Recurrent Vulvovaginal Candidiasis: a Dynamic Interkingdom Biofilm Disease of
            <i>Candida</i>
            and
            <i>Lactobacillus</i>

McKloud, Emily; Delaney, Christopher; Sherry, Leighann; Kean, Ryan; Williams, Shanice; Metcalfe, Rebecca; Thomas, Rachael; Rautemaa‐Richardson, Riina; Gerasimidis, Konstantinos; Nile, Christopher J.; Williams, Craig; Ramage, Gordon

doi:10.1128/msystems.00622-21

Cited by 38 publications

(44 citation statements)

References 59 publications

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“…In addition, it is well known that Candida species, mainly C. albicans, can form thick and tough biofilms, which greatly increases the tolerance to antifungal drugs during the treatment of recurrent vulvovaginal candidiasis (Taff et al, 2013). Mckloud et al reported the ability of various Lactobacillus species to inhibit C. albicans biofilm formation and biofilm-related gene expression when cocultured (McKloud et al, 2021). Lactobacillus rhamnosus could down-regulate C. albicans biofilm-related gene expression.…”

Section: Iners and Biofilm Formationmentioning

confidence: 99%

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Contribution of Lactobacillus iners to Vaginal Health and Diseases: A Systematic Review

Zheng

Guo

Wang

et al. 2021

Front. Cell. Infect. Microbiol.

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Lactobacillus iners, first described in 1999, is a prevalent bacterial species of the vaginal microbiome. As L. iners does not easily grow on de Man-Rogosa-Sharpe agar, but can grow anaerobically on blood agar, it has been initially overlooked by traditional culture methods. It was not until the wide application of molecular biology techniques that the function of L. iners in the vaginal microbiome was carefully explored. L. iners has the smallest genome among known Lactobacilli and it has many probiotic characteristics, but is partly different from other major vaginal Lactobacillus species, such as L. crispatus, in contributing to the maintenance of a healthy vaginal microbiome. It is not only commonly present in the healthy vagina but quite often recovered in high numbers in bacterial vaginosis (BV). Increasing evidence suggests that L. iners is a transitional species that colonizes after the vaginal environment is disturbed and offers overall less protection against vaginal dysbiosis and, subsequently, leads to BV, sexually transmitted infections, and adverse pregnancy outcomes. Accordingly, under certain conditions, L. iners is a genuine vaginal symbiont, but it also seems to be an opportunistic pathogen. Further studies are necessary to identify the exact role of this intriguing species in vaginal health and diseases.

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Section: Iners and Biofilm Formationmentioning

confidence: 99%

“…Mckloud et al. reported the ability of various Lactobacillus species to inhibit C. albicans biofilm formation and biofilm-related gene expression when cocultured ( McKloud et al., 2021 ). Lactobacillus rhamnosus could down-regulate C. albicans biofilm-related gene expression.…”

Section: Iners and Women Diseasesmentioning

confidence: 99%

Contribution of Lactobacillus iners to Vaginal Health and Diseases: A Systematic Review

Zheng

Guo

Wang

et al. 2021

Front. Cell. Infect. Microbiol.

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“…More specifically, there is a particular interest in characterizing the complex interactions that may occur between Candida yeasts, bacterial communities of the microflora, and epithelial and immune cells residing in the vaginal mucosa, because this knowledge could help in developing new strategies for early diagnoses and better targeting of antifungal therapeutic interventions ( 4 ). As such, the study led by the Gordon Ramage research group and recently published in mSystems provides an unprecedented insight into the fluctuations in antagonistic interkingdom interactions between Candida and Lactobacillus associated with RVVC disease ( 5 ) ( Fig. 1 ).…”

Section: Commentarymentioning

confidence: 99%

“…Pathobiology consists of a strong inflammation of the mucosa at the origin of typical symptoms such as burning, itching, white clumpy discharge, and redness of the genital track. McKloud and colleagues ( 5 ) provide unprecedented insight into the complex microbial interplay underlying RVVC. Notably, they show that the bacterium Lactobacillus crispatus is able to condition a healthy vaginal environment by reducing Candida albicans load.…”

Section: Commentarymentioning

confidence: 99%

A Complex Microbial Interplay Underlies Recurrent Vulvovaginal Candidiasis Pathobiology

Papon

Dijck

2021

mSystems

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“…Several studies have proposed that biofilm formation by C. albicans plays a crucial role in the development of vaginal candidiasis [11][12][13][14][15]. Wu et al [16] supported the essential role of biofilm formation in the pathogenesis of vaginal candidiasis, demonstrating that histological damages of mucosal epithelial cells and local inflammation are associated with biofilm growth on the vaginal epithelium.…”

Section: Introductionmentioning

confidence: 99%

Lactobacillus iners Cell-Free Supernatant Enhances Biofilm Formation and Hyphal/Pseudohyphal Growth by Candida albicans Vaginal Isolates

et al. 2021

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Candida albicans is a commensal fungus of the vaginal mucosa and the principal etiological agent of vaginal candidiasis. Vaginal dysbiosis has been reported during vulvovaginal candidiasis (VVC), with a progressive decrease in Lactobacillus crispatus population and an increase in L. iners population. To date, the role of L. iners in VVC pathogenesis remains scarcely explored. Herein we investigated the in vitro effect of L. iners cell-free supernatant (CFS) on the ability of C. albicans to form biofilms. Biomass and metabolic activity were measured by crystal violet and XTT assays. Further, light microscopy was performed to determine the effect of L. iners CFS on biofilm cellular morphology. We found that L. iners CFS induced a significant increase in biofilm formation by C. albicans clinical isolates which were categorized as moderate or weak biofilm producers. This effect was associated with an enhancement of hyphal/pseudohyphal growth, and the expression levels of HWP1 and ECE1, which are typical hyphae-associated genes, were upregulated. Overall, these results suggest that L. iners contributes to the pathogenesis of VVC and highlight the complexity of the interaction between C. albicans and vaginal lactobacilli. Understanding these interactions could prove essential for the development of new strategies for treating VVC.

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Recurrent Vulvovaginal Candidiasis: a Dynamic Interkingdom Biofilm Disease of Candida and Lactobacillus

Cited by 38 publications

References 59 publications

Contribution of Lactobacillus iners to Vaginal Health and Diseases: A Systematic Review

Contribution of Lactobacillus iners to Vaginal Health and Diseases: A Systematic Review

A Complex Microbial Interplay Underlies Recurrent Vulvovaginal Candidiasis Pathobiology

Lactobacillus iners Cell-Free Supernatant Enhances Biofilm Formation and Hyphal/Pseudohyphal Growth by Candida albicans Vaginal Isolates

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