Attenuation of Candida albicans virulence with focus on disruption of its vacuole functions.

The objective of the present review is to discuss if the yeast vacuole can be used as a target for attenuation of Candida albicans virulence. Literature searches were made electronically using predetermined inclusion criteria. The main searches were made through a systematic strategy in PubMed and authoritative journals in microbiology. It appeared that C. albicans virulence may be reduced by inhibiting vacuolar proton-translocating ATPase (V-ATPase) functions and acidification of the yeast vacuole by V-ATPase inhibitors, by seeking the synergistic effect of antifungals and non-antifungals affecting yeast vacuolar functions, and by inhibiting filament production - also regulated by the vacuole. Accordingly, we may impair C. albicans virulence by inhibiting functions of its vacuole, which plays essential roles during colonization and invasion of the host. Except for drugs where indications for clinical use can be redefined, such interventions may be closer to theory than to reality at the moment. But since the yeast is so difficult to eradicate by antifungal treatment, it could be rewarding to seek new strategies for reducing its virulence rather than trying to eradicate it completely from the microbiota, which often turns out to be impossible.