A Role for Yeast/Pseudohyphal Cells of Candida albicans in the Correlated Expression of NLRP3 Inflammasome Inducers in Women With Acute Vulvovaginal Candidiasis

In acute vulvovaginal candidiasis (VVC), the fungus Candida albicans activates inflammasome receptors of vaginal epithelial cells through the production of virulence and immuno-inflammatory factors. Here we show thatin VVC patients, genes encoding some of the above factors (SAP2, SAP5, SAP6, ECE1 and HWP1) are expressedin a correlated fashion. Cytological observations pointed out that pseudo-hyphal filaments with yeast cells are dominantat the acidic vaginal pH, and this is coupled with co-expression, at roughly similar level, of SAP2, a typical yeast- and ECE1, a typical hyphae-associated genes. In contrast, vigorous hyphal growth dominated at the neutral vaginal pH of mice experimentally infected with C. albicans isolates from VVC subjects, and this is coupled with a high ratio of ECE1 to SAP2 expression. We suggest the pseudo-hyphal rather than true hyphal cells of C. albicans play a critical role in VVC, possibly through the activity of multiple inflammasome inducers.