Antibiolm and Anti-candidal Activity of Extract of the Marine Sponge Agelas Dispar

This study aimed to determine the antifungal and antibiolm activity of Agelas dispar on biolm-producing of Candida species. Methanolic extract of A. dispar was obtained and the fraction Ag2 showed inhibitory activity for all the 13 Candida strains tested, in concentrations ranging from 2.5 mg/ml to 0.15625 mg/ml. Antifungal activity of fungicidal nature was seen between 5.0 mg/ml and 0.3125 mg/ml of extract against the strains. All strains were classied as biolm producers. Methanolic extract Ag2 was tested at concentrations of 2.5 mg/ml and 1.25 mg/ml for antibiolm activity against the biolm in formation and mature biolm from all the strains of the genus Candida. Treated and untreated biolm samples were selected for visualization on Scanning Electron Microscopy (SEM). SEM allowed the visualization of the quantitative decrease of the microbial community, alterations of structural morphology and destruction, at the cellular level, in both forming and mature biolm. It was suggested that the mechanism of action of the fraction is at a plasma membrane and/or cell wall alteration level. The fraction of methanolic extract of A. dispar may be a promising antifungal and antibiolm therapeutic strategy against different species of the genus Candida. Biolms on sterilized, polystyrene, at-bottomed, 96-well microtiter plates. For the biolm adhesion phase, 100 µL of the adjusted cell suspension of 10 7 cells/ml sterile 0.85% NaCl transferred each well. No cells were added to the nal column to be used as the negative control. The plate was incubated at 37°C for 1.5h with shaking at 0.62g so that the cells could attach to the surfaces of the wells.


Introduction
Candida species, and as other fungi, have developed virulence mechanisms that increase survival ability, pathogenesis, as well as the maintenance of the infectious condition in human host. Besides, resistance mechanisms to most commercial antifungal agents are often seen in conventional therapy. Among the virulence factors, it should be highlighted the ability of yeast fungi to produce bio lm, which contributes to microrganisms maintenance in a favorable environment for their development [1] Fungal bio lms are predominantly related to biomaterial associated chronic infection, such as the use of catheters and prostheses. At these sites, the bio lm is composed of a cluster of microorganisms, allowing them to exchange genetic information, such as resistance genes, which favors the development of antifungal resistance and decreases host immune responses [2].
Considering the antifungal resistance pro le, the greatest challenge for an e cient fungal infection control is the scope of pharmacological research for new compounds that are potentially strong antifungal candidates. This is due to the small and limited number of antifungals commercially available for the treatment of infections, especially systemic infections caused by multiresistant yeast, as in the case of Candida species [3,4] alternative to conventional new compounds that are potentially antifungal drugs are urgetly needed.
In this context, due to chemical diversity and bioactivity, natural products such as vegetables or marine products show promise as alternative sources to circumvent issues related to fungal resistance to drugs and the reduction of toxicity [5]. Previous studies show that marine environments are poorly explored compared to other environments and could provide a variety of compounds that set a new path for antimicrobial drugs [6,7].
Marine sponges of the Agelasidae family are abundantly distributed throughout the marine ecosystem, totaling 19 species already described, including Agelas dispar, which has a diversity of bioactive secondary metabolites such as pyrrolic alkaloids [8,9] Studies of the biological activity of Agelas species is still scarce, but these sponges are of great interest to the scienti c community. Activities such as, antimicrobial, antiprotozoal, anticancer, and also the anti-in ammatory has been reported [10][11][12].
Considering the current context and the possibility of better understanding the appreciation and applicability of marine organisms to obtain antifungal compounds, this work evaluated the biological pro le of a methanolic extract fraction obtained from the marine sponge Agelas dispar against bio lmforming species of the genus Candida.

Fraction preparation and chemical characterization
The fresh sponge was kept in methanol for three days, after which a remaining solution was ltered, concentrated under reduced pressure at temperature of up to 40°C to obtain the crude extract. The Ag extract was suspended in 6:1 (v/v) MeOH: H 2 O and subjected to liquid/liquid partition with the increasing polarity solvents n-hexane, chloroform, ethyl acetate and n-butanol. Subsequently, the marine natural product was dried under reduced pressure in rotoevaporator (FISATOM® ) ) and stored for partition and chromatographic fractionation, obtaining fraction 2 (Ag2). The chemical characterization of the fractions was obtained by mass spectrum coupled with liquid chromatography (HPLC-MS-MS) using the Dionex Ultimate 3000 liquid chromatography system. Thus, the constituents were separated into a Phenomenex Hydro C-18 column (2.0 x 50 mm, 4 µm), with an equivalent precolumn, at a ow rate of 600 µl/min. The mobile phase was a gradient of 0.1% formic acid in water and 0.1% formic acid in methanol.
The mass spectra were recorded on an AB Sciex triple linear quadrupole ion capture spectrometer (3200 QTRAP® LC-MS/MS), type ion source (AB Sciex TurboIonSpray®). For chromatograms and spectra acquisition, the software PeakView® version 2.2 was used. The spectral data of Ag2 fraction were similar to those found in the literature and thus used as the object of study on this research [9,13].

Fungal strains and inoculum preparation
A total of thirteen strains of Candida species was tested according Table 1. The strains tested included the species Candida albicans (ATCC 90028), C. tropicalis (ATCC 13803), C. krusei (ATCC 6258), C. glabrata (ATCC 2001), C. parapsilosis (ATCC 22019), and sequenced samples available from GenBank. For inoculum preparation, the specimens were grown on Sabouraud Dextrose Agar with chloramphenicol (SDA, KASVI, PR, Brazil) at 35°C for 24-48 h; colonies were suspended in sterile 0.85% NaCl solution and adjusted according to McFarland standard 0.5, which is equivalent to 10 6 CFU/ml [14][15][16].  [14,17]. MIC was de ned as the lowest extract concentration capable of producing visible fungal growth inhibition recorded in the wells. MIC results were compared to the standard amphotericin B antifungal drug (16 µg/ml) used as a positive control.
The Minimum Fungicidal Concentration (MFC) value was de ned as the lowest concentration of the compound that was able to kill the fungal strains [18,19]. Following MIC assays, 10 µl of the supernatant from the wells with complete visual inhibition of fungal growth were transferred to Petri dishes containing SDA with chloramphenicol (KASVI, Brazil) [20]. Subsequently, the plates were incubated at 35 ± 2°C for 48h. The MFC value was de ned as the lowest concentration of the compound that was able to kill the fungal strains [18,19]. Results were expressed as the arithmetic means of MICs and MFCs values obtained in three independent trials and in triplicate.

Bio lm formation in Candida species
Bio lms were evaluated according to Jin and colleagues [21] modi ed by Melo and colleagues [22]. Thus, for adhesion phase 100 µl of a standard cell suspension of 10 7 cells/ml in sterile 0.85% NaCl solution were transferred to at bottomed microtiter plates and incubated for 1.5h at 37°C on a shaker at 0.62g at 570 nm. The bio lm formation was classi ed according to Stepanovic and colleagues [24].

Antibio lm activity
The antibio lm activity was evaluated according methodology adapted from Barbosa and colleagues [25]. The Ag2 fraction was tested at concentrations of 2.5 mg/ml and 1.25 mg/ml for antibio lm activity against the bio lm in formation and mature bio lm from Candida krusei (ATCC 6258), C. glabrata (ATCC 2001), and C. parapsilosis strains. Bio lms were produced on sterilized, polystyrene, at-bottomed, 96well microtiter plates. For the bio lm adhesion phase, 100 µL of the adjusted cell suspension of 10 7 cells/ml in sterile 0.85% NaCl solution was transferred each well. No cells were added to the nal column to be used as the negative control. The plate was incubated at 37°C for 1.5h with shaking at 0.62g so that the cells could attach to the surfaces of the wells.
Following the attachment phase, unattached cells were removed, the wells were washed 2x with 150 µL of PBS. After the adhesion phase [21,22] for the bio lm in formation, 100 µL of YNB medium (Himedia, India) were added. The Ag2 fraction was added at each concentration tested (2.5 mg/mL and 1.25 mg/mL) and incubated for 24h with shaking at 0.62g (Tecnal, Brasil) at 37°C. Concomitantly, for the mature bio lm, 100 µl of YNB medium (Himedia, India) was added and incubated for 24h shaking at 0.62g and at 37°C in a 96 well at-bottom microplate, and then washed twice with 150 µl PBS. After washing, 100 µl of diluted Ag2 fraction were added in 100 µl of YNB medium and nally incubated for 24h, stirring at 0.62g at 37°C. Then, the post-treated bio lms were quanti ed by the 0.4% aqueous violet crystal solution.
For the analysis of bio lm cell viability inhibition (post-treatment), a formula from Jadhav and colleagues [26] was used with adaptations to calculate the inhibition percentage and remove the colorimetric interference of the optical density concentrations used in the test. The inhibition percentage was considered to be the concentration that demonstrated 50% (IC50%) or higher inhibition of the forming and mature bio lm. All assays were performed in triplicate.

Scanning Electron Microscopy (SEM)
Three strains were selected for the SEM, Candida krusei (ATCC 6258), C. glabrata (ATCC 2001) and C. parapsilosis 50. Yeast inoculum was adjusted according to the bio lm formation assay. Inoculum suspension and cell adhesion procedures were performed in a 24 well polystyrene plate (JET BIOFIL®, China) and washed as described above. Pre-formed bio lms were incubated for 24h at 37°C with 100 µl of YNB medium, along with the concentrations used in the antibio lm activity assays. Concomitantly, the mature bio lm was incubated for 24h at 37°C, with 100 µl of YNB medium. Then, the plate was treated with 1.25 mg/ml and 2.5 mg/ml of Ag2 fraction and incubated for 24h at 37°C. The bio lms were xed with 2% (v/v) glutaraldehyde (Sigma) and dehydrated with an ethanol solution series (50%, 70%, 90% and 100%). Samples were taken, dried, glued on microscopy slides and metallized with 24k gold and then subjected to visualization on the SEM apparatus (JEOL, JSM 5600LV, Japan). An in formation and mature bio lms not exposed to the Ag2 fraction were used as control. Treated and untreated bio lm samples followed the protocol described by Barbosa and colleagues [25].

Statistical analysis
The results were analyzed using the statistical software "GraphPad, Prism" version 7.0 and the obtained MIC and MFC data were plotted using Microsoft excel® version 2010. Data on bio lm formation and antibio lm activity were presented by the mean standard deviation. Differences/comparisons were analyzed by the Dunnett variance test (ANOVA), bilateral (p < 0.05) (p < 0.01) (p < 0.0001) with 95% con dence interval.

Identi cation of Ag2 fraction chemical compounds
Sponge metabolites were identi ed by classical chromatographic techniques and the secondary metabolite found in greater amount in the Ag2 fraction was 4,5-dibromopyrrol-2-carboxylic acid (Fig. 1), thus considered the major compound for the studied specimen. In addition, agelasidine A, oroidin, manzacidine A, bromohimenialsidine, among others, were also identi ed according to the chemical evaluation. The chemical structures of the compounds are shown in Fig. 2.
In vitro susceptibility testing The Ag2 fraction showed values of MIC's, and 5 strains (38%) of the 13 Candida species tested showed sensitivity at 0.625 mg/ml. The MIC values for the other species were 2.5 mg/ml (7.7%), 1.25 mg/ml (23.1%), 0.3125 mg/ml (15.4%), 0.15625 mg/ml (15.4%), as shown in Table 2. All 13 strains of the yeast were sensitive to 2.5 mg/ml and 5.0 mg/ml of Ag2 fraction of Agelas dispar extract, which were able to completely inhibit microrganisms growth (Table 2). The MFC assay showed that the strains sensitivity to Ag2 fraction ranged from 5.0 mg/ml to 0.3125 mg/ml. The concentration that was able to eliminate 90% of the population was 5.0 mg/ml (Table 2). Besides, the extract exhibited fungicidal activity against all Candida species evaluated.
Evaluation of bio lm formation in Candida spp.
Antibio lm activity of the Ag2 fraction of Agelas dispar methanolic extract Only Candida krusei (ATCC 6258), C. glabrata (ATCC 2001) and C. parapsilosis 50 strains that showed moderate bio lm formation, were submitted to treatment with Ag2 fraction of Agelas dispar methanolic extract. Thus, by assessing the inhibition percentage of 50% (IC50%) against the forming bio lm, it was observed that post-treatment with 1.25 mg/ml of Ag2 fraction did not show activity against C. krusei bio lm formation, with inhibition of cell viability value of 49.6% ± 1.69 and fungal growth of 50.4%. In contrast, C. krusei presented low metabolic activity with 23.7% cell viability of the bio lm when the concentration of 2.5 mg/ml was used, which presented a fungal growth inhibition activity of 76.3% ± 1.31 (Fig. 4a).
For C. glabrata, 1.25 mg/ml of Ag2 fraction inhibit 57.6% ± 1.20 of fungal community formation, while 2.5 mg/ml inhibit 73.2% ± 1.68. The same inhibitory pro le was seen in bio lm formation for C. parapsilosis 50, indicating values of 57.1% ± 2.16 and 70.5% ± 1.42 respectively, for concentrations of 1.25 mg/ml and 2.5 mg/ml. The Ag2 fraction antibio lm activity results of concentrations of 1.25 mg/ml and 2.5 mg/ml evaluated against immature bio lm of different Candida species (p < 0.001) are shown in Fig. 4a.
For mature bio lm, it was observed that the concentration of 1.25 mg/ml did not inhibit 50% of the bio lm formed in C. parapsilosis 50 (42.8% ± 5.63), thus maintaining the microbial community in 57.2%. For the other strains, the same concentration indicated a decrease in the yeast bio lm biomass for C. krusei ATCC 6258 (67.2% ± 0.88) and C. glabrata ATCC 2001 (65.4% ± 0.92). All strains showed susceptibility to 2.5 mg ml − 1 of Ag2 fraction and the cell viability inhibition was 78.8% ± 0.84, 76.2% ± 1.26 and 63, 3% ± 2.77 for C. krusei, C. glabrata and C. parapsilosis, respectively. All tested concentrations showed statistical difference when compared to the control (p < 0.001) (Fig. 4b).
Forming bio lm treated with Ag2 Scanning electron microscopy analysis showed that the controls of C. krusei forming bio lm (ATCC 6258) showed blastoconidia clusters in its basal layer, a thin extrapolymeric coating and few pseudohyphae formations. For C. glabrata (ATCC 2001) cells with intact morphologies were shown and for C. parapsilosis 50 a smaller amount of blastospores were seen. In contrast, the specimen produced pseudohyphae grouped in substantial amounts of the bio lm in formation.
When C. krusei forming bio lm was treated with 1.25 mg/ml of Ag2, a signi cant decrease in yeast cells with cell deformities and extravasation was observed. Their original morphology was lost when 2.5 mg/ml was used. At this concentration, Ag2 fraction was able to adhere to the yeast cell surface, providing separation of the microbial community and consequently cell loss. When subjected to two concentrations of Ag2 fraction, C. glabrata showed a decrease in bio lm clusters, generating a larger number of free cells and no apparent morphological changes. For C. parapsilosis 50, its cell density presented a higher susceptibility to the concentrations used when compared to the other Candida species. It is possible to visualize in both concentrations the destruction of the hyphal structures and groupings of the blastospores, deformities, roughness and extravasation of their intracellular material. All images are shown in Fig. 5.

Mature bio lm treated with Ag2
The mature ultrastructures of C. krusei (ATCC 6258) and C. parapsilosis 50 strains analyzed by SEM indicated a dense network of morphologically diverse cells (blastoconidia and pseudohyphae) covering the entire evaluated surface shown in Fig. 6. C. glabrata (ATCC 2001) control showed only buds and blastoconidia, in which it provided a thick and compact multilayer bio lm with co-aggregated cells.
The images of treatments with the Ag2 fraction at a concentration of 1.25 mg/ml showed a decrease in cell volume and small deformities with cell leakage in C. krusei. At the highest concentration (2.5 mg/ml), C. krusei cells were disrupted, partially destroyed, presented cell leaks and substance aggregation on the yeast surface. At the lowest concentration (1.25 mg/ml), the quantitative decrease in cell aggregates was intensi ed in C. glabrata, reducing the formed microbial community. Applying 2.5 mg/ml of Ag2, free yeast cells were identi ed in the basal surface layer and some extravasations and deformities were observed. For C. parapsilosis 50, a decrease in cell biomass of the three-dimensional structure was observed when exposed to 1.25 mg/ml of Ag2. By submitting the mature C. parapsilosis bio lm to 2.5 mg/ml, the amount of pseudohyphae decreased compared to its control. In addition, extravasations and cellular deformities were also seen in the treated bio lm. All images are shown in Fig. 6.

Discussion
The incessant search for promising natural, synthetic or semi-synthetic compounds that demonstrate antimicrobial and antibio lm activity and that can be safely administered for infection control has motivated areas of scienti c research, especially the attempt to elucidate antifungal compounds. Microorganisms are rapidly proving resistant to a variety of antimicrobials employed in clinical practice, which makes the search for antifungals even more urgent. The literature has reported that natural products of aquatic origin provide a variety of chemically bioactive compounds, especially antifungal substances [27,28].
The biological activity of Ag2 fraction found at of A. dispar methanolic extract stoods out as a signi cant antifungal potential to the inhibition and elimination of different Candida species. The fact that the MIC values vary between 0.15625 mg/ml and 2.5 mg/ml is probably due to the large variations related to the phenotypic and genotypic particularities of each Candida species, as shown in Table 2. Similar to our ndings, Nazemi and colleagues [29] found variations in MIC's when evaluating the antifungal activity of the methanolic extract of the Haliclona sp. against clinical isolates of C. albicans (0.75 mg/ml) and Aspergillus fumigatus (2 mg/ml).
Based on the results of our study and considering the resistance pro le by the MFC/MIC ratio, C. albicans (ATCC 90028) and two C. parapsilosis (samples 31 and 33) were sensitive to Ag2 only at higher concentrations, and both species presented an MFC of 5.0 mg/ml (Table 2) to achieve complete elimination of the pathogens. In comparison, the study of Galeano and Martinez [30] veri ed the antifungal potential of 24 marine sponge extracts, among which 14 compounds showed inhibitory activity against C. albicans. In this same study, it was emphasized that species of marine sponges Leucetta aff. oridana and Cinachyrella presented higher anti-Candida activity.
Recently, Dogan and colleagues [31] tested the methanolic extract of Agelas oroides against yeasts such as C. glabrata, Cryptococcus neoformans and C. gattii at concentrations between 256 and 0.5 µg/ml, and found MICs of 16 and 32 µg/ml, respectively. It is possible to suggest that extracts from marine sponges are more effective against Candida yeasts, especially C. glabrata species. Similarly, this specie showed higher sensitivity to lower concentrations of the Ag2 fraction of A. dispar extract in the present study ( Table 2). Given this, it is possible to observe the antimicrobial potential that this fraction present, which revealed excellent MICs values against different Candida species. These results suggest that methanolic extracts of marine sponges may give rise to antifungal products, speci cally against C. glabrata species, since it already has an innate resistance pro le to the azole class [32].
The bioactive capacity of oroidin isolated from other Agelas species was evaluated against yeasts, in which Zidar and colleagues [33] veri ed the alkaloid derivative activity against C. albicans (ATCC 90028) and demonstrated inhibitory activity with 50 µg/ml. Additionally, the antifungal potential of agelasidine had already been reported in the literature by Stout and colleagues [34]. The researchers isolated agelasidine from Agelas citrina and tested the compound against Cryptococcus grubii, Cryptococcus gattii and Candida strains, which had their growth inhibited by this metabolite. Complementing these ndings, Hammami and colleagues [35] reported the antifungal activity of oroidin for the lamentous fungus Alternaria solani, for which the compound exhibited satisfactory inhibitory activity at a concentration of 16 µg/ml. This data suggests that the antifungal activity of Agelas sponges may be associated with their secondary metabolites, also found in other genera of marine sponges [36]. There are increasing studies evaluating the identi cation of virulence factors of Candida yeasts, such as the ability to form bio lms and their elimination. Research on bio lm production by Candida spp. and other microrganisms species stands out in the literature. Data on the greatest bio lm formation are highlighted for Candida albicans species. For non-C.albicans species, such as C. parapsilosis, C. krusei and C. glabrata bio lm formation is variable and thus little reported [37]. Contrary to the literature, this study showed that the C. albicans strain (ATCC 90028) showed weak bio lm production. Noteworthy, the ATCC's of C. krusei (6258) and C. glabrata (2001) showed moderate bio lm production, and sample C. parapsilosis 50 proved to be a potential bio lm forming strain, also showing moderate bio lm production. However, C. parapsilosis 50 stooded out when compared to others species.
Some studies such as of Modrzwska and Kurnatowski [38] reported that the ability to adhere to materials surfaces and human host cells varies among Candida species. Chaves and colleagues [39] evidenced that the species of C. parapsilosis is strongly adherent to different surfaces when compared with C. albicans. From the previous evidence, it is possible to suggest that the C. parapsilosis strain (sample 50) in our study had a greater ability to adhere to polystyrene plaque when compared to the other strains used to identify the bio lm. This result has motivated further studies for quanti cation of adhesinassociated genes expressed on bio lm production, even though some strains of C. parapsilosis have shown weak adhesin production. Similar data have been described when clinical isolates of candidemia were used and they showed that C. albicans species presented the lowest bio lm expressions when compared to the other species reported on the studies [40,41].
Candida krusei (ATCC 6258), C. glabrata (ATCC 2001) and C. parapsilosis 50 strains were treated with the Ag2 fraction of the marine sponge and showed a biomass reduction on in formation and mature bio lm capacity at both concentrations tested. When subjected to both treatments, a quantitative decrease in cell viability of all strains was seen. The effectiveness of the highest concentration (2.5 mg/ml) was also demonstrated in the mature bio lm, indicating that Ag2 fraction remained active even in face of the complete development of the microbial community.
The lowest concentration evaluated in this study (1.25 mg/ml) showed a slight variation in its effectiveness for the bio lm in formation and after formation, which can be plausibly explained by the lower amount of bioactive secondary metabolites present on this concentration. Corroborating with this data, Cepas and colleagues [42] reported that higher concentrations of marine natural products such as extracts and fractions are necessary to inhibit C. parapsilosis bio lms when compared with C. albicans bio lms. Thus, the lower inhibition value of cell viability of mature bio lm of sample 50 (C. parapsilosis) at a concentration of 1.25 mg/ml can be explained when compared to the highest concentration.
Investigations of ultrastructures (bio lm) subjected to the activity of marine natural products on yeast morphology using SEM are limited and scarce. In this study, the activity of the Ag2 fraction of A. dispar extract revealed structural and morphological differences on bio lm from all Candida strains analyzed. Both concentrations used in this study induced pseudohyphae and blastoconidia deformities, roughness, cell extravasation, disintegration and reduction of cell volume, which affect the entire structure of the forming and mature bio lm, and suggests a disruption action and destruction of the plasma membrane and/or cell wall. For this, Zore and colleagues [43] described that antibio lm activity of natural compounds against Candida species are not fully elucidated, but some chemical compounds found in extracts, fractions and oils, such as terpenoids and their derivatives have bioactive activity already reported. These include the action of disrupting the integrity of the cell membrane and controlling functions related to the fungal membrane, such as quorum-sensing signaling and cell permeability.
The possible explanations for the observed and con rmed SEM antibio lm activity found in this study may be associated with the presence of Agelasidin A identi ed in the Ag2 fraction. This secondary metabolite of A. dispar is considered a sesquiterpene derivative and it is described for its ability to originate farnesol (quorum-sensing signaling molecule), which in turn is responsible for the inhibition of hyphal forms (regulatory response) and able to prevent bio lm formation [44,45].
Another possible explanation for the antibio lm effect would be the a nity of terpenes, such as agelasidine A, to the fungal plasma membrane. This a nity is generated by Agelasidine A structure, which presents elongated aliphatic chain, some unsaturations and polar functional groups, indicating a higher fat solubility pro le and interaction with the fungal structure. Besides, Agelasidine A structure resembles the chemical chains of antifungals such as amphotericin B and nystatin [46,47]. Additionally, this activity against fungal membrane, which was also observed in SEM, may have been intensi ed by other compounds, such as oroidin and 4,5-dibromopyrrol-2-carboxylic acid. They are found in the Ag2 fraction of A. dispar methanolic extract and present nitrogenous heterocyclics linked to pyrrolic rings, which makes them similar to the chemical structure of azoles, especially triazoles [48,49].

Conclusion
The Ag2 fraction of A. dispar methanolic extract showed antifungal activity and presented fungicidal nature, besides being e cient to decrease microbial load and modify the structural morphology of the yeasts involved in bio lm production. These ndings suggest that the mechanism of action of the fraction showed a nity to act at the level of plasma membrane and/or cell wall level, inferring that the Ag2 fraction may be a promising antifungal and antibio lm therapeutic strategy against different Candida species. These ndings suggest that the Ag2 fraction may be useful in the treatment and/or prevention of fungal infections, especially those caused by bio lm forming Candida species, which are known to be the most resistant to conventional antifungal therapy.