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Review
. 2023 Oct 13:13:1245808.
doi: 10.3389/fcimb.2023.1245808. eCollection 2023.

Molecular association of Candida albicans and vulvovaginal candidiasis: focusing on a solution

Helma David  1 , Adline Princy Solomon  1
Affiliations
Review

Molecular association of Candida albicans and vulvovaginal candidiasis: focusing on a solution

Helma David et al. Front Cell Infect Microbiol. .

Abstract

Candida albicans-mediated vulvovaginal candidiasis (VVC) is a significant challenge in clinical settings, owing to the inefficacy of current antifungals in modulating virulence, development of resistance, and poor penetration into the biofilm matrix. Various predisposition factors are molecular drivers that lead to the dysbiosis of normal microflora of the vagina, upregulation of central metabolic pathways, morphogenesis, hyphal extension, adhesion, invasion, and biofilm formation leading to chronic infection and recurrence. Hence, it is crucial to understand the molecular mechanism behind the virulence pathways driven by those drivers to decode the drug targets. Finding innovative solutions targeting fungal virulence/biofilm may potentiate the antifungals at low concentrations without affecting the recurrence of resistance. With this background, the present review details the critical molecular drivers and associated network of virulence pathways, possible drug targets, target-specific inhibitors, and probable mode of drug delivery to cross the preclinical phase by appropriate in vivo models.

Keywords: C. albicans; morphogenesis; multidrug resistance; possible drug targets; predisposition factors; vaginal candidiasis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Network pathway analysis of Candida pathogenicity and virulence driven by various predisposition factors. (1 and 2) Yeast cells that are planktonic colonize surfaces. Favorable conditions promote overgrowth and adherence (3), where cells stick to host cells using adhesins, and hyphae formation/extension and environmental constraints activate HSPs, signaling, and adaptation pathways that activate genes related to morphology. The pathogenesis of C. albicans begins with hyphal development. (4 and 5) Epithelial/endothelial adhesion/invasion with the help of hydrolytic enzymes. Prior to the onset of infection, generate biofilms (6). After the maturation of the biofilm, the dispersed cells from the biofilm localize to other areas leading to the spread of infection. Different kinds of candidiasis are caused by cytolytic proteins and enzymes destroying epithelial and mucosal surfaces (created using BioRender.com).
Figure 2
Figure 2
Conventional and advanced vaginal drug delivery systems (created using BioRender.com).
See this image and copyright information in PMC

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