Correlation of cutaneous hypersensitivity with lymphocytic response to Candida albicans

The relationship between delayed cutaneous hypersensitivity to Candida albicans and in-vitro lymphocytic proliferative response using a highly sensitive micro-technic was studied in 26 healthy adult subjects and six children with chronic mucocutaneous candidiasis. The maximum in-vitro lymphocytic proliferative response in adult subjects with cutaneous hypersensitivity, 18.94 +/- 4.16 (SE), was significantly greater than that in those without cutaneous reactions, 2.49 +/- 0.45 (SE) (P less than 0.005). A close correlation was found between cutaneous hypersensitivity (mean diameter of induration at 48 hours) and in-vitro lymphocytic proliferative response (r = 0.73, P less than 0.001). A cutaneous reaction of 5 mm or more of induration after injection of 0.1 ml of 1:100 Candida albicans extract corresponded to an in-vitro lymphocytic proliferative index of 5 or more (P less than 0.005), which supports the previously empiric use of 5 mm of induration as an indicator of intact cellular immunity in clinical practice. In the children with chronic mucocutaneous candidiasis, no consistent relationship between cutaneous hypersensitivity and lymphocytic proliferative response was found. Administration of Levamisole resulted in increased lymphocytic proliferation in vitro, and the development of cutaneous hypersensitivity, suggesting potentiation of cellular immune function.