Should we absolutely reject the hypothesis that epithelium-based Candida biofilms contribute to the pathogenesis of human vulvovaginal candidiasis?

Xu, Boyun; Qu, Yue; Deighton, Margaret

doi:10.1016/j.ajog.2019.07.007

Cited by 4 publications

(3 citation statements)

References 6 publications

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“…Recent work by Swidsinski et al (2019) found endocytosed hyphae or pseudohyphae in the vaginal epithelium in patients with confirmed vaginal candidiasis, although no typical multi-layer biofilm structure was detected in the human vagina (Swidsinski et al, 2019). We propose that the biofilm-related fungal infiltration might resemble microcolony biofilms that are more frequently found in vivo, and share some important traits with in vivo biofilms, such as harboring antifungal-tolerant persister cells (Bjarnsholt et al, 2013;Xu et al, 2019). It is now known that dense microbial growth in a confined space promotes the formation of persister cells (Qu et al, 2010).…”

Section: Discussionmentioning

confidence: 84%

Biofilm Formation of Candida albicans Facilitates Fungal Infiltration and Persister Cell Formation in Vaginal Candidiasis

Zhang

et al. 2020

Front. Microbiol.

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Background: Vaginal candidiasis is an important medical condition awaiting more effective treatment. How Candida albicans causes this disease and survives antifungal treatment is not yet fully understood. This study aimed to establish a comprehensive understanding of biofilm-related defensive strategies that C. albicans uses to establish vaginal candidiasis and to survive antifungal treatment. Methods: A mouse model of vaginal candidiasis was adopted to examine the formation of biotic biofilms on the vaginal epithelium and fungal infiltration by laboratory and clinical strains of C. albicans. Histopathological changes and local inflammation in the vaginal epithelium caused by C. albicans of different biofilm phenotypes were compared. Antifungal susceptibility testing was carried out for C. albicans grown as planktonic cells, microplate-based abiotic biofilms, and epithelium-based biotic biofilms. Formation of persister cells by C. albicans in different growth modes was also quantified and compared. Results: C. albicans wild-type reference strains and clinical isolates, but not the biofilm-defective mutants, formed a significant number of biotic biofilms on the vaginal epithelium of mice and infiltrated the epithelium. Biofilm formation and epithelial invasion induced local inflammatory responses and histopathological changes in the vaginal epithelium including neutrophil infiltration and subcorneal microabscesses. Biofilm growth on the vaginal epithelium also led to high resistance to antifungal treatments and promoted the formation of antifungal-tolerant persister cells. Conclusion: This study comprehensively assessed biofilm-related microbial strategies that C. albicans uses in vaginal candidiasis and provided experimental evidence to support the important role of biofilm formation in the histopathogenesis of vaginal candidiasis and the recalcitrance of the infection to antifungal treatment.

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Section: Discussionmentioning

confidence: 84%

Biofilm Formation of Candida albicans Facilitates Fungal Infiltration and Persister Cell Formation in Vaginal Candidiasis

Zhang

et al. 2020

Front. Microbiol.

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“…Utilising a rat central venous catheter model, the duration of the early phase and maturation of biofilm formation in vivo was shorter than that observed in vitro (Andes et al 2004). While C. albicans forms biofilms readily on abiotic substrates and on the mucosal surfaces of the oral cavity, conflicting observations have been made regarding the formation of biofilms on the vaginal mucosa (Harriott et al 2010;Paiva et al 2012;Sherry et al 2017;Noverr and Fidel 2019;Swidsinski et al 2019;Xu et al 2019), suggesting that tissue/anatomical location and surrounding microbiota are likely to influence biofilm development. These observations have led to some contention regarding the definition of clinical diseases that specifically involve biofilms as opposed to diseases that are associated with a diverse or altered microbiota (Harriott et al 2010;Paiva et al 2012;Sobel 2015;Sherry et al 2017;Noverr and Fidel 2019;Swidsinski et al 2019;Xu et al 2019).…”

Section: Transcriptional Regulation Of Biofilm Formation and Maintenancementioning

confidence: 99%

Candida albicans biofilms and polymicrobial interactions

Ponde

Lortal

Ramage

et al. 2021

Critical Reviews in Microbiology

153

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Candida albicans is a common fungus of the human microbiota. While generally a harmless commensal in healthy individuals, several factors can lead to its overgrowth and cause a range of complications within the host, from localized superficial infections to systemic life-threatening disseminated candidiasis. A major virulence factor of C. albicans is its ability to form biofilms, a closely packed community of cells that can grow on both abiotic and biotic substrates, including implanted medical devices and mucosal surfaces. These biofilms are extremely hard to eradicate, are resistant to conventional antifungal treatment and are associated with high morbidity and mortality rates, making biofilm-associated infections a major clinical challenge. Here, we review the current knowledge of the processes involved in C. albicans biofilm formation and development, including the central processes of adhesion, extracellular matrix production and the transcriptional network that regulates biofilm development. We also consider the advantages of the biofilm lifestyle and explore polymicrobial interactions within multispecies biofilms that are formed by C. albicans and selected microbial species.

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“…We have found that dense growth of monolayer biofilms in a confined space stimulated persister cell production and led to antimicrobial tolerance in vitro. 5 The further clarification of the possible dynamic change of Candida growth in the human vagina VVC and whether the endocytosed hyphal cell growth mode promotes persister cell production needs collaborative efforts from experimental microbiologists and clinical investigators.…”

Section: Replymentioning

confidence: 99%

Should we absolutely reject the hypothesis that epithelium-based Candida biofilms contribute to the pathogenesis of human vulvovaginal candidiasis?

Cited by 4 publications

References 6 publications

Biofilm Formation of Candida albicans Facilitates Fungal Infiltration and Persister Cell Formation in Vaginal Candidiasis

Biofilm Formation of Candida albicans Facilitates Fungal Infiltration and Persister Cell Formation in Vaginal Candidiasis

Candida albicans biofilms and polymicrobial interactions

Should we absolutely reject the hypothesis that epithelium-based Candida biofilms contribute to the pathogenesis of human vulvovaginal candidiasis?

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