title: In vitro evaluation of virulence attributes of Candida spp. isolated from patients affected by diabetes mellitus.
abstract: BACKGROUND
  Diabetes mellitus is a common disease found worldwide and it has been previously suggested that oral candidal infections may be more frequent or severe in patients with this disease. Systemic and local factors may influence the balance between the host and yeasts, and favour the transformation of Candida isolates from commensal to pathogenic microorganisms. Candida species have developed specific virulence mechanisms that confer the ability to colonise host surfaces, to invade deeper host tissue, or to evade host defences. Few studies have investigated the expression of the virulence attributes of oral Candida isolates in patients with diabetes mellitus.
  
  
  METHODS
  The in vitro extracellular proteinase production and the in vitro ability to adhere to fibronectin of 229 Candida isolates of two geographic different groups of patients with diabetes mellitus and of healthy subjects were assessed.
  
  
  RESULTS
  Candida isolates of patients with diabetes mellitus expressed a higher ability to adhere than those of healthy subjects. Higher levels of adhesion were also recorded in patients with a lower oral Candida colonisation. No differences were observed in the in vitro expression of extracellular proteinase of Candida isolates of patients with diabetes mellitus and those of non-diabetic subjects. Isolates of patients with type 2 diabetes mellitus expressed greater levels of proteinase than isolates of type 1 diabetes mellitus.
  
  
  CONCLUSIONS
  Diabetes mellitus could be considered as an additional variable that may influence not only oral Candida carriage but also the ability of isolates to enhance the expression of virulence attributes.
authors.affiliation: Oral Medicine, Division of Infection and Immunity, Eastman Dental Institute, UCL, University of London, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Manfredi
authors.forename: M J
authors.initials: MJ
authors.lastname: McCullough
authors.forename: Z M
authors.initials: ZM
authors.lastname: Al-Karaawi
authors.forename: P
authors.initials: P
authors.lastname: Vescovi
authors.forename: S R
authors.initials: SR
authors.lastname: Porter
mesh_terms: D002175:Candida / Q000302:isolation & purification / Q000378:metabolism / Q000472:pathogenicity*; D016022:Case-Control Studies; D002448:Cell Adhesion; D015169:Colony Count, Microbial; D003920:Diabetes Mellitus / Q000378:metabolism; D020689:Exopeptidases / Q000096:biosynthesis; D005260:Female; D005353:Fibronectins / Q000378:metabolism; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007558:Italy; D008131:London; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000382:microbiology*; D011485:Protein Binding; D037521:Virulence Factors
chemical_list: D020689:Exopeptidases; D005353:Fibronectins; D006442:Glycated Hemoglobin; D037521:Virulence Factors