Presence pattern of genes related to ergosterol biosynthesis in colonizing Candida albicans isolates from patients with multiple sclerosis

Subject Areas : Molecular Microbiology

Hajar Mahmoudi ¹ , Fahimeh Alizadeh ² , Alireza Khodavandi ³ , Maryam Rahimi Foroudi ⁴ , Elham Phishgar ⁵

1 - Department of Microbiology, Shiraz Branch, Islamic Azad University, Shiraz, Iran.
2 - Department of Biology, Gachsaran Branch, Islamic Azad University, Gachsaran, Iran.
3 - Department of Biology, Gachsaran Branch, Islamic Azad University, Gachsaran, Iran.
4 - Department of Microbiology, Shiraz Branch, Islamic Azad University, Shiraz, Iran.
5 - Department of Microbiology, Shiraz Branch, Islamic Azad University, Shiraz, Iran.

Received: 2024-11-27 Accepted : 2025-01-29 Published : 2025-03-10

Keywords: Multiple sclerosis, Candida albicans, ergosterol biosynthesis, drug resistance, ERG genes,

Abstract :

 

Background & objectives: Multiple sclerosis (MS) is a chronic autoimmune and inflammatory disease of the central nervous system that can make patients more susceptible to fungal infections such as candidiasis, which can potentially exacerbate neuroinflammation. Candidiasis is typically treated with azole antifungals like fluconazole. However, the increasing resistance to antifungal agents presents a therapeutic challenge. This study aimed to assess fluconazole resistance and identify associated resistance genes in Candida albicans isolates from MS patients.

Materials & methods: A cross-sectional study of 30 C. albicans isolates from MS patients was conducted. The isolates were identified using phenotypic and molecular methods. Antifungal susceptibility to fluconazole was assessed using disk diffusion and broth microdilution methods following CLSI guidelines. The presence of ERG1, ERG3, and ERG11 genes was determined through PCR.

Results: Among the C. albicans isolates, 10 (33.33%) were resistant, 2 (6.67%) were intermediate, and 18 (60%) were sensitive to fluconazole. The ERG1 gene was present in all isolates, while the ERG3 and ERG11 genes were only found in resistant and intermediate isolates. In resistant isolates, both ERG3 and ERG11 genes were present at a frequency of 100%, whereas only ERG3 was detected in intermediate isolates. A significant association was observed between the presence of these genes and antifungal resistance.

Conclusion: The presence of ERG3 and ERG11 genes may contribute to the development of fluconazole resistance in C. albicans. Further studies on gene mutations and protein alterations may aid in the development of targeted therapeutic strategies to combat drug resistance.

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