Extracellular Enzymatic Activity of Candida Species Isolated from Patients with Head and Neck Cancer Undergoing Radiation Therapy and Its Correlation with Mucositis: A Cross-Sectional Study
Introduction: The differences in enzymatic activity expressed by various Candida species determine their virulence and play a pivotal role in understanding the pathogenesis of candidiasis. Additionally, this knowledge aids in the development of new antifungal drugs that target these enzymes, the...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2023-09-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://www.jcdr.net/articles/PDF/18373/65554_CE[Ra1]_F[SK]_QC(KK_SHU_OM)_PF1(AG_KM)_PFA(AG_KM)_PN(KM).pdf |
| Summary: | Introduction: The differences in enzymatic activity expressed
by various Candida species determine their virulence and play
a pivotal role in understanding the pathogenesis of candidiasis.
Additionally, this knowledge aids in the development of
new antifungal drugs that target these enzymes, thereby
enhancing therapeutic approaches. Understanding the
extracellular enzymatic activity of Candida species is crucial
for the development of new anticandidial drugs targeting these
enzymes.
Aim: To determine the differences in enzymatic activity expressed
by various Candida species isolated from patients with Head
and Neck Cancer (HNC) undergoing Radiation Therapy (RT) and
to correlate these differences with the severity of mucositis.
Materials and Methods: This cross-sectional study evaluated
the enzymatic activity of Candida species, including C. albicans
and Non albicans Candida species (NAC), isolated from HNC
patients undergoing RT at the radiation oncology department,
Amala Institute of Medical Sciences, Thrissur, Kerala, India. A
total of 276 patients were enrolled in the study over a four-year
period (January 2019 to December 2022). Extracellular enzymatic
activities such as proteinase, phospholipase, haemolysin, and
esterase were detected using the plate method, as described
previously. Mucositis was graded according to the Radiation
Therapy Oncology Group (RTOG) criteria. Data were analysed
using Statistical Package for the Social Sciences (SPSS) version
23.0 (IBM, Illinois, US). The Chi-square test was used to analyse
the variables, and the unpaired t-test was used to compare
enzymatic activity. Spearman’s rank correlation was used to
identify any correlation between mucositis and extracellular
enzymatic activity.
Results: A total of 97 Candida strains (56 C. albicans and 41 NAC)
were isolated. There was no statistically significant difference
between C. albicans and NAC species causing infections in men
and women (p-value=0.390), as well as in those with diabetes
(p-value=0.127) and hypertension (p-value=0.979). Proteinase,
haemolytic activity, and esterase production were detected in 88
(90.7%), 84 (86.6%), and 67 (69.0%) isolates, respectively, while
phospholipase activity was shown by 18 (18.5%) isolates. There
was no statistically significant difference between C. albicans
and NAC species regarding the mean phospholipase, proteinase,
haemolysin, and esterase activity (p-value>0.05). C. albicans
exhibited high activity for all four enzymes, while a considerable
percentage of NAC showed moderate activity. High phospholipase
and proteinase activity in C. albicans showed a good correlation
(r=0.148 and r=0.186, respectively) with mucositis.
Conclusion: C. albicans showed high activity for all four
enzymes, indicating its virulence. The majority of C. albicans
strains exhibited proteinase activity, which is associated with the
severity of mucosal infections. The phospholipase activity has
the potential to play a role in the emergence of drug resistance
and should be closely monitored. |
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| ISSN: | 2249-782X 0973-709X |