Application of probiotics in candidiasis management

Abstract

Candidiasis (e.g., oral, gastrointestinal, vaginal, urinary tract, systemic) is a worldwide growing problem, since antifungal resistance and immunosuppression states are rising. To address this problem, very few drugs are available for the treatment of Candida spp. infections. Therefore, novel therapeutic strategies are urgently required. Probiotics have been proposed for the prevention and treatment of bacterial infections due to their safety record and efficacy, however, little is still known about their potential role regarding fungal infections. The purpose of this review is to present an updated summary of the evidence of the antifungal effects of probiotics along with a discussion of their potential use as an alternative/complementary therapy against Candida spp. infections. Thus, we performed a literature search using appropriate keywords (“Probiotic + Candida”, “Candidiasis treatment”, and “Probiotic + candidiasis”) to retrieve relevant studies (both preclinical and clinical) with special emphasis on the works published in the last 5 years. An increasing amount of evidence has shown the potential usefulness of probiotics in the management of oral and vulvovaginal candidiasis in recent years. Among other results, we found that, as for bacterial infections, Lactobacillus, Bifidobacterium, and Saccharomyces are the most studied and effective genus for this purpose. However, in other areas, particularly in skincandidiaisis, studies are low or lacking. Thus, further investigation is necessary including in vitro and in vivo studies to establish the usefulness of probiotics in the management of candidiasis.

Keywords:

• Candida spp
• candidiasis
• antifungal resistance
• probiotics
• Lactobacillus
• Bifidobacterium
• infection

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

S.K. and A.K. Authors thank the Shri Ramswaroop Memorial University, Barabanki (UP), India, and National Institute of Technology, Raipur (CG), India, for continuous support and assistance during the work and scientific writing. L.C. thanks the Slovak Research and Development Agency under contract no. APVV-15-0347 and the grant of VEGA 1/0537/19 from the Ministry of Education, Science, Research, and the Sport of the Slovak Republic. C.F.R. would like to acknowledge the UID/EQU/00511/2020 Project—Laboratory of Process Engineering, Environment, Biotechnology and Energy (LEPABE), financed by national funds through FCT/MCTES (PIDDAC).