Vaginal Candida albicans infections: host-pathogen-microbiome interactions

Area of Science:

• Mycology
• Immunology
• Microbiome research

Background:

• Candida albicans is a common commensal fungus that can cause superficial and invasive infections.
• Vulvovaginal candidiasis (VVC), affecting approximately 75% of women, is a prevalent superficial infection.
• Recurrent VVC (RVVC) involves multiple symptomatic infections annually.

Purpose of the Study:

• To review the factors contributing to Candida albicans pathogenicity in vulvovaginal candidiasis (VVC).
• To explore the interplay between C. albicans, host immunity, and the vaginal microbiota in health and disease.
• To discuss novel therapeutic strategies for VVC and RVVC based on these interactions.

Main Methods:

• Literature review focusing on fungal virulence factors, host immune responses, and vaginal microbiome dynamics.
• Analysis of host-pathogen interactions in the context of VVC and RVVC.
• Synthesis of current knowledge to identify potential treatment avenues.

Main Results:

• C. albicans transitions from yeast to hyphal forms, expressing virulence factors crucial for candidiasis.
• Inflammation during VVC is driven by fungal factors and a dysregulated host innate immune response, leading to immunopathology.
• The Lactobacillus-dominated vaginal microbiota is hypothesized to antagonize C. albicans.

Conclusions:

• Understanding the complex interactions between C. albicans, the host immune system, and the vaginal microbiome is key to managing VVC and RVVC.
• This knowledge can guide the development of targeted therapies for vaginal candidiasis.
• Further research into these interactions will enhance our understanding of vaginal C. albicans infections.