念珠菌通过在人阴道上皮上形成形态不同的生物膜而引起复发性外阴阴道念珠菌病

IF 5.9 Q1 MICROBIOLOGY Biofilm Pub Date : 2023-10-22 DOI:10.1016/j.bioflm.2023.100162
Yihong Pan , Yao Sun , Lanqian Chen , Yali Cheng , Panpan Jin , Weidan Zhang , Lingzhi Zheng , Junyan Liu , Tieli Zhou , Zhenbo Xu , Cheng Li , Xenia Kostoulias , Cathy J. Watson , David McGiffin , Anton Y. Peleg , Yue Qu
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引用次数: 0

摘要

背景:复发性外阴阴道念珠菌病(RVVC)是一种难治性疾病,影响许多育龄妇女。念珠菌在RVVC中形成生物膜的重要性最近受到质疑。本研究旨在阐明散发性外阴阴道念珠菌病(VVC)患者阴道内念珠菌的基本生长模式,并评估其在RVVC持续中的作用。方法对12例临床和微生物学诊断为RVVC或抗真菌治疗后无症状期VVC的患者进行阴道组织取样。采用高分辨率扫描电镜、荧光原位杂交结合念珠菌特异性18S rRNA探针和活菌负荷对人阴道内念珠菌生长进行定性和定量评价。使用共聚焦激光扫描显微镜和活检切片检测假丝酵母生物膜细胞外聚合物质的存在,并用魔芋蛋白a预染色,对感染的阴道组织进行苏木精和伊红染色的组织病理学分析。最后,评估了在血清浓度峰值时上皮相关念珠菌生物膜对氟康唑的敏感性。结果在RVVC患者阴道上皮上,除了零星的贴壁细胞外,还可生长出形态不同的生物膜,包括单层、微菌落和大菌落。阴道上皮上念珠菌生物膜的生长与阴道黏膜轻度淋巴细胞浸润有关。这些基于上皮的念珠菌生物膜表现出对氟康唑的高耐受性,这是导致RVVC持续存在的重要特征。结论本研究为RVVC中念珠菌生物膜的存在以及生物膜的形成在疾病持续中发挥重要作用提供了直接证据。
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Candida causes recurrent vulvovaginal candidiasis by forming morphologically disparate biofilms on the human vaginal epithelium

Background

Recurrent vulvovaginal candidiasis (RVVC) is a recalcitrant medical condition that affects many women of reproductive age. The importance of biofilm formation by Candida in RVVC has been recently questioned. This study aimed to elucidate the fundamental growth modes of Candida in the vagina of patients with RVVC or sporadic vulvovaginal candidiasis (VVC) and to assess their roles in the persistence of RVVC.

Methods

Vaginal tissues were sampled from twelve patients clinically and microbiologically diagnosed as RVVC or VVC at a post-antifungal-treatment and asymptomatic period. High-resolution scanning electron microscopy, fluorescence in situ hybridization in combination with Candida-specific 18S rRNA probes and viable fungal burden were used to qualitatively and quantitatively evaluate Candida growth in the human vagina. The presence of Candida biofilm extracellular polymeric substances was examined using confocal laser scanning microscopy and biopsy sections pre-stained with Concanavalin A. Histopathological analysis was carried out on infected vaginal tissues stained with hematoxylin and eosin. Lastly, the susceptibility of epithelium-associated Candida biofilms to fluconazole at the peak serum concentration was evaluated.

Results

Candida species grew on the vaginal epithelium of RVVC patients as morphologically disparate biofilms including monolayers, microcolonies, and macro-colonies, in addition to sporadic adherent cells. Candida biofilm growth on the vaginal epithelium was associated with mild lymphocytic infiltration of the vaginal mucosa. These epithelium-based Candida biofilms presented an important characteristic contributing to the persistence of RVVC that is the high tolerance to fluconazole.

Conclusions

In summary, our study provides direct evidence to support the presence of Candida biofilms in RVVC and an important role of biofilm formation in disease persistence.

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来源期刊
Biofilm
Biofilm MICROBIOLOGY-
CiteScore
7.50
自引率
1.50%
发文量
30
审稿时长
57 days
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