{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T18:06:55Z","timestamp":1780337215795,"version":"3.54.1"},"reference-count":81,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>\n                    Vulvovaginal candidiasis is a common infection that affects women of reproductive age, with a high prevalence among pregnant women. When left untreated, it can lead to pregnancy complications including miscarriage. The study evaluated the activity of the ethyl acetate (EtOAc) extract of\n                    <jats:italic>Paullinia pinnata<\/jats:italic>\n                    and its isolated compound 6\u03b1-(3\u2019-methoxy-4\u2019-hydroxybenzoyl)-lup-20(29)-ene-3-one against drug-resistant strains and clinical isolates of\n                    <jats:italic>Candida albicans<\/jats:italic>\n                    ,\n                    <jats:italic>Candida glabrata<\/jats:italic>\n                    ,\n                    <jats:italic>Candida krusei<\/jats:italic>\n                    ,\n                    <jats:italic>Candida parapsilosis<\/jats:italic>\n                    and\n                    <jats:italic>Candida tropicalis<\/jats:italic>\n                    . Furthermore, the effects of the combinations of 6\u03b1-(3\u2019-methoxy-4\u2019-hydroxybenzoyl)-lup-20(29)-ene-3-one with voriconazole, nystatin or caspofungin on the\n                    <jats:italic>Candida<\/jats:italic>\n                    strains and isolates as well as its antibiofilm activity against the drug-resistant strains are reported in this study. The EtOAc leaves extract of\n                    <jats:italic>P. pinnata<\/jats:italic>\n                    demonstrated considerable activity against the drug-resistant\n                    <jats:italic>Candida<\/jats:italic>\n                    strains and clinical isolates with minimum inhibitory concentrations (MICs) of 31.25 to 500 \u00b5g\/mL when assessed for anti-\n                    <jats:italic>Candida<\/jats:italic>\n                    activity using the microbroth dilution method. The extract was column fractionated to obtain five bulk fractions, and from the most active bulk fraction, BF4 (MIC\u2009=\u20093.91\u201331.25 \u00b5g\/mL), 6\u03b1-(3\u2019-methoxy-4\u2019-hydroxybenzoyl)-lup-20(29)-ene-3-one was isolated. This study is the first reported biological activity of the compound. 6\u03b1-(3\u2019-methoxy-4\u2019-hydroxybenzoyl)-lup-20(29)-ene-3-one exhibited strong activity against the panel of drug-resistant\n                    <jats:italic>Candida<\/jats:italic>\n                    species with MIC ranging from 0.5 to 16 \u00b5g\/mL (0.85\u201327.10 \u00b5M). This activity was within similar range to that of ketoconazole (MIC\u2009=\u20091\u20138 \u00b5g\/mL) and amphotericin B (MIC\u2009=\u20090.5\u20132 \u00b5g\/mL). When combined with voriconazole, nystatin or caspofungin using the checkerboard assay, 6\u03b1-(3\u2019-methoxy-4\u2019-hydroxybenzoyl)-lup-20(29)-ene-3-one recorded synergism of 33.33% to 83.33% with the antifungals, with majority of the synergistic interactions observed against\n                    <jats:italic>C. albicans<\/jats:italic>\n                    and\n                    <jats:italic>C. glabrata<\/jats:italic>\n                    strains and isolates. 6\u03b1-(3\u2019-methoxy-4\u2019-hydroxybenzoyl)-lup-20(29)-ene-3-one also demonstrated anti-biofilm activity. Its IC\n                    <jats:sub>50<\/jats:sub>\n                    values against the formation of biofilms and preformed biofilms of the\n                    <jats:italic>Candida<\/jats:italic>\n                    species were 15.30\u201346.40 \u03bcg\/mL (25.91\u201378.60 \u03bcM) and 25.40\u201390.84 \u03bcg\/mL (43.02\u2013153.86 \u03bcM), respectively. In conclusion,\n                    <jats:italic>P. pinnata<\/jats:italic>\n                    possesses strong anti-\n                    <jats:italic>Candida<\/jats:italic>\n                    activity and its isolated compound, 6\u03b1-(3\u2019-methoxy-4\u2019-hydroxybenzoyl)-lup-20(29)-ene-3-one displayed potent anti-\n                    <jats:italic>Candida<\/jats:italic>\n                    and anti-biofilm action. These findings identify 6\u03b1-(3\u2019-methoxy-4\u2019-hydroxybenzoyl)-lup-20(29)-ene-3-one as a promising anti-\n                    <jats:italic>Candida<\/jats:italic>\n                    compound warranting further investigation, including cytotoxicity in mammalian cells, before its therapeutic potential can be fully assessed.\n                  <\/jats:p>","DOI":"10.1371\/journal.pone.0350399","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T17:24:46Z","timestamp":1780334686000},"page":"e0350399","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Potent and broad-spectrum anti-Candida activity of 6\u03b1-(3\u2019-methoxy-4\u2019-hydroxybenzoyl)-lup-20(29)-ene-3-one, a triterpenoid from Paullinia pinnata"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1459-3516","authenticated-orcid":true,"given":"Benjamin 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Dandy, involves inhibition of carbohydrate metabolic enzymes and promotion of glucose uptake","volume":"149","author":"BK Harley","year":"2022","journal-title":"Biomed Pharmacother"},{"key":"pone.0350399.ref033","doi-asserted-by":"crossref","first-page":"110847","DOI":"10.1016\/j.biopha.2020.110847","article-title":"Flavanols and triterpenoids from Myrianthus arboreus ameliorate hyperglycaemia in streptozotocin-induced diabetic rats possibly via glucose uptake enhancement and \u03b1-amylase inhibition","volume":"132","author":"BK Harley","year":"2020","journal-title":"Biomed Pharmacother"},{"issue":"1","key":"pone.0350399.ref034","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1186\/s12884-020-02963-3","article-title":"Prevalence of vulvovaginal candidiasis among pregnant women in the Ho municipality, Ghana: species identification and antifungal susceptibility of Candida isolates","volume":"20","author":"SD Waikhom","year":"2020","journal-title":"BMC Pregnancy 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auris","volume":"55","author":"AL Bidaud","year":"2020","journal-title":"Int J Antimicrob Agents"},{"issue":"9","key":"pone.0350399.ref044","doi-asserted-by":"crossref","first-page":"1494","DOI":"10.1038\/nprot.2008.141","article-title":"A simple and reproducible 96-well plate-based method for the formation of fungal biofilms and its application to antifungal susceptibility testing","volume":"3","author":"CG Pierce","year":"2008","journal-title":"Nat Protoc"},{"issue":"44","key":"pone.0350399.ref045","first-page":"2287","article-title":"A 96 well microtiter plate-based method for monitoring formation and antifungal susceptibility testing of Candida albicans biofilms","author":"CG Pierce","year":"2010","journal-title":"J Vis Exp"},{"issue":"6","key":"pone.0350399.ref046","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1007\/s11908-015-0462-0","article-title":"Vulvovaginal candidiasis in pregnancy","volume":"17","author":"TJ Aguin","year":"2015","journal-title":"Curr Infect Dis Rep"},{"issue":"4","key":"pone.0350399.ref047","doi-asserted-by":"crossref","first-page":"57","DOI":"10.3390\/jof3040057","article-title":"Global and multi-national prevalence of fungal diseases-estimate precision","volume":"3","author":"F Bongomin","year":"2017","journal-title":"J Fungi (Basel)"},{"issue":"1","key":"pone.0350399.ref048","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1186\/s12884-019-2488-z","article-title":"Prevalence of vulvovaginal candidiasis, bacterial vaginosis and trichomoniasis in pregnant women attending antenatal clinic in the middle belt of Ghana","volume":"19","author":"DG Konadu","year":"2019","journal-title":"BMC Pregnancy Childbirth"},{"issue":"1","key":"pone.0350399.ref049","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1186\/s12884-020-02963-3","article-title":"Prevalence of vulvovaginal candidiasis among pregnant women in the Ho municipality, Ghana: species identification and antifungal susceptibility of Candida 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