Role of Candida albicans polymorphism in interactions with oral epithelial cells

Background: Candida albicans is a polymorphic organism which undergoes morphologic transition between yeast, pseudohyphal and hyphal forms. The ability of C. albicans to change from yeast to filamentous types is a major virulence determinant of this organism. However, the exact role of hyphal transformation in establishing oral mucosal infection is still poorly understood. Methods: In this study we used mutants with defects in filamentation, as well as oral strains, which differ in their capacity to form true hyphae, to examine the role of hyphal transformation in the interactions of C. albicans with oral epithelial cells in vitro. These interactions included the ability of these strains to adhere to and injure epithelial cells, as well as their ability to trigger a proinflammatory cytokine response. Results: We found that strains SC5314 and ATCC28366 formed true hyphae on epithelial cells, whereas strain ATCC32077 and the tup1/tup1 mutant formed only pseudohyphae. Double mutant efg1/efg1cph1/cph1 grew exclusively as blastospores. We also found that yeast and pseudohyphal strains showed reduced adherence capacity to oral keratinocytes and caused minimal cell damage. Moreover, we showed that both yeast and pseudohyphal forms have a strongly attenuated proinflammatory phenotype, since they failed to induce significant interleukin (IL)-1alpha and IL-8 responses by oral epithelial cells. Conclusions: Germination of C. albicans into true hyphae is particularly important in the interactions with oral epithelial cells in vitro.