A Role for Yeast/Pseudohyphal Cells of Candida albicans in the Correlated Expression of NLRP3 Inflammasome Inducers in Women With Acute Vulvovaginal Candidiasis

Roselletti, Elena; Monari, Claudia; Sabbatini, Samuele; Perito, Stefano; Vecchiarelli, Anna; Sobel, Jack D.; Cassone, Antonio

doi:10.3389/fmicb.2019.02669

Cited by 16 publications

(24 citation statements)

References 45 publications

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“…However, its role in clinical isolates and during human infection has not yet been resolved. This, along with the absolute requirement of filamentous or pseudofilamentous morphology in driving immunopathology, remain important, unanswered clinical questions [84].…”

Section: An Indispensable Role For Candidalysinmentioning

confidence: 99%

Vulvovaginal Candidiasis: A Current Understanding and Burning Questions

Willems

Ahmed

Liu

et al. 2020

JoF

201

197

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Candida albicans, along with other closely related Candida species, are the primary causative agents of vulvovaginal candidiasis (VVC)-a multifactorial infectious disease of the lower female reproductive tract resulting in pathologic inflammation. Unlike other forms of candidiasis, VVC is a disease of immunocompetent and otherwise healthy women, most predominant during their child-bearing years. While VVC is non-lethal, its high global incidence and profound negative impact on quality-of-life necessitates further understanding of the host and fungal factors that drive disease pathogenesis. In this review, we cover the current state of our understanding of the epidemiology, host response, fungal pathogenicity mechanisms, impact of the microbiome, and novel approaches to treatment of this most prevalent human candidal infection. We also offer insight into the latest advancements in the VVC field and identify important questions that still remain.

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Section: An Indispensable Role For Candidalysinmentioning

confidence: 99%

Vulvovaginal Candidiasis: A Current Understanding and Burning Questions

Willems

Ahmed

Liu

et al. 2020

JoF

201

197

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“…Other factors include pH tolerance 57 and presence of enzymes that allow C albicans to survive in macrophages 58 . Cytological observations indicate that pseudohyphal filaments dominate yeast cells at a vaginal pH level of 4.0‐5.0, together with the co‐expression of typical hyphal‐associated genes 59 …”

Section: Host Factorsmentioning

confidence: 99%

“…Beta‐glucan binds to dectin‐1 and stimulates the release of proinflammatory cytokines 60 . This, in turn, leads to the activation of innate immunity and NLRP3 inflammasome, 59 which is important in the development of VVC 61‐63 …”

Section: Host Factorsmentioning

confidence: 99%

“…58 Cytological observations indicate that pseudohyphal filaments dominate yeast cells at a vaginal pH level of 4.0-5.0, together with the co-expression of typical hyphal-associated genes. 59 In an acute infection, inflammasome receptors of the vaginal epithelial cells are activated by the formation of virulence and immune inflammation factors. Fungal components, such as glucan, mannan and chitin, bind to specific receptors of macrophages and stimulate various cytokines.…”

Section: Hos T Fac Tor Smentioning

confidence: 99%

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Guideline: Vulvovaginal candidosis (AWMF 015/072, level S2k)

Farr

Effendy

Tirri

et al. 2021

Mycoses

146

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Approximately 70‐75% of women will have vulvovaginal candidosis (VVC) at least once in their lifetime. In premenopausal, pregnant, asymptomatic and healthy women and women with acute VVC, Candida albicans is the predominant species. The diagnosis of VVC should be based on clinical symptoms and microscopic detection of pseudohyphae. Symptoms alone do not allow reliable differentiation of the causes of vaginitis. In recurrent or complicated cases, diagnostics should involve fungal culture with species identification. Serological determination of antibody titres has no role in VVC. Before the induction of therapy, VVC should always be medically confirmed. Acute VVC can be treated with local imidazoles, polyenes or ciclopirox olamine, using vaginal tablets, ovules or creams. Triazoles can also be prescribed orally, together with antifungal creams, for the treatment of the vulva. Commonly available antimycotics are generally well tolerated, and the different regimens show similarly good results. Antiseptics are potentially effective but act against the physiological vaginal flora. Neither a woman with asymptomatic colonisation nor an asymptomatic sexual partner should be treated. Women with chronic recurrent Candida albicans vulvovaginitis should undergo dose‐reducing maintenance therapy with oral triazoles. Unnecessary antimycotic therapies should always be avoided, and non‐albicans vaginitis should be treated with alternative antifungal agents. In the last 6 weeks of pregnancy, women should receive antifungal treatment to reduce the risk of vertical transmission, oral thrush and diaper dermatitis of the newborn. Local treatment is preferred during pregnancy.

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“…reduction of LAB population) may promote the ability of Candida species to invade vaginal epithelial cells [ 18 ]. Following the breach of vaginal epithelial cells, pseudohyphae and hyphae of C. albicans induced the NLRP3 inflammasome receptors of the epithelial cells through a cascade activation and ultimately triggered severe vaginal inflammation [ 86 ]. Of all the vaginal microbiota and mycobiota studies, C. albicans remains the most described causative agent for VVC [ 87 ].…”

Section: Indigenous Vaginal Microbiota In Womenmentioning

confidence: 99%

Vaginal microbiota and the potential of Lactobacillus derivatives in maintaining vaginal health

2020

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Human vagina is colonised by a diverse array of microorganisms that make up the normal microbiota and mycobiota. Lactobacillus is the most frequently isolated microorganism from the healthy human vagina, this includes Lactobacillus crispatus, Lactobacillus gasseri, Lactobacillus iners, and Lactobacillus jensenii. These vaginal lactobacilli have been touted to prevent invasion of pathogens by keeping their population in check. However, the disruption of vaginal ecosystem contributes to the overgrowth of pathogens which causes complicated vaginal infections such as bacterial vaginosis (BV), sexually transmitted infections (STIs), and vulvovaginal candidiasis (VVC). Predisposing factors such as menses, pregnancy, sexual practice, uncontrolled usage of antibiotics, and vaginal douching can alter the microbial community. Therefore, the composition of vaginal microbiota serves an important role in determining vagina health. Owing to their Generally Recognised as Safe (GRAS) status, lactobacilli have been widely utilised as one of the alternatives besides conventional antimicrobial treatment against vaginal pathogens for the prevention of chronic vaginitis and the restoration of vaginal ecosystem. In addition, the effectiveness of Lactobacillus as prophylaxis has also been well-founded in long-term administration. This review aimed to highlight the beneficial effects of lactobacilli derivatives (i.e. surface-active molecules) with anti-biofilm, antioxidant, pathogen-inhibition, and immunomodulation activities in developing remedies for vaginal infections. We also discuss the current challenges in the implementation of the use of lactobacilli derivatives in promotion of human health. In the current review, we intend to provide insights for the development of lactobacilli derivatives as a complementary or alternative medicine to conventional probiotic therapy in vaginal health.

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A Role for Yeast/Pseudohyphal Cells of Candida albicans in the Correlated Expression of NLRP3 Inflammasome Inducers in Women With Acute Vulvovaginal Candidiasis

Cited by 16 publications

References 45 publications

Vulvovaginal Candidiasis: A Current Understanding and Burning Questions

Vulvovaginal Candidiasis: A Current Understanding and Burning Questions

Guideline: Vulvovaginal candidosis (AWMF 015/072, level S2k)

Vaginal microbiota and the potential of Lactobacillus derivatives in maintaining vaginal health

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