Intra-amniotic Candida albicans infection induces mucosal injury and inflammation in the ovine fetal intestine

Sci Rep. 2016 Jul 14:6:29806. doi: 10.1038/srep29806.

Abstract

Chorioamnionitis is caused by intrauterine infection with microorganisms including Candida albicans (C.albicans). Chorioamnionitis is associated with postnatal intestinal pathologies including necrotizing enterocolitis. The underlying mechanisms by which intra-amniotic C.albicans infection adversely affects the fetal gut remain unknown. Therefore, we assessed whether intra-amniotic C.albicans infection would cause intestinal inflammation and mucosal injury in an ovine model. Additionally, we tested whether treatment with the fungistatic fluconazole ameliorated the adverse intestinal outcome of intra-amniotic C.albicans infection. Pregnant sheep received intra-amniotic injections with 10(7) colony-forming units C.albicans or saline at 3 or 5 days before preterm delivery at 122 days of gestation. Fetuses were given intra-amniotic and intra-peritoneal fluconazole treatments 2 days after intra-amniotic administration of C.albicans. Intra-amniotic C.albicans caused intestinal colonization and invasive growth within the fetal gut with mucosal injury and intestinal inflammation, characterized by increased CD3(+) lymphocytes, MPO(+) cells and elevated TNF-α and IL-17 mRNA levels. Fluconazole treatment in utero decreased intestinal C.albicans colonization, mucosal injury but failed to attenuate intestinal inflammation. Intra-amniotic C.albicans caused intestinal infection, injury and inflammation. Fluconazole treatment decreased mucosal injury but failed to ameliorate C.albicans-mediated mucosal inflammation emphasizing the need to optimize the applied antifungal therapeutic strategy.

MeSH terms

  • Animals
  • Antifungal Agents / pharmacology
  • Candida albicans / drug effects
  • Candida albicans / physiology*
  • Candidiasis / drug therapy
  • Candidiasis / microbiology
  • Candidiasis / veterinary*
  • Chorioamnionitis / drug therapy
  • Chorioamnionitis / microbiology
  • Chorioamnionitis / veterinary*
  • Cytokines / genetics
  • Cytokines / metabolism
  • Female
  • Fetus / metabolism
  • Fetus / microbiology
  • Fetus / pathology
  • Fluconazole / pharmacology
  • Host-Pathogen Interactions
  • Inflammation / microbiology
  • Inflammation / veterinary*
  • Intestinal Mucosa / embryology
  • Intestinal Mucosa / microbiology*
  • Intestinal Mucosa / pathology
  • Pregnancy
  • Sheep
  • Sheep Diseases / microbiology*
  • Sheep Diseases / pathology

Substances

  • Antifungal Agents
  • Cytokines
  • Fluconazole