Candida Albicans In Patients Research Articles

Suppression of fungal growth exhibited by Pseudomonas aeruginosa.

Three surgery patients were monitored postoperatively, with particular reference to lung infection. In each case there was a clinical impression that Pseudomonas aeruginosa suppressed the growth of Candida albicans in patients with clinically significant lung infections from whom both of these organisms were isolated from serial sputum samples. Regrowth of C. albicans after P. aeruginosa eradication occurred in two patients, despite fluconazole therapy, to which both C. albicans isolates were susceptible. In all three patients, the strain of P. aeruginosa was found to inhibit the growth of the corresponding C. albicans strain in vitro. Further in vitro susceptibility studies revealed significant inhibition by 10 strains of P. aeruginosa of 11 strains of fungi known to infect humans; these were Candida krusei, Candida keyfr, Candida guillermondii, Candida tropicalis, Candida lusitaniae, Candida parapsilosis, Candida pseudotropicalis, Candida albicans, Torulopsis glabrata, Saccharomyces cerevisiae, and Aspergillus fumigatus.

Interleukin 8 in serum in granulocytopenic patients with infections.

Serum levels of interleukin 8 (IL-8) were examined in eight patients with acute myeloid leukaemia during 16 courses of chemotherapy. The patients experienced 14 episodes of fever which occurred in periods with granulocyte counts < 0.5 x 10(9)/l. Febrile episodes were classified as bacteriologically defined infection (n = 6), clinically defined infection (n = 2), and unexplained fever (n = 6). IL-8 was detected in 18/25 (72%), 2/3 (67%) and 3/7 (43%) of the serum samples in the respective groups. In contrast, IL-8 was detected in 22/90 (24%) of the samples taken when no fever was present (P < 0.00003 versus bacteriologically defined infection). The median concentration of IL-8 in samples taken during febrile episodes was 194 ng/ml (range 0-6358 ng/ml) and 0 (range 0-5392 ng/ml) on days without fever (not significant). In three patients with infections caused by, respectively, Streptococcus sanguis, Acinetobacter calcoanitratus and Candida albicans, IL-8 rose to a peak levels and declined during recovery. We conclude that IL-I is released systemically during infections with gram-positive and gram-negative bacteria and Candida albicans in patients with acute myeloid leukaemia and peripheral granulocytopenia due to chemotherapy. However, IL-8 can also be detected when no sign of infection is present.

Humoral and cellular immunity to Candida albicans in patients with bronchial asthma.

Delayed cutaneous reactivity to Candida albicans (C. albicans) and PPD (purified protein derivative) was examined in 52 patients with bronchial asthma in relation to the production of specific IgG4 antibodies against the antigen. 1. The frequency of a positive, immediate skin reaction to C. albicans was similar among the five age groups, ranging from 60.0% to 66.7%. 2. The incidence of a positive delayed skin reaction to C. albicans was lower in patients between the ages of 10 and 30 and tended to decrease with aging in the patients over the age of 51. 3. A delayed skin reaction to PPD was positive in patients between 31 and 50 with a higher incidence; this incidence decreased in patients over age 51. 4. The level of C. albicans-specific IgG4 antibodies was significantly higher (26.7 u/ml) in patients with a negative delayed skin reaction to the antigen than in those with a positive reaction (5.9 u/ml) (p less than 0.001). There was no correlation between delayed skin reaction to PPD and production of specific IgG4 antibodies.

Immunological responses to Candida albicans in patients with bronchial asthma and its relationship to patient age.

The release of histamine induced by C. albicans was significantly higher in asthmatics aged 21-30 yr, 41-50 yr and 61+ years old compared with the age-matched groups of healthy subjects. The level of C. albicans specific IgG was significantly higher in asthmatics aged 41-50 years old compared with age-matched group of healthy subjects. No significant difference was found among any age groups of healthy and asthmatic subjects. The increased level of C. albicans specific IgG seemed not to be of significance in the pathogenesis of asthma.

An increased level of specific IgG4 antibodies against Candida albicans in patients with bronchial asthma.

Specific IgG4 antibodies against Candida albicans in sera were measured in 76 asthmatics. The increased level of specific IgG4 was found in cases 10-40 years old sensitive to house dust mite and/or Candida albicans, in cases with steroid-dependent intractable asthma (SDIA) and in elderly cases. The frequency of SDIA was the highest in cases 41 to 60 years old with higher frequency of increased IgG4 antibodies. The results show that specific IgG4 increases in relation to IgE-mediated immune response, long-term steroid therapy, and aging. All of these conditions may induce depressed cell-mediated immunity.

Candida albicans in Patients with the Acquired Immunodeficiency Syndrome: Absence of a Novel or Hypervirulent Strain

To determine whether Candida albicans in patients with AIDS represents a unique strain, C. albicans isolated from 24 patients with AIDS was compared with Candida isolated from 23 healthy adults. Resistance to 5-fluorocytosine, synthesis of amino acids and nucleotides, sugar use, and enzyme activity patterns were similar among isolates from the two groups. Molecular analysis revealed similar banding patterns of EcoRI restriction fragments of DNA between 2.5-3 and 6-7 kb. In addition, the frequency of a dimorphic 3.7-versus 4.2-kb band, identified by agarose gel electrophoresis and by probing Southern transfers of EcoRI digests with a cloned fragment of C. albicans DNA encoding 25S ribosomal RNA, was not significantly different between the AIDS-derived and control C. albicans. C. albicans isolated at different time points in the course of disease and from different sites in individual patients showed identical DNA fingerprints. The similarity in isolates of C. albicans that cause disease in AIDS patients and those present in healthy subjects suggests that the candidiasis associated with AIDS is not due to the presence of a unique or particularly virulent strain but is likely the consequence of a defect in host defense mechanisms.

Identification of immunodominant antigens of Candida albicans in patients with superficial candidosis

The aims of this study were to identify the immunodominant protein antigens of Candida albicans in patients with superficial infections of the oral and vaginal mucosa. Cytoplasmic protein extract from C. albicans was analyzed by the immunoblot technique using sera from 20 patients with chronic atrophic oral candidosis, from 8 patients with vulvovaginal candidosis, and from 20 control subjects. A significantly greater proportion of patient sera reacted with the 65- and 32-kDa antigens when compared with sera from controls ( P < 0.001). Sera from patients also reacted more often with 38- and 29-kDa antigens ( P < 0.05), while sera from both patients and controls reacted with the 47-kDa antigen. The identified 65-, 38-, 32-, and 29-kDa antigens may be of importance for the development and also for the recurrence of superficial candidosis of the oral and/or vaginal mucosa.

Immunoblot analysis of the serological response in systemic candidosis.

To investigate the heterogeneity in antibody response to the various antigenic determinants of Candida albicans in patients with disseminated candidosis 201 serial serum samples from 45 patients with proven systemic candidosis were examined by immunoblotting (Western blotting) for antibodies to C albicans type A NCTC 3153. 40 patients had detectable antibody. 26 different antigen bands, ranging from 104 kD to 23 kD, were identified. Despite wide variation in the antigens recognised by different patients, the antibody responses fell into six patterns (A to F). 13 patients infected during an outbreak of systemic candidosis gave the same response (A). Of a further 7 patients with this response, 2 had isolates indistinguishable from the outbreak strain. Group B responses were associated with leukaemias and lymphomas. Groups C-F responses were seen in 9 patients. Production of antibody to a 47 kD antigen, common to all six groups, occurred in all those who recovered from the infection and may therefore be of prognostic significance. Whether this antigen could be used as the basis of a vaccine remains to be determined.

Antibodies against antigens of Candida albicans in patients with fungaemia and bacteraemia, studied by ELISA, precipitation, passive haemagglutination and immunofluorescence techniques.

Antibodies against commercially available antigens of Candida albicans were assayed in 54 sera from 24 patients with fungaemia and in 66 sera from 33 patients with bacteraemia. In patients with persistent fungaemia, antibody was found during the week after the fungus was first cultured from the blood, but peak titres did not usually occur until the end of the second week. A significant rise in titre in C. albicans infection was observed in 50% of paired sera tested by passive haemagglutination (PHA), indirect immunofluorescence (IF) and Ouchterlony immunodiffusion (ID). The same percentage was obtained by counterimmunoelectrophoresis (CIE) against candida metabolic antigens, whereas it was increased to 88% when somatic antigens were used. Enzyme-linked immunosorbent assay (ELISA) demonstrated a rise of titre in 25, 75 and 50% of sera in IgM, IgG and IgA assays, respectively. Sera from patients with transient fungaemia demonstrated persistent antibody titres. In paired sera from patients with bacteraemia, ID and CIE titres were low (greater than or equal to 4). There was an increase of candida antibodies in 0-9% of patients by ELISA, ID or CIE and in 18-21% by PHA or IF. Clinically significant fungaemia was most reliably differentiated serologically from bacteraemia by CIE S-antigen and ELISA IgG assays.

Detection of candida antigenemia in human invasive candidiasis by a new solid phase radioimmunoassay.

There is a continuing need to develop reliable non-invasive methods to aid in the early diagnosis of disseminatyed candidiasis. We report the development of a solid phase "sandwich" radioimmunoassay (RIA) for the detection of soluble cytoplasmic protein antigens (SPA) of Candida albicans in patients with systemic candidiasis. SPA were prepared by ultrasonic disruption of blastospores of C. albicans. Anti-SPA IgG was covalently linked to a solid phase of polyacrylamide-like microspheres. Standard amounts of patient sample or SPA in pooled normal human serum were reacted with the conjugated microspheres, washed and reacted with anti-SPA IgG-125I. The amount of antigen was directly correlated with the amount of bound 125I-IgG anti-SPA. In a retrospective analysis, circulating SPA in the range of 0.5-1.6 microgram/ml was detected in the serum of 12 of 19 patients (63%) with documented systemic candidiasis. There was no detectable SPA in the serum of 20 hospitalized patients with bacteremia, two patients with aspergillosis, one with cryptococcosis, and three with invasive Candida tropicalis. We observed no crossreaction of the RIA with mannan from C. albicans, coccidioidin or culture filtrate antigen of Aspergillus fumigatus. There was significant inhibition of the RIA by serum samples from two patients with chronic candidiasis suggestive of anti-SPA antibody excess. The solid phase RIA to detect circulating SPA can provide a useful noninvasive method for the diagnosis of systemic C. albicans infection.

Evaluation of the antigen specific to the mycelial phase of Candida albicans in the serodiagnosis of candidiasis.

We demonstrated 2 different antibodies against Candida albicans in patients' sera, the detection rates were proportional to the severity of candidiasis. One antibody was directed toward antigen shared by Candida in both blastospore and mycelial phases and the other was directed against antigen found only in the mycelial phase of Candida. The presence of the latter may reflect the invasive form of candidiasis.