Candida albicans induces mucosal bacterial dysbiosis that promotes invasive infection.

Authors:
Dr. Amit Ranjan, PhD
Dr. Amit Ranjan, PhD
ACTREC
Cancer Biology
Navi Mumbai, Maharashtra | India
Angela Thompson
Angela Thompson
St. Francis Xavier University
Canada
Patricia I Diaz
Patricia I Diaz
The University of Connecticut Health Center
United States
Takanori Sobue
Takanori Sobue
a School of Dental Medicine
Cleveland | United States
Kendra Maas
Kendra Maas
Life Sciences Institute
Anna Dongari-Bagtzoglou
Anna Dongari-Bagtzoglou
School of Dental Medicine
United States

PLoS Pathog 2019 Apr 22;15(4):e1007717. Epub 2019 Apr 22.

Department of Oral Health Sciences, University of Connecticut Health Center, Farmington, Connecticut, United States of America.

Infectious complications are a common cause of morbidity and mortality in cancer patients undergoing chemotherapy due to increased risk of oral and gastrointestinal candidiasis, candidemia and septicemia. Interactions between C. albicans and endogenous mucosal bacteria are important in understanding the mechanisms of invasive infection. We published a mouse intravenous chemotherapy model that recapitulates oral and intestinal mucositis, and myelosuppression in patients receiving 5-fluorouracil. We used this model to study the influence of C. albicans on the mucosal bacterial microbiome and compared global community changes in the oral and intestinal mucosa of the same mice. We validated 16S rRNA gene sequencing data by qPCR, in situ hybridization and culture approaches. Mice receiving both 5Fu and C. albicans had an endogenous bacterial overgrowth on the oral but not the small intestinal mucosa. C. albicans infection was associated with loss of mucosal bacterial diversity in both sites with indigenous Stenotrophomonas, Alphaproteobacteria and Enterococcus species dominating the small intestinal, and Enterococcus species dominating the oral mucosa. Both immunosuppression and Candida infection contributed to changes in the oral microbiota. Enterococci isolated from mice with oropharyngeal candidiasis were implicated in degrading the epithelial junction protein E-cadherin and increasing the permeability of the oral epithelial barrier in vitro. Importantly, depletion of these organisms with antibiotics in vivo attenuated oral mucosal E-cadherin degradation and C. albicans invasion without affecting fungal burdens, indicating that bacterial community changes represent overt dysbiosis. Our studies demonstrate a complex interaction between C. albicans, the resident mucosal bacterial microbiota and the host environment in pathogenesis. We shed significant new light on the role of C. albicans in shaping resident bacterial communities and driving mucosal dysbiosis.

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http://dx.doi.org/10.1371/journal.ppat.1007717DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6497318PMC
April 2019

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