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Pulmonary defence mechanism in mice. A comparative role of alveolar macrophages and polymorphonuclear cells against infection with Candida albicans.

The protective roles of alveolar macrophages and polymorphonuclear cells were analyzed against intratracheal challenge with Candida albicans in mice. When mice were treated with carrageenan, a known cytotoxic agent for macrophages, there was no change in susceptibilities to the challenge in terms of the survival and the progressive elimination of fungi from the lung and kidney, in spite of a decreased in vitro phagocytosis of Candida albicans by their alveolar macrophages. On the other hand, irradiated mice (whole body irradiation with 800 rads) showed an enhanced mortality and a progressive growth of Candida albicans in their lungs and kidneys, although no change was observed in the in vitro phagocytic activity of alveolar macrophages until day 6 after irradiation. In normal and carrageenan treated mice, there was a progressive increase in the recruitment of polymorphonuclear cells into the lung after the challenge as shown by bronchoalveolar lavage and histological examination. In irradiated mice, on the other hand, there was a decreased recruitment of polymorphonuclear cells at 24 hr after the challenge, and a complete impairment at a late stage. When phagocytes were obtained from normal mice and examined for in vitro phagocytic activity to Candida albicans, polymorphonuclear cells showed higher activity than that of alveolar macrophages. These results suggest that polymorphonuclear cells play a very important role in the protection against intratracheal infection with Candida albicans.

Animals↗

Specificity and mechanism of in vitro adherence of Candida albicans.

Adherence of 14C-glucose labeled Candida albicans to vaginal epithelial cells was measured in the presence of 10 potential inhibitory sugars at concentrations of 5 to 150 mg per ml for 90 minutes at 37 degrees C. In competitive inhibition experiments, no inhibition of adherence was seen with any sugar at any concentration. On the contrary, with the exception of the aminosugars glucosamine, galactosamine, and mannosamine, increased attachment of Candida to vaginal epithelial cells was found in the presence of dextrose, galactose, mannose, alpha-methyl-mannoside, N-acetyl-glucosamine, N-acetyl-galactosamine, and N-acetyl-mannosamine. Increased adherence was not associated with recognizable changes in the electron microscopic appearance of Candida cell surface or alterations in fungal cell hydrophobicity as measured by interaction chromatography. Measurement of nonreceptor-specific adherence of Candida to glass beads revealed similar increased attachment in the presence of the test sugars, suggesting that adherence of Candida may not require specific yeast adhesin-cell receptor interaction.

Binding Sites↗

A variety of Candida proteinases and their possible targets of proteolytic attack in the host.

Acid proteinases are secreted by the majority of strains of Candida albicans, C. tropicalis and C. parapsilosis, reflecting the sequence of virulence of Candida spp. for man. As revealed by exposure to various substrates and inhibitors, Candida proteinases are strain-specific, although close relationships exist between enzymes from strains of the same species. Possible targets of hydrolytic attack by Candida proteinases in the host are immunoglobulins, the proteinase scavenger alpha-2-macroglobulin, zymogens of regulatory serine proteinases such as coagulation factor X, and angiotensinogen. The involvement of Candida proteinase in the pathogenesis of acronecrosis is discussed.

Candida↗

[Histologic studies on the frequency of Candida invasion in precancerous oral leukoplakia].

Out of 243 biopsies taken from oral leukoplakias of 202 patients we found 53 precancerous lesions (21,8%). According to different degrees of epithelial dysplasia, we differentiated the lesions into three histological grades of precancerosis and examined them, in additon to previous mykologic investigations on oral smears, as to the occurrence of Candida species in the epithelium. A significant increase (p less than or equal to 5%) of Candida occurrence parallel to the grade of the precancerous dysplasia could be demonstrated. The rates of Candida invasion run from 10% in dysplasia grade 1 to 31% in grade 2, and 56% in grade 3. The results indicate a lowered resistence of precancerous lesions against Candida, which allows the microorganisms to invade the displastic epithelium. Our findings are in favour of the view that Candida acts not as a co-carcinogenic agent but points to a weakened defence activity of the host cellular immune system.

Candida albicans↗

Modification of an experimental mouse Candida infection by human dialyzable leukocyte extract.

Human dialyzable leukocyte extract (10(7) - 10(8) leukocyte equivalents, containing transfer factor) was administered intraperitoneally to CFW mice the day of and 2 days after intravenous infection with Candida albicans. Tissue Candida populations were determined immediately after and 2, 4, 7 and 14 days after infection. Kidney populations were significantly reduced on 27% of the days studied. Similar reduction in C. albicans census was obtained after injection of leukocyte extracts from donors skin test-positive to Candida antigens or donors negative to Candida antigens by skin test and migration inhibition analyses. There was no evidence of a dose-response relationship for leukocyte extract in the range 10(5) - 10(9) leukocyte equivalents. When mice were primed with C. albicans antigen 4 weeks prior to challenge the efficacy of leukocyte extracts was not augmented. There was no evidence that the infection-reducing effects were related to augmented polymorphonuclear leukocyte mobilization, increased mononuclear clearance of C. albicans, or to a direct toxic effect on C. albicans blastospores. These studies suggest that the reduction in Candida populations was non-specific and give further impetus to the use of the dialyzable leukocyte extracts as non-specific supplements to antibiotics in overwhelming or recalcitrant infections in man.

Animals↗

Hyaluronidase and chondroitin sulphatase production by different species of Candida.

The production of hyaluronidase and chondroitin sulphatase by Candida albicans, Candida tropicalis, Candida parapsilosis, Candida guilliermondii and Candida krusei was investigated using a complex culture medium (Sabouraud glucose agar) and a chemically defined medium. Among the 63 C. albicans isolates tested, 61 (97.8%) were found to be hyaluronidase and chondroitin sulphatase producers; one isolate produced only chondroitin sulphatase and one other was unable to produce either enzyme. The second major hyaluronidase and chondroitin sulphatase producing species was C. tropicalis followed by C. guilliermondii, C. parapsilosis and C. krusei. Among the C. albicans isolates tested no relation between the source of isolation and the amount of hyaluronidase and chondroitin sulphatase produced was found.

Candida↗

[Hypersensitivity to "Candida albicans" and other fungi in patients with chronic urticaria].

Considering the high incidence of chronic urticaria among female patients and the frequent difficulty in identifying the etiologic factor of factors the author decided to investigate the possible role of Candida albicans and other yeasts usually found as contaminants in certain foods and beverages or purposely cultivated for industrial products, as the sensitizing agents leading to the clinical picture of chronic urticaria. One hundred female patients with urticaria which had persisted for more than 6 weeks were selected and investigated, disregarding those with dermographism or cholinergic and cold urticaria. Aside from a careful history and laboratory tests to complement the physical examination that could rule out chronic bacterial infectious foci, intestinal parasitic infestation and thyroid disorders, intradermal skin tests with standard doses of Candida albicans and Saccharomyces cerevisiae and other common environmental and food allergens were done. The patients' age ranged from 4 to 70 years. The skin tests sites were examined for Type I reactions at 15 and 20 minutes; for Type III reactions at 8 and 12 hours; and for Type IV reactions at 48 and 72 hours. When tested with Candida albicans antigen, 35% had Type I/III reactions and 60% presented Type IV reaction. When Saccharomyces cerevisiae antigen was used for testing, 29% had Type I/III reactions and none presented Type IV. Forty-nine of the sixty patients who presented Type IV reaction to Candida albicans had in the past significant vaginal discharge (or vaginal symptoms: burning, itching) that obliged the patients to consult a gynecologist, but only ten had stained smears and cultures from the vaginal secretions and four were told to have a monilia vaginal infection confirmed by the microbiological tests, although forty of them received Nistatin therapy at the time of the gynecological complaints. At the time the patients were seen by the allergist, complaining about urticaria, only four had symptoms and signs of monilia infection and were confirmed by culture: one presented oral moniliasis following broad-spectrum antibiotic, two had vaginal moniliasis developing right after their menstrual period; one had intestinal and cutaneous manifestations (perineal and crural) developing also after broad-spectrum antibiotic therapy. All the four patients had exacerbation of the urticaria while undergoing the monilia infection. After 1-2 weeks of elimination diet, each patient was challenged with yeasts-containing foods (bread, buns, sausages, beer, wines, grapes, cheese, vinegar, tomato catsup). Twenty-five patients (71%) of the group who positively reacted with a Type I/III reaction when tested with Candida antigen, showed a positive provocation test (reappearance of urticaria) and twenty patients (69%) of the group who reacted with Saccharomyces had a positive challenge test...

Adolescent↗

Mechanisms involved in elimination of organisms from experimental cutaneous Candida albicans infections in guinea pigs.

Experimental cutaneous Candida albicans infections were produced in guinea pigs either by using occlusive dressings over the organisms or by applying them to the shaved skin directly without occlusive dressings. In either model there was clearance of the infecting organisms from the skin by a process involving profuse scaling of the keratinized layer in which they were confined. However, for each type of infection the mechanisms producing this scaling seemed to involve different parts of the host defense system. Infections produced under occlusive dressings were characterized by a rapid accumulation of polymorphonuclear leukocytes (PMN) in the epidermis and formation of thick crusts in which organisms were trapped. Sloughing of the crust removed the organisms. In this model, evolution of the lesions and the rate of clearance of the organisms did not depend on prior immunity to Candida. Two possible mechanisms for attraction of PMN into the lesions were direct activation of the alternative complement pathway by the organisms in the lesions and direct chemotactic activity in components of Candida albicans. In contrast, infections produced without occlusive dressings showed only minimal epidermal PMN infiltration, but also underwent profuse scaling of the keratinized layer. This response appeared to depend on cell-mediated immunity. Only animals with previously-acquired delayed hypersensitivity to Candida antigens could undergo this type of scaling, and indeed, this response was transferable to nonimmue animals with peritoneal exudate cells from Candida-immune animals. Clearance of the infecting organisms from this type of infection was significantly faster in immune than in nonimmune animals. It is postulated that a lymphokine released from lymphocytes in the upper epidermis acts on epidermal cells to increase the rate of keratin turnover either by the mitotic rate of the germinal cells or by increasing their rate of keratinization.

Animals↗

Inhibition of Candida albicans adhesiveness to human buccal and vaginal cells by sub-inhibitory concentrations of rilopirox.

Candida albicans is an opportunistic dimorphic pathogenic yeast which is present on the human mucosal epithelial cell surface. Its adhesion is considered to be an important first step in colonization and in the subsequent symptomatic or asymptomatic infection of buccal or vaginal mucosa. Because the ability to adhere is an important element of the pathogenicity of Candida we investigated in this study the compared effects of sub-inhibitory concentrations (sub-MICs) of rilopirox (CAS 104153-37-9) with those of ciclopirox olamine (CAS 41621-49-2) in inhibiting Candida adhesion to human buccal (BEC) and vaginal cells (VEC). Rilopirox is a new hydroxypyridone antimycotic agent with strong activity, especially against Candida albicans. There was a significant reduction in the mean number of Candida adhering to both buccal and vaginal cells with up to 1/8 MIC rilopirox for buccal and 1/16 MIC for vaginal cells, while for ciclopirox olamine reduction was significant up to 1/16 MIC for buccal and 1/8 MIC for vaginal cells. There were no significant differences in the dose-effect curves for BEC and VEC with either rilopirox and ciclopirox olamine, but on a molar basis, rilopirox was more active than ciclopirox olamine. The present in-vitro results support the developmental concept of an oropharyngeal and vaginal preparation of rilopirox. It can be expected that even sub-inhibitory concentrations of rilopirox exert an important additional effect in the treatment of oral and vaginal candidosis by impairing the pathogenic adhesion process of the fungus.

Antifungal Agents↗

[Change in the sensitivity of dysentery bacteria to certain antibiotics, furazolidone and antifungal preparations when cultured together with Candida albicans].

The effect of Candida albicans (2 collection cultures and 1 freshly isolated culture) on sensitivity of dysentery bacteria (5 Zonne strains, 4 Flexner strains and 2 Newcastle strains) to antibiotics, furazolidone and their combinations with nystatin or decamine was studied by the method of serial dilutions. A total of 937 tests were performed with the use of 10 concentrations in each test. It was found that sensitivity of the Shigella to levomycetin succinate, monomycin and furazolidone decreased in the presence of Candida. Decamine increased the bactericidal effect of furazolidone on Shigella in pure cultures and in addition increased sensitivity of various Shigella species to the antibiotics tested and especially furazolidone when the cultures were grown together with Candida albicans. Nystatin combination with levomycetin succinate and especially with monomycin increased sensitivity of various Shigella species in the presence of Candida albicans. The data are useful in treatment of dysentery since Candida are often isolated from dysentery patients.

Anti-Bacterial Agents↗

Cancer-specific binding of a mouse MAb vs. Candida krusei cytochrome c: an antigen recognized by a cancer-associated human MAb HB4C5.

More than 60 mouse monoclonal antibodies directed to cytochrome c from Candida krusei with different specificities were raised. Most of these monoclonal antibodies, except for three of them, did not cross-react with bovine cytochrome c. By the immunoblotting method, the monoclonal antibodies of clones HCC 5-13, 9-2, and 10-5 reacted with the Candida cytochrome c, which had been transferred onto nitrocellulose membrane, but those of clones HCC 1-22, 6-3, and 17-3 did not, although all these monoclonal antibodies strongly reacted with coated Candida cytochrome c on plastic immunoplates when examined by ELISA. On the contrary, monoclonal antibody activities of clones HCC 1-22, 6-3, and 17-3 in binding to the coated cytochrome c in ELISA were inhibited competitively by the addition of extra Candida cytochrome c, whereas those of clones HCC 5-13, 9-2, and 10-5 were not inhibited. Among these monoclonal antibodies, the antibody of clone HCC 6-3, which showed a good reactivity to added cytochrome c in inhibiting ELISA reaction but was not reactive with the transblotted cytochrome c on nitrocellulose, was found to be reactive with human lung cancer tissues specifically with no reactivity to normal tissues. The immunostaining of lung cancer tissue showed that this mouse monoclonal antibody to Candida cytochrome c reacted to the cytoplasmic fraction of the cancer cells specifically.

Animals↗

[An autopsy case of brain candidiasis in premature infant: morphology and intraparenchymal distribution of Candida foci].

An autopsy case of brain candidiasis occurring in a premature infant is presented, and the morphology and intraparenchymal distribution of Candida foci are described in detail with the aid of serial sections of the affected brain. The patient was a boy, who was born after 25 weeks of gestation and died on day 15. Candida foci were composed of two infectious forms of Candida (yeasts and pseudohyphae) and various inflammatory reactions of the host. They were widely disseminated in the brain parenchyma, leptomeninges and ventricular system. In view of their morphology, they were classified into the acute and chronic inflammatory types. The acute type foci, characterized by microabscess of infiltration of neutrophils, were large and localized predominantly in the cerebral white matter, fiber tracts, central grey matter of the midbrain, reticular formation, floor of fourth ventricle and subependymal germinal layer; most of the acute type foci were found in the watershed zones where the blood supply was considered to be poorer than the other parts of the brain parenchyma. In contrast, the chronic type foci, characterized by nodular proliferation of astrocytes, were small and localized in the grey matter (the cerebral cortex, basal ganglia and brainstem nuclei) and the leptomeninges. This study suggests that Candida infection to the brain may occur by different two kinds of way correlating with the proper vasoarchitecture of brain. In addition, it is recommended to make a close examination of the maternal vagina, placenta and umbilical cord after delivery to detect the risk of Candida infection.

Brain↗

Influence of free or liposomal amphotericin B on killing of Candida species by human peritoneal macrophages.

The influence of free and liposomal amphotericin B at subinhibitory and inhibitory concentrations on killing of Candida albicans (ATCC 10231), Candida tropicalis (ATCC 13803) and Cryptococcus neoformans (930) by human peritoneal macrophages was investigated in vitro. Peritoneal macrophages were harvested from overnight peritoneal dialysate of 10 patients undergoing regular continuous ambulatory peritoneal dialysis and incubated with Candida species (1:2), pooled human serum, fetal calf serum, Medium 199 and Sabouraud broth (with or without amphotericin B) for 6 hours. The killing of Candida species was determined using subculture technique. The combination of amphotericin B (free or liposomal) with peritoneal macrophages enhanced the killing of the Candida species. Candidacidal activity of free and liposomal amphotericin B resulted in comparable effects; however, the killing of the yeasts by liposomal amphotericin B was slower than by free amphotericin B.

Adult↗

[Experimental study and clinical application of rapid diagnosis of systemic candida albicans infection in burns by polymerase chain reaction].

For rapid diagnosis of systemic candidiasis, the polymerase chain reaction (PCR) was used to amplify a segment of Candida albican DNA coding for the cytochrome P450 L1 A1 in vitro. The technique provided unambiguous evidence of the presence of Candida albicans in as short as 8 hours with a detection threshold of 20 organisms. 200 blood and 120 urine specimens were collected from thirty rabbits with burn and candidiasis. Specimens of blood (n = 6), urine (n = 6), sputum (n = 7) and wound exudate (n = 7) were also collected from eight serious burn patients. PCR technique was used in all the specimens, and the result was compared with conventional fungus culture. It was shown that: (1) The positive detection rate of Candida by PCR was significantly higher than by culture for blood specimens (P < 0.01) and serial specimens of urine (P < 0.05) in infected burn animals. The clinical specimens showed the same results; (2) In evaluating diagnostic value of PCR for systemic Candida albicans infection, it was found that sensitivity, accuracy and negative prediction rate were superior to the conventional culture method. These results suggest that PCR technic may provide a rapid sensitive and specific means for the diagnosis of systemic Candida albicans infection. In addition, it may be helpful in the evaluation of therapeutic response or recurrence of infection.

Adult↗

Candida'the cancer of silastic'.

Candida species have the propensity to colonize and erode into the surface of silastic causing a loss of function. Colonization of silastic tracheo-oesophageal speaking-valves is an important cause of valve failure post-laryngectomy: the exact nature of the colonization is unknown and light microscopic studies have not been reported previously. Microbiological examination of scrapings taken from the colonized oesophageal surface of failed speaking valves was arranged before sectioning for light microscopy. Conventional ultrathin sectioning of silastic was difficult, therefore 15 micrometre sections were cut after cooling the material to -30 degrees C. These sections were then stained with toluidine blue; Candida species taking up the stain. Microbiological examination of the colonies confirmed the predominance of Candida species in the biofilm. Light microscopy of the 15 micrometer sections revealed that the Candida colonies had invaded the silastic. This work demonstrates that the colonization of the silastic valve prosthesis in the oesophageal area is due predominantly to Candida species which actively invade the structure of the silastic. This is an important cause of speaking-valve failure post-laryngectomy.

Candida↗

Deep Candida infection in children receiving allogeneic bone marrow transplants: incidence, risk factors and diagnosis.

Fifty-eight children, who received 60 allogeneic bone marrow transplants (BMT), were studied with regard to incidence, risk factors and diagnosis of deep Candida infection (DCI). Serum samples were analysed for the presence of Candida IgA, IgM and IgG antibodies and free C. albicans glucoprotein antigen (Ag). Five children (8.7%) had a confirmed DCI and died before engraftment of the new bone marrow. When four patients with suspected deep Candida infection (SDCI) were included, the incidence was 15.6%. Four of the five children (80%) with DCI had pathological Candida IgM antibody (Ab) titers and/or free C. albicans glucoprotein Ag, 2-50 days before DCI was verified by culture, direct microscopy and/or autopsy. Risk factors, using Fisher's exact test for DCI, included not receiving bone marrow from an HLA-identical sibling donor, having a seropositive Herpes simplex virus (HSV) donor and pathological IgA and/or IgM Ab titers against Candida before BMT. In conclusion, a child with the above-mentioned risk factors, runs a risk of acquiring fatal DCI before engraftment. The institution of systemic antifungal prophylactic treatment may prevent death from DCI. After BMT, serological examinations may be of value in the early detection of DCI.

Adolescent↗

A simple synthetic liquid medium for development of yeast and mycelial form of pathogenic species of Candida.

Thirty two known strains of Candida species were used for evaluation of glucose, serine, ornithine, methionine, GSOM medium and its comparison with Lee's medium for the production of yeast and mycelial phase at different temperatures and on prolonged incubation. No mycelial form was observed when various Candida species in GSOM and Lee's medium were incubated at 25 degrees C up to 72 hours. Percentage of mycelial forming cells of Candida species were more in GSOM medium than Lee's medium in 48 hours at 37 degrees C. Among various species of Candida, albicans and C. parapsilosis showed maximum mycelium formation. GSOM medium can be used for growing Candida species particularly C. albicans in mycelial phase.

Candida↗

[Genotyping of isolates of bacteria and Candida].

Strain differentiation of Staphylococcus species, Streptococcus pneumoniae, Escherichia coli, Clostridium difficile, and Candida species was performed by restriction endonuclease analysis (REA) of genomic DNA with HinfI or HaeIII followed by conventional agarose gel electrophoresis. REA of 19 methicillin-resistant S. aureus isolates and 19 methicillin-susceptible S. aureus isolates revealed 8, and 14 patterns, respectively. Fifty-three isolates of S. epidermidis were divided into 39 groups on the basis of REA pattern. REA patterns obtained from different strains of the same species were more similar than those from different Staphylococcus species. A total of 67 patterns were noted among 215 S. pneumoniae isolates. There was some correlation between the REA patterns and serotypes. In addition, all 61 isolates showing the pattern 6 (serotype 19) were penicillin-resistant. Sixteen isolates of E. coli O157 and 18 isolates of E. coli O25 were analyzed by REA with HaeIII. Among 14 epidemiologically unrelated E. coli O157:H7 isolates, REA patterns were either identical or differed only by a few fragment bands. REA patterns of 7 isolates of heat stable enterotoxin producing E. coli O25 from an outbreak were identical. Eight distinct REA patterns were noted among 7 toxigenic C. difficile strains, and one to two strains were included in each group. Candida strains belonging to different six Candida species were analysed by REA. All C. albicans isolates (148 strains) showed one to four bright bands ranging from 4 to 8kb in size, and these strains were divided into 37 groups according to the REA patterns. Each Candida strain showed species-specific REA patterns. Twenty-one isolates of Mycobacterium tuberculosis complex were analyzed by PCR with primer complementary to the inverted repeat of IS6110(IS6110-PCR). The results of PCR of 19 M. tuberculosis isolates and 2 M. bovis BCG isolates revealed 15 patterns, and 1 pattern, respectively. Our results demonstrated that REA of genomic DNA with HinfI or HaeIII was a useful tool for strain differentiation. By comparing the species-specific REA patterns of reference strains, clinical isolates of Candida and Staphylococci could be identified to the species level if they could not be identified by routine biochemical methods. Because IS6110-PCR is simple and rapid to perform, it seems to be a good screening method to differentiate M. tuberculosis strains.

Bacterial Typing Techniques↗