Metabolites can be used as indicators of Candida albicans infection, according to a recent study published in Microorganisms.
Takeaways
- Metabolites can serve as indicators of Candida albicans infection, offering a potential diagnostic tool for vulvovaginal candidiasis (VVC).
- VVC is prevalent among reproductive-aged women, with C. albicans being the primary pathogen. Symptoms include vaginal pain, itching, and increased discharge, highlighting the importance of early detection and treatment.
- The study examined the metabolic effects of C. albicans on vaginal epithelial cells using an in vitro model, revealing significant changes in metabolic profiles.
- Metabolomics analysis identified potential biomarkers for VVC induced by C. albicans, offering insights into the disease process and potential diagnostic avenues beyond traditional methods like clinical symptoms and fungal cultures.
- Administration of antifungal drug amphotericin B (AmB) led to the normalization of certain metabolites, suggesting its effectiveness in controlling VVC pathogenesis. This underscores the importance of targeted therapies based on metabolic insights.
Vulvovaginal candidiasis (VVC) is reported at least once in approximately 75% of reproductive-aged women, making it the second most common inflammatory vaginal disease. C. albicans can be isolated in 75% to 90% of VVC cases and is the most common pathogen associated with the condition.
Symptoms of VVC include vaginal pain, vulvar itching, and increased discharge. Infection with C. albicans can lead to various diseases such as superficial infections of the vaginal mucosa, esophagus, and skin. Early detection is vital for timely treatment.
C. albicans is often identified through clinical symptoms and fungal cultures, but these methods often delay diagnosis, preventing early treatment. Recent data has indicated metabolomics may be used to diagnose VVC, but there is little information on disease metabolites for VVC induced by C. albicans.
Investigators conducted a study to evaluate the metabolic effects of C. albicans on vaginal epithelial cells. A control group, model group, and amphotericin B (AmB) group were developed. Human vaginal epithelial cells were added with 1% penicillin–streptomycin–gentamicin mixed solution and 10% FBS, then maintained at 37 ◦C with a 5% CO2 atmosphere.
An in vitro model of VVC was developed through a 24-hour coculture infection of C. albicans cells with vaginal epithelial cells. Metabolomics analysis was performed through adding the cultures with 1mL 80% methanol aqueous solution to grind in a freeze grinder and centrifuge at 4 ◦C, 14,000 rpm for 15 min.
Samples were detected using UHPLC-Q-Exactive Plus Orbitrap MS equipped with Thermo Hypersil GOLD column. Scanning electron microscopy was used for further analysis of vaginal epithelial cell damage. Enzyme expression was evaluated using immunofluorescence assays.
Following centrifugation, the supernatant was processed with a glucose assay kit, pyruvic acid, lactic acid, and lactate dehydrogenase (LDH) assay kits to identify glycolysis-related metabolite and LDH content. Glycolysis-related metabolites and LDH were detected by human interleukin-6 and human interleukin-8 ELISA kit (4 A Biotech, Beijing, China).
Significant differences in metabolic profiles were observed between the control, model, and AmB groups. For example, 50 endogenous metabolites were significantly changed in the model group vs the control group, 19 of which were up-regulated and 31 were down-regulated. Investigators theorized these metabolites were potential disease biomarkers for VVC caused by C. albicans.
AmB, an antifungal drug commonly used to treat fungal infections caused by C. albicans, was used to observe whether changes in metabolites returned to those of the control group following administration. In the AmB group, 28 metabolites reverted to the control group after treatment and were considered potential biomarkers of effective control of VVC pathologic process.
Significantly reduced lactic acid content was also observed in the model group, indicating C. albicans may disturb glycolysis response of vaginal epithelial cells. Cells in the model group also had severely damaged surfaces and were invaded by hyphae. C. albicans growth was inhibited following antifungal therapy administration and pyruvic acid and glucose content was elevated.
These results highlighted metabolic disorders and inhibition of glucose in vaginal epithelial cells induced by C. albicans infection. Investigators concluded these findings could be utilized for further C. albicans pathogenesis exploration.
Reference
Zhao Y, Wang P, Sun X, Zhao M, Chen Y, Gao X. Candida albicans infection disrupts the metabolism of vaginal epithelial cells and inhibits cellular glycolysis. Microorganisms. 2024;12(2):292. doi:10.3390/microorganisms12020292
