AUTHOR=Zhu Yuxia , Fang Chao , Shi Yu , Shan Yingying , Liu Xiaoping , Liang Yiheng , Huang Liting , Liu Xinyang , Liu Chunfeng , Zhao Yin , Fan Shangrong , Zhang Xiaowei
TITLE=Candida albicans Multilocus Sequence Typing Clade I Contributes to the Clinical Phenotype of Vulvovaginal Candidiasis Patients
JOURNAL=Frontiers in Medicine
VOLUME=9
YEAR=2022
URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.837536
DOI=10.3389/fmed.2022.837536
ISSN=2296-858X
ABSTRACT=
Candida albicans is the most frequent fungal species responsible for vulvovaginal candidiasis (VVC), which exhibits distinct genetic diversity that is linked with the clinical phenotype. This study aimed to assess the genotypes and clinical characteristics of different C. albicans isolates from VVC patients. Based on multilocus sequence typing (MLST), clade 1 was identified as the largest C. albicans group, which appeared most frequently in recurrent VVC and treatment failure cases. Further study of antifungal susceptibility demonstrated that MLST clade 1 strains presented significantly higher drug resistance ability than non-clade 1 strains, which result from the overexpression of MDR1. The mRNA and protein expression levels of virulence-related genes were also significantly higher in clade 1 isolates than in non-clade 1 isolates. Proteomic analysis indicated that the protein stabilization pathway was significantly enriched in clade 1 strains and that RPS4 was a central regulator of proteins involved in stress resistance, adherence, and DNA repair, which all contribute to the resistance and virulence of MLST clade 1 strains. This study was the first attempt to compare the correlation mechanisms between C. albicans MLST clade 1 and non-clade 1 strains and the clinical phenotype, which is of great significance for VVC classification and treatment.