Chemical composition of the traditional Chinese medicine compound (ICAM), its antifungal effects against Candida albicans, and the underlying Mechanisms: Therapeutic potential and safety evaluation for vulvovaginal candidiasis

Zhu S, Sun J, Bi X, Wang Z, Yang F, Ta R, Su C, Wu X, Han K, Lan M, Hu H, Li H, Li Y · Journal of Ethnopharmacology · 2025 May

DOI 10.1016/j.jep.2025.119844

Objective

To investigate the chemical composition, antifungal mechanisms, and therapeutic efficacy of ICAM, a TCM compound preparation, against Candida albicans and vulvovaginal candidiasis.

Conclusions

ICAM showed significant antifungal activity against Candida albicans by inhibiting adherence, hyphal growth, and biofilm formation, disrupting membrane integrity, and downregulating genes and proteins associated with biofilm and hyphal formation. In addition, ICAM effectively treated vulvovaginal candidiasis in an in vivo model and demonstrated mucosal compatibility.

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Insights

ICAM, a Traditional Chinese Medicine compound, has demonstrated a strong capability of inhibiting growth and biofilm formation of Candida albicans, a fungal pathogen implicated in vulvovaginal candidiasis.

In the experiments, the main components of ICAM were analyzed using gas chromatography-mass spectrometry. To understand ICAM's antifungal activity various assays, transcriptome and proteome analyses were employed. ICAM was found to contain various phenolic compounds and it demonstrated significant disruption of Candida albicans membrane integrity at a certain concentration. In the results and interpretation of the study, ICAM was effective in inhibiting adherence, growth, and biofilm formation of Candida albicans, reduced surface hydrophobicity and exopolysaccharide production considerably. Transcriptome and proteome analyses revealed significant downregulation of multiple genes and proteins associated with the pathogen's biofilm and hyphal formation signifying the MAPK signaling pathway's role in mediating ICAM's inhibition. Comparatively, ICAM completely eradicated the Candida albicans infection symptoms at a certain concentration with mucosal compatibility, reducing fungal burden and inflammatory markers to zero after a set period, displaying efficacy parallel to the positive control.