1. Introduction

JBM

Journal of Biosciences and Medicines

2327-5081

Scientific Research Publishing

10.4236/jbm.2023.117008

JBM-126298

Articles

Biomedical&Life Sciences

Anticandidal Activity of Moroccan Medicinal Plants

Khadija

El Assraoui

¹^*Tarik

Rochd

Department of Removable Prosthodontics, Faculty of Dentistry, Hassan II University, Casablanca, Morocco

Laboratory of Oral Biology, Faculty of Dentistry, Hassan II University, Casablanca, Morocco

06072023

1107799517, May 202311, July 2023 14, July 2023

2014

This work is licensed under the Creative Commons Attribution International License (CC BY). http://creativecommons.org/licenses/by/4.0/

The prevalence of oral candidiasis has increased over recent years in patients with the compromised general condition. There are a large number of plant species that have been traditionally used for oral diseases by the Moroccan population. These species could provide a source for discovering new active principles of natural origin against Candida albicans involved in the appearance of candidiasis infections. Information was acquired using the electronic databases Web of Science, Scopus and PubMed. In the first part, this review presents the medicinal plants used by the Moroccan population for the treatment of oral disorders (Toothaches, gingivitis, ulcers, stomatitis, abscesses, ...). The second part describes different studies regarding the antifungal activity of essential oils and organic extracts of some Moroccan species against Candida albicans. Inhibition zone diameter (IZD), Minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) values of essential oils and plant’s extracts were noted. The third part concerns Moroccan plants with the antifungal activity that can be used in medical and agricultural fields. Several species of Moroccan plant proved their effectiveness against Candida albicans and can be used for the treatment of oral candidiasis. Further research should be undertaken in the future to investigate the toxicity of essential oils and plant extracts with antifungal properties for clinical use. This review provided an update on Moroccan plants presenting antifungal activity and especially those active against Candida albicans.

Oral Candidiasis Antifungal Moroccan Plants <i>Candida albicans</i> Essential Oil Plant Extracts

1. Introduction

Oral health is an integral part of general human health. Oral health disorders can have consequences on mastication, phonation, and aesthetics, which can have an impact on psychosocial well-being [1] .

Among the most common opportunistic infections in several high-risk patient groups is oropharyngeal candidiasis. Cancer radiation and/or chemotherapy, immunosuppression, immunodeficiency, diabetes, vitamin deficiency, hyposalivation, denture wear, patients under frequent topical antibiotic, glucocorticoid treatment and patients with anemia are predisposing factors for oropharyngeal candidiasis [2] [3] [4] . The pathogenic mechanism of Candida spp. depend on both Candida virulence and human host conditions. There has been an increased virulence of Candida spp. colonized in several groups of cancer and non-cancer population groups, such as diabetic patients, HIV-infected patients, hospitalized patients, and denture wearers. Candida albicans is the most common opportunistic fungal pathogen in humans. It causes superficial mucosal candidiasis or even disseminated candidiasis [2] [3] [4] . Antifungal drugs are the indicated treatment in the case of fungal infection. They are administered systemically or topically [4] . However, their usage is limited due to their side effects, in addition to the fact that Candida is becoming increasingly resistant [3] . That’s why the search for new, less toxic, more effective and environment-friendly therapeutic approaches is becoming a necessity. Therefore, several types of research have been conducted on natural plant-based antimicrobials [5] .

Plants have been utilized for centuries in folk medicine and there is a strong belief that herbal medicines are healthier and safer than drugs. Owing to their antimicrobial activities, efficacy, higher safety margins, ease of access, and economic feasibility, medicinal plants are used in developed as well as developing countries for primary healthcare.

Morocco, due to its geographical location and the variety of climates and microclimates, offers a rich and diversified vegetation [6] [7] . 4200 among 5000 species and subspecies listed in North Africa grow in Morocco of which at least 500 are potent medicinal and 250 are currently used [8] [9] . Its population is familiar with the use of plants [10] . Infusion, decoction, powder, and maceration of various parts of plants (Roots, flowers, fruits, seeds, leaves), and the whole plants have been used in the treatment of several diseases.

Morocco is one of the providers in the international market of aromatic and medicinal plants and their products, especially essential oils [11] .

Essential oils plant-derived have proven their values as a source of molecules with antimicrobial effects [12] . Numerous studies have proven their antifungal effects [5] [13] .

The action mechanism of essential oils is difficult to explain due to its complexity. It may be possible that every single component has its mechanism of action. The essential oil efficacy depends on the most abundant compound described [14] . According to Boukssaim et al. (2013), the inhibition of germs by essential oils is dependent on their chemical profiles and the structure of the cell membrane [11] . They are distinguished by their hydrophobicity, which helps them to penetrate the membrane of cells and mitochondria, disrupting the cell structure and making it more permeable, resulting in cell death [15] . Many researchers have also explored their combinational effect with drugs to overcome microbial resistance and to decrease the minimum effective dose of conventional antimicrobial drugs [16] [17] . The knowledge of plants and the study of their properties, and their therapeutic effects are primordial, to discover new active principles [6] [15] .

The aim of this article is to review Moroccan plants used for oral disorders and the anti-candidal activities of Moroccan plant essential oils and extracts.

2. Methodology

The literature on Moroccan plants and essential oil and plant’s extract with antifungal activities from 2000 to 2022 were collected, and summarized in this review. The electronic databases Web of Science, Scopus, Pubmed were used to explore the published papers. The search terms used were antifungal, Moroccan plants, Candida albicans, and Essential oil. All published work in different languages (French or English) were cited in this review. Data provided in editorial/letters, symposiums, case reports, and conference papers were excluded.

The scientific names of all plants mentioned in this article were updated and verified using https://wfoplantlist.org/plant-list.

3. Results and Discussion3.1. Plants Traditionally Used in Morocco for the Treatment of Oral Disease

The data presented in Table 1 show several species of plants, their local name and their method of use, frequently used in Moroccan for the treatment of oral diseases. Lamiaceae are widely used in traditional medicine by the Moroccan population to treat several diseases [18] .

Thymus saturejoides [18] , Thymus Capitatus [19] , Marrubium vulgare L [20] , Rosmarinus officinalis L. Ficus carica L, Olea europaea L, Hyoscyamussp, Peganumharmala L [1] , Daphne gnidium [21] , Pinus halepensis L [8] , Allium sativum L, Pistacia lentiscus L, Hedera helix L, Tetraclinis articulata (Vahl) Masters, Anacyclus pyrethrum (L.) Link [21] , Ammi visnaga (L.) Lam, Pimpinella anisum [20] , Cedrus atlantica (Endl.) Manettiex Carrière, Populus nigra L, Acacia nilotica L, Juglans regia L. Euphorbia officinarum subsp. Echinus (Hook. F. &Coss.) Vindt, Commiphora africana (A. Rich.) Engl., Heliotropium curassavicum L, Rhus albida schousboe [22] are used to heal toothache.

Thymus saturejoides Coss. [18] , Thymus willdenowii Boiss, Origanum compactum Benth, Marrubium vulgare L, Laurus nobilis L, Ficus carica L, Olea europaea L, Ruta montana L, Peganum harmala L [1] , Calendula arvensis L. [21] , Melissa officinalis, Laurus nobilis L, Cinnamomum zeylanicum, Ammi visnaga (L.) Lam, Coriandrum sativum L. Chamaemelum nobile L, Artemisia herba alba

Table 1 Plants used by the Moroccan population for the treatment of oral pathology

Plant family	Plant species	Local name	Used parts	Indication according to the population	The method of preparation (Mode of use)	References
Lamiaceae	Thymus maraccanus Ball	Azukni	Leave and Flowers	Mouth affections	Infusion and maceration	[21]
	Thymus saturejoides Coss.	Tazouknit	Leave and Flowers	Gum, Toothache Gingivitis Mouth ulcer	Infusion, Decoction	[18]
	Thymus willdenowii Boiss	Zaîtra	Leaves Flowers	Mouth infection Mouth ulcer Gingivitis Gingival bleeding Bad breath	Decoction (Gargle, Masticatory)	[1]
	Thymus Capitatus		Aerial parts	Toothache	Infusion, decoction (external Application, massage, washings)	[19]
	Marrubium vulgare L.	Mariouta	Leaves	Toothache Gingival bleeding Bad breath Gingivitis	Crude (Masticatory)	[1] [20]
	Origanum compactum Benth	Zaatar tadlaoui	Leaves Flowers	Mouth ulcers Gingivitis Dental carie	Decoction (Gargle)	[1]
	Origanum vulgare L.	Zaater	Sap	Stomatitis Oral lesions	Crude (Touching the lesions with a cotton pad soaked in fresh sap)	[1] [20]
	Rosmarinus officinalis L.	Azir	Leaves Flowers	Toothache	Fumigation (Inhalation)	[1] [20]
	Ocimum basilicum L.	Hbak	Leaves	Oral ulcer	Decoction (Mouthwash)	[20]
	Melissa officinalis	Naanaa soufi	Leaves	Gum	Decoction (Mouthwash)	[20]
Lauraceae	Laurus nobilis L.	Wrak moussa	Leaves	Ulcers Gingivitis Bad breath	Decoction (Gargle)	[1]
	Cinnamomum zeylanicum	Karfa	Bark of the trunk	Gum Mouth ulcer	Decoction, Essential oil (Mouthwash, Direct application)	[20]
Apiaceae	Ammi visnaga (L.) Lam.	Bechnikha	Fruits	Gum disease Toothache	Raw/Decoction (Mouthwash, Direct application)	[20]
	Coriandrum sativum L.	Kozbore	Leaves	Toothache	Raw (Direct application)	[20]
	Pimpinella anisum	Nafae	Seeds	Gum disease	Decoction/ Infusion (Mouthwash)	[20]
Moraceae	Ficus carica L	Karmous	Fruit	Dental abscesses Toothache Gingivitis	Decoction Cataplasm (Gargle, Direct Application)	[1]
Portulacaceae	Portulaca oleracea L	Rajla	Leaves	Dental abscesses	Cataplasm (Direct Application)	[1]
Oleaceae	Olea europaea L.	Zitoune	Leaves Branches	Gingival bleeding Bad breath Gingivitis Toothache Mouth ulcer Herpes Stomatitis	Decoction, Infusion, Crude (Gargle Brushing)	[1] [20]
Rosaceae	Sanguisorba Minor Scop.	Faggass laklab	Roots	Gum infectious	Powder	[21]
	Rosa canina L.	Nisrîne	Bark Fruit	Gingival bleeding	Decoction (Rinsing, Oral use)	[1]
	Rubus ulmifolius Schott.,	Tût azzarb Serrmû	Leaves	Mouth ulcer	Decoction Crude (Masticatory, Rinsing Oral use)	[2]
	Eriobotryajaponica (Thunb.) Lindl.	Mzah	Leaves/Bark of the stem	Mouth ulcer	Decoction (Direct application)	[20]
Rutaceae	Ruta montana L.	Figel	Leaves	Gingivitis	Decoction (Rinsing)	[1]
Solanaceae	Hyoscyamus sp	Sikran	Seeds	Toothache	Decoction (Gargle)	[1]
Thymeleaceae	Daphne gnidium L.	Alezz^az	Leaves	Toothache	Decoction (Gargle)	[1]
	Daphne gnidium L.	Lazzaz	Leaves	Toothache	Decoction	[1] [21]
Urticaceae	Urtica urens	Hariga	Leaves	Mouth ulcer	Decoction (Rinsing)	[1] [21]
Nitrariaceae	Peganum harmala L.	Lharmel	Seeds	Gingivitis Toothache Mouth ulcer Herpes Bad breath Stomatitis	Maceration in vinegar Decoction (Gargle)	[1]
Lythraceae	Lawsonia inermis	Henna	Leaves	Mouth ulcer	Raw (Direct application)	[20]
Pinaceae	Pinus halepensis L.	Taydâ	Leaf	Antifungal Toothache	Decoction	[8]
	Cedrus atlantica (Endl.) Manettiex Carrière	Kdran	Resin	Toothache	Raw (Applied externally)	[22]
Amaryllidaceae	Allium sativum L.	Touma/ Tishert	Bulbs	Gum disease Toothache	Cataplasm (Direct application)	[20] [21]
Anacardiaceae	Pistacia lentiscus L	Drou	Leaves Barks Root	Toothache Gum	Decoction, Infusion Cataplasm (Mouthwash)	[20] [21]
Araliaceae	Hedera helix L	Lwwaya	Leaves	Toothache	Infusion, Cataplasm Decoction	[21]
Asteraceae	Anacyclus pyrethrum (L.) Link	Tiguentest	Wholeplant	Toothaches	Decoction Infusion	[21]
	Calendula Arvensis L.	Jamra	Flowers	Gingivitis	Infusion, Compress (Gargles)	[21]
	Chamaemelum nobile L.	Baboneje	Flower	Gum	Decoction (Mouthwash)	[20]
	Artemisia herba alba Asso	Chih	Leaves/ Flower bud	Gum	Decoction (Mouthwash)	[20]
	Bubonium graveolens (Forssk) Maire	Tafsa	Leaf	Toothache	Powder (Applied externally)	[22]
Salicaceae	Populus nigra L	Safsaf	Leaves	Gum	Decoction (Mouthwash)	[20]
Cupressaceae	Tetraclinis articulata (Vahl) Masters	Azougaâ El arâar	Leaves Fruits	Toothache	Cataplasm, Compress, Maceration	[21]
	Thuja occidentalis L.	Afsa	Leaves	Gum	Decoction (Mouthwash)	[20]
Fabaceae	Retama monosperma (L.) Boiss	Rtam	Stems Roots Leaves	Gum	Infusion, Decoction	[21]
	Acacia nilotica L	Sllaha	Fruit	Toothache Gingivitis	Powder (Applied externally, Rinsing)	[22]
Myrtaceae	Eugenia caryophyllata Thunb	Qronfel	Cloves	Gum	Maceration	[21]
Iridaceae	Crocus sativus L.	Zaafranhor	Stigma	Gum	Decoction (Mouthwash)	[20]
Juglandaceae	Juglans regia L.	Souak	Bark of the root	Gum	Raw/Cataplasm(Brushing/Gum)	[20] [22]
Burseraceae	Commiphora africana (A. Rich.) Engl.	Oum nas	Gum	Toothache	Powder (Applied externally)	[22]
Euphorbiaceae	Euphorbia officinarum subsp. Echinus (Hook. F. &Coss.) Vindt	Dghmouss	Stem	Toothache	Powder (Applied externally)	[22]
Boraginaceae	Heliotropium curassavicum L	Lehbalia	Leaf	Toothache	Powder (Appliedexternally)	[22]
Anacardiaceae	Rhus albida schousboe	Zewaya	Bark	Toothache	Decoction	[22]

Asso, Bubonium graveolens (Forssk) Maire, Thuja occidentalis L. Acacia nilotica L, Crocus sativus L, Juglans regia L. [20] are used to heal gingivitis and gum diseases.

Many species have been used in different regions of Morocco to treat mouth ulcers and stomatitis: Thymus saturejoides [18] , Origanum vulgare L S. [20] , Thymus willdenowii Boiss, Origanum compactum Benth, Laurus nobilis, Olea europaea L. Rubus ulmifolius Schott., Peganum harmala L [1] , Urtica urens [21] , Ocimum basilicum L., Cinnamomum zeylanicum, Eriobotrya japonica (Thunb.) Lindl., Lawsonia inermis S. [20] .

According to our review report, the preparation methods used by the Moroccan population were infusion, maceration, decoction, fumigation, cataplasm, and powder. Regarding the mode of use, it can be either by mastication, inhalation, brushing, gargling, or direct application.

3.2. Moroccan Plants with Anticandidal Activity

Several studies have demonstrated the existence of antifungal activity in several plant species belonging to different families [23] . Research studies that explored the anticandidal activity of essential oils (EO) and plant extracts obtained from different regions of Morocco are listed in Table 2. Antifungal activity against Candida albicans was assessed by the disc diffusion method, minimum inhibitory concentration (MIC), and minimum fungicidal concentration (MFC) values.

In all reported studies, inhibition zone diameter (IZD) was assessed including the disc diameter of 6 mm determined by the agar disc-diffusion method at a concentration of 10 ul of oil/disc except Abdelghani Aboukhalaf et al. [24] who used 20 ul of oil/disc, and Jeldi et al. 2 ul of oil/disc [25] . MIC represents the lowest essential oil/plant extracts concentration that completely inhibits the growth of Candida albicans. It was determined using macro/microdilution methods in mg/ml. MFC corresponds to the lowest concentration at which the incubated microorganism was completely killed [26] .

The most cited plant family in the present work was Lamiaceae. Other families that were also mentioned are Mytraceae, Geraniaceae, Apocynaceae, Cictaceae, Asteraceae, Amaranthaceae, Rutaceae, Cannabaceae Ranunculaceae, Euphorbiaceae, Papaveraceae, Apiaceae, Fagaceae, Lauraceae.

When the inhibition zone diameter is 8 mm or more, the crude extracts have good antimicrobial activity. It is moderate if IZD is 6 - 7 mm; low if it is 4 - 5 mm; very low if it is 2 - 3 mm, or without antimicrobial activity [24] . Regarding essential oils, they are considered active if the IZD is greater than or equal to 15 mm [6] . In this review, the values for IZD of plants extract vary between 6 and 13 mm and those for essential oil from 7 to 85 mm.

The antimicrobial activity of plants extracts is considered significant when MIC ≤ 0.1 mg/mL, moderate when 0.1 ≤ MIC ≤ 0.5 mg/ml, low when 0.5 ≤ MIC ≤ 0.1 mg/ml, and inactive when the value of MIC is higher than 1 mg/ml [27] . In this review, the lowest value of MIC of plants extracts was that found by Benoutman et al. (MIC: 0.63 mg/ml. Acetonic extract of Thymus capitatus). However, a higher concentration of crude methanol extract of Cistus monspeliensis was needed to inhibit the growth of Candida albicans (MIC: 200 mg/ml).

The EO isolated from Mentha suaveolens exhibited the highest activity against Candida albicans (MIC: 0.00069 mg/ml) reported by Oumzil et al. (2002) [28] . 20.00 mg/ml of Laurus nobilis EO was needed to inhibit Candida albicans

Table 2 Moroccan plants with antifungal activity against Candida albicans

Family	Species (Local name)	IZD mm	MIC (mg/ml)	MFC (mg/ml)	References
Lamiaceae	Thymus broussonetii	38.5 ± 0.70 EO	0.25 EO	–	[30]
	T. broussonetii	50.00 ± 1.00 W 49.67 ± 1.15 C EO	0.45 W; 0.46 C EO	0.45 W 0.46 C EO	[34]
	T. broussonetii	50.00 ± 1.00 EO	0.45 EO	0.45 EO	[36]
	Thymus maroccanus	44.5 ± 0.35 EO	0.25 EO	–	[36]
	T. maroccanus	52.33 ± 1.15 EO	0.46 EO	0.46 EO	[36]
	T. maroccanus	52.3 ± 1.2 W 41.3 ± 0.6 CWtF 41.0 ± 1.0 CWF EO	0.16 W 0.14 CWtF 0.03 CWF EO	0.16 W 0.14 CWtF 0.03 CWF EO	[33]
	T. maroccanus	52.33 ± 1.15 W 51.00 ± 1.00 C EO	0.46 W; 0.48 C EO	0.46 W; 0.48 C EO	[34]
	T. maroccanus	31 ± 0.1 EO	–	–	[37]
	Thymus saturejoides (Tazouknit)	42.00 ± 1.00 W 41.33 ± 0.76 C EO	0.89 W; 0.90 C EO	0.89 W; 0.90 C EO	[34]
	T. saturejoides	42.00 ± 1.00 EO	0.89 EO	0.89 EO	[36]
	T.saturejoides	_	0.0059 EO		[38]
	T. saturejoides (Tazouknit)	53 EO	0.9062 EO	0.9062 EO	[39]
	T. saturejoides	–	2.5 EO	5 EO	[40]
	Thymus vulgaris (Ziitra)	–	0.6 EO	0.6 EO	[40]
	Thymus zygis subsp. Gracilis/Timahdite	–	0.15 EO	0.3 EO	[40]
	Thymus zygis subsp. Gracilis/Ain Aghbal	–	1.2 EO	1.2 EO	[40]
	Thymus zygis subsp. Gracilis/Tigrigra	–	0.6 EO	1.2 EO	[40]
	Thymus zygis subsp. Gracilis/Bensmim	–	0.3 EO	0.3 EO	[40]
	Thymus serpyllum	17.33 ± 1.15 EO	3.52 EO	3.52 EO	[36]
	Thymus willdenowii	32 WP; 39 L 32S 27 I EO	0.0069WP 0.0138 L 0.0069 S 0.0138 I EO	–	[31]
	Thymus ciliatus	48.00 ± 1.32 EO	0.43 EO	0.43 EO	[36]
	Thymus pallidus	–	0.0214 EO	–	[38]
	T. pallidus (Ajellabi)	37.67 ± 0.58 EO	0.90 EO	0.90 EO	[36]
	T. pallidus	85 EO	0.7837 EO	0.7837 EO	[39]
	Thymus leptobotrys (Azoukni)	50.00 ± 0.57 EO	0.23 EO	0.46 EO	[36]
	T. leptobotrys	85 EO	0.33 EO	0.33 EO	[39]
	T. leptobotrys	50.0 ± 0.6 W 41.0 ± 1.0 CWtF 43.0 ± 1.0 CWF EO	0.13 W 0.14CWtF 0.05 CWF EO	0.26W 0.14CWtF 0.05 CWF EO	[33]
	T. leptobotrys	–	0.0022 EO	–	[38]
	T. leptobotrys	27.00 ± 1.00 EO	1.25 EO	1.25 EO	[29]
	Thymus capitatus	–	0.0025 EO 0.63 AE 2.5 ME	0.00375 EO 2.08 ± 0.54 AE 3.75 ± 1.37 ME	[41]
	Mentha * piperita	–	0.0057 EO	–	[38]
	Mentha pulegium (Fliou)	–	0.016 EO	–	[38]
	Mentha spicata	–	0.0093 EO	–	[38]
	Mentha suaveolens (Timija)	–	EO-Pul 0.00069	–	[28]
	Mentha rotundifolia	32 EO	0.63 EO	–	[6]
	Rosmarinus officinalis L. (Azir)		0.0228 EO		[38]
	Origanum compactum (Za’tar)	36.0 ± 1.7 EO	0.216 EO	0.288 EO	[25]
	Origanum compactum	34.0 ± 1.7 EO	0.216 EO	0.288 EO	[25]
	Majorana hortensis (Merdedouche)	35 EO	0.63 EO	0.63 EO	[6]
	Vitex Angus-castus L. (Anguerf)	50 EO	0.53 EO	1.06 EO	[5]
	Salvia officinalis (Salmia)	15 EO	0.63 EO	–	[6]
	Lavandula stoechas (Halhal)	8 EO	1.25 EO	–	[6]
	Lavandula angustifolia (Khzamafassiya)	30 EO	0.63 EO	12.5 EO	[6]
Geraniaceae	Pelargonium graveolens	–	0.0045 EO	–	[38]
	Pelargonium graveolens	45 EO	1.25 EO	–	[6]
	Pelargonium graveolens	13.60 ± 0.17 ME	0.47 ME	–	[27]
		9.42 ± 0.37 DCM	1.87 DCM	–
		7.53 ± 0.32 HX	3.75 HX	–
Rutaceae	Citrus limon	–	0.0855 EO	–	[38]
Cistaceae	Cistus villosus	–	6.25 Crude ME 50 ETAC 3.125 B	–	[32]
	Cistus monspeliensis (Tuzzalabéda)	–	200 Crude ME 100 ETAC 50 B	–	[32]
Cannabaceae	Cannabis sativa L. (Lkif)	12.0 ± 0.7 EO	9.5 EO	–	[17]
Apocynaceae	Caralluma europaea (Guss.) (Daghmous, Zakkum, Tikiwt)	14.50 ± 0.35 EO	3.75 EO	7.5 EO	[42]
	Periploca laevigata Aiton (elhallaba)	12.50 ± 0.35 EO	0.937 EO	1.875 EO	[16]
Ranunculaceae	Nigella sativa (Black cumin, Habbatul baraka, alhabbaassaouda,sanouje)	–	0.008 EO	–	[14]
Amaranthaceae	Chenopodium mural L. (Berremram)	NI EO	–	–	[24]
	Dysphania ambrosioides (L.) Mosyakin & Clemants (Mkhinza)	15 EO	0.075 EO	–	[15]
Myrtaceae	Myrtuscommunis (Rihàn)	22 EO	5 EO	–	[6]
	Syzygium aromaticum (Qronfel)	14.00 ± 1.00 EO	5 EO	5.00 EO	[29]
	Psidiumguajava (Guava)	16 ± 1.73 EO			[43]
Asteraceae	Scolymushispanicus L. (El guernina)	NI	–	–	[24]
	Senecioanteuphorbium (Achbartou)	22.00 ± 0.17 CA (CCMM L61) 27.00 ± 1.00 CA (CCMM L4) EO	1.024 CA (CCMM L61) 2.048 CA (CCMM L4) EO	4.096 CA (CCMM L61) 4.096 CA (CCMM L4) EO	[12]
	Dittrichia viscosa L. (Trehla or Magramane)	7 ± 0.05 EtOH	0.93 EtOH	1.75 EtOH	[10]
	Dittrichia viscosa L. (Trehla or Magramane)	10.6 ± 0.03 AE	0.87 AE	1.75 ACE	[10]
Euphorbiaceae	Mercurialis annua L. (Horrigalmalssa)	NI Crude extracts	–	–	[24]
Papaveraceae	Papaver rhoeas L. (Belaaman)	6 ± 0.3 Crude extracts	–	–	[24]
Apiaceae	Foeniculum vulgare Mill (Besbas beldi)	8 ± 0.15 Crude extracts	–	–	[24]
Fagaceae	Quercus suber (fernan)	–	12.5 ME (Bark)	–	[44]
Lauraceae	Laurus nobilis	7.00 EO	20.00 EO	20.00 EO	[29]

IZD: Inhibition zone diameter. MIC: Minimum inhibitory concentration. MFC: Minimum fungicidal concentration, W: wild; C: cultivated, CWtF: Cultivated without Fertilizer; CWF: Cultivated with Fertilizer; WP: Whole Plant; L: Leaves; S: Stems, I: Inflorescences, EO: Essential oil; AE: Acetonic extract; EtOH: ethanolic extract; ME: Methanolic extract; EO-Pul: Essential oil rich in pulegone, DCM: Dichloromethane, HX: Hexane. ETAC: ethyl acetate; B: Butanol; NI: No inhibition; CA: Candida albicans.

growth [29] .

These findings suggest that EO and plant extract can be considered as a potential source of natural antimicrobials. Therefore, their utilization in addition to antifungal drugs for the treatment of some candidiasis due to C. albicans is possible. It may constitute a promising strategy to overcome the intense use of antifungal drugs and reduce the minimum effective dose, thus minimizing their toxic side effects and the treatment cost [30] .

The effectiveness of essential oils is influenced by the plant’s origin and the parts used in their preparation [10] . Essential oil of Thymus willdenowii stems (MIC = 0.0069 mg/ml) was more active than that of leaves (MIC = 0.0138 mg/ml) and inflorescences (MIC = 0.0138 mg/ml) [31] .

The type of organic extract (Hexane, methanol, dichloromethane, ethanol, ethyl acetate, butanol, acetonic/extract) also affects the antifungal activity as shown by the studies of S. El Aanachi et al., H. Bouamama et al. and I. Mssillou et al. [10] [27] [32] .

The activity of essential oils and plant extracts also depends on whether the plants are wild or cultivated with or without fertilizersn [33] [34] .

In this review, Thymus is one of the most cited genera. 21 species represent the genus Thymus (Lamiacae) in Morocco. IMC values vary from 0.0022 mg/ml to 0.9 mg/ml. This variation may depend on the chemical composition of thyme essential oils, which in turn depends on several factors such as species, genetic heritage, origin, environmental influences, and growth stage [35] .

3.3. Moroccan Plants with Antifungal Activities

In recent years, several studies have been devoted to the study of plant extracts to develop new antifungal compounds that can be used in medical fields to treat various infections and in agricultural fields to control post-harvest diseases of fruits and vegetables.

A promising antifungal activity for several plants used in Morocco against many fungal species involved in plant or human diseases has been evidenced. According to studies, this activity exists whether it was in essential oils, plant extracts, or powders. These plants are listed in Table 3.

These results may provide support for further studies to evaluate the antifungal action of Moroccan plants against Candida albicans. The effectiveness of phytotherapy is well-proven. It is currently one of the main health care in Morocco. However, numerous studies show that medicinal plants can be carcinogenic, teratogenic, or even endanger life conditions. The toxicity of a plant is related to several factors, including the type and quantity of chemical compounds present in the plants, the quantity consumed, the exposure time, the part used (Seeds, leaves, oil, bark, stem, root), the climate and the soil, body chemistry, genetic and the preparation method used (Extraction: Solvent types, essential oils). Guidelines must be established to protect medicinal and aromatic plants and to regulate their local use by the population [56] [57] .

Table 3 Moroccan plants with antifungal activities

Family	Species		Forme	References
Rosaceae	Rubus ulmifolius Schott		Powder	[45]
Amaranthaceae	Hammada scoparia		Powder	[45]
Cistaceae	Halimium antiatlanticum		Powder	[45]
	Halimium umbellatum		Powder	[45]
	Cistus Creticus		EO	[46]
Anacardiaceae	Pistacia atlantica		Powder	[45]
Fabaceae	Ceratoniasiliqua		Powder	[45]
Cupressaceae	Cupressus atlantica		EO	[11]
Cupressaceae	Juniperus phoenicea (Ar’ar)		EO	[47]
Cyperaceae	Cyperus longus		EO	[47]
Lamiaceae	Mentha viridis (Naanaa)		EO	[19]
Lamiaceae	Thymus bleicherianus		EO	[35]
	Origanum compactum		EO	[23]
	Thymus glandulosus		EO	[23]
	Lavandula dentata		Organic extract	[23]
	Origanum vulgare		Organic extract	[23]
Pinaceae	Pinus halepensis Mill		Extracts and EO	[48]
Gentianceae	Centaurium erythraea Rafn (Korsatlhaya)		Extracts and EO	[49]
Zingiberaceae	Zingiber officinale extracts roscoe		Ethyl acetate extracts Ethanol extracts Water extracts	[50]
Rutaceae	Citrus limonum		EO	[23]
Asteraceae	Anvillea radiata		Organic extract	[23]
	Silybum marianum (L.) Gaertn		Decoction	[51]
	Ighermia pinifolia		Powder	[45]
	Inula viscosa		Powder	[45]
	Artemisia absinthium L. (Chiba)		Decoction	[8]
	Anthemis tenuisecta		EO	[52]
	Artemisia campestris L.		Extracts and EO	[53]
Myrtaceae	Eucalypltu scitriodora L. (kelitto)		Powder	[8]
	Eucalyptus globulus L. (Kalitouse)		Organic extract	[23]
Lauraceae	Cinnamomum zeylanicum		EO	[23]
Apiaceae	Cuminum cyminum L. (Kammun)		Cooking	[8]
Amarillydaceae		Allium sativum L. (Touma)	Cooking	[8]
		Allium cepa L. (Bsal)	Maceration	[8]
Apocynaceae		Nerium oleander L. (Dafla)	Infusion	[8]
Salicaceae		Salix alba L. (Ud el-mâ)	Decoction	[8]
Vitaceae		Vitis vinifera L. (La’anb)	Powder	[8]
Arecaceae		Phoenix dactylifera L. (Tamr)	Extract	[54]
Urticaceae		Urtica dioica L. (Hourriga, al quarâs)	Powder, Infusions Decoction	[55]

4. Conclusion

The research of new active principles extracted from medicinal and aromatic plants is nowadays a priority for many countries to face the increasing resistance of the human body against drugs. In this article, a review of existing knowledge on the antifungal activity of different plants of Moroccan origin was carried out. First, plants used by the Moroccan population for oral diseases were cited. Then, studies that discussed the anti-candidal activity of essential oils and extracts from Moroccan plants were reported. This review represents the unique comprehensive overview of Moroccan plants active against Candida albicans. Finally, the plants presenting an antifungal action against fungal species involved in plant or human diseases were listed. The anticandidal activity has been proven for several Moroccan plants, and this review will supply a baseline to identify this activity for other Moroccan plants. Further investigation should be undertaken in the future to study the toxicity of essential oils and plant extracts and to determine the optimal concentrations for clinical use. This article will provide supporting data and perspectives for future research studies on the antifungal activities of Moroccan plants.

Conflicts of Interest

The authors declare no conflicts of interest regarding the publication of this paper.

Cite this paper

El Assraoui, K. and Rochd, T. (2023) Anticandidal Activity of Moroccan Medicinal Plants. Journal of Biosciences and Medicines, 11, 79-95. https://doi.org/10.4236/jbm.2023.117008

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