Effectiveness of photodynamic therapy with curcumin against Candida species: A systematic review

Abstract

Introduction: In recent years, photodynamic therapy (PDT) has shown an effective role in controlling fungal infections such as oral candidiasis both in laboratory and clinical settings. Curcumin as a natural photosensitizer has antibacterial as well as antifungal effects. The aim of the present study was to evaluate the anti-Candida spp. effects of PDT by using curcumin. Methods: First, the intended keywords were searched in the four following databases: Google Scholar, PubMed, Scopus and Web of Science. The titles were then merged, and the original eligible articles published by the end of 2020 were scrutinized. Results: Out of 167 merged titles, 12 articles (In-vitro, in-vivo: mice & G. mellonella) met the required criteria and were included in the study. The studied Candida spp. were C. albicans, C. dubliniensis, C. glabrata and C. tropicalis. Concentrations of curcumin used in the studies ranged from 0.005 to 1000 µM. The light sources included LED (440-460 nm), diode laser (405, 532, 650 nm) and Xenon lamp (370-680 nm). The results of all studies showed that PDT reduced the colony count and the level of Candida spp. metabolism significantly. PDT efficacy was dependent on curcumin concentration, Candida spp., energy and wavelength of radiations, and it proved more effective in planktonic environments than biofilm environments. Conclusion: PDT using curcumin in a concentration-dependent manner has a potent lethal effect against some Candida spp. and may be considered as a major or adjuvant treatment for some Candida infections.