Relationship between antifungal susceptibility profile and virulence factors in Candida albicans isolated from nail specimens

Abstract

Introduction: The aim of this study was to evaluate some virulence factors in Candida albicans isolates from patients with onychomycosis and determine the correlation between these factors and the antifungal resistance profile. Methods: Seventy species of C. albicans were confirmed using polymerase chain reaction amplification of the HWP1 gene. According to the Clinical & Laboratory Standards Institute guidelines, the susceptibility profile of four antifungal agents was investigated, and the production of aspartyl protease, phospholipase, haemolysin, and biofilm was determined. The correlation between these profiles was also investigated. Results: The isolates indicated different levels of resistance and production of virulence factors. Significant correlations were observed between the minimum inhibitory concentration (MIC) of fluconazole/itraconazole and biofilm production, between phospholipase production and fluconazole/ itraconazole MIC, and between fluconazole MIC and hemolytic activity in C. albicans isolates. The results also showed significant correlations between phospholipase activity and biofilm production. Conclusions: Our findings will contribute to a better understanding of the pathogenesis of C. albicans and characterize the relationship between virulence factors and antifungal resistance, which may suggest new therapeutic strategies considering the possible involvement of the virulence mechanism in the effectiveness of treatment.

Factors associated with the isolation of Candida Spp. from the oral microbiota of people living with HIV

“…[38] The production of the phospholipase enzyme is considered an important virulence factor of Candida spp., since it binds the yeast to the target tissue and generates an entry pathway in the same hydrolyzed phospholipids and degrading the host cell membranes, being fundamental for the establishment of the infectious process. [37] According to the present research, all isolated Candida species produce phospholipases, with C. albicans having the strongest Pz activity, corroborating the findings of another study that described phospholipae production in 61.42% of C. albicans isolates, in addition the majority were considered as strong producers. [37] Our findings regarding Pz [17,30,39,40] and hemolytic activities [21,39] in PLHIV are consistent with the findings of several previous studies.…”

“…The production of hemolytic activity by Candida species can be justified by the fact that hemolysin is considered a nanoprotein that is linked to the cellular appearance of this genus of yeasts, enabling the exploration of iron from the host. [37] Correspondingly, iron is an essential cofactor for its proteins and contributes to several metabolic processes, such as cellular respiration and DNA synthesis. [38] The production of the phospholipase enzyme is considered an important virulence factor of Candida spp., since it binds the yeast to the target tissue and generates an entry pathway in the same hydrolyzed phospholipids and degrading the host cell membranes, being fundamental for the establishment of the infectious process.…”

Immune Sensing of Candida albicans

“…Warm and moist environments promote the expansion of C. albicans on the skin, leading to superficial skin infections, such as nappy rash, athlete’s foot and nail infections. C. albicans uses hydrolytic enzymes, such as secreted aspartic proteinases, shown to be important in tissue invasion and believed to be involved in establishing nail and other superficial infections [ 67 , 68 , 69 ]. Such infections are potentiated by increased phospholipase activity, which also correlates with biofilm formation, particularly in nail infections [ 67 , 69 ].…”

“…C. albicans uses hydrolytic enzymes, such as secreted aspartic proteinases, shown to be important in tissue invasion and believed to be involved in establishing nail and other superficial infections [ 67 , 68 , 69 ]. Such infections are potentiated by increased phospholipase activity, which also correlates with biofilm formation, particularly in nail infections [ 67 , 69 ]. Although little is known about immune sensing in the skin and nails, the presence of DCs in the skin suggests their involvement in C. albicans sensing and the immune response in this context.…”

In vitro evaluation of the hemolytic activity of clinical and environmental isolates from dermatophyte fungi

“…As hemolisinas são exotoxinas de efeito citotóxico nas membranas dos eritrócitos e células fagocíticas, com capacidade de lisar os glóbulos vermelhos e liberar ferro, requerido no crescimento fúngico, contribuindo para a estratégia de sobrevivência durante infecções oportunistas (Aktas & Yıgıt, 2015), sendo relatadas em fungos como Histoplasma capsulatum, Candida albicans, Malassezia spp., Paracoccidioides spp. e Cryptococcus neoformans (Cezar-dos-Santos et al, 2018;Mohammadi et al, 2020;Salvin, 1951;Tee et al, 2019).…”