Mannose-Binding Lectin Gene Polymorphism versus Microbial Virulence in the Pathogenesis of Vulvovaginal Candidiasis and Recurrent Vulvovaginal Candidiasis

Iman Wali; Eman M. Haggag; Alaa R. Awad; Mohammad A. El-Sharkawy; Marwa K. Sallam

doi:10.3889/oamjms.2023.8261

Authors

Iman Wali Department of Medical Microbiology and Immunology https://orcid.org/0000-0002-0913-7172
Eman M. Haggag Department of Medical Microbiology and Immunology, Faculty of Medicine, Cairo University, Kasr Al Ainy Hospitals, Cairo, Egypt
Alaa R. Awad Department of Medical Microbiology and Immunology, Faculty of Medicine, Cairo University, Kasr Al Ainy Hospitals, Cairo, Egypt
Mohammad A. El-Sharkawy Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Kasr Al Ainy Hospitals, Cairo, Egypt
Marwa K. Sallam Department of Medical Microbiology and Immunology, Faculty of Medicine, Cairo University, Kasr Al Ainy Hospitals, Cairo, Egypt; Department of Basic Medical Sciences, Faculty of Medicine, King Salman International University (KSIU), El-Tor, Egypt https://orcid.org/0000-0001-5281-1727

DOI:

https://doi.org/10.3889/oamjms.2023.8261

Keywords:

Candida, virulence, Mannose Binding Lectin, Gene polymorphism, Vulvovaginal candidiasis, recurrent, D-ARMs, esterase, phospholipase, Biofilm

Abstract

BACKGROUND: Vulvovaginal candidiasis (VVC) is one of the most common infections affecting women.

AIM: This study aimed to determine MBL2 polymorphism frequency among females with VVC together with assessment of Candida virulence attributes in the pathogenesis of it.

METHODS: Fifty Egyptian patients and 50 controls were included in the study. Vaginal swabs were cultured to identify Candida spp. D-ARMs were used to determine MBL2 polymorphism.

RESULTS: Cases with VVC revealed Candida albicans 37(74%) and non-Albicans Candida (NAC) 13 (26%) with a significant difference between C. albicans and NAC esterase and phospholipase. Thirty C. albicans isolates (81.1%) possessed three or more virulence factors, compared to only four NAC (30.8%) (p = 0.002). As regards MBL2 polymorphism, the X allele was found to be significantly high in cases than in controls (p ≤ 0.001). B allele on codon 54 and L allele on promoter region was more in cases. Other haplotypes were more in cases than controls with a significant difference for LXQB and HXQB. HXPB and LXQB were detected among recurrent VVC (RVVC) cases more than VVC cases.

CONCLUSION: RVVC appears to be a multi-factorial disorder; hence, treatment should be individualized. Recombinant MBL may be considered in the future treatment of RVVC in the case of associated genetic MBL2 polymorphism.

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