Virulence and pathogenicity of Candida albicans is enhanced in biofilms containing oral bacteria

Yuri Wanderley Cavalcanti, Daniel James Morse, Wander José da Silva, Altair Antoninha Del-Bel-Cury, Xiaoqing Wei, Melanie Wilson, Paul Milward, Michael Lewis, David Bradshaw, David Wynne Williams

Research output: Contribution to journalArticle (Academic Journal)peer-review

60 Citations (Scopus)


This study examined the influence of bacteria on the virulence and pathogenicity of candidal biofilms. Mature biofilms (Candida albicans-only, bacteria-only, C. albicans with bacteria) were generated on acrylic and either analysed directly, or used to infect a reconstituted human oral epithelium (RHOE). Analyses included Candida hyphae enumeration and assessment of Candida virulence gene expression. Lactate dehydrogenase (LDH) activity and Candida tissue invasion following biofilm infection of the RHOE were also measured. Candida hyphae were more prevalent (p < 0.05) in acrylic biofilms also containing bacteria, with genes encoding secreted aspartyl-proteinases (SAP4/SAP6) and hyphal-wall protein (HWP1) up-regulated (p < 0.05). Candida adhesin genes (ALS3/EPA1), SAP6 and HWP1 were up-regulated in mixed-species biofilm infections of RHOE. Multi-species infections exhibited higher hyphal proportions (p < 0.05), up-regulation of IL-18, higher LDH activity and tissue invasion. As the presence of bacteria in acrylic biofilms promoted Candida virulence, consideration should be given to the bacterial component when managing denture biofilm associated candidoses.

Original languageEnglish
Pages (from-to)27-38
Number of pages12
Issue number1
Publication statusPublished - 2015


  • Aspartic Acid Proteases/genetics
  • Bacteria
  • Biofilms
  • Candida albicans/growth & development
  • Epithelium/microbiology
  • Fungal Proteins/genetics
  • Humans
  • Hyphae/growth & development
  • L-Lactate Dehydrogenase/metabolism
  • Mouth Mucosa/microbiology
  • Stomatitis, Denture/microbiology
  • Virulence


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