Abstract

The widespread occurrence of vaginal candidiasis and the development of resistance against anti-fungal agents has stimulated interest in understanding the pathogenesis of this disease. The aim of our work was to characterize, in an animal model of vaginal candidiasis, the mechanisms that play a role in the induction of mucosal immunity against C. albicans and the interaction between innate and adaptive immunity. Our studies evidenced the elicitation of cell-mediated immunity (CMIs) and antibody (Abs)-mediated immunity with a Th1 protective immunity. An immune response of this magnitude in the vagina was very encouraging to identify the proper targets for new strategies for vaccination or immunotherapy of vaginal candidiasis. Overall, our data provide clear evidence that it is possible to prevent C. albicans vaginal infection by active intravaginal immunization with aspartyl proteinase expressed as recombinant protein. This opens the way to a modality for anti-Candida protection at the mucosa. The recombinant protein Sap2 was assembled with virosomes, and a vaccine PEVION7 (PEV7) was obtained. The results have given evidence that the vaccine, constituted of virosomes and Secretory aspartyl proteinase 2 (Sap2) (PEV7), has an encouraging therapeutic potential for the treatment of recurrent vulvovaginal candidiasis.

Highlights

  • IntroductionSeveral epidemiological studies [3,4,5,6,7] have documented that vulvovaginal candidiasis is a widespread, common disease affecting up to 75% of healthy women, with some of them affected by recurrent, often intractable forms of the disease

  • The majority of human infections by Candida occur at the mucosa [1,2]

  • Several epidemiological studies [3,4,5,6,7] have documented that vulvovaginal candidiasis is a widespread, common disease affecting up to 75% of healthy women, with some of them affected by recurrent, often intractable forms of the disease

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Summary

Introduction

Several epidemiological studies [3,4,5,6,7] have documented that vulvovaginal candidiasis is a widespread, common disease affecting up to 75% of healthy women, with some of them affected by recurrent, often intractable forms of the disease. Long-term maintenance therapy with fluconazole may help lengthen the asymptomatic periods between recurrences, but does not provide a long-lasting cure [5]. 7%–8% of women who experience a first episode. In these cases, the quality of life is devastated, and the associated cost of medical visits is high. Maintenance therapy with an efficacious anti-Candida drug lengthens the time to recurrence, but does not provide a long-term cure [5,6]

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