antifungal drug resistance.
keywords:

antifungal drugs, drugs resistance, ellagic acid, HIV/AIDS, oropharyngeal candidiasis

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