{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T22:12:04Z","timestamp":1790201524332,"version":"4.1.0"},"reference-count":122,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,10,29]],"date-time":"2023-10-29T00:00:00Z","timestamp":1698537600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Candida albicans, along with several non-albicans Candida species, comprise a prominent fungal pathogen in humans, leading to candidiasis in various organs. The global impact of candidiasis in terms of disease burden, suffering, and fatalities is alarmingly high, making it a pressing global healthcare concern. Current treatment options rely on antifungal drugs such as azoles, polyenes, and echinocandins but are delimited due to the emergence of drug-resistant strains and associated adverse effects. The current review highlights the striking absence of a licensed antifungal vaccine for human use and the urgent need to shift our focus toward developing an anti-Candida vaccine. A number of factors affect the development of vaccines against fungal infections, including the host, intraspecies and interspecies antigenic variations, and hence, a lack of commercial interest. In addition, individuals with a high risk of fungal infection tend to be immunocompromised, so they are less likely to respond to inactivated or subunit whole organisms. Therefore, it is pertinent to discover newer and novel alternative strategies to develop safe and effective vaccines against fungal infections. This review article provides an overview of current vaccination strategies (live attenuated, whole-cell killed, subunit, conjugate, and oral vaccine), including their preclinical and clinical data on efficacy and safety. We also discuss the mechanisms of immune protection against candidiasis, including the role of innate and adaptive immunity and potential biomarkers of protection. Challenges, solutions, and future directions in vaccine development, namely, exploring novel adjuvants, harnessing the trained immunity, and utilizing immunoinformatics approaches for vaccine design and development, are also discussed. This review concludes with a summary of key findings, their implications for clinical practice and public health, and a call to action for continued investment in candidiasis vaccine research.<\/jats:p>","DOI":"10.3390\/vaccines11111658","type":"journal-article","created":{"date-parts":[[2023,10,29]],"date-time":"2023-10-29T05:01:08Z","timestamp":1698555668000},"page":"1658","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Advancing Vaccine Strategies against Candida Infections: Exploring New Frontiers"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9605-5502","authenticated-orcid":false,"given":"Gurpreet","family":"Kaur","sequence":"first","affiliation":[{"name":"Department of Biotechnology, Chandigarh College of Technology (CCT), Chandigarh Group of Colleges (CGC), Landran, Mohali 140307, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6187-4778","authenticated-orcid":false,"given":"Sonam","family":"Chawla","sequence":"additional","affiliation":[{"name":"Department of Biotechnology, Jaypee Institute of Information Technology, Sector 62, Noida 201309, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9140-6898","authenticated-orcid":false,"given":"Piyush","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Biotechnology, Jaypee Institute of Information Technology, Sector 62, Noida 201309, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5950-2888","authenticated-orcid":false,"given":"Ritu","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Biotechnology, Jaypee Institute of Information Technology, Sector 62, Noida 201309, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,29]]},"reference":[{"key":"ref_1","first-page":"1","article-title":"Invasive candidiasis","volume":"4","author":"Pappas","year":"2018","journal-title":"Nature Rev. Dis. Primers"},{"key":"ref_2","unstructured":"(2023, August 24). Centre for Disease Control and Prevention, CDC, Available online: https:\/\/www.cdc.gov\/fungal\/diseases\/candidiasis\/invasive\/statistics.html."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"114960","DOI":"10.1016\/j.addr.2023.114960","article-title":"Candidiasis: From cutaneous to systemic, new perspectives of potential targets and therapeutic strategies","volume":"199","author":"Hui","year":"2023","journal-title":"Adv. Drug Deliv. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/s12281-023-00455-3","article-title":"Candidiasis and Other Emerging Yeasts","volume":"17","author":"Sharma","year":"2023","journal-title":"Curr. Fungal Infect. Rep."},{"key":"ref_5","unstructured":"Vazquez, J.A., and Sobel, J.D. (2011). Essentials of Clinical Mycology, Springer."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1136\/pmj.78.922.455","article-title":"Oral candidiasis","volume":"78","author":"Akpan","year":"2002","journal-title":"Postgrad. Med. J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1038\/s41541-021-00294-8","article-title":"Vaccines for human fungal diseases: Close but still a long way to go","volume":"6","author":"Oliveira","year":"2021","journal-title":"Npj Vaccines"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1080\/14787210.2023.2227790","article-title":"Will invasive fungal infections be The Last of Us? The importance of surveillance, public-health interventions, and antifungal stewardship","volume":"21","author":"Gold","year":"2023","journal-title":"Expert Rev. Anti. Infect. Ther."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1093\/jac\/dkad139","article-title":"Invasive candidiasis: Current clinical challenges and unmet needs in adult populations","volume":"78","author":"Soriano","year":"2023","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Sahu, S.R., Bose, S., Singh, M., Kumari, P., Dutta, A., Utkalaja, B.G., Patel, S.K., and Acharya, N. (2022). Vaccines against candidiasis: Status, challenges and emerging opportunity. Front. Cell. Infect. Microbiol., 12.","DOI":"10.3389\/fcimb.2022.1002406"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1093\/infdis\/jix597","article-title":"The Candida auris alert: Facts and perspectives","volume":"217","author":"Lamoth","year":"2018","journal-title":"J. Infect Dis."},{"key":"ref_12","unstructured":"WHO (2023, September 30). Available online: https:\/\/iris.who.int\/bitstream\/handle\/10665\/363682\/9789240060241-eng.pdf?sequence=1."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3139","DOI":"10.1128\/JCM.00319-11","article-title":"First three reported cases of nosocomial fungemia caused by Candida auris","volume":"49","author":"Lee","year":"2011","journal-title":"J. Clin. Microbiol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Chakrabarti, A., and Sood, P. (2021). On the emergence, spread and resistance of Candida auris: Host, pathogen and environmental tipping points. J. Med. Microbiol., 70.","DOI":"10.1099\/jmm.0.001318"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e01909","DOI":"10.1128\/JCM.01909-17","article-title":"Diagnosing Invasive Candidiasis","volume":"56","author":"Clancy","year":"2018","journal-title":"J. Clin. Microbiol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Fang, W., Wu, J., Cheng, M., Zhu, X., Du, M., Chen, C., Liao, W., Zhi, K., and Pan, W. (2023). Diagnosis of invasive fungal infections: Challenges and recent developments. J. Biomed. Sci., 30.","DOI":"10.1186\/s12929-023-00926-2"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Ahmed, N., Mahmood, M.S., Ullah, M.A., Araf, Y., Rahaman, T.I., Moin, A.T., and Hosen, M.J. (2022). COVID-19-Associated Candidiasis: Possible Patho-Mechanism, Predisposing Factors, and Prevention Strategies. Curr. Microbiol., 79.","DOI":"10.1007\/s00284-022-02824-6"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1111\/ors.12561","article-title":"Oral candidiasis in non-severe COVID-19 patients: Call for antibiotic stewardship","volume":"15","author":"Riad","year":"2020","journal-title":"Oral Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1580","DOI":"10.1111\/jocd.14066","article-title":"Oral candidiasis of COVID-19 patients: Case report and review of evidence","volume":"20","author":"Riad","year":"2021","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Kozlova, O., Burygina, E., Khostelidi, S., Shadrivova, O., Saturnov, A., Gusev, D., Rysev, A., Zavrazhnov, A., Vashukova, M., and Pichugina, G. (2023). Invasive Candidiasis in Adult Patients with COVID-19: Results of a Multicenter Study in St. Petersburg, Russia. J. Fungi, 9.","DOI":"10.3390\/jof9090927"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1016\/j.cell.2012.02.012","article-title":"Beyond empiricism: Informing vaccine development through innate immunity research","volume":"148","author":"Levitz","year":"2012","journal-title":"Cell"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1038\/s41541-019-0132-6","article-title":"The how\u2019s and what\u2019s of vaccine reactogenicity","volume":"4","author":"Didierlaurent","year":"2019","journal-title":"NPJ Vaccines"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"In\u00e1cio, M.M., Moreira, A.L.E., Cruz-Leite, V.R.M., Mattos, K., Silva, L.O.S., Venturini, J., Ruiz, O.H., Ribeiro-Dias, F., Weber, S.S., and Soares, C.M.A. (2023). Fungal Vaccine Development: State of the Art and Perspectives Using Immunoinformatics. J. Fungi, 9.","DOI":"10.3390\/jof9060633"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.mib.2017.10.018","article-title":"Modulating host immune responses to fight invasive fungal infections","volume":"40","author":"Scriven","year":"2017","journal-title":"Curr. Opin. Microbiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"7594","DOI":"10.1016\/j.vaccine.2012.10.038","article-title":"NDV-3, a recombinant alum-adjuvanted vaccine for Candida and Staphylococcus aureus, is safe and immunogenic in healthy adults","volume":"30","author":"Schmidt","year":"2012","journal-title":"Vaccine"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"6191","DOI":"10.1128\/IAI.73.9.6191-6193.2005","article-title":"The anti-Candida albicans vaccine composed of the recombinant n terminus of Als1p reduces fungal burden and improves survival in both immunocompetent and immunocompromised mice","volume":"73","author":"Spellberg","year":"2005","journal-title":"Infect. Immun."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1086\/504691","article-title":"Efficacy of the anti-Candida rAls3p-n or rAls1p-n vaccines against disseminated and mucosal candidiasis","volume":"194","author":"Spellberg","year":"2006","journal-title":"J. Infect. Dis."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Bhattacharya, S., Sae-Tia, S., and Fries, B.C. (2020). Candidiasis and Mechanisms of Antifungal Resistance. Antibiotics, 9.","DOI":"10.3390\/antibiotics9060312"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1007\/s40265-019-01127-8","article-title":"Adverse effects associated with long-term administration of azole antifungal agents","volume":"79","author":"Benitez","year":"2019","journal-title":"Drugs"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"897","DOI":"10.3389\/fimmu.2018.00897","article-title":"The Elusive Anti-Candida Vaccine: Lessons from the Past and Opportunities for the Future","volume":"9","author":"Tso","year":"2018","journal-title":"Front. Immunol."},{"key":"ref_31","unstructured":"(2023, August 24). World Health Organisation. Available online: https:\/\/www.who.int\/health-topics\/vaccines-and-immunization#tab=tab_1."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1007\/s13577-021-00512-4","article-title":"COVID-19 vaccines: Rapid development, implications, challenges and future prospects","volume":"34","author":"Kashte","year":"2021","journal-title":"Hum. Cell"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"4490","DOI":"10.1016\/j.vaccine.2012.04.069","article-title":"A virosomal vaccine against Candida vaginitis: Immunogenicity, efficacy and safety profile in animal models","volume":"30","author":"Amacker","year":"2012","journal-title":"Vaccine"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1038\/nrmicro1537","article-title":"Advances in combating fungal diseases: Vaccines on the threshold","volume":"5","author":"Cutler","year":"2007","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1007\/s13311-016-0453-3","article-title":"Vaccinations for Neuroinfectious Disease: A Global Health Priority","volume":"13","author":"Leibovitch","year":"2016","journal-title":"Neurotherapeutics"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.biopha.2018.10.075","article-title":"Fungal vaccines, mechanism of actions and immunology: A comprehensive review","volume":"109","author":"Nami","year":"2019","journal-title":"Biomed Pharmacother."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1128\/CVI.00480-08","article-title":"Efficacy of a genetically engineered Candida albicans tet-NRG1 strain as an experimental live attenuated vaccine against hematogenously disseminated candidiasis","volume":"16","author":"Saville","year":"2009","journal-title":"Clin. Vaccine Immunol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"3007","DOI":"10.1002\/pmic.200400929","article-title":"Low virulent strains of Candida albicans: Unravelling the antigens for a future vaccine","volume":"4","author":"Molero","year":"2004","journal-title":"Proteomics"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1128\/iai.51.2.668-674.1986","article-title":"Evidence for macrophage-mediated protection against lethal Candida albicans infection","volume":"51","author":"Bistoni","year":"1986","journal-title":"Infect. Immun."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Shen, H., Yu, Y., Chen, S.M., Sun, J.J., Fang, W., Guo, S.Y., Hou, W.T., Qiu, X.R., Zhang, Y., and Chen, Y.L. (2020). Dectin-1 facilitates IL-18 production for the generation of protective antibodies against Candida albicans. Front. Microbiol., 11.","DOI":"10.3389\/fmicb.2020.01648"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Austriaco, N. (2023). Yeast oral vaccines against infectious diseases. Front. Microbiol., 14.","DOI":"10.3389\/fmicb.2023.1150412"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/j.chom.2011.04.006","article-title":"Trained immunity: A memory for innate host defense","volume":"9","author":"Netea","year":"2011","journal-title":"Cell Host Microbe"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Kaur, G., Singh, S., Nanda, S., Zafar, M.A., Malik, J.A., Arshi, M.U., Lamba, T., and Agrewala, J.N. (2022). Fiction and Facts about BCG Imparting Trained Immunity against COVID-19. Vaccines, 10.","DOI":"10.3390\/vaccines10071006"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"17537","DOI":"10.1073\/pnas.1202870109","article-title":"Bacille Calmette-Guerin induces NOD2-dependent nonspecific protection from reinfection via epigenetic reprogramming of monocytes","volume":"109","author":"Kleinnijenhuis","year":"2012","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.chom.2017.12.010","article-title":"BCG vaccination protects against experimental viral infection in humans through the induction of cytokines associated with trained immunity","volume":"23","author":"Arts","year":"2018","journal-title":"Cell Host Microbe"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"9778","DOI":"10.1128\/JVI.00355-11","article-title":"Mechanisms controlling virulence thresholds of mixed viral populations","volume":"85","author":"Lancaster","year":"2011","journal-title":"J. Virol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1164\/ajrccm\/148.3.656","article-title":"Evaluation of the protective efficacy of the killed Coccidioides immitis spherule vaccine in humans. The Valley Fever Vaccine Study Group","volume":"148","author":"Pappagianis","year":"1993","journal-title":"Am. Rev. Respir. Dis."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1128\/CMR.11.1.1","article-title":"Use of licensed vaccines for active immunization of the immunocompromised host","volume":"11","author":"Pirofski","year":"1998","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1007\/s40475-019-00173-2","article-title":"Difficult but not impossible: In search of an anti-Candida vaccine","volume":"15","author":"Piccione","year":"2019","journal-title":"Curr. Trop. Med. Rep."},{"key":"ref_50","first-page":"309","article-title":"Vaccines in the treatment of invasive candidiasis","volume":"6","author":"Wang","year":"2015","journal-title":"Virulence"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"3039","DOI":"10.1128\/IAI.74.5.3039-3041.2006","article-title":"The anti-candida vaccine based on the recombinant n-terminal domain of Als1p is broadly active against disseminated candidiasis","volume":"74","author":"Ibrahim","year":"2006","journal-title":"Infect. Immun."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"6194","DOI":"10.1038\/s41598-019-42517-y","article-title":"NDV-3A vaccination prevents C. albicans colonization of jugular vein catheters in mice","volume":"9","author":"Alqarihi","year":"2019","journal-title":"Sci Rep."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1111\/j.1365-2567.2004.01819.x","article-title":"Protection against systemic candidiasis in mice immunized with secreted aspartic proteinase 2","volume":"111","author":"Vilanova","year":"2004","journal-title":"Immunology"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"2725","DOI":"10.1128\/IAI.70.5.2725-2729.2002","article-title":"Intravaginal and intranasal immunizations are equally effective in inducing vaginal antibodies and conferring protection against vaginal candidiasis","volume":"70","author":"Boccanera","year":"2002","journal-title":"Infect. Immun."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Akhtar, N., Magdaleno, J.S.L., Ranjan, S., Wani, A.K., Grewal, R.K., Oliva, R., Shaikh, A.R., Cavallo, L., and Chawla, M. (2023). Secreted Aspartyl Proteinases Targeted Multi-Epitope Vaccine Design for Candida dubliniensis Using Immunoinformatics. Vaccines, 11.","DOI":"10.3390\/vaccines11020364"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"51","DOI":"10.4265\/bio.19.51","article-title":"Evaluation of Mdh1 protein as an antigenic candidate for a vaccine against candidiasis","volume":"19","author":"Shibasaki","year":"2014","journal-title":"Biocontrol Sci."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"2208","DOI":"10.1128\/AAC.47.7.2208-2216.2003","article-title":"Preclinical assessment of the efficacy of mycograb, a human recombinant antibody against fungal HSP90","volume":"47","author":"Matthews","year":"2003","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Luo, G., Ibrahim, A.S., French, S.W., Edwards, J.E., and Fu, Y. (2011). Active and passive immunization with rHyr1p-N protects mice against hematogenously disseminated candidiasis. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0025909"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"W\u00fcthrich, M., Dobson, H.E., Ledesma Taira, C., Okaa, U.J., Dos Santos Dias, L., Isidoro-Ayza, M., Petrovsky, N., and Klein, B.S. (2021). Combination Adjuvants Enhance Recombinant Protein Vaccine Protection against Fungal Infection. mBio, 21.","DOI":"10.1101\/2021.03.11.434977"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1080\/07328303.2011.604453","article-title":"Synthesis of laminarin fragments and evaluation of a \u03b2-(1, 3) glucan hexasaccaride-CRM197 conjugate as vaccine Candidate against Candida albicans","volume":"30","author":"Adamo","year":"2011","journal-title":"J. Carbohydr. Chem."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1750","DOI":"10.1099\/jmm.0.079681-0","article-title":"Whole Glucan Particles as a Vaccine against Murine Aspergillosis","volume":"63","author":"Clemons","year":"2014","journal-title":"J. Med. Microbiol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"13526","DOI":"10.1073\/pnas.0803195105","article-title":"Synthetic glycopeptide vaccines combining beta-mannan and peptide epitopes induce protection against candidiasis","volume":"105","author":"Xin","year":"2008","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Xin, H., Cartmell, J., Bailey, J.J., Dziadek, S., Bundle, D.R., and Cutler, J.E. (2012). Self-adjuvanting glycopeptide conjugate vaccine against disseminated candidiasis. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0035106"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1038\/nrd3012","article-title":"Carbohydrate vaccines: Developing sweet solutions to sticky situations?","volume":"9","author":"Astronomo","year":"2010","journal-title":"Nat. Rev. Drug Discov."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"4543","DOI":"10.1039\/C2CS35422E","article-title":"Clustered carbohydrates in synthetic vaccines","volume":"42","author":"Peri","year":"2013","journal-title":"Chem. Soc. Rev."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"2430","DOI":"10.1016\/j.vaccine.2019.03.061","article-title":"Design of a mimotope-peptide based double epitope vaccine against disseminated candidiasis","volume":"37","author":"Xin","year":"2019","journal-title":"Vaccine"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1128\/IAI.67.2.826-833.1999","article-title":"Effectiveness of a vaccine composed of heat-killed candida albicans and a novel mucosal adjuvant, LT(R192G), against systemic candidiasis","volume":"67","author":"Cheng","year":"1999","journal-title":"Infect. Immun."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"847","DOI":"10.3109\/08820139.2012.692418","article-title":"Saccharomyces as a vaccine against systemic candidiasis","volume":"41","author":"Liu","year":"2012","journal-title":"Immunol. Investig."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"S170","DOI":"10.3109\/13693786.2010.497775","article-title":"Developing a vaccine against-aspergillosis","volume":"49","author":"Stevens","year":"2011","journal-title":"Med. Mycol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1007\/978-1-4939-7104-6_2","article-title":"Heat-Killed Yeast as a Pan-Fungal Vaccine","volume":"1625","author":"Martinez","year":"2017","journal-title":"Methods Mol. Biol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"foz007","DOI":"10.1093\/femsyr\/foz007","article-title":"Yeast-based vaccines: New perspective in vaccine development and application","volume":"19","author":"Kumar","year":"2019","journal-title":"FEMS Yeast Res."},{"key":"ref_72","first-page":"612269","article-title":"A combination of polybacterial MV140 and Candida albicans V132 as a potential novel trained immunity-based vaccine for genitourinary tract infections","volume":"11","author":"Subiza","year":"2020","journal-title":"Front. Immunol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1111\/2049-632X.12068","article-title":"An oral vaccine against candidiasis generated by a yeast molecular display system","volume":"69","author":"Shibasaki","year":"2013","journal-title":"Pathog. Dis."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"697","DOI":"10.3797\/scipharm.1404-07","article-title":"Oral Immunization Against Candidiasis Using Lactobacillus casei Displaying Enolase 1 from Candida albicans","volume":"82","author":"Shibasaki","year":"2014","journal-title":"Sci. Pharm."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1111\/2049-632X.12003","article-title":"Time-course proteomic profile of Candida albicans during adaptation to a fetal serum","volume":"67","author":"Aoki","year":"2013","journal-title":"Pathog. Dis."},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Chen, H., Ji, H., Kong, X., Lei, P., Yang, Q., Wu, W., Jin, L., and Sun, D. (2021). Bacterial Ghosts-Based Vaccine and Drug Delivery Systems. Pharmaceutics, 13.","DOI":"10.3390\/pharmaceutics13111892"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"102862","DOI":"10.1016\/j.jddst.2021.102862","article-title":"Synthesis and evaluation of metallic nanoparticles-based vaccines against Candida albicans infections","volume":"68","author":"Abdelnaby","year":"2022","journal-title":"J. Drug Deliv. Sci. Technol."},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Peroumal, D., Sahu, S.R., Kumari, P., Utkalaja, B., and Acharya, N. (2022). Commensal fungi candida albicans modulates dietary high-fat induced alterations in metabolism, immunity, and gut microbiota. bioRxiv.","DOI":"10.1101\/2022.03.23.485455"},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Akhtar, N., Singh, A., Upadhyay, A.K., and Mannan, M.A. (2022). Design of a multi-epitope vaccine against the pathogenic fungi Candida tropicalis using an in silico approach. J. Genet. Eng. Biotechnol., 20.","DOI":"10.1186\/s43141-022-00415-3"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1038\/s41598-020-57906-x","article-title":"In silico design of a multivalent vaccine against Candida albicans","volume":"10","author":"Tarang","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_81","first-page":"pgac248","article-title":"Immunogenicity and protective efficacy of a pan-fungal vaccine in preclinical models of aspergillosis, candidiasis, and pneumocystosis","volume":"1","author":"Rayens","year":"2022","journal-title":"Proc. Natl. Acad. Sci. USA Nexus"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.ajog.2015.06.067","article-title":"Recurrent vulvovaginal candidiasis","volume":"214","author":"Sobel","year":"2016","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1016\/j.vaccine.2009.10.082","article-title":"The role of Toll-like receptors and C-type lectins for vaccination against Candida albicans","volume":"28","author":"Ferwerda","year":"2010","journal-title":"Vaccine"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"905867","DOI":"10.3389\/fimmu.2022.905867","article-title":"T cell responses to control fungal infection in an immunological memory lens","volume":"13","author":"Sharma","year":"2022","journal-title":"Front. Immunol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1093\/mmy\/myu045","article-title":"Adjuvants and delivery systems for antifungal vaccines: Current state and future developments","volume":"53","author":"Portuondo","year":"2015","journal-title":"Med. Mycol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"2069","DOI":"10.4049\/jimmunol.135.3.2069","article-title":"Activation of human polymorphonuclear neutrophil functions by interferon-gamma and tumor necrosis factors","volume":"135","author":"Shalaby","year":"1985","journal-title":"J. Immunol."},{"key":"ref_87","doi-asserted-by":"crossref","unstructured":"Mengesha, B.G., and Conti, H.R. (2017). The role of IL-17 in protection against mucosal Candida infections. J. Fungi, 3.","DOI":"10.3390\/jof3040052"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1034\/j.1601-0825.2002.00015.x","article-title":"Immunity to Candida","volume":"8","author":"Fidel","year":"2002","journal-title":"Oral Dis."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.coi.2006.05.003","article-title":"Immunity to fungi","volume":"18","author":"Hohl","year":"2006","journal-title":"Curr. Opin. Immunol."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"377","DOI":"10.2174\/1566524054022549","article-title":"An outline of the role of anti-Candida antibodies within the context of passive immunization and protection from candidiasis","volume":"5","author":"Cassone","year":"2005","journal-title":"Curr. Mol. Med."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1084\/jem.158.3.670","article-title":"Identification of interferon-\u03b3 as the lymphokine that activates human macrophage oxidative metabolism and antimicrobial activity","volume":"158","author":"Nathan","year":"1983","journal-title":"J. Exp. Med."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"1894","DOI":"10.1002\/eji.201041197","article-title":"IL-22 and TNF-\u03b1 represent a key cytokine combination for epidermal integrity during infection with Candida albicans","volume":"41","author":"Eyerich","year":"2011","journal-title":"Eur. J. Immunol."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1086\/315674","article-title":"Increased resistance to systemic candidiasis in athymic or interleukin-10-depleted mice","volume":"182","author":"Tavares","year":"2000","journal-title":"J. Infect. Dis."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1084\/jem.187.3.307","article-title":"Endogenous interleukin 4 is required for development of protective CD4+ T helper type 1 cell responses to Candida albicans","volume":"187","author":"Mencacci","year":"1998","journal-title":"J. Exp. Med."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"3679","DOI":"10.1128\/IAI.00233-09","article-title":"Complement C3 plays an essential role in the control of opportunistic fungal infections","volume":"77","author":"Tsoni","year":"2009","journal-title":"Infect. Immun."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"5868","DOI":"10.1128\/IAI.72.10.5868-5876.2004","article-title":"Dysregulated inflammatory response to Candida albicans in a C5-deficient mouse strain","volume":"72","author":"Mullick","year":"2004","journal-title":"Infect. Immun."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"5288","DOI":"10.1038\/s41467-018-07738-1","article-title":"Single human B cell-derived monoclonal anti-Candida antibodies enhance phagocytosis and protect against disseminated candidiasis","volume":"9","author":"Rudkin","year":"2018","journal-title":"Nat. Commun."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1111\/j.1574-695X.2011.00802.x","article-title":"A highly immunogenic recombinant and truncated protein of the secreted aspartic proteases family (rSap2t) of Candida albicans as a mucosal anti-candidal vaccine","volume":"62","author":"Sandini","year":"2011","journal-title":"FEMS Immunol. Med. Microbiol."},{"key":"ref_99","doi-asserted-by":"crossref","unstructured":"Torosantucci, A., Chiani, P., Bromuro, C., De Bernardis, F., Palma, A.S., Liu, Y., Mignogna, G., Maras, B., Colone, M., and Stringaro, A. (2009). Protection by anti-\u03b2-glucan antibodies is associated with restricted \u03b2-1,3 glucan binding specificity and inhibition of fungal growth and adherence. PLoS ONE, 4.","DOI":"10.1371\/journal.pone.0005392"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1111\/j.1439-0507.2008.01574.x","article-title":"Candida infection in HIV positive patients 1985\u20132007","volume":"51","author":"Traeder","year":"2008","journal-title":"Mycoses"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.1097\/QAD.0b013e3283536ba8","article-title":"Candida and candidiasis in HIV-infected patients: Where commensalism, opportunistic behavior and frank pathogenicity lose their borders","volume":"26","author":"Cassone","year":"2012","journal-title":"Aids"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1101\/gr.174623.114","article-title":"Genetic and phenotypic intra-species variation in Candida albicans","volume":"25","author":"Hirakawa","year":"2015","journal-title":"Genome Res."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"2297","DOI":"10.1099\/mic.0.049395-0","article-title":"Hyphal induction in the human fungal pathogen Candida albicans reveals a characteristic wall protein profile","volume":"157","author":"Heilmann","year":"2011","journal-title":"Microbiology"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/s12275-016-5514-0","article-title":"Interaction of Candida albicans with host cells: Virulence factors, host defense, escape strategies, and the microbiota","volume":"54","author":"Mogavero","year":"2016","journal-title":"J. Microbiol."},{"key":"ref_105","doi-asserted-by":"crossref","unstructured":"Gaziano, R., Sabbatini, S., and Monari, C. (2023). The Interplay between Candida albicans, Vaginal Mucosa, Host Immunity and Resident Microbiota in Health and Disease: An Overview and Future Perspectives. Microorganisms, 11.","DOI":"10.3390\/microorganisms11051211"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1016\/j.mib.2009.09.010","article-title":"White-opaque switching in Candida albicans","volume":"12","author":"Lohse","year":"2009","journal-title":"Curr. Opin. Microbiol."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1128\/EC.00060-10","article-title":"Genomic plasticity of the human fungal pathogen Candida albicans","volume":"9","author":"Selmecki","year":"2010","journal-title":"Eukaryot. Cell"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1038\/nrmicro3156","article-title":"Development of vaccines for Candida albicans: Fighting a skilled transformer","volume":"11","author":"Cassone","year":"2013","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"3192","DOI":"10.1002\/eji.201344406","article-title":"Microbiota control of a tryptophan-AhR pathway in disease tolerance to fungi","volume":"44","author":"Romani","year":"2014","journal-title":"Eur. J. Immunol."},{"key":"ref_110","first-page":"316","article-title":"Host response to Candida albicans bloodstream infection and sepsis","volume":"6","author":"Duggan","year":"2015","journal-title":"Virulence"},{"key":"ref_111","doi-asserted-by":"crossref","unstructured":"Carpino, N., Naseem, S., Frank, D.M., and Konopka, J.B. (2017). Modulating host signaling pathways to promote resistance to infection by Candida albicans. Front. Cell. Infect. Microbiol., 7.","DOI":"10.3389\/fcimb.2017.00481"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1111\/nyas.13739","article-title":"New pathogens, new tricks: Emerging, drug-resistant fungal pathogens and future prospects for antifungal therapeutics: Drug-resistant fungal pathogens","volume":"1435","author":"Shapiro","year":"2019","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1038\/s41577-020-0285-6","article-title":"Defining trained immunity and its role in health and disease","volume":"20","author":"Netea","year":"2020","journal-title":"Nat. Rev. Immunol."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.chom.2012.06.006","article-title":"Candida albicans infection affords protection against reinfection via functional reprogramming of monocytes","volume":"12","author":"Quintin","year":"2012","journal-title":"Cell Host Microbe"},{"key":"ref_115","doi-asserted-by":"crossref","unstructured":"Leentjens, J., Quintin, J., Gerretsen, J., Kox, M., Pickkers, P., and Netea, M.G. (2014). The effects of orally administered Beta-glucan on innate immune responses in humans, a randomized open-label intervention pilot-study. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0108794"},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"2936","DOI":"10.3389\/fimmu.2018.02936","article-title":"Trained Immunity-Based Vaccines: A New Paradigm for the Development of Broad-Spectrum Anti-infectious Formulations","volume":"9","author":"Conejero","year":"2018","journal-title":"Front. Immunol."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1586\/14760584.2014.932253","article-title":"Candida antigens and immune responses: Implications for a vaccine","volume":"13","author":"Moragues","year":"2014","journal-title":"Expert Rev. Vaccines"},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1128\/CMR.17.2.281-310.2004","article-title":"Surface glycans of Candida albicans and other pathogenic fungi: Physiological roles, clinical uses, and experimental challenges","volume":"17","author":"Masuoka","year":"2004","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_119","doi-asserted-by":"crossref","unstructured":"Kaur, H., and Chakrabarti, A. (2017). Strategies to reduce mortality in adult and neonatal candidemia in developing countries. J. Fungi, 3.","DOI":"10.3390\/jof3030041"},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"3390","DOI":"10.1021\/acs.chemrev.0c00199","article-title":"Antifungal drug resistance: Molecular mechanisms in Candida albicans and beyond","volume":"121","author":"Lee","year":"2021","journal-title":"Chem. Rev."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1016\/j.intimp.2013.08.003","article-title":"Ginsenoside Rd induces protective anti-Candida albicans antibody through immunological adjuvant activity","volume":"17","author":"Han","year":"2013","journal-title":"Int. Immunopharmacol."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"25151355221100218","DOI":"10.1177\/25151355221100218","article-title":"Predicting epitopes for vaccine development using bioinformatics tools","volume":"10","author":"Yurina","year":"2022","journal-title":"Ther. Adv. 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