Mechanism of Candida pathogenesis: revisiting the vital drivers
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REVIEW
Mechanism of Candida pathogenesis: revisiting the vital drivers Ifeanyi Elibe Mba 1 & Emeka Innocent Nweze 1 Received: 11 March 2020 / Accepted: 17 April 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Candida is the most implicated fungal pathogen in the clinical setting. Several factors play important roles in the pathogenesis of Candida spp. Multiple transcriptional circuits, morphological and phenotypic switching, biofilm formation, tissue damaging extracellular hydrolytic enzymes, metabolic flexibility, genome plasticity, adaptation to environmental pH fluctuation, robust nutrient acquisition system, adherence and invasions (mediated by adhesins and invasins), heat shock proteins (HSPs), cytolytic proteins, escape from phagocytosis, evasion from host immune system, synergistic coaggregation with resident microbiota, resistance to antifungal agents, and the ability to efficiently respond to multiple stresses are some of the major pathogenic determinants of Candida species. The existence of multiple connections, in addition to the interactions and associations among all of these factors, are distinctive features that play important roles in the establishment of Candida infections. This review describes all the underlying factors and mechanisms involved in Candida pathogenesis by evaluating pathogenic determinants of Candida species. It reinforces the already available pool of data on the pathogenesis of Candida species by providing a clear and simplified understanding of the most important factors implicated in the pathogenesis of Candida species. The Candida pathogenesis network, an illustration linking all the major determinants of Candida pathogenesis, is also presented. Taken together, they will further improve our current understanding of how these factors modulate virulence and consequent infection(s). Development of new antifungal drugs and better therapeutic approaches to candidiasis can be achieved in the near future with continuing progress in the understanding of the mechanisms of Candida pathogenesis. Keywords Candida . Pathogenesis . Virulence . Fungi . Infections
Introduction Candida is a diploid fungus that frequently causes mucosal and systemic infections in humans. The organism exists as a normal flora in both humans and animals but can become opportunistic causing disabling and lethal infections [1]. Candida species can colonize several distinct anatomical sites. Majority of infections by commensal microorganisms come from endogenous colonization. However, exogenous contamination, such as infections transmitted via hospital employees, hospital atmosphere, and biofilm-contaminated invasive devices like catheters, can also occur [2–4]. Infections caused by Candida can be classified as superficial, cutaneous, mucosal, and systemic infection (deep and widespread). When Candida spp. infect the oral cavity, skin, genitalia, respiratory
* Emeka Innocent Nweze [email protected] 1
Department of Microbiology, University of Nigeria, Nsukka, Nigeria
system, and
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