Contributions of the Biofilm Matrix to Candida Pathogenesis

Abstract

In healthcare settings, Candida spp. cause invasive disease with high mortality. The overwhelming majority of cases are associated with the use of critically-needed medical devices, such as vascular catheters. On the surface of these indwelling materials, Candida forms resilient, adherent biofilm communities. A hallmark characteristic of this process is the production of an extracellular matrix, which promotes fungal adhesion and provides protection from external threats. In this review, we highlight the medical relevance of device-associated Candida biofilms and draw attention to the process of Candida-biofilm-matrix production. We provide an update on the current understanding of how biofilm extracellular matrix contributes to pathogenicity, particularly through its roles in the promoting antifungal drug tolerance and immune evasion.

Candida albicans—The Virulence Factors and Clinical Manifestations of Infection

“…An essential part of the extracellular matrix are β-1,3-glucans, which significantly contribute to the biofilm’s resistance to antifungal drugs because they prevent contact with target cells [ 36 ]. C. albicans cells in biofilm release more β-1,3-glucans into the extracellular matrix than planktonic cells [ 37 ]. The biofilm channels facilitate cell supply with nutrients, air, and water, giving it new “multicellular” properties [ 32 ].…”

Candida albicans biofilms and polymicrobial interactions

“…Candida species, which include the opportunistic pathogen Candida albicans, are one of the main causes of nosocomial infections worldwide, particularly in immunocompromised individuals (Hajjeh et al 2004). Candida albicans can form complex biofilms on medical devices and, often, device removal is recommended (Kojic and Darouiche 2004;Pappas et al 2016;Cavalheiro and Teixeira 2018;Nett and Andes 2020). Biofilms are also associated with recurrent candidaemia, which affects more than 400 000 people per year and has an alarming mortality rate of approximately 50% (Tumbarello et al 2012;Bongomin et al 2017;Li et al 2018).…”

A Label-Free Cellular Proteomics Approach to Decipher the Antifungal Action of DiMIQ, a Potent Indolo[2,3-b]Quinoline Agent, against Candida albicans Biofilms

“…As biofilms strongly contribute to the fungal pathogenicity, unraveling and understanding the mechanisms of drug resistance is a key approach to develop antibiofilm treatment regimens and successfully deal with the problem of medical device-associated fungal infections [ 32 ]. Because of the lack of effective antifungal therapy against biofilm infections, the only recommended treatment for Candida biofilm infections is removal of the infected device [ 33 ]. Over the last few decades, only a handful of novel approaches that theoretically prevent and control biofilm formation and development have been developed.…”