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Infect Immun. 2016 Sep 19;84(10):2724-39. doi: 10.1128/IAI.00469-16. Print 2016 Oct.

Candida albicans Pathogenesis: Fitting within the Host-Microbe Damage Response Framework.

Author information

1
Department of Oncology and Diagnostic Sciences, Dental School, University of Maryland, Baltimore, Maryland, USA Department of Microbiology and Immunology, School of Medicine, University of Maryland, Baltimore, Maryland, USA mrizk@umaryland.edu.
2
Department of Oncology and Diagnostic Sciences, Dental School, University of Maryland, Baltimore, Maryland, USA Department of Microbiology and Immunology, School of Medicine, University of Maryland, Baltimore, Maryland, USA Graduate Program in Life Sciences, Molecular Microbiology and Immunology Program, University of Maryland, Baltimore, Maryland, USA.
3
Department of Oncology and Diagnostic Sciences, Dental School, University of Maryland, Baltimore, Maryland, USA.
4
Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
5
Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA Infectious Diseases Section, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
6
Center of Excellence in Oral and Craniofacial Biology, Louisiana State University Health Sciences Center School of Dentistry, New Orleans, Louisiana, USA.

Abstract

Historically, the nature and extent of host damage by a microbe were considered highly dependent on virulence attributes of the microbe. However, it has become clear that disease is a complex outcome which can arise because of pathogen-mediated damage, host-mediated damage, or both, with active participation from the host microbiota. This awareness led to the formulation of the damage response framework (DRF), a revolutionary concept that defined microbial virulence as a function of host immunity. The DRF outlines six classifications of host damage outcomes based on the microbe and the strength of the immune response. In this review, we revisit this concept from the perspective of Candida albicans, a microbial pathogen uniquely adapted to its human host. This fungus commonly colonizes various anatomical sites without causing notable damage. However, depending on environmental conditions, a diverse array of diseases may occur, ranging from mucosal to invasive systemic infections resulting in microbe-mediated and/or host-mediated damage. Remarkably, C. albicans infections can fit into all six DRF classifications, depending on the anatomical site and associated host immune response. Here, we highlight some of these diverse and site-specific diseases and how they fit the DRF classifications, and we describe the animal models available to uncover pathogenic mechanisms and related host immune responses.

PMID:
27430274
PMCID:
PMC5038058
DOI:
10.1128/IAI.00469-16
[Indexed for MEDLINE]
Free PMC Article

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