Abstract
Vulvovaginal candidiasis (VVC) is among the most prevalent vaginal diseases. Candida albicans is still the most prevalent species associated with this pathology, however, the prevalence of other Candida species, such as C. glabrata, is increasing. The pathogenesis of these infections has been intensely studied, nevertheless, no consensus has been reached on the pathogenicity of VVC. In addition, inappropriate treatment or the presence of resistant strains can lead to RVVC (vulvovaginal candidiasis recurrent). Immunomodulation therapy studies have become increasingly promising, including with the β-glucans. Thus, in the present study, we evaluated microbicidal activity, phagocytosis, intracellular oxidant species production, oxygen consumption, myeloperoxidase (MPO) activity, and the release of tumor necrosis factor α (TNF-α), interleukin-8 (IL-8), IL-1β, and IL-1Ra in neutrophils previously treated or not with β-glucan. In all of the assays, human neutrophils were challenged with C. albicans and C. glabrata isolated from vulvovaginal candidiasis. β-glucan significantly increased oxidant species production, suggesting that β-glucan may be an efficient immunomodulator that triggers an increase in the microbicidal response of neutrophils for both of the species isolated from vulvovaginal candidiasis. The effects of β-glucan appeared to be mainly related to the activation of reactive oxygen species and modulation of cytokine release.
Highlights
Vulvovaginal candidiasis (VVC) is an important public health problem that affects a large number of healthy women of childbearing age, resulting in an estimated cost of USDS|1 billion per year in the United States [1]
Based on the effect of b-glucan on the microbicidal activity of neutrophils, we evaluated whether this carbohydrate modulates the phagocytosis of neutrophils that were activated by the recurrent VVC (RVVC) isolate compared with the VVC and ASS isolates and reference strain of C. albicans and C. glabrata
We evaluated the production of total intracellular oxidant species in b-glucan-treated neutrophils that were activated by the RVVC isolate compared with the VVC and ASS isolates and reference strain of C. albicans and C. glabrata. b-glucan induced an increase in rhodamine 123 (Rh123) fluorescence for all of the isolates of C. albicans compared with the activated and untreated neutrophil group (Fig. 3A), indicating intracellular oxidant species production by b-glucan-treated neutrophils
Summary
Vulvovaginal candidiasis (VVC) is an important public health problem that affects a large number of healthy women of childbearing age, resulting in an estimated cost of USDS|1 billion per year in the United States [1]. A significant trend toward the emergence of non-Candida albicans Candida (NCAC) species, such as C. glabrata, has been observed in recent years [4,7] The pathogenesis of these infections has been intensely studied over the past two decades. The beneficial effects of b-glucan treatment have been attributed to modulation of the immune response, such as the stimulation of phagocytosis and activation of oxidative burst, which contribute to microbicidal activity [16]. These carbohydrates can stimulate or suppress the secretion of cytokines [11,17]. We suggest that RVVC isolate caused by C. glabrata does not involve impairment of the microbicidal activity of neutrophils
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