Characterization of virulence factors of vaginal and anal isolates of Candida albicans sequentially obtained from patients with vulvovaginal candidiasis in north-east Brazil

In order to better understand the pathogenesis of VVC, focusing on the role of C. albicans virulence factors in triggering this infirmity; we evaluated four virulence factors of 62 clinical isolates of C. albicans sequentially obtained from the vagina and anus of patients with sporadic and recurrent VVC. Virulence factors were phenotypically evaluated in vitro, including: adhesion capacity to epithelial cells obtained from healthy individuals, morphogenesis in the presence of fetal bovine serum, biofilm formation in polystyrene microtiter plates and proteinase activity using bovine serum albumin. Colonizing anal isolates were as able as infecting vaginal isolates to express the virulence factors evaluated in vitro. It was observed an association between the expression of virulence factors studied and the signs and symptoms of VVC presented by the patients. No statistically significant difference was observed in the expression of virulence factors between vaginal isolates of C. albicans obtained from patients with sporadic VVC and those obtained from patients with recurrent VVC. Our results suggest that the ability to express virulence factors is important for the pathogenesis of VVC, but it seems not to be crucial for the transition from colonization to infection.