Revista de Odontologia da UNESP
https://revodontolunesp.com.br/article/588018437f8c9d0a098b4b45
Revista de Odontologia da UNESP
Original Article

Candida dubliniensis – levedura emergente associada à candidose oral

Candida dubliniensis – emergent yeast associated with oral candidosis

Nonaka, C.F.W.; Nascimento, G.J.F.; Goulart Filho, J.A.V.; Lima, K.C.; Milan, E.P.

Downloads: 2
Views: 1983

Resumo

Dentre os microrganismos capazes de determinar o desenvolvimento de processos patológicos em humanos, encontram-se as espécies de leveduras pertencentes ao gênero Candida. A presença destas leveduras em pacientes que apresentam condições predisponentes como terapias com múltiplos antimicrobianos, imunossupressores e imunodeficiências, é capaz de determinar numerosos processos patológicos, sejam estes de ordem local ou sistêmica. Apesar da Candida albicans ser implicada como principal patógeno relacionado ao desenvolvimento de candidose oral, o isolamento de uma espécie intimamente relacionada, denominada Candida dubliniensis, tem sido reportado de forma crescente. Diversos fatores de virulência são descritos para esta nova levedura, assumindo destaque a hidrofobicidade de superfície celular, as aspartil proteinases secretadas (Saps) e compostos enzimáticos extracelulares, como fosfatase ácida, leucinaarilamidase, estearases e α-mannosidase. Além disso, isolados de C. dubliniensis apresentam bombas de efluxo de drogas, codificadas pelos genes CdCR1 e CdMDR1, um dos mecanismos propostos para explicar o desenvolvimento de resistência a quimioterápicos como o fluconazol e, em certos casos, ao cetoconazol e itraconazol. Em decorrência do emergente número de relatos e pesquisas enfatizando o papel da C. dubliniensis no desenvolvimento de doença local e sistêmica, o presente trabalho realiza uma revisão da literatura acerca dos aspectos epidemiológicos, métodos de identificação, fatores de virulência e mecanismos de resistência a antifúngicos inerentes a esta levedura.

Palavras-chave

Candida dubliniensis, candidose oral, virulência, resistência.

Abstract

Amongst the microorganisms that can cause pathologic processes in humans are yeasts species belonging to the genus Candida. The presence of these yeasts in patients with a number of predisposing conditions such as multiple therapies with antibiotics and immunossupressors and immunodeficiencies is capable of causing a variety of local and systemic diseases. Although Candida albicans remains the most common cause of oral candidosis, the identification of a close related species, named Candida dubliniensis, has been increasing steadily. Numerous virulence factors are described for this new yeast, mainly represented by cell surface hydrophobicity, secretory aspartyl proteinases (Saps) and extracellular enzymatic compounds as acid phosphatase, leucine-arylamidase, esterases and α-mannosidase. Besides, C. dubliniensis presents drug efflux pumps, encoded by CdCR1 and CdMDR1 genes, one of the proposed mechanisms to explain the development of antifungal drug resistance against fluconazole, and occasionally, ketoconazole and itraconazole. In view of the emergent number of case reports and studies emphasizing the importance of C. dubliniensis on the development of local and systemic diseases, the present paper performs a review of the literature about the epidemiology, identification methods, factors of virulence and mechanisms of antifungal resistance inherent to this yeast.

Keywords

Candida dubliniensis, oral candidosis, virulence, resistance

References



1. Hazen KC. Relationship between expression of cell surface hydrophobicity protein 1 (CSH1p) and surface hydrophobicity properties of Candida dubliniensis. Curr Microbiol. 2004;48:447-51.

2. Sullivan DJ, Moran GP, Pinjon E, Al-Mosaid A, Stokes C, Vaughan C, et al. Comparison of the epidemiology, drug resistance mechanisms, and virulence of Candida dubliniensis and Candida albicans. FEMS Yeast Res. 2004;4:369-76.

3. Mirhendi H, Makimura K, Zomorodian K, Maeda N, Ohshima T, Yamaguchi H. Differentiation of Candida albicans and Candida dubliniensis using a single-enzyme PCR-RFLP method. Jpn J Infect Dis. 2005;58:235-7.

4. Mosca CO, Moragues MD, Brena S, Rosa AC, Potón J. Isolation of Candida dubliniensis in a teenager with denture stomatitis. Med Oral Patol Oral Cir Bucal. 2005;10(1):25-31.

5. Sullivan DJ, Moran GP, Coleman DC. Candida dubliniensis: ten years on. FEMS Microbiol Lett. 2005;253:9-17.

6. Tekeli A, Akan OA, Koyuncu E, Dolapci I, Uysal S. Initial Candida dubliniensis isolate in Candida spp. positive haemocultures in Turkey between 2001 and 2004. Mycoses. 2006;49:60-4.

7. Liguori G, Lucariello A, Colella G, De Luca A, Marinelli P. Rapid identification of Candida species in oral rinse solutions by PCR. J Clin Pathol. 2007;60:1035-9.

8. Kirkpatrick WR, Revankar SG, Mcatee RK, Lopez-Ribot JL, Fothergill AW, McCarthy DI, et al. Detection of Candida dubliniensis in oropharyngeal samples from human immunodeficiency virus-infected patients in North America by primary CHROMagar Candida screening and susceptibility testing of isolates. J Clin Microbiol. 1998;36:3007-12.

9. Staib P, Morschhäuser J. Chlamydospore formation in Candida albicans and Candida dubliniensis: an enigmatic developmental programme. Mycoses. 2006;50:1-12.

10. Ellepola AN, Hurst SF, Elie CM, Morrison CJ. Rapid and unequivocal differentiation of Candida dubliniensis from other Candida species using species-specific DNA probes: comparison with phenotypic identification methods. Oral Microbiol Immunol. 2003;18:379-88.

11. Gilfillan GD, Sullivan DJ, Haynes K, Parkinson T, Coleman DC, Gow NA. Candida dubliniensis: phylogeny and putative virulence factors. Microbiol. 1998;144(Pt 4):829-38.

12. Alonso-Vargas R, Garaizar J, Potón J, Quindós G. Utility of random amplified polymorphic DNA in the discrimination between Candida albicans and Candida dubliniensis. Rev Iberoam Micol. 2000;17:10-3.

13. Perea S, Lopez-Ribot JL, Wickes BL, Kirkpatrick WR, Dib OP, Bachmann SP, et al. Molecular mechanisms of fluconazole resistance in Candida dubliniensis isolates from human immunodeficiency virus-infected patients with oropharyngeal candidiasis. Antimicrob Agents Chemoter. 2002;46:1695-793.

14. Wirsching S, Moran GP, Sullivan DJ, Coleman DC, Morschhauser J. MDR1-mediated drug resistance in Candida dubliniensis. Antimicrob Agents Chemoter. 2001;45:3416-21.

15. Sullivan D, Westerneng T, Haynes K, Bennet D, Coleman D. Candida dubliniensis sp. nov.: phenotypic and molecular characterization of a novel species associated with oral candidosis in HIV-infected individuals. Microbiology. 1995;141(Pt 7):1507-21.

16. Moran GP, Sullivan DJ, Henman MC, McCreary CE, Harrington BJ, Shanley DB, et al. Antifungal drug susceptibilities of oral Candida dubliniensis isolates from human immunodeficiency virus (HIV)-infected and non-HIV-infected subjects and generation of stable fluconazole-resistant derivates in vitro. Antimicrob Agents Chemoter. 1997;41:617-23.

17. Hartung de Capriles C, Mata-Essayag S, Pérez C, Colella MT, Roselló A, Olaizola C, et al. Detection of Candida dubliniensis in Venezuela. Mycopathologia. 2005;160:227-34.

18. Brena S, Rubio MC, Salesa R, Iglesias I, Gil J, Rezusta A, et al. Genotipos de Candida dubliniensis en aislamientos clínicos. Rev Iberoam Micol. 2004;21:20-3.

19. Fotedar R, Al-Hedaithy SS. Comparison of phospholipase and proteinase activity in Candida albicans and C. dubliniensis. Mycoses. 2005;48:62-7.

20. Tay ST, Chai HC, Na SL, Ng KP, Soo-Hoo TS. Molecular subtyping of clinical isolates of Candida albicans and identification of Candida dubliniensis in Malaysia. Mycopathologia. 2005;159:325-9.

21. Pontón J, Ruchel R, Clemons KV, Coleman DC, Grillot R, Guarro J, et al. Emerging pathogens. Med Mycol. 2000;38:225-36.

22. Mariano PLS, Milan EP, Matta DA, Colombo AL. Candida dubliniensis: identification in Brazilian yeast stock collection. Mem Inst Oswaldo Cruz. 2003;98:533-8.

23. Chavasco JK, Paula CR, Hirata MH, Aleva NA, Melo CE Gambale W, et al. Molecular identification of Candida dubliniensis isolated from oral lesions of HIV-positive and HIV-negative patients in São Paulo, Brazil. Rev Inst Med Trop S Paulo. 2006;48:21-6.

24. Mähnß B, Stehr F, Schäfer W, Neuber K. Comparison of standard phenotypic assays with a PCR method to discriminate Candida albicans and C. dubliniensis. Mycoses. 2005;48:55-61.

25. Meiller TF, Jabra-Rizk MA, Baqui A, Kelley JI, Meeks VI, Merz WG, et al. Oral Candida dubliniensis as a clinically important species in HIV-seropositive patients in the United States. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999; 88:573-80.

26. Sano A, Vilela MM, Takahashi I, Fukushima K, Takizawa K, Silva MT, et al. Isolation of Candida dubliniensis from the oral cavity of an HIV-positive child in Brazil. Nippon Ishikin Gakkai Zasshi. 2000;41:177-81.

27. Alves SH, Milan EP, Moretti-Branchini ML, Nishimura K, Fukushima K, Oliveira LO, et al. First isolation of Candida dubliniensis in Rio Grande do Sul, Brazil. Diagn Microbiol Infect Dis. 2001;39:165-8.

28. Milan EP, Sant´ana PL, Melo ASA, Sullivan DJ, Coleman DC, Lewi D, et al. Multicenter prospective surveillance of oral Candida dubliniensis among adult Brazilian human immunodeficiency virus-positive and AIDS patients. Diagn Microbiol Infect Dis. 2001;41:29-35.

29. Blignaut E, Pujol C, Joly S, Soll DR. Racial distribution of Candida dubliniensis colonization among South Africans. J Clin Microbiol. 2003;41:1838-42.

30. Vidotto V, Mantoan B, Pugliesi A, Pontón J, Quindós G, Aoki S, et al. Adherence of Candida albicans and Candida dubliniensis to buccal and vaginal cells. Rev Iberoam Micol. 2003;20:52-4.

31. Hospenthal DR, Beckius ML, Floyd KL, Horvath LL, Murray CK. Presumptive identification of Candida species other than C. albicans, C. krusei, and C. tropicalis with the chromogenic medium CHROMagar Candida. Ann Clin Microbiol Antimicrob. 2006;5:1.

32. Mesa LM, Arcaya N, Cañas O, Machado Y, Calvo B. Evaluación de los caracteres fenotípicos para diferenciar Candida albicans de Candida dubliniensis. Rev Iberoam Micol. 2004;21:135-8.

33. Al-Mosaid A, Sullivan DJ, Coleman DC. Differentiation of Candida dubliniensis from Candida albicans on Pal’s agar. J Clin Microbiol. 2003;41:4787-9.

34. Khan ZU, Ahmad S, Mokaddas E, Chandy R. Tobacco agar, a new medium for differentiating Candida dubliniensis from Candida albicans. J Clin Microbiol. 2004;42:4796-8.

35. Alves SH, Milan EP, de Laet Sant’Ana P, Oliveira LO, Santurio JM, Colombo AL. Hypertonic Sabouraud broth as a simple and powerful test for Candida dubliniensis screening. Diagn Microbiol Infect Dis. 2002;43:85-6.

36. Romeo O, Racco C, Criseo G. Amplification of the hyphal wall protein 1 gene to distinguish Candida albicans from Candida dubliniensis. J Clin Microbiol. 2006;44:2590-2.

37. Somogyvari F, Doczi I, Serly J, Ahmad S, Nagy E. Rapid discrimination between Candida albicans and Candida dubliniensis by using a real-time polymerase chain reaction. Diagn Microbiol Infect Dis. 2007;58:367-9.

38. Borst A, Theelen B, Reinders E, Boekhout T, Fluit AC, Savelkoul PHM. Use of amplified length polymorphism analysis to identify medically important Candida spp., including C. dubliniensis. J Clin Microbiol. 2003;41:1357-62.

39. Joly S, Pujol C, Rysz M, Vargas K, Soll DR. Development and characterization of complex DNA fingerprinting probes for the infectious yeast Candida dubliniensis. J Clin Microbiol. 1999;37:1035-44.

40. Gee SF, Joly S, Soll DR, Meis JF, Verweij PE, Polacheck I, et al. Identification of four distinct genotypes of Candida dubliniensis and detection of microevolution in vitro and in vivo. J Clin Microbiol. 2002;40:556-74.

41. Henriques M, Azeredo J, Oliveira R. Candida species adhesion to oral epithelium: factors involved and experimental methodology used. Crit Rev Microbiol. 2006;32:217-26.

42. Henriques M, Azeredo J, Oliveira R. The involvement of physico-chemical interactions in the adhesion of Candida albicans and Candida dubliniensis to epithelial cells. Mycoses. 2007;50:391-6.

43. Silva GM, Silveira FRX, Pires MFC. Adherence to HeLa cells, typing by killer toxins and susceptibility to antifungal agents of Candida dubliniensis strains. Braz Oral Res. 2007;21:87-91.

44. Jabra-Rizk MA, Falkler Jr WA, Merz WG, Baqui AA, Kelley JI, Meiller TF. Cell surface hydrophobicity-associated adherence of Candida dubliniensis to human buccal epithelial cells. Rev Iberoam Micol. 2001;18:17-22.

45. De Repentigny L, Aumont F, Bernard K, Belhumeur P. Characterization of binding of Candida albicans to small intestinal mucin and its role in adherence to mucosal epithelial cells. Infect Immun. 2000;68:3172-9.

46. Hornby JM, Jensen EC, Lisec AD Tasto JJ, Jahnke B, Shoemake R, et al. Quorum sensing in the dimorphic fungus Candida albicans is mediated by farnesol. Appl Environ Microbiol. 2001;67:2982-92.

47. Henriques M, Martins M, Azeredo J, Oliveira R. Effect of farnesol on Candida dubliniensis morphogenesis. Lett Appl Microbiol. 2007;44:199-205.

48. Magee BB, Sanchez MD, Saunders D, Harris D, Berriman M, Magee PT. Extensive chromosome rearrangements distinguish the karyotype of the hypovirulent species Candida dubliniensis from the virulent Candida albicans. Fungal Genet Biol. 2008;45:338-50.

49. Pinjon E, Moran GP, Coleman DC, Sullivan DJ. Azole susceptibility and resistance in Candida dubliniensis. Biochem Soc Trans. 2005;33:1210-14.

50. Borg-von Zepelin M, Niederhaus T, Gross U, Seibold M, Monod M, Tintelnot K. Adherence of different Candida dubliniensis isolates in the presence of fluconazole. AIDS. 2002;16:1237-44.

51. Fotedar R, Al-Hedaithy SS. Prevalence of Candida dubliniensis among germ tube-positive yeasts recovered from the respiratory specimens in HIV-negative patients. Mycoses. 2004;47:150-5.
588018437f8c9d0a098b4b45 rou Articles
Links & Downloads

Rev. odontol. UNESP

Share this page
Page Sections