Adherence of Candida species to host tissues and nonbiologic materials has been studied in vivo and in vitro. Attachment of Candida albicans to mucosal cells, fibrin-platelet matrices, vascular endothelial cells, and plastic materials has been examined to elucidate early events in the pathogenesis of mucosal colonization and infection, candidal endocarditis, tissue invasion from the intravascular space, and infection of prosthetic devices. Adherence of C. albicans and Candida tropicalis exceeds that of less virulent Candida species, and germinated C. albicans cells adhere to host tissues more readily than do yeast-phase organisms. The adhesin of Candida that mediates attachment has yet to be characterized at the molecular level; however, on the basis of competitive inhibition by crude and purified cell wall products, blocking by antibody and lectin, and controlled degradation of the cell surface of Candida, it appears that mannans and mannoproteins are important constituents of the adhesin. The methods currently used to assay adherence of Candida all have limitations, and an approach to resolving these limitations is one of several areas that warrant further investigation.
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