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Immunity to Candida.

P L Fidel1

  • 1Department of Microbiology, Immunology, and Parasitology, Louisiana State University Health Sciences Center, New Orleans, USA. pfidel@lsumc.edu

Oral Diseases
|August 8, 2002
PubMed
Summary

Host immunity to Candida is site-specific. In HIV disease, oropharyngeal candidiasis (OPC) correlates with low CD4+ cells, but systemic immunity is similar. Local immunity and epithelial cell activity differ by site and HIV status.

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Area of Science:

  • Immunology
  • Mycology
  • Infectious Diseases

Background:

  • Candida species are common fungi, acting as commensals and opportunistic pathogens.
  • HIV infection significantly increases the risk of oropharyngeal candidiasis (OPC), a recurrent mucosal infection.
  • Immunity to Candida is compartmentalized, with differing responses at oral versus vaginal mucosa and systemic circulation.

Purpose of the Study:

  • To investigate the site-specific nature of host immunity against Candida infections.
  • To elucidate the roles of innate and acquired immunity in mucosal and systemic candidiasis, particularly in HIV+ individuals.
  • To explore the correlation between CD4+ cell counts, cell-mediated immunity (CMI), and mucosal candidiasis incidence.

Main Methods:

  • Evaluation of systemic cell-mediated immunity (CMI) in HIV+ and HIV- individuals with and without mucosal candidiasis.
  • Analysis of salivary cytokine profiles (Th1/Th2) in relation to OPC.
  • In vitro assessment of epithelial cell anti-Candida activity from oral and vaginal samples.

Main Results:

  • Systemic Candida-specific CMI was not significantly different between HIV+ individuals with OPC/VVC and HIV- individuals.
  • HIV+ individuals with OPC exhibited a Th2-type salivary cytokine profile, contrasting with a protective Th0/Th1 profile in HIV- individuals.
  • Oral epithelial cells from HIV+ individuals with OPC showed reduced in vitro growth inhibition of Candida compared to healthy controls.

Conclusions:

  • Host immunity to Candida is compartmentalized and site-specific, involving both innate and acquired mechanisms.
  • Reduced CD4+ cell counts in HIV+ individuals may impact oral mucosal protection by requiring a threshold for systemic CD4+ cells and local immunity.
  • Epithelial cell anti-Candida activity and local cytokine profiles contribute to site-specific susceptibility or protection against Candida infections.

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