Cell-directed inhibition of polymorphonuclear leukocyte chemotaxis in a patient with mucocutaneous candidiasis

A patient with mucocutaneous candidiasis and impaired polymorphonuclear leukocyte (PMN) chemotaxis is described. The patient's PMN chemotaxis was markedly decreased in the presence of autologous plasma but normal in control plasma. Cell-directed inhibitory activity was found in whole patient plasma as well as the 40% ammonium sulfate precipitate fraction of both the patient's and the control plasma. The inhibitor was heat stable, reversible, nondialyzable, eluted from DEAE cellulose with 0.005 M sodium phosphate buffer, and migrated with IgG on immunoelectrophoresis. The supernate from 40% ammonium sulfate-fractionated patient and control plasma contained a cell-directed enhancer of PMN chemotaxis that antagonized the cell-directed inhibitor activity. It is possible that the patient's chemotactic defect may be caused by imbalance between plasma factors that regulate chemotaxis.