Characterization of virulence factors of vaginal and anal isolates of Candida albicans sequentially obtained from patients with vulvovaginal candidiasis in north-east Brazil

Medeiros, Mariana Araújo Paulo de; Melo, Ana Patrícia Vieira de; Sousa, A.M. Maia de; Silva-Rocha, Walicyranison Plinio da; Milan, Eveline Pı́polo; Chaves, Guilherme Maranhão

doi:10.1016/j.mycmed.2017.06.002

Cited by 14 publications

(8 citation statements)

References 17 publications

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“…Medeiros et al concluded that germ tube formation is of great importance in the development of VVC, as they found in Candida spp. obtained from the vagina and anus of 62 women with VVC a correlation between germination and the presence of symptoms, and that germ tube formation is relevant during infection but not in colonization [85].…”

Section: Morphological Switchmentioning

confidence: 91%

Virulence Factors as Promoters of Chronic Vulvovaginal Candidosis: A Review

et al. 2021

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Section: Morphological Switchmentioning

confidence: 91%

Virulence Factors as Promoters of Chronic Vulvovaginal Candidosis: A Review

et al. 2021

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“…modifies to favor adhesion or penetration processes and, consequently, modifies its role to become a pathogenic microorganism (Silva et al, 2012;Kalaiarasan et al, 2018;Willems et al, 2018). Araújo Paulo, de Medeiros et al (2017) reported that the virulence characteristics of C. albicans contributing to its pathogenicity include the skill to adhere to human epithelial and endothelial cells, yeast to hyphae transition, extracellular hydrolytic enzyme (proteinases and phospholipases) secretion, phenotypic adaptability, and biofilm formation. Further, there is a relationship between virulence factor expression and VVC signs and symptoms identified in the patients, but it does not seem to be essential for the transition from colonization to infection.…”

Section: Vaginal Ecosystemmentioning

confidence: 99%

Pathogenesis and Clinical Relevance of Candida Biofilms in Vulvovaginal Candidiasis

et al. 2020

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The ability of Candida spp. to form biofilms is crucial for its pathogenicity, and thus, it should be considered an important virulence factor in vulvovaginal candidiasis (VVC) and recurrent VVC (RVVC). Its ability to generate biofilms is multifactorial and is generally believed to depend on the site of infection, species and strain involved, and the microenvironment in which the infection develops. Therefore, both cell surface proteins, such as Hwp1, Als1, and Als2, and the cell wall-related protein, Sun41, play a critical role in the adhesion and virulence of the biofilm. Immunological and pharmacological approaches have identified the NLRP3 inflammasome as a crucial molecular factor contributing to host immunopathology. In this context, we have earlier shown that Candida albicans associated with hyphae-secreted aspartyl proteinases (specifically SAP4-6) contribute to the immunopathology of the disease. Transcriptome profiling has revealed that non-coding transcripts regulate protein synthesis post-transcriptionally, which is important for the growth of Candida spp. Other studies have employed RNA sequencing to identify differences in the 1,245 Candida genes involved in surface and invasive cellular metabolism regulation. In vitro systems allow the simultaneous processing of a large number of samples, making them an ideal screening technique for estimating various physicochemical parameters, testing the activity of antimicrobial agents, and analyzing genes involved in biofilm formation and regulation ( in situ ) in specific strains. Murine VVC models are used to study C. albicans infection, especially in trials of novel treatments and to understand the cause(s) for resistance to conventional therapeutics. This review on the clinical relevance of Candida biofilms in VVC focuses on important advances in its genomics, transcriptomics, and proteomics. Moreover, recent experiments on the influence of biofilm formation on VVC or RVVC pathogenesis in laboratory animals have been discussed. A clear elucidation of one of the pathogenesis mechanisms employed by Candida biofilms in vulvovaginal candidiasis and its applications in clinical practice represents the most significant contribution of this manuscript.

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“…Though remaining controversial, 63 the secretion of extracellular tissue-damaging hydrolytic enzymes such as proteinases seems to have a significant role in both invasive Candida infection and in mucosal infections such as vulvovaginitis. C. albicans isolates causing vaginitis were shown to produce a significantly higher level of aspartyl proteinases than isolates recovered from asymptomatic vaginal carriers.…”

Section: Discussionmentioning

confidence: 99%

“…61 This could be attributed to the different nature of the study and to the immune state of the studied patients which may interact with the organism in a complex way that affects the organism's virulence and pathogenesis. 62 Though remaining controversial, 63 the secretion of extracellular tissue-damaging hydrolytic enzymes such as proteinases seems to have a significant role in both invasive Candida infection and in mucosal infections such as vulvovaginitis. C. albicans isolates causing vaginitis were shown to produce a significantly higher level of aspartyl proteinases than isolates recovered from asymptomatic vaginal carriers.…”

mentioning

confidence: 99%

Biofilm Formation and Aspartyl Proteinase Activity and Their Association with Azole Resistance Among Candida albicans Causing Vulvovaginal Candidiasis, Egypt

Gerges,

Fahmy,

Hosny

et al. 2023

IDR

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Background Candida albicans ( C. albicans ) is a major cause of vulvovaginal candidiasis (VVC), a condition that is commonly treated with azole agents. Biofilm formation and aspartyl proteinase production are important virulence factors that could be linked to azole resistance in C. albicans impeding therapy. Aim To find out the association of both factors with azole resistance among C. albicans isolated from VVC cases in Egyptian nonpregnant women of childbearing age. Patients and Methods In a cross-sectional study, C. albicans was isolated from nonpregnant females diagnosed clinically as having VVC during a 1-year study period. Susceptibility to azole agents was tested using the disc diffusion method. Biofilm formation and aspartyl proteinase production were assessed phenotypically. Additionally, two biofilm-related genes ( ALS1 and HWP1 ) and three proteinase genes ( SAP2, SAP4 , and SAP6 ) were screened for using polymerase chain reaction (PCR). Results Among 204 C. albicans isolates, azole resistance ratios were as follows: voriconazole (30.4%), itraconazole (17.6%), fluconazole (11.3%) and econazole (6.4%). Biofilm-producing capacity was detected in 63.2% of isolates, and 63.2% were proteinase producers. The frequencies of ALS1 and HWP1 were 69.6% and 74.5%, respectively, while SAP2, SAP4 , and SAP6 were 69.2%, 88.7%, and 64.7%, respectively. Biofilm formation was significantly associated with azole resistance (P < 0.001 for each tested azole agent) as was proteinase production (P < 0.001 for fluconazole, voriconazole, and econazole resistance and P = 0.047 for itraconazole). Conclusion Among nonpregnant Egyptian women of childbearing age, azole resistance in C. albicans causing VVC is significantly associated with biofilm formation and proteinase production. The development of new therapeutic agents that can target these factors is warranted.

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Characterization of virulence factors of vaginal and anal isolates of Candida albicans sequentially obtained from patients with vulvovaginal candidiasis in north-east Brazil

Cited by 14 publications

References 17 publications

Virulence Factors as Promoters of Chronic Vulvovaginal Candidosis: A Review

Virulence Factors as Promoters of Chronic Vulvovaginal Candidosis: A Review

Pathogenesis and Clinical Relevance of Candida Biofilms in Vulvovaginal Candidiasis

Biofilm Formation and Aspartyl Proteinase Activity and Their Association with Azole Resistance Among Candida albicans Causing Vulvovaginal Candidiasis, Egypt

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