Curcumin and Fluconazole to Resolve Fluconazole-resistant Candida albicans Infection in HIV Patient

In the last decade, there has been a significant increase in antifungal resistance against C. albicans. Curcumin is a choice of a novel therapy that is currently developing because curcumin is an agent that can affect epigenetics. Epigenetic factors significantly affect the expression of drug efflux transporter proteins, one of which is Cdr1p. This protein is encoded by CDR1. This research aimed to show documentation that curcumin overcomes Candida albicans resistance through Candida drug resistance protein (Cdr1p) expression and CDR1 methylation. C. albicans from HIV patient's oropharyngeal isolates were observed by molecular (SDS PAGE, DNA sequence analysis), colony growth, and MICs (Minimum Inhibition Concentrations) of Fluconazole and Curcumin combination. The MICs of compounds for C. albicans strains were determined using the tube dilution test by the CLSI microdilution reference method. The endpoint may be read spectrophotometrically. Colony growth was assessed by staking 0.001 ml of dilution into an agar plate. Yeast DNA isolation using Zymo Research Quick DNA Fumgal Miniprep Kit No. D6005, followed by Bisulfite treatment, Polymerase Chain Reaction (PCR), and CDR1 sequences. The most significant decrease in MICs in the C. albicans colony occurs for a combination of Fluconazole and Curcumin with a value of 6.25+ 12.5 μg/ml. Cdr1p expression for the curcumin group and the combination of fluconazole plus curcumin group was much lower than other groups, but CDR1 silencing was higher. Thus, combining curcumin with fluconazole has synergized to resolve fluconazole resistance through CDR1 silencing and decreasing Cdr1p expression.