Mucosal Immunity toCandida albicans

Abstract

Prior to the human immunodeficiency virus (HIV) epidemic, host defense against Candida albicans at mucosal sites was largely considered one-dimensional. This chapter is divided into in-depth reviews of host defense mechanisms against oral, vaginal, and Gastrointestinal (GI) candidiasis, with emphasis on the uniqueness of the responses at each site. Then it has a short discussion of the emerging role of mucosal Candida biofilms in pathogenesis and host defense. The chapter concludes with suggested future directions for the field of mucosal immunity and candidiasis. Oropharyngeal candidiasis (OPC) encompasses infections of the hard and soft palate, tongue, buccal mucosa, and floor of the mouth and can present as reddened patches (erythematous) or white curdlike lesions (pseudomembranous). Interestingly, highly active antiretroviral therapy (HAART) has reduced the incidence of OPC. Polymorphonuclear cells (PMNs) are considered to play a role in innate defenses against OPC because neutropenic cancer patients are susceptible to disease. Another form of oral candidiasis is Candida-associated denture stomatitis (DS). Candida albicans is the most common cause of DS and can readily form biofilms on denture material. The most recent data on host defense against GI candidiasis involve understanding the role of dendritic cells (DCs) in directing both local and systemic adaptive immunity. Vulvovaginal candidiasis (VVC) affects a significant number of women, predominantly in their reproductive years.