Objectives:
The objective of this project was to identify and quantify key virulence determinants from clinical isolates of Candida albicans in well controlled type 1 diabetic patients (WC), poorly controlled type 1 diabetic patients (PC) and non-diabetic (ND) healthy individuals.
Methods:
Non-smoking patients were classified based on their HbA1c value as WC (<8%), PC (≥8%) or ND (<6%). Oral swabs were collected from patients (n=30) and C. albicans identified using an API biochemical assay, which was then stored on beads till required. C. albicans colonies were propagated and examined for their capacity to produce phospholipase activity, haemolysin activity, proteinase activity, oral epithelial cell adhesion and biofilm formation. The results obtained were statistically analysed and compared.
Results:
The results demonstrated that strains isolated from the PC group had increased haemolysin and proteinase activity when compared with healthy controls. In addition, these strains were able to form structurally more dense biofilms and adhere better to epithelial cells when compared to the ND and WC group. No statistically significant differences in phospholipase activity were observed.
Conclusion:
In this small study, key determinants of C. albicans virulence, such as secreted enzyme production, adhesion and biofilm formation, from strains associated with poorly controlled type 1 diabetes, were increased. This suggests that individuals with compromised physiological function have the capacity to support the growth and maintenance of a subset of C. albicans strains with increased pathogenic potential, which may be related to increased morbidity.