Candida albicans, a commensal fungus of the oral microbiome, causes oral candidiasis in humans with localized or systemic immune deficiencies. Secreted aspartic proteinases (Saps) are a family of 10 related proteases and are virulence factors due to their proteolytic activity, as well as their roles in adherence and colonization of host tissues. We found that mice infected sublingually with C. albicans cells overexpressing Sap6 (SAP6 OE and a ⌬sap8 strain) had thicker fungal plaques and more severe oral infection, while infection with the ⌬sap6 strain was attenuated. These hypervirulent strains had highly aggregative colony structure in vitro and higher secreted proteinase activity; however, the levels of proteinase activity of C. albicans Saps did not uniformly match their abilities to damage cultured oral epithelial cells (SCC-15 cells). Hyphal induction in cells overexpressing Sap6 (SAP6 OE and ⌬sap8 cells) resulted in formation of large cell-cell aggregates. These aggregates could be produced in germinated wild-type cells by addition of native or heat-inactivated Sap6. Sap6 bound only to germinated cells and increased C. albicans adhesion to oral epithelial cells. The adhesion properties of Sap6 were lost upon deletion of its integrin-binding motif (RGD) and could be inhibited by addition of RGD peptide or anti-integrin antibodies. Thus, Sap6 (but not Sap5) has an alternative novel function in cell-cell aggregation, independent of its proteinase activity, to promote infection and virulence in oral candidiasis.
Candida albicans is a commensal fungus that is often part of the oral microflora of healthy people. Loss of host immunity, HIV infection, corticosteroid use, or alteration of the oral microflora following antibiotic therapies permits a pathogenic transition of C. albicans to cause oropharyngeal candidiasis (OPC) (1, 2). Acute pseudomembranous candidiasis is one of the most common forms of OPC, in which C. albicans forms white patches on the surface of the buccal mucosa, tongue, or soft palate. These superficial fungal plaques can be lifted from underlying tissues for purposes of clinical diagnosis and analysis (3).C. albicans expresses specific sets of virulence factors that promote hypha formation and adhesion and invasion of host tissues (4). Secreted aspartyl proteinases (Saps) are recognized virulence factors because they degrade host proteins to provide nitrogen for fungal cell metabolism, contribute to adherence, facilitate fungal epithelial and endothelial penetration, and are immunogenic during infection (5-7). Microbial proteinases are classified as serine, cysteine, metallo-, or aspartyl proteinases according to the site of catalytic hydrolysis of substrate peptide bonds; however, C. albicans produces only aspartyl proteinases (5, 6).C. albicans expresses a family of 10 SAP genes that are clustered into groups SAP1 to SAP3, SAP4 to SAP6, SAP7, SAP8, and SAP9 and SAP10 based upon their sequence homologies and pH activities (8, 9). Sap1 through Sap8 are processed and transported via the secreto...