Candidiasis — Do we need to fight or to tolerate theCandida fungus?

Abstract

Candidiases, infections caused by germination forms of the Candida fungus, represent a heterogeneous group of diseases from systemic infection, through mucocutaneous form, to vulvovaginal form. Although caused by one organism, each form is controlled by distinct host immune mechanisms. Phagocytosis by polymorphonuclears and macrophages is generally accepted as the host immune mechanism for Candida elimination. Phagocytes require proinflammatory cytokine stimulation which could be harmful and must be regulated during the course of infection by the activity of CD8+ and CD4+ T cells. In the vaginal tissue the phagocytes are inefficient and inflammation is generally an unwanted reaction because it could damage mucosal tissue and break the tolerance to common vagina antigens including the otherwise saprophyting Candida yeast. Recurrent form of vulvovaginal candidiasis is probably associated with breaking of such tolerance. Beside the phagocytosis, specific antibodies, complement, and mucosal epithelial cell comprise Candida eliminating immune mechanisms. They are regulated by CD4+ and CD8+ T cells which produce cytokines IL-12, IFN-gamma, IL-10, TGF-beta, etc. as the response to signals from dendritic cells specialized to sense actual Candida morphotypes. During the course of Candida infection proinflammatory signals (if initially necessary) are replaced successively by antiinflammatory signals. This balance is absolutely distinct during each candidiasis form and it is crucial to describe and understand the basic principles before designing new therapeutic and/or preventive approaches.

Molecular Adjuvants Based on Nonpyrogenic Lipophilic Derivatives of norAbuMDP/GMDP Formulated in Nanoliposomes: Stimulation of Innate and Adaptive Immunity

“…The mounting of recombinant antigen proteins (such as rHsp90) on liposomes by metallochelation represent an interesting new system for the formulation of weak recombinant antigens with a His-Tag anchor [15,16]. In the present work we tested the adjuvant effect of lipophilic MDP derivatives during immunization with recombinant Candida Hsp90 antigen that is a target for specific antibodies during systemic candidiasis [17,41]. The IgG2a and IgG2b antibody response associated with Th1 dominance was elicited by the immunization with metallochelating rHsp90 liposomes containing MT03, MT07, or MT06 adjuvants.…”

“…The IgG2a and IgG2b antibody response associated with Th1 dominance was elicited by the immunization with metallochelating rHsp90 liposomes containing MT03, MT07, or MT06 adjuvants. Such antibodies can act by opsonization, neutralization of extracellular virulence factors, inhibition of the Candida adherence to host tissues, inhibition of the yeast-to-mycelium transition, and by direct fungicidal activity [41].…”

Case Report Dynamical evaluation of vaginal micro-ecosystem in a Chinese woman with recurrent vulvovaginal candidiasis

“…If the endogenous or exogenous factors of germination are increased, the patient generally shows VVC symptoms. In contrast, if the germination of Candida albicans occurs after adhesion, the acute or recurrent outbreak of carrier women with asymptomatic VVC can be prevented (Raska et al, 2007). RVVC refers to the VVC during which clinical symptoms and signs disappeared after treatment.…”

Candida peritonitis in dogs: report of 5 cases

“…Other less common inciting causes of Candida peritonitis in people include pancreatitis, appendicitis, diverticulitis, diabetes mellitus, and penetrating trauma. Most notably, the majority of cases of Candida peritonitis were receiving systemic, broad‐spectrum antimicrobial therapy at the time of diagnosis …”