Candida albicans: Virulence factors, pathogenesis, and ways to diagnose and control its infection
DOI:
https://doi.org/10.33448/rsd-v13i1.44781Keywords:
Candida albicans; Candidiasis; Diagnosis; Virulence factors.Abstract
The objective of this study was to provide a review on Candida albicans, focusing on its main virulence factors, pathogenesis, and methods of diagnosis and control of infections caused by this microorganism, known as candidiasis. Its main virulence factors are adhesion, polymorphism and dimorphism, which aid in tissue invasion, phenotypic variability, tolerance to toxins, and the presence of enzymes such as proteases and phospholipases. These factors confer the fungus with the ability to colonize, establish itself, and consequently, cause infections. C. albicans can proliferate on the skin and mucous membranes of the oropharyngeal cavity, gastrointestinal tract, and vaginal tract. The result of this colonization is the formation of white plaques or nodules with erythematous borders in the infected area. Additionally, it may cause pain and burning or be asymptomatic. The diagnosis of candidiasis is based on the symptoms presented by the host. Cultures, histopathological examinations, blood cultures, and serum beta-glucan tests can also be used. The treatment of candidiasis is carried out with antifungals such as nystatin, clotrimazole, fluconazole, itraconazole, and amphotericin B. However, research on medicinal plant products has been conducted to provide an integrative and complementary approach to controlling this pathogen. Thymus vulgaris L. is a good example of this. It is a plant with various phytochemicals and recognized biological activities, including antifungal effects. Thus, this study demonstrated some morphological and pathological characteristics of C. albicans. It was also possible to understand how candidiasis manifests, and how it can be diagnosed and treated both conventionally and integratively.
References
Allert, S., Förster, T. M., Svensson, C.-M., Richardson, J. P., Pawlik, T., Hebecker, B., Rudolphi, S., Juraschitz, M., Schaller, M., Blagojevic, M., Morschhäuser, J., Figge, M. T., Jacobsen, I. D., Naglik, J. R., Kasper, L., Mogavero, S., & Hube, B. (2018). Candida albicans-induced epithelial damage mediates translocation through intestinal barriers. mBio, 9(3). https://doi.org/10.1128/mbio.00915-18
Al-Shahrani, M. H., Mahfoud, M., Anvarbatcha, R., Athar, M. T., & Al Asmari, A. (2017). Evaluation of antifungal activity and cytotoxicity of Thymus vulgaris essential oil. Pharmacognosy Communications, 7(1), 34–40. https://doi.org/10.5530/pc.2017.1.5
Bailly, S., Maubon, D., Fournier, P., Pelloux, H., Schwebel, C., Chapuis, C., Foroni, L., Cornet, M., & Timsit, J.-F. (2016). Impact of antifungal prescription on relative distribution and susceptibility of Candida spp. – Trends over 10 years. The Journal of Infection, 72(1), 103–111. https://doi.org/10.1016/j.jinf.2015.09.041
Bakhshi, M., Taheri, J.-B., Basir Shabestari, S., Tanik, A., & Pahlevan, R. (2012). Comparison of therapeutic effect of aqueous extract of garlic and nystatin mouthwash in denture stomatitis. Gerodontology, 29(2). https://doi.org/10.1111/j.1741-2358.2011.00544.x
Baumgardner, D. J. (2019). Oral fungal Microbiota: To thrush and beyond. Journal of Patient-Centered Research and Reviews, 6(4), 252–261. https://doi.org/10.17294/2330-0698.1705
Bezerra, L. S., Silva, J. A. da, Santos-Veloso, M. A. O., Lima, S. G. de, Chaves-Markman, Â. V., & Jucá, M. B. (2020). Antifungal Efficacy of Amphotericin B in Candida Albicans Endocarditis Therapy: Systematic Review. Revista Brasileira de Cirurgia Cardiovascular: Orgao Oficial Da Sociedade Brasileira de Cirurgia Cardiovascular, 35(5). https://doi.org/10.21470/1678-9741-2019-0159
Birmpa, A., Vantarakis, A., Paparrodopoulos, S., Whyte, P., & Lyng, J. (2014). Efficacy of three light technologies for reducing microbial populations in liquid suspensions. BioMed Research International, 2014, 1–9. https://doi.org/10.1155/2014/673939
Borugă, O., Jianu, C., Mişcă, C., Goleţ, I., Gruia, A. T., & Horhat, F. G. (2014). Thymus vulgaris essential oil: chemical composition and antimicrobial activity. Journal of Medicine and Life, 7 Spec No. 3, 56–60.
Brito, E. H. S. de, Fontenelle, R. O. dos S., Brilhante, R. S. N., Cordeiro, R. de A., Sidrim, J. J. C., & Rocha, M. F. G. (2009). Candidose na medicina veterinária: um enfoque micológico, clínico e terapêutico. Ciencia Rural, 39(9), 2655–2664. https://doi.org/10.1590/s0103-84782009000900046
Cavalheiro, M., & Teixeira, M. C. (2018). Candida biofilms: Threats, challenges, and promising strategies. Frontiers in Medicine, 5. https://doi.org/10.3389/fmed.2018.00028
César de Souza Vasconcelos, L., Sampaio, M. C. C., Sampaio, F. C., & Higino, J. S. (2003). Use of Punica granatum as an antifungal agent against candidosis associated with denture stomatitis. Mycoses, 46(5–6), 192–196. https://doi.org/10.1046/j.1439-0507.2003.00884.x
Colombo, A. L., Guimarães, T., Camargo, L. F. A., Richtmann, R., de Queiroz-Telles, F., Salles, M. J. C., da Cunha, C. A., Yasuda, M. A. S., Moretti, M. L., & Nucci, M. (2013). Brazilian guidelines for the management of candidiasis – a joint meeting report of three medical societies: Sociedade Brasileira de Infectologia, Sociedade Paulista de Infectologia and Sociedade Brasileira de Medicina Tropical. The Brazilian Journal of Infectious Diseases: An Official Publication of the Brazilian Society of Infectious Diseases, 17(3), 283–312. https://doi.org/10.1016/j.bjid.2013.02.001
Costa, M., de Fátima Lisboa Fernandes, O., & do Rosârio Rodrigues Silva, M. (2003). Candidiase vulvovaginal: aspectos clinicos, tratamentos oral com azólicos e suscetibilidade in vitro. Revista de patologia tropical, 32(2), 145–162. https://doi.org/10.5216/rpt.v32i2.31727
C., Carretto, P., Aparecida Ferraz De Araujo Navas, E., Paradella, C., Dias De Oliveira, L., Campos Junqueira, J., Olavo, A., & Jorge, C. (2007). Efeitos do chá de tomilho sobre a aderência in vitro de Streptococcus mutans ao esmalte dentário e. Com.Br. https://www.revodontolunesp.com.br/article/5880180e7f8c9d0a098b4a49/pdf/rou-36-3-281.pdf
Donnelly, R. F., McCarron, P. A., & Tunney, M. M. (2008). Antifungal photodynamic therapy. Microbiological Research, 163(1), 1–12. https://doi.org/10.1016/j.micres.2007.08.001
Dorsa, A. C. (2020). O papel da revisão da literatura na escrita de artigos científicos. https://www.scielo.br/j/inter/a/ctsj4sLz6CkZYQfZWBS4Lbr/
Ellis, M. E., Al-Abdely, H., Sandridge, A., Greer, W., & Ventura, W. (2001). Fungal endocarditis: Evidence in the world literature, 1965-1995. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 32(1), 50–62. https://doi.org/10.1086/317550
Gad, M., & Fouda, S. (2020). Current perspectives and the future of Candida albicans-associated denture stomatitis treatment. Dental and Medical Problems, 57(1), 95–102. https://doi.org/10.17219/dmp/112861
Gulati, M., & Nobile, C. J. (2016). Candida albicans biofilms: development, regulation, and molecular mechanisms. Microbes and Infection, 18(5), 310–321. https://doi.org/10.1016/j.micinf.2016.01.002
Hani, U., Shivakumar, H., Vaghela, R., M. Osmani, R., & Shrivastava, A. (2015). Candidiasis: A fungal infection- current challenges and progress in prevention and treatment. Infectious Disorders Drug Targets, 15(1), 42–52. https://doi.org/10.2174/1871526515666150320162036
Jafri, H., & Ahmad, I. (2020). Thymus vulgaris essential oil and thymol inhibit biofilms and interact synergistically with antifungal drugs against drug resistant strains of Candida albicans and Candida tropicalis. Journal de Mycologie Medicale, 30(1), 100911. https://doi.org/10.1016/j.mycmed.2019.100911
Jakiemiu, E. A. R., Scheer, A. D. P., Oliveira, J. S. de, Côcco, L. C., Yamamoto, C. I., & Deschamps, C. (2010). Estudo da composição e do rendimento do óleo essencial de tomilho (Thymus vulgaris L.). Semina. Ciencias Agrarias, 31(3), 683. https://doi.org/10.5433/1679-0359.2010v31n3p683
Jean L. Bolognia, Julie V. Schaffer, Lorenzo Cerroni. (2017). Dermatology. Elsevier 4th ed.; Elsevier: Amsterdam, The Netherlands, 2018; Volume 2, ISBN 978-0-7020-6275-9.
Kadosh, D. (2019). Regulatory mechanisms controlling morphology and pathogenesis in Candida albicans. Current Opinion in Microbiology, 52, 27–34. https://doi.org/10.1016/j.mib.2019.04.005
Kowalczyk, A., Przychodna, M., Sopata, S., Bodalska, A., & Fecka, I. (2020). Thymol and thyme essential oil—new insights into selected therapeutic applications. Molecules (Basel, Switzerland), 25(18), 4125. https://doi.org/10.3390/molecules25184125
Labib, G., & Aldawsari, H. (2015). Innovation of natural essential oil-loaded Orabase for local treatment of oral candidiasis. Drug Design, Development and Therapy, 3349. https://doi.org/10.2147/dddt.s85356
Lewis, M. A. O., & Williams, D. W. (2017). Diagnosis and management of oral candidosis. British Dental Journal, 223(9), 675–681. https://doi.org/10.1038/sj.bdj.2017.886
Lohse, M. B., Gulati, M., Johnson, A. D., & Nobile, C. J. (2018). Development and regulation of single- and multi-species Candida albicans biofilms. Nature Reviews. Microbiology, 16(1), 19–31. https://doi.org/10.1038/nrmicro.2017.107
Lu, Y., Su, C., & Liu, H. (2014). Candida albicans hyphal initiation and elongation. Trends in Microbiology, 22(12), 707–714. https://doi.org/10.1016/j.tim.2014.09.001
Marqués-Calvo, M. S., Codony, F., Agustí, G., & Lahera, C. (2017). Visible light enhances the antimicrobial effect of some essential oils. Photodiagnosis and Photodynamic Therapy, 17, 180–184. https://doi.org/10.1016/j.pdpdt.2016.12.002
Martins, N., Ferreira, I. C. F. R., Barros, L., Silva, S., & Henriques, M. (2014). Candidiasis: Predisposing factors, prevention, diagnosis and alternative treatment. Mycopathologia, 177(5–6), 223–240. https://doi.org/10.1007/s11046-014-9749-1
Maubon, D., Garnaud, C., Calandra, T., Sanglard, D., & Cornet, M. (2014). Resistance of Candida spp. to antifungal drugs in the ICU: where are we now? Intensive Care Medicine, 40(9), 1241–1255. https://doi.org/10.1007/s00134-014-3404-7
Micucci, M., Protti, M., Aldini, R., Frosini, M., Corazza, I., Marzetti, C., Mattioli, L. B., Tocci, G., Chiarini, A., Mercolini, L., & Budriesi, R. (2020). Thymus vulgaris L. essential oil solid formulation: Chemical profile and spasmolytic and antimicrobial effects. Biomolecules, 10(6), 860. https://doi.org/10.3390/biom10060860
Mohammadi, M., Shahisaraee, S. A., Tavajjohi, A., Pournoori, N., Muhammadnejad, S., Mohammadi, S. R., Poursalehi, R., & Delavari H, H. (2019). Green synthesis of silver nanoparticles using Zingiber officinale and Thymus vulgaris extracts: characterisation, cell cytotoxicity, and its antifungal activity against Candida albicans in comparison to fluconazole. IET Nanobiotechnology, 13(2), 114–119. https://doi.org/10.1049/iet-nbt.2018.5146
Moreira, W. (2004). Revisão de literatura e desenvolvimento científico: conceitos e estratégias para confecção. Janus V.1 N.1. https://files.cercomp.ufg.br/weby/up/19/o/Revis__o_de_Literatura_e_desenvolvimento_cient__fico.pdf
Mukaremera, L., Lee, K. K., Mora-Montes, H. M., & Gow, N. A. R. (2017). Candida albicans Yeast, Pseudohyphal, and Hyphal Morphogenesis Differentially Affects Immune Recognition. Frontiers in Immunology, 8. https://doi.org/10.3389/fimmu.2017.00629
Nascimento, G. G. F., Locatelli, J., Freitas, P. C., & Silva, G. L. (2000). Antibacterial activity of plant extracts and phytochemicals on antibiotic-resistant bacteria. Brazilian Journal of Microbiology, 31(4). https://doi.org/10.1590/s1517-83822000000400003
Nobile, C. J., & Johnson, A. D. (2015). Candida albicans Biofilms and Human Disease. Annual Review of Microbiology, 69(1), 71–92. https://doi.org/10.1146/annurev-micro-091014-104330
Oliveira, J. R. de, de Jesus Viegas, D., Martins, A. P. R., Carvalho, C. A. T., Soares, C. P., Camargo, S. E. A., Jorge, A. O. C., & de Oliveira, L. D. (2017). Thymus vulgaris L. extract has antimicrobial and anti-inflammatory effects in the absence of cytotoxicity and genotoxicity. Archives of Oral Biology, 82, 271–279. https://doi.org/10.1016/j.archoralbio.2017.06.031
Pappas, P. G., Kauffman, C. A., Andes, D. R., Clancy, C. J., Marr, K. A., Ostrosky-Zeichner, L., Reboli, A. C., Schuster, M. G., Vazquez, J. A., Walsh, T. J., Zaoutis, T. E., & Sobel, J. D. (2016). Clinical practice guideline for the management of candidiasis: 2016 update by the infectious diseases society of America. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 62(4), e1–e50. https://doi.org/10.1093/cid/civ933
Pereira, J. V. et al. (2005). Estudos com o extrato da Punica granatum Linn. (Romã): efeito antimicrobiano in vitro e avaliação clínica de um dentifrício sobre microrganismos do biofilme dental / Studies with the extract of the Punica granatum Linn. (Pomegranate): effect antimicrobial. Revista Odonto Ciência, v. 20, n. 49, p. 262-269. https://pesquisa.bvsalud.org/portal/resource/pt/lil-428107
Poulain, D. (2015). Candida albicans, plasticity and pathogenesis. Critical Reviews in Microbiology, 41(2), 208–217. https://doi.org/10.3109/1040841x.2013.813904
Rother, E. T. (2007). Revisão sistemática X revisão narrativa. Acta Paulista de Enfermagem, 20(2), v–vi. https://doi.org/10.1590/s0103-21002007000200001
Shu, C., Sun, L., & Zhang, W. (2016). Thymol has antifungal activity against Candida albicans during infection and maintains the innate immune response required for function of the p38 MAPK signaling pathway in Caenorhabditis elegans. Immunologic Research, 64(4), 1013–1024. https://doi.org/10.1007/s12026-016-8785-y
Smetana, Z., Mendelson, E., Manor, J., van Lier, J. E., Ben-Hur, E., Salzberg, S., & Malik, Z. (1994). Photodynamic inactivation of herpes viruses with phthalocyanine derivatives. Journal of Photochemistry and Photobiology. B, Biology, 22(1), 37–43. https://doi.org/10.1016/1011-1344(93)06949-4
Tamyris B. Silva1*, E. T. R. (2010). Avaliação da atividade antimicrobiana do extrato etanólico do tomilho (Thymus vulgaris L.) invitro. Revista Eletrônica de Farmácia ISSN 1808-0804Vol. VII (2), 48 –58,2010. https://revistas.ufg.br/REF/article/view/11859/7803
Villar, C. C., Kashleva, H., & Dongari-Bagtzoglou, A. (2004). Role of Candida albicans polymorphism in interactions with oral epithelial cells. Oral Microbiology and Immunology, 19(4), 262–269. https://doi.org/10.1111/j.1399-302x.2004.00150.x
Wainwright, M., Phoenix, D. A., Gaskell, M., & Marshall, B. (1999). Photobactericidal activity of methylene blue derivatives against vancomycin-resistant Enterococcus spp. The Journal of Antimicrobial Chemotherapy, 44(6), 823–825. https://doi.org/10.1093/jac/44.6.823
Wainwright, M., Phoenix, D. A., Laycock, S. L., Wareing, D. R. A., & Wright, P. A. (1998). Photobactericidal activity of phenothiazinium dyes against methicillin-resistant strains ofStaphylococcus aureus. FEMS Microbiology Letters, 160(2), 177–181. https://doi.org/10.1111/j.1574-6968.1998.tb12908.x
Wainwright, Mark, & Crossley, K. B. (2004). Photosensitising agents—circumventing resistance and breaking down biofilms: a review. International Biodeterioration & Biodegradation, 53(2), 119–126. https://doi.org/10.1016/j.ibiod.2003.11.006
Wainwright, Mark, Phoenix, D. A., Nickson, P. B., & Morton, G. (2002). The use of new methylene blue inPseudomonas aeruginosabiofilm destruction. Biofouling, 18(4), 247–249. https://doi.org/10.1080/08927010290017653
Wang, Y. (2015). Looking intoCandida albicansinfection, host response, and antifungal strategies. Virulence, 6(4), 307–308. https://doi.org/10.1080/21505594.2014.1000752
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Kevin Gustavo dos Santos Silva; Gabriela Oliveira do Nascimento; Erik Ernani Marques da Silva; Luiza Helena Virgilio Cabral; Tatiana Mayra Rocha Faria; Jonatas Rafael de Oliveira
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
