Anti-candidal activities of lactoferrin in systemic candidiasis

Candida albicans, the most prevalent fungal biofilm-forming pathogen, is responsible for several types of oral and systemic infections. Several studies have reported resistant strains of C. albicans, due to the recurrent episodes of oral thrush and prolonged use of azole antibiotics. During disseminated infection, candida hyphae invade mucosal epithelial cells and target organs, particularly the kidney. Death from candidemia results from renal insufficiency in a substantial number of patients. The lack of effective treatment against resistant strains of C. albicans is a major constraint in successfully treating these patients. Therefore, there is an urgent need to develop better therapeutic and prophylactic strategies to combat these fatal infections. Lactoferrin is a host defense factor, present in saliva, neutrophils and milk, which exhibit anti-candidal activities against C. albicans in vitro and in vivo. However, the underlying mechanisms by which human lactoferrin (hLF) mediate host defenses against systemic candidiasis, are not known. In the present report, the literature on the current epidemiology, pathogenicity, antifungal resistance of candida species, as well as new therapies for systemic infection including hLF, is reviewed.