Autophagy Alters the Susceptibility of Candida albicans Biofilms to Antifungal Agents.

() reigns as a major cause of clinical candidiasis. biofilms are known to increase resistance to antifungal agents, making biofilm-related infections particularly challenging to treat. Drug resistance is of particular concern due to the spread of multidrug-resistant fungal pathogens, while autophagy is crucial for the maintenance of cellular homeostasis. Therefore, this study aimed to investigate the effects of an activator and an inhibitor of autophagy on the susceptibility of biofilms to antifungal agents and the related mechanisms. The susceptibility of biofilms to different antifungal agents after treatment with or without the autophagy activator or inhibitor was evaluated using XTT assay. Alkaline phosphatase (ALP) activity and reactive oxygen species (ROS) level, as well as the expression of ROS-related and autophagy-related genes, were examined to evaluate the autophagic activity of biofilms when treated with antifungal agents. The autophagosomes were observed by transmission electron microscopy (TEM). The susceptibility of biofilms to antifungal agents changed when autophagy changed. The ALP activity and ROS level of biofilms increased with the treatment of antifungal agents, and autophagosomes could be observed in biofilms. Autophagy was involved in the susceptibility of biofilms to antifungal agents.