Na Li,1,2 Junli Zhang,3 Fei Yu,1,2 Fanghang Ye,1,2 Wanying Tan,4 Liyuan Hao,1,2 Shenghao Li,1,2 Jiali Deng,1,2 Xiaoyu Hu2 

1Department of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China; 2Department of Infectious Diseases, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China; 3Jiangsu Provincial Hospital of Traditional Chinese Medicine, Nanjing, People’s Republic of China; 4Center for Infectious Diseases, West China Hospital, Sichuan University, Chengdu, People’s Republic of China

Correspondence: Xiaoyu Hu, Email TCMxiaoyuhu@aliyun.com

Abstract: In recent years, the incidence of fungal infections has been rising annually, especially among immunocompromised populations, posing a significant challenge to public health. Although antifungal medications provide some relief, the escalating problem of resistance sharply curtails their effectiveness, presenting an urgent clinical dilemma that demands immediate attention. Research has shown that fungal resistance is closely related to quorum sensing (QS), and QS inhibitors (QSIs) are considered an effective solution to this issue. Garlic, as a natural QSI, has demonstrated significant effects in inhibiting fungal growth, preventing biofilm formation, enhancing immunity, and combating resistance. This study explores the potential of garlic in mitigating fungal drug resistance and identifies its key role in inhibiting the QS mechanism, these findings offer a new perspective for the treatment of fungal infections, especially in addressing the increasingly severe problem of resistance. However, the clinical application of garlic still faces several challenges, such as ensuring the standardization of active ingredient extraction, as well as issues of safety and stability. Future research should focus on the QS mechanism and promote interdisciplinary collaboration to develop more natural, effective, and safe QSI drugs like garlic, while actively conducting clinical trials to validate their efficacy and safety. Additionally, incorporating advanced technologies such as nanotechnology to enhance drug stability and targeting, provide a more comprehensive strategy for the treatment of fungal infections. Overall, Our study provides scientific evidence supporting the potential of garlic as a novel antifungal treatment and lays the groundwork for the development of future natural QSIs for therapeutic use. It offers new insights, particularly for the treatment of immunocompromised populations and drug-resistant fungal strains.

Keywords: fungal infection, drug resistance, garlic, quorum sensing, quorum sensing inhibitors