Contributions of the Biofilm Matrix to Candida Pathogenesis

Abstract

In healthcare settings, Candida spp. cause invasive disease with high mortality. The overwhelming majority of cases are associated with the use of critically-needed medical devices, such as vascular catheters. On the surface of these indwelling materials, Candida forms resilient, adherent biofilm communities. A hallmark characteristic of this process is the production of an extracellular matrix, which promotes fungal adhesion and provides protection from external threats. In this review, we highlight the medical relevance of device-associated Candida biofilms and draw attention to the process of Candida-biofilm-matrix production. We provide an update on the current understanding of how biofilm extracellular matrix contributes to pathogenicity, particularly through its roles in the promoting antifungal drug tolerance and immune evasion.

Keywords: Candida; biofilm; drug resistance; immunity; matrix.

Figure 1

Influence of Candida biofilm extracellular matrix on pathogenicity. The scanning electron micrograph shows a Candida albicans biofilm consisting of yeast and hyphae encased in an extracellular matrix. This material contains a combination of polysaccharides, proteins, DNA, and lipids. Extracellular matrix contributes to pathogenicity by enhancing drug tolerance and promoting immune evasion.