Candida albicans is a fungal organism that is an integral and usually innocuous component of the normal human microbiome, as well as being an opportunistic pathogen. Despite asymptomatically colonising numerous regions of the body, under conditions of immune suppression and specific nutrient deficiency, such as vitamin B12, vitamin C and zinc, Candida albicans can easily transition from a commensal yeast to its pathogenic (H-Candida) state (Kim et al, 2016; Paillaud et al, 2004; Edman et al, 1986). This can also be caused by a variety of disruptions to an individual’s internal environment. This would include antibiotic therapy, a change in pH, oestrogen imbalance, the contraceptive pill, CO2 presence, excessive sugar consumption, and even a shift in temperature (Aminzadeh et al. 2016; Nobile and Johnson, 2015; Hall et al, 2010; Cheng et al, 2006; Horowitz et al, 1984).
The pathogenic hyphal form of Candida albicans is elongated in nature and is very different in terms of its internal structure to the commensal form (Y Candida) During hyphal transformation, the appearance of new surface antigens improves the adhesion capability of hyphae to their host’s cells and also enables them to penetrate both the epithelium and endothelium (Meri et al, 2004). This inevitably results in tissue damage and thus ultimately permits access into the bloodstream, allowing it to become systemic.
Symptoms most commonly associated with candida infection (candidiasis) include fatigue and brain fog, but research continues to uncover evidence of just what a negative impact this condition can have upon human health.
Candida antigens have shown superantigen-like effects in stimulating the excessive release of proinflammatory cytokines and have been shown to play a significant role in triggering psoriasis flares, with increased candida colonization confirmed in individuals with psoriasis (Pietrzak et al, 2018).
As part of the normal vaginal microbiota, Candida albicans is actually the leading cause of vaginitis. In fact, as many as ¾ of all women of childbearing age have suffered from vulvovaginal candidiasis at least once within their lifetime, with an estimated 8% of those having faced recurring episodes (Peters et al. 2014).
In addition to HIV positive individuals, candidiasis is also common in cancer patients undergoing chemotherapy or radiotherapy too. Diabetics and people with other metabolic or hormonal disorders, children and the elderly, as well as those on antibiotics are also predisposed to candida infection (Williams and Lewis 2011).
Candida biofilms on prosthetic devices such as pacemakers, heart valves, vascular catheters and replacement joints have perhaps the most significant impact upon public health however, as they have been associated with systemic infection, with device-associated candida infections having a mortality rate of 30% (Williams and Lewis 2011). In healthy individuals, the most common biofilm-related candida infection is candida-associated denture stomatitis, which is characterised by localised inflammation of the denture-supporting mucosa and occurs in as many as 70% of all denture wearers (Tsui et al, 2016).
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