Hindawi Publishing Corporation Evidence-Based Complementary and Alternative Medicine Volume 2013, Article ID 261978, 6 pages http://dx.doi.org/10.1155/2013/261978 Research Article Dodonaea viscosa var. angustifolia Inhibits Germ Tube and Biofilm Formation by C. albicans Serisha Devi Naicker and Mrudula Patel Division of Oral Microbiology, Department of Clinical Microbiology and Infectious Diseases, National Health Laboratory Services and Faculty of Health Sciences, University of the Witwatersrand, Private Bag 3, Wits, Johannesburg 2050, Gauteng, South Africa Correspondence should be addressed to Mrudula Patel; mrudula.patel@wits.ac.za Received 26 July 2013; Accepted 5 September 2013 Academic Editor: Veronique Seidel Copyright © 2013 S. D. Naicker and M. Patel. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. he virulence factors of Candida albicans are germ tube and bioilm formation, adherence to host tissues, and production of hydrolytic enzymes. his study investigated the efect of Dodonaea viscosa var. angustifolia extract on the germ tube and bioilm formation of C. albicans. Serum containing the three subinhibitory concentrations of leaf extract was inoculated with C. albicans, incubated, and viewed under a light microscope. Number of cells with germ tube was recorded and the results were analysed using Schefe test for pairwise comparison. Bioilms were grown on coverslips in the presence of plant extracts and processed for scanning electron microscopy (SEM). Planktonic cells were grown in the presence of plant extract for 6h and processed for electron microscopy (TEM). he crude plant extract signiicantly ( < 0.01) reduced the germ tube formation of C. albicans at 3.125 (85.36%), 1.56 (61.91%), and 0.78mg/mL (26.27%) showing a concentration dependent efect. SEM results showed concentration dependent reduction in bioilm and hyphae formation. TEM results showed that the plant extract caused damage to the cell wall and cell membrane. DVA extract has ability to reduce virulence of C. albicans by inhibiting germ tube and bioilm formation through damage to the cell wall. herefore, it has therapeutic potential. 1. Introduction Oral candidiasis is an opportunistic infection of the oral cav- ity which usually occurs in the elderly and immunocompro- mised individuals [1]. Candida albicans is the most common species of yeast isolated from patients with oral candidiasis [2]. It can cause supericial infections such as thrush and denture stomatitis; however in more severe cases, it causes life-threatening systemic mycoses. Most of these commensal C. albicans cells proliferate as budding yeasts. However, when the epithelial barrier is breached due to trauma, immuno- suppression, or hormonal alterations, the budding form is converted into a hyphal form which causes invasion of sub- mucosal tissues [3]. he ability to switch between yeast and hyphal morphologies can play a role in the virulence of C. albicans [4]. Other virulence properties are adherence to host tissues and prostheses and ability to produce hydrolytic enzy- mes. Some of these factors are interrelated. C. albicans cells bearing germ tubes are more adherent to buccal epithelial cells (BEC) than yeast forms of C. albicans [5] due to the anti- gens found on germ tubes [6]. Many efective antifungal agents such as amphotericin B, nystatin, and luconazole are available. However, poor solu- bility, stability, and absorption, toxicity, and the development of drug resistance are a problem with existing drugs [7]. A novel approach to therapy has been suggested by some researchers, where the virulence of C. albicans can be targeted instead of an antimicrobial property. his would be ideal where the causative organism is a part of the normal lora, such as C. albicans in the oral cavity [2, 8]. Pathogenic chara- cteristics such as germ tube and bioilm formation and pro- duction of tissue damaging enzymes are possible targets of new drugs. Many medicinal plants used in Africa have been explored for their anticandida activities [9]. D. viscosa var. angustifolia (DVA) belongs to the Sapindaceae family and it is found in many parts of the world including South Africa. Leaves and tips of the twigs have many medicinal properties and they are traditionally used to treat colds, fever, lu, sore throats, and oral thrush worldwide [10, 11]. It has demonstrated in vitro anticandida activity at high (MIC of 6.25–25mg/mL)