Immunohistochemical Expression Patterns of Inflammatory Cells Involved in Chronic Hyperplastic Candidosis

Ailish Williams,Michael Lewis,Sue Wozniak,Helen Rogers,David Williams,Damian Farnell,Xiaoqing Wei,Adam Jones

doi:10.3390/pathogens8040232

Ailish Williams, Michael Lewis + Show 6 more

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https://doi.org/10.3390/pathogens8040232

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Abstract

The profile of the inflammatory cell infiltrate in chronic hyperplastic candidosis (CHC) was determined in oral mucosal biopsies by immunohistochemistry. One tonsillar tissue section was included as an immunohistochemistry control, whilst squamous papilloma (n = 4) with secondary Candida infection was used as Candida controls. Oral lichen planus tissues (n = 10) provided negative controls for Candida presence, as well as positive controls for inflammation. Immunohistochemistry employed antibodies specific for CD3+ (T lymphocytes), CD4+ (T helper cells), CD8+ (cytotoxic T cells), and CD20+ (B lymphocytes). Manual counting of stained cells from digitised images determined the proportion of each cell type relative to the total number of cells, and these were assessed in the mucosa, the epithelium, and the lamina propria. The mean proportion of CD3+ cells was significantly higher than CD20+ cells in all tissue types. For CHC, the mean proportion of CD3+ cells in entire tissues was 15.6%, with the highest proportion in the lamina propria (32.6%) compared with the epithelium (3.9%). CD20+ cells were in much lower proportions (1.8%) in CHC, with the highest proportion (3.6%) in the lamina propria. T lymphocytes were predominately CD4+ cells (9.0%) compared with CD8+ cells (4.4%). CD4+ cells were most prevalent in the lamina propria (23.1%) compared with the epithelium (mean = 3.2%). From these results, it was concluded that the immune response invoked by Candida in CHC is primarily driven by the T helper cells.

Highlights

Candida albicans is a commensal fungus of humans, where it typically resides on the skin and mucosal surfaces without detriment to health
Tonsil tissue was included as an staining of the targeted cell types for the differentpapilloma tissue types
The oral lichen planus tissue provided a negative control for Candida presence, asasCandida oral for lichen planus tissue provided a negative control for Candida presence, well ascontrols

Summary

Introduction

Candida albicans is a commensal fungus of humans, where it typically resides on the skin and mucosal surfaces without detriment to health. In debilitated individuals, including those with immune deficiency, C. albicans can cause a range of opportunistic infections, collectively referred to as candidoses. Whilst these infections are mostly superficial, primarily effecting the oral and vaginal mucosa, in severely immunocompromised patients, serious systemic infections can arise, which have mortality rates approaching 50% [1]. Several clinical presentations of oral candidoses are recognised, including acute and chronic pseudomembranous candidosis, acute erythematous candidosis, chronic erythematous candidosis, and chronic hyperplastic candidosis (CHC) [2] These infections typically arise following changes in the Pathogens 2019, 8, 232; doi:10.3390/pathogens8040232 www.mdpi.com/journal/pathogens. An appropriately functioning immune response is essential in protecting the host against candidosis [4]

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