Differences in Ocular Complications Between Candida albicans and Non-albicans Candida Infection Analyzed by Epidemiology and a Mouse Ocular Candidiasis Model

Abstract

Objectives: Candida species are a major cause of hospital infections, including ocular candidiasis, but few studies have examined the propensities of specific species to invade the eye or the unique immunological responses induced. This study examined the frequency and characteristics of species-specific Candida eye infections by epidemiology and experiments using a mouse ocular candidiasis model.Methods: We reviewed medical records of candidemia patients from January 2012 to March 2017. We also evaluated ocular fungal burden, inflammatory cytokine and chemokine profiles, and inflammatory cell profiles in mice infected with Candida albicans, Candida glabrata, or Candida parapsilosis.Results: During the study period, 20 ocular candidiasis cases were diagnosed among 99 candidemia patients examined by ophthalmologists. Although C. parapsilosis was the most frequent candidemia pathogen, only C. albicans infection was significantly associated with ocular candidiasis by multivariate analysis. In mice, ocular fungal burden and inflammatory mediators were significantly higher during C. albicans infection, and histopathological analysis revealed invading C. albicans surrounded by inflammatory cells. Ocular neutrophil and inflammatory monocyte numbers were significantly greater during C. albicans infection.Conclusion: Candida albicans is strongly associated with ocular candidiasis due to greater capacity for invasion, induction of inflammatory mediators, and recruitment of neutrophils and inflammatory monocytes.

Factors associated with the development of ocular candidiasis and ocular prognosis with echinocandin therapy for candidemia

“…Among 8 cases of probable OC, 7 had C. albicans involvement, which was considered to be a significant factor associated with OC, consistent with previous reports [16,25]. Abe et al [26] also reported that C. albicans might have greater risk for OC over other Candida species. In addition, Abe et al reported that ocular inflammation was more severe because of the greater cytokine/chemokine release and concomitant recruitment of neutrophils and monocytes in mice with C. albicans infection as compared with Candida non-albicans infection.…”

DABCO-Customized Nanoemulsions: Characterization, Cell Viability and Genotoxicity in Retinal Pigmented Epithelium and Microglia Cells

“…The antifungal treatment should thus start immediately [38]. Candida albicans is the most predominant species that causes infection in the eye, namely endogenous yeast endophthalmitis, for example [39], and about 10-25% of infections provoked by Candida result in ocular candidiasis [40]. The MIC values of the nanoemulsions against Candida albicans are shown in Table 5.…”

Microglial Response to Aspergillus flavus and Candida albicans: Implications in Endophthalmitis

“…It has also been reported that these mannoproteins are glycosylphosphatidylinositol-modified during interactions with the host, allowing the activation of the immune response by masking the β-glucan layer and thereby leading to an ineffective activation of the host immune system [31]. Similarly, it has been reported that C. albicans tended to cause higher inflammatory cytokine and chemokine concentrations, along with increased neutrophils and inflammatory monocytes, compared with nonalbicans Candida infections [33]. Additionally, the MAPK signaling pathway was also demonstrated by Galan-Diéz et al [30] to be involved in the process of β-glucan masking.…”