Scientists from research institutions in Spain and Austria studied the resistance mechanisms developed by the fungus species. Candida glabrata, which causes candidiasis, to exposure to various drugs, and identified eight genes that, when mutated, are responsible for allowing the pathogen to adapt and survive the treatment.
So far, only half of these genes were known to be candidates for drug resistance. The new study was published this week in the journal Current Biology.
It is estimated that 80% of women will suffer from vaginal thrush at least once in their lifetime. Candidiasis is a fungal infection – the most frequent is the Candida albicans – which can affect the inguinal, perianal and perineum regions. It is usually associated with decreased immunity, the use of antibiotics, contraceptives, immunosuppressants and corticoids, pregnancy, diabetes, allergies and HPV (papiloma virus).
Treatment for candidiasis should be recommended by a gynecologist and is done by applying antifungal ointments directly to the vagina or using pills.
While there are medications available to treat these conditions, infections with Candida have become a serious problem for global health as doctors are increasingly finding a variety of fungi that develop resistance to treatment.
“The interesting thing about this work is that the identification of these eight genes allows us to use a genetic test to diagnose the potential drug resistance present in a given patient’s infection and thus help in choosing the best treatment,” said Toni Gabaldon, biochemist and molecular biologist at Icrea (Catalan Institute for Research and Advanced Studies) and head of the group that carried out the study.
Evolutionary process underlying the incorporation of resistance mechanisms
To conduct this study, the researchers cultivated populations independent of the fund. Candida glabrata and administered a variety of drugs available on the market that have different mechanisms of action.
They then analyzed the developed resistance and genomes of distinct populations to correlate mechanisms with genetic differences.
The strains generated in this work, which combine resistance to different drugs, can serve as a study model in the search for new treatments.
(Reproduction/IRB Barcelona)Source: IRB Barcelona
In addition to resistance to the treatment given, the researchers also found that exposure to one drug (fluconazole) also caused resistance to another type of drug (echinocandin) in 50% of cases, although these populations were never exposed to the second drug.
“This phenomenon is known as cross-resistance and, in this sense, our findings should lead to an adaptation of the treatment guidelines so as not to favor the appearance of multi-resistance”, says Gabaldon.
The laboratory headed by Gabaldon received support from Fundação la Caixa, which provides research incentives and is linked to a Spanish bank, to start a project related to these discoveries. This effort seeks to improve the diagnosis of candidiasis and design new treatments, seeking patterns of infection and drug adaptation in different Candida species.
ARTICLE Current Biology: doi.org/10.1016/j.cub.2021.09.084