Abstract

Vaginal candidiasis is an extremely common disease predominantly caused by four phylogenetically diverse species: Candida albicans; Candida glabrata; Candida parapsilosis; and Candida tropicalis. Using a time course infection model of vaginal epithelial cells and dual RNA sequencing, we show that these species exhibit distinct pathogenicity patterns, which are defined by highly species-specific transcriptional profiles during infection of vaginal epithelial cells. In contrast, host cells exhibit a homogeneous response to all species at the early stages of infection, which is characterized by sublethal mitochondrial signalling inducing a protective type I interferon response. At the later stages, the transcriptional response of the host diverges in a species-dependent manner. This divergence is primarily driven by the extent of epithelial damage elicited by species-specific mechanisms, such as secretion of the toxin candidalysin by C. albicans. Our results uncover a dynamic, biphasic response of vaginal epithelial cells to Candida species, which is characterized by protective mitochondria-associated type I interferon signalling and a species-specific damage-driven response.

Highlights

  • Vulvovaginal candidiasis (VVC) is among the most common fungal infections, affecting 70-75% of women at least once in their lifetime 1

  • Despite similar adhesion rates of all species, only C. albicans switched to hyphal growth, invaded epithelial cells, and induced necrotic cell damage

  • Parapsilosis remained in the yeast morphology during the entire course of infection, forming cell aggregates, but did not invade or caused damage

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Summary

Introduction

Vulvovaginal candidiasis (VVC) is among the most common fungal infections, affecting 70-75% of women at least once in their lifetime 1. VVC is characterized by acute inflammation of the vaginal mucosa due to the overgrowth of normally commensal Candida species [2,3,4]. Despite the shared genus name, these species are phylogenetically diverse and often have non-pathogenic close relatives, indicating that their ability to infect humans have emerged independently 6. How these diverse Candida species interact with host cells have rarely been addressed on a comparative basis. Improved knowledge of similarities and species-specific characteristics of infection processes is crucial to understand the pathogenesis, improve diagnostics, and therapy of candidiasis 7

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