Phagocytosis of Candida albicans in chronic mucocutaneous candidiasis

Inasmuch as human monocytes are able to kill Candida albicans (C. albicans) only through oxidative pathways, which also produce chemiluminescence (CL), CL was used to assess the ability of polymorphonuclear neutrophils and monocytes to phagocytose and kill C. albicans in a 12-year-old girl with chronic mucocutaneous candidiasis. In contrast to normal mononuclear cells (monocytes and lymphocytes), mononuclear cells from the patient did not respond with a CL burst when mixed with opsonized C. albicans (peak CL, 55 versus 105 cpm X 10(-3) for control). Phagocytosis of C. albicans by monocytes, assessed by electron microscopy, was normal. The patient's mononuclear cells did produce CL when mixed with Candida parapsilosis (peak CL, 68 versus 72 cpm X 10(-3) for control) or zymosan (peak CL, 149 versus 180 cpm X 10(-3) for control). Myeloperoxidase activity in monocytes assessed by light microscopy was normal. However, peroxidase activity in the patient's monocytes persisted in glass-adherent monocyte-macrophages after 5 days incubation, suggesting that her cells may mature poorly. In contrast to the poor CL response of monocytes to C. albicans, polymorphonuclear neutrophils from the patient had increased CL (peak, 858 versus 458 cpm X 10(-3) for control). Also, the patient's serum showed increased opsonic activity for C. albicans (peak, 1800 versus 1100 cpm X 10(-3) for control).