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Bio-energetics Investigation of Candida albicans Using Real-time Extracellular Flux Analysis
Published on: March 19, 2019
Intestinal Candida albicans is Associated with Subclinical Coronary Atherosclerosis in Metabolic
Nantawat Satthawiwat1, Suthida Visedthorn2, Pakorn Ruengket2
1Center of Excellence in Hepatitis and Liver Cancer, Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Background And Aims:
Metabolic dysfunction-associated steatotic liver disease (MASLD) is an independent risk factor for cardiovascular disease (CVD). While gut bacteria have been linked to CVD, the role of intestinal fungi in subclinical coronary atherosclerosis (SCA) remains unclear. In this study, we aimed to investigate the association between the gut mycobiome and SCA in MASLD.
Methods:
A cross-sectional study was conducted among 103 MASLD patients without established CVD. Fibrosis and steatosis were assessed using magnetic resonance elastography (MRE) and proton density fat fraction, respectively. SCA was defined by coronary artery calcification (CAC). Fecal fungal composition was analyzed via internal transcribed spacer sequencing.
Results:
Mean age was 60.8 ± 11.2 years; 51.5% were men; 20.4% had cirrhosis. CAC correlated with MRE (r = 0.489, p < 0.001), interleukin-6 (r = 0.407, p < 0.001), and tumor necrosis factor-α (r = 0.254, p = 0.018), but not proton density fat fraction. Cirrhosis patients had higher CAC than F0-F3 (456.9 vs. 205.9, p = 0.033). Candida albicans (C. albicans) abundance was greater in cirrhosis and correlated with CAC (r = 0.403, p < 0.001) and MRE (r = 0.212, p = 0.032). In multivariate analysis, older age, diabetes, obesity, cirrhosis, and enriched C. albicans independently predicted CAC ≥ 100 AU in MASLD.
Conclusions:
In MASLD, cirrhosis and C. albicans enrichment are independently associated with higher SCA burden, suggesting advanced liver disease and a potential fungal contribution to CVD pathogenesis.
Insights
In metabolic dysfunction-associated steatotic liver disease (MASLD), advanced liver disease and Candida albicans enrichment are linked to coronary atherosclerosis. This suggests fungi may play a role in cardiovascular disease development.
Area of Science:
- Gastroenterology
- Cardiology
- Microbiology
Background:
- Metabolic dysfunction-associated steatotic liver disease (MASLD) is a known cardiovascular disease (CVD) risk factor.
- The gut microbiome's role in CVD is established, but the contribution of intestinal fungi to subclinical coronary atherosclerosis (SCA) in MASLD patients is not well understood.
Purpose of the Study:
- To investigate the association between the gut mycobiome and SCA in patients with MASLD.
- To explore the relationship between specific fungal species, liver disease severity, and the presence of coronary artery calcification (CAC).
Main Methods:
- A cross-sectional study involving 103 MASLD patients without pre-existing CVD.
- Assessment of liver fibrosis and steatosis using magnetic resonance elastography (MRE) and proton density fat fraction.
- Analysis of fecal fungal composition via internal transcribed spacer sequencing and definition of SCA by CAC.
Main Results:
- Coronary artery calcification (CAC) correlated with liver fibrosis (MRE) and inflammatory markers (IL-6, TNF-α), but not steatosis.
- Patients with cirrhosis exhibited significantly higher CAC compared to those without advanced fibrosis.
- Enrichment of Candida albicans was observed in cirrhosis patients and independently predicted higher CAC and liver fibrosis.
Conclusions:
- In MASLD patients, advanced liver disease (cirrhosis) and an enriched gut mycobiome, specifically Candida albicans, are independently associated with a higher burden of subclinical coronary atherosclerosis.
- These findings highlight a potential role for gut fungi in the pathogenesis of cardiovascular complications in MASLD.
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