Candida albicans- The Virulence Factors and Clinical Manifestations of Infection

Abstract

Candida albicans is a common commensal fungus that colonizes the oropharyngeal cavity, gastrointestinal and vaginal tract, and healthy individuals' skin. In 50% of the population, C. albicans is part of the normal flora of the microbiota. The various clinical manifestations of Candida species range from localized, superficial mucocutaneous disorders to invasive diseases that involve multiple organ systems and are life-threatening. From systemic and local to hereditary and environmental, diverse factors lead to disturbances in Candida's normal homeostasis, resulting in a transition from normal flora to pathogenic and opportunistic infections. The transition in the pathophysiology of the onset and progression of infection is also influenced by Candida's virulence traits that lead to the development of candidiasis. Oral candidiasis has a wide range of clinical manifestations, divided into primary and secondary candidiasis. The main supply of C. albicans in the body is located in the gastrointestinal tract, and the development of infections occurs due to dysbiosis of the residential microbiota, immune dysfunction, and damage to the muco-intestinal barrier. The presence of C. albicans in the blood is associated with candidemia-invasive Candida infections. The commensal relationship exists as long as there is a balance between the host immune system and the virulence factors of C. albicans. This paper presents the virulence traits of Candida albicans and clinical manifestations of specific candidiasis.

Keywords: Candida albicans; dermatovenerology; gastroenterology; oral cavity; virulence traits.

Figure 1

The morphological switches and transitions of Candida albicans during the infection process. The morphological transitions from blastospore to pseudohyphae and hyphae are reversible.

Figure 2

Schematic presentation of (A) adherence and colonization, and (B) penetration and invasion of C. albicans.

Figure 3

Phases of C. albicans biofilm formation. The formation starts with the attachment of yeast cells (green) to the surface (grey). In the early phase of the biofilm occurs the proliferation of C. albicans and hyphal cells’ formation. The production of the extracellular matrix follows. The maturation phase includes the accumulation of an extracellular matrix. Finally, yeast cells disperse to a new site and form a new biofilm.