Evaluation of the Efficacy of Acarbose on Ovarian Microbiota Profile, Ovary–Gut Axis, and SAP (1–10) Gene Expression in Rats Administered With Candida albicans Exosomes

Candida albicans is a commensal fungus of the vaginal and reproductive tract microbiota, but its overgrowth contributes to mucosal infections and reproductive dysfunctions. The fungus secretes exosomes carrying virulence factors, including secreted aspartyl proteinase (SAP) genes, which are critical for tissue invasion and immune modulation. Acarbose, an α-glucosidase inhibitor, has been shown to suppress C. albicans biofilm formation and hyphal transition. This study is aimed at evaluating the effects of acarbose on the ovarian microbiota, gut–ovary axis, and SAP gene expression profile in a rat model following exposure to C. albicans exosomes. Rats were divided into two groups: the control group received intraperitoneal C. albicans exosomes (8 log10 CFU/mL), whereas the acarbose group received the same exosomes followed by oral acarbose (25 mg/kg/day). Exosomes were characterized by NTA and SEM. Ovarian tissue gene expression (SAP1–10) was analyzed by qRT-PCR. Inflammatory cytokines and tight junction proteins were assessed via ELISA, and microbiota composition was determined using 16S rRNA sequencing. Acarbose significantly reduced IL-8 and TNF-α levels while increasing IL-10, ZO-1, claudin-5, and occludin expression compared with Candida-infected controls (p < 0.05). Gut microbiota diversity and classification success were higher in the acarbose group, indicating microbial balance restoration. Acarbose mitigated C. albicans exosome-induced inflammation and barrier dysfunction while enhancing microbial diversity, suggesting its potential role in modulating the ovarian–gut axis and reducing fungal virulence through SAP gene suppression. Copyright © 2026 Bulent Dabanlioglu et al. Cellular Microbiology published by John Wiley & Sons Ltd.