The pathogenicity and future treatment strategies of Candida albicans

Candida albicans (C. albicans) is a major pathogenic fungus that severely impacts on human health. This review systematically elaborates on the key pathogenic processes of C. albicans, starting with its colonization, morphological transformation and biofilm formation under different carbon sources. The interaction between C. albicans and host immunity, including the role of PRRs, host genetics and immune polymorphisms, and trained immunity. Candidalysin regulating cAMP/PKA signaling pathway of C. albicans hyphae-biofilm transformation, the interaction between C. albicans and bacteria, as well as mucosal and invasive C. albicans infections, persister cells in anti-C. albicans therapy, emerging biology and pathogenicity aspects, epigenetic and chromatin regulation of host-drug adaptation, and strain-specific heterogeneity in pathogenicity, biofilm traits and drug susceptibility. Additionally, it summarizes novel therapeutic strategies, emphasizing probiotics and antimicrobial peptides (AMPs), and combination strategies with novel targeted therapy and traditional anti-fungal therapy to improve the survival of patients with Candida albicans infection. It systematically and comprehensively summarizes the pathogenicity of C. albicans and the possible therapeutic targets, providing new ideas for the development of novel antifungal drugs in the future.