Candida albicans 의 바이오필름 (Biofilm) 형성 기전과 병태 생리
Candida albicans Biofilm Formation and Pathophysiology
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C. albicans는 건강한 사람의 구강이나 질 내,위장관에서 정상적으로 집락을 이루고 있으나 면역력이 떨어진 사람에게는 기회 감염을 일으키며,혈행성 전신 파종증으로 발전될 수도 있다. 현재C. albicans는 병원에서 획득되는 감염의 매우 주요한 원인균으로 자리하고 있다. 면역억제제나세포 독성 약제의 사용, 정상 세균을 억제하는강력한 항생제 처치, 그리고 여러 가지 인체 삽입기구 또는 보조물 이식 등 많은 의학적 처치들이 칸디다증 발생을 유발하는 위험 요인으로 작용하고 있다. 대부분의 C. albicans는 자연 환경에서 자유롭게 떠있는 상태보다는 세포외 물질들의 표면에 고착하여 바이오필름 형태로 존재하는데, 생체에 생기는 바이오필름은 칸디다 감염증 성립과 그 발전 과정에서 결정적인 역할을 한다. 또한 생체뿐만 아니라, 카테터, 삽입 보철물등의 의학적 처치기구에 형성되는 바이오필름은지속적 칸디다 감염증의 감염원으로써 매우 중요한 의미를 가진다. 또한 삽입 의료기구의 사용이증가함에 따라 바이오필름 관련 감염 발생은 현재는 물론 앞으로 점점 더 커지게 될 의학적 위급 상황이 되고 있다. 따라서 이를 해결하기 위한 C. albicans 바이오필름의 제어 방법 개발 및항진균제 개발을 위하여, 바이오필름에 대한 군집 및 개체군 수준, 그리고 세포 및 분자 수준에서의 총체적인 연구가 반드시 시행되어져야 할것이다.
Abstract
Candida species are frequently found in the normal microorganism of humans, which facilitates their encounter with most implanted biomaterials and host surfaces. Medical devices such as stents, prostheses,implants and various types of catheters have all been shown to support colonization and biofilm formation by Candida. Candida albicans remains the fungal species most commonly associated with biofilm formation and the increase in Candida infections in the last decades has almost paralleled the increase and widespread use of a broad range of medical implant devices, mainly in populations with impaired host defenses. The formation of C. albicans biofilms carries important clinical repercussions because of their increased resistance to antifungal therapy and the ability of cells within biofilms to withstand host immune defenses. Also, biofilm formation on medical devices can negatively impact the host by serving as a reservoir or source for future continuing infections. This review article aims to provide insights on various aspects of C. albicans biofilms, formation and structure, their role in pathogenesis and antifungal drug resistance.
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