Contact sensitivity to Candida albicans—comparative studies in man and animal (guinea-pig)

We studied the elicitation of contact sensitivity to Candida albicans antigen in guinea-pigs with experimental cutaneous candidiasis and in humans, using commercially available potent 1:100 C. albicans antigen (Torii) by patch testing on abraded skin. In guinea-pigs, non-immune animals became patch test-reactive 4-5 days after topical application of viable C. albicans, either under occlusion or without occlusive dressings, concurrently with the demonstrability of delayed responses to intradermally injected 1:10 000 Candida antigen. In humans, all healthy adults who showed delayed hypersensitivity reactions to intradermally injected 1:10 000 C. albicans antigen demonstrated positive patch-test reactions to 1:100 C. albicans antigen. There was a significant correlation between the magnitude of responses to these tests. In contrast, no positive patch test reactions were elicited to the 1:100 C. albicans antigen on neonatal skin, emphasizing the lack of irritability of this test agent. These results also indicate that in humans contact sensitivity to Candida antigen occurs during later life because C. albicans is a ubiquitous organism. The practical value of this Candida patch test for evaluation of patients' immune function was assessed by a prospective study in patients with various skin disorders. The results obtained suggested some potential value of the test for evaluation of cell-mediated immune function of patients with regard to ubiquitous recall antigens.     

用单克隆抗体检测白念珠菌表面抗原

关于用单克隆抗体研究白念珠菌表面抗原表达的研究很少,尚未见用单克隆抗体作系统性念珠菌病诊断的报告.新近我们以完整白念珠菌孢子免疫小鼠,获得一株针对白念珠菌表面抗原(可能是甘露聚糖)的单克隆抗体E₈H₁₀.它除与白念珠菌有反应外,尚与热带念珠菌、高里氏念珠菌有反应;仅对20株临床分离的白念珠菌中的s株起反应.用E₈H₁₀通过免疫荧光法直接检查标木中的念珠菌,较常规培养法速度快,检出率高.     

液体硅胶注射隆鼻术引起鼻背肉芽肿一例

液体硅胶注射隆鼻术是近年来我国美容隆鼻术采用的一种方法。掖体硅胶即MDX-4210加成型硅橡胶。     

白念珠菌芽管特异性抗原快速检测方法的建立和初步评价北大核心CSCD

目的建立白念珠菌芽管特异性抗原快速检测系统,探讨其特异性和敏感性。方法以单克隆抗体McAb03．2C1-C2作为一抗,辣根过氧化物酶标记McAb03．2C1-C2为二抗,建立双抗体夹心ELISA实验方法并检测6只动物模型和5例系统性白念珠菌感染患者的血清标本。结果筛选出McAb03．2C1-C2最佳稀释度和检测包被抗原浓度分别为l：4000和1．25-40μg,／ml;双抗体夹心ELISA检测动物模型的特异性和敏感性分别为95％、92％,其对阳性临床标本的检测结果与常规鉴定方法一致。结论初步建立白念珠菌芽管特异性抗原的双抗体ELISA快速检测系统,动物模型实验证实该系统有较好的特异性和敏感性。     

Altered,but not diminished specific T cell response in chronic mucocutaneous candidiasis patients

Patients suffering from chronic mucocutaneous infections with the yeast Candida albicans (CMC) are discussed to have an underlying primary cellular immunodeficiency. In order to characterise cellular immunity in CMC patients, we analysed chemotaxis and myeloperoxidase (MPO) releases of neutrophils and T cell proliferation and cytokine production to Candida albicans. Patients with chronic mucocutaneous candidiasis (n = 4) and healthy volunteers of same sex and similar age (n = 14) were enrolled into the study. Neutrophil chemotaxis was assessed by transwell migration assay, and MPO release by ELISA. T cell proliferation capacity was investigated by thymidine incorporation and cytokine secretion in supernatants by ELISA. Neither neutrophil migration nor MPO release differed between CMC patients and healthy controls. The relative lymphocyte stimulation index (SI Candida/SI PHA) was heterogenous, but overall it was higher in CMC patients compared to controls. However, Candida-specific IFN-γ production was significantly reduced in CMC patients. Notably, Candida-specific T cell IL-10 production was markedly higher in CMC patients. The inability to clear the yeast Candida albicans in our CMC patients does not seem to be due to an impaired neutrophil function or reduced antigen specific proliferation of lymphocytes. In fact, our patients tended to proliferate stronger to Candida antigen relative to PHA than healthy controls. However, the impaired Th1 cytokine production with an enhanced IL-10 production could play an important role in the pathogenesis of chronic mucocutaneous Candida infections.     

Evaluation of Immune-enhancing Effects of Ibuprofen in an Immunodeficiency Model

Three children and one adult with chronic mucocutaneous candidosis with documented deficient cellular immunity to Candida antigen were evaluated as a model to study the specific cellular immune-enhancing potential of the prostaglandin synthetase inhibitor ibuprofen. Oral ibuprofen failed to have any consistent effect during sequential 4-week on and off cycles on the following parameters: delayed hypersensitivity skin testing; lymphocyte transformation to Candida antigen; T-cell subsets as determined by monoclonal antibody techniques; production of human immune interferon in response to staphylococcal enterotoxin A (SEA). Two patients showed a trend toward enhanced lymphocyte transformation to PHA while taking ibuprofen. In two patients who were studied 8-10 weeks after discontinuation of oral ketoconazole therapy, clinical recurrence of CMC was not prevented by oral ibuprofen therapy.     

The quantitative immunochemical determination of Candida albicans-specific antibodies (author's transl)]

A diffusion method is described for quantitative determination of precipitating antibodies against polysaccharide antigen from Candida albicans. It is a reversed single radial immunodiffusion method with the antigen in the gel layer. As one parameter within an immunological testing programme antibody levels were estimated in serum samples from a patient suffering from malignant melanoma.     

Palmar and plantar pustulosis elicited by Candida antigen.

Intracutaneous injection of Candida albicans was done on the forearm of 30 patients with palmar and plantar pustulosis. This induced an aggravation of pustular eruptions on the palms and soles in 11 (37%) of the 30 patients. The aggravation occurred only in those patients who had a positive delayed skin reaction to the Candida antigen. It is suggested that a delayed hypersensitivity inflammatory reaction somewhere in the body is attended with an aggravation of palmar plantar pustulosis.     

Evaluation of Immune-enhancing Effects of Ibuprofen in an Immunodeficiency Model

Abstract: Three children and one adult with chronic mucocutaneous candidosis with documented deficient cellular immunity to Candida antigen were evaluated as a model to study the specific cellular immune-enhancing potential of the prostaglandin synthetase inhibitor ibuprofen. Oral ibuprofen failed to have any consistent effect during sequential 4-week on and off cycles on the following parameters: delayed hypersensitivity skin testing; lymphocyte transformation to Candida antigen; T-cell subsets as determined by monoclonal antibody techniques; production of human immune interferon in response to staphylococcal enterotoxin A (SEA). Two patients showed a trend toward enhanced lymphocyte transformation to PHA while taking ibuprofen. In two patients who were studied 8–10 weeks after discontinuation of oral ketoconazole therapy, clinical recurrence of CMC was not prevented by oral ibuproten therapy.     

Topical zinc sulfate augmentation of human delayed type skin test response

The ability of topical zinc sulfate to augment the cutaneous delayed hypersensitivity response to Candida antigen was evaluated in 47 adults (15 controls and 32 hospitalized patients). On each adult subject, intradermal standard Candida extract was administered to each forearm followed immediately by topical application of 10% zinc sulfate in Aquaphor ointment on one arm and Aquaphor alone on the other arm. The reaction size was assessed in a single blinded manner. Of the 24 subjects who reacted positively to Candida antigen, a significantly larger (p less than 0.01) number of individuals showed an augmented cutaneous delayed hypersensitivity response in the arm on which the topical zinc sulfate had been applied. However, when patients were stratified by plasma zinc concentrations, only the normal plasma zinc patient group demonstrated a statistical augmentation. Possible mechanisms and selectivity of this observed effect are discussed. These findings suggest a role for topical zinc application to augment cutaneous immune responsiveness.     

Immunologic features of chronic granulomatous mucocutaneous candidiasis before and after treatment with transfer factor.

We report the acquisition of skin test sensitivity to Candida albicans antigen and the ability to produce leukocyte migration inhibition factor (MIF) by a Candida-negative patient with chronic granulomatous mucocutaneous candidiasis after treatment with dialyzable transfer factor (TFd). The TFd was acquired from Candida-positive healthy donors. Three of seven attempts to transfer Candida skin test sensitivity were successful, and the acquired skin reactivity lasted for 12 to 21 days. The acquisition of cellular immunity to Candida was demonstrated in vitro by production of leukocyte MIF. No Candida-induced lymphocyte transformation was observed before or after TFd injection. The TFd did not cause Candida-induced blast transformation when added directly to cultures of lymphocytes from the patient. Pain, tenderness, redness, and edema were observed around the Candida granulomas on each occasion when the skin test to Candida became positive. Two weeks after TDd injection, the proliferative response of peripheral blood lymphocytes increased, as measured by incorporation of tritiated thymidine into lymphocytes within the first hour of in vitro incubation.     

A Q‐Tip Tip: Use of a Cotton‐Tipped Applicator to Desensitize Children to Intralesional Candida Antigen

We suggest the following technique that uses readily available, inexpensive, nonthreatening cotton‐tipped applicators to model Candida antigen injection.     

Immunotherapy for recalcitrant warts in children using intralesional mumps or Candida antigens

Intralesional injection of mumps and Candida skin test antigens has been shown to be effective in the treatment of warts. Warts are generally difficult to treat in children. To determine the efficacy of intralesional skin test antigen injection for the treatment of resistant warts in children, we treated 47 pediatric patients with one or more warts with intralesional injection of mumps or Candida skin test antigen into one wart. Twenty-two patients (47%) with resistant warts experienced complete resolution of treated warts. An average of 3.78 treatments were necessary. An additional 34% of children had a greater than 25% improvement in their warts. Sixty-eight percent of subjects with more than one wart also noted at least partial resolution (greater than 25% resolution) of untreated warts at distant sites, with 34% experiencing complete resolution. We concluded that intralesional injection of skin test antigens is an effective therapy for children who have recalcitrant, nongenital, cutaneous warts.     

Patients with chronic mucocutaneous candidiasis exhibit reduced production of Th17-associated cytokines IL-17 and IL-22

Chronic mucocutaneous candidiasis (CMC) constitutes a selective inability to clear infection with the yeast Candida, resulting in persistent debilitating inflammation of skin, nails, and mucous membranes. The underlying defect is unknown. Only recently, IL-17-producing T cells have been reported to be involved in clearing Candida infections. In order to characterize T cellular immune response to Candida, we analyzed T-cell cytokine secretion to Candida antigen and mitogenic stimuli in CMC patients, immunocompetent patients suffering from acute Candida infection, and healthy volunteers. Peripheral blood mononuclear cells (PBMCs) from CMC patients produced significantly lower amounts of IL-17 and IL-22 mRNA and protein when stimulated with Candida albicans or mitogen in vitro compared with that in matched healthy individuals. Additionally, PBMCs from immunocompetent Candida-infected patients secreted more IL-17 and IL-22 than those of both CMC patients and healthy, non-infected controls. Flow cytometry revealed a decreased number of CCR6+ IL-17-producing T cells in CMC patients, whereas the amount of CCR6+/CCR4+ cells was not altered. Levels of differentiating cytokines for human Th17 cells, IL-1beta and IL-6, tended to be higher in CMC patients. The inability to clear C. albicans in CMC patients could be due to a defect in the immune response of IL-17-producing T cells.     

白念珠菌保护性单抗的研究

目的 探讨抗白念珠菌单克隆抗体在系统性念珠菌感染动物中的保护作用。方法 制备抗白念珠菌单抗,观察单抗对系统性念珠菌感染小鼠存活时间,组织病理改变以及组织中菌落形成单位的影响。结果 制备出3株抗白念珠菌胞壁外膜抗原单克隆抗体-1B5、3E8、4C7;1B5、3E8两株单抗能显著延长致死量白念珠菌感染小鼠存活时间,减少感染小鼠主要脏器组织中白念珠菌菌落形成单位,减轻组织病理改变;1B5单抗能识别白念珠菌胞壁外膜上相对分子质量约为32000抗原;并在体外能抑制白念珠菌孢子对人颊粘膜上皮细胞,胎儿脐静脉内皮细胞的粘附。结论 1B5、3E8是具有保护作用的抗白念珠孢子对人颊粘膜上皮细胞,胎儿脐静脉内皮细胞的粘附。结论 1B5、3E8是具有保护作用的抗白念珠菌单抗;其中1B5是抗白念珠菌胞壁外膜上相对分子质量为32000的抗原的单抗;1B5单抗可通过抑制白念珠菌对上皮细胞,内皮细胞的粘附,降低该菌的侵袭力。     

Goodbye Warts,Hello Vitiligo: Candida Antigen‐Induced Depigmentation

Depigmentation after the use of topical immune modulators is a rare but reported event. Herein we present what is to our knowledge the first case of vitiligo at a site of Candida antigen injection.     

Oral papillary plasmacytosis resembling candidosis without demonstrable fungus in lesional tissue

Two cases with exuberant papillary and nodular hyperplasia of the hard and soft palates are described. Both were elderly edentulous men with bilateral angular stomatitis. The papillary hyperplasia extended as far as the epiglottis and was associated with swelling and fissuring of the upper lip in patient 1. In patient 2, the palatal change extended to the maxillary gingiva and was associated with smooth plaques and fissuring of the dorsal tongue. Histology of both cases showed a dense polyclonal plasma-cell infiltrate with overlying epithelial hyperplasia, parakeratinization and neutrophil micro-abscesses suggesting Candida infection but fungal elements could not be demonstrated. Patient 1 also showed defective cellular immunity to Candida antigen which was reversed by treatment with ketoconazole and levamisole, antedating clinical improvement.     

Effect of varicella zoster vaccine vs candida antigen injection in treatment of warts

Treatment of warts is considered as a big challenge for patients as well as doctors. Immunotherapy represents a promising and successful method of warts treatment. A great attention has been paid for various types of immunotherapeutic agents. One of the immunotherapeutic approaches is intralesional immunotherapy that showed a successful result in treatment of warts. Complete resolution of warts was achieved in many of studied patients, while some of them showed partial response and only few patients showed no response. Our study was based on the previous observations and reports of regression of several types of warts after administration of candida antigen and other new immunotherapeutic antigens. Candida antigen group showed complete clearance in 16 patients (69.6%), partial response in seven patients (30.4%). In VZV vaccine group, complete clearance was observed in 15 patients (65.2%), partial response in eight patients (34.8%). These results showed that the therapeutic response in two groups had a close statistical result and more chances must be given to VZV vaccine specially after its promising and successful results. In conclusion, we presented a novel approach for the treatment of recalcitrant wart using intralesional immunotherapy with Candida antigen and VZV vaccine. VZV vaccine seems to be promising, safe and effective remedy for any type warts mainly plantar warts.     

Intralesional immunotherapy with Candida antigen for the treatment of molluscum contagiosum in children

Intralesional injection of Candida and other antigens is an established and useful therapy for warts; a cutaneous immune response can induce improvement and or clearance of warts, often with response in anatomically distinct lesions other than those injected. Molluscum contagiosum virus is a common cutaneous infection seen primarily in pediatric dermatology clinics. Treatment is often unsatisfactory, painful, and time consuming. A retrospective chart review was conducted to examine the efficacy of intralesional injection of Candida antigen into a maximum of three individual molluscum lesions. Twenty-nine patients were treated with this therapy; 55% had complete resolution. In addition, 37.9% experienced partial resolution, yielding an overall response rate of 93%. Only two patients failed to respond (6.9%). In addition, only four patients reported a single adverse effect of pain with injection. No other adverse effects were reported or noted clinically. Scarring was absent. No recurrences were reported at the time of publication. This report establishes the efficacy of intralesional injection of Candida for molluscum contagiosum.     

The characteristics of the clinical manifestations and the pathogenesis of foot mycoses complicated by candidiasis in metallurgists

Mycologic examinations of patients with mycoses of the soles, working at 5 metallurgical plants in the town of Zaporozhye, have detected T. rubrum in 71.3 percent and T. interdigitale in 28.7 percent of cases. In 110 (18.3 percent) patients C. albicans were isolated from foci of involvement in parallel with Trichophyton. As a rule these patients were engaged in 'hot' shops and suffered from dysfunctions of various vital organs and from metabolic disorders. Mycoses of the soles complicated with Candida infection were characterized by marked exudation and dissemination with symptoms of eczema, intensive itching, efflorescence of the allergic type. High immediate and delayed-type hypersensitivity to administration of Candida antigen was observed in them. Cell-mediated and humoral immune response of these patients was essentially uncoordinated with depression of the T-immunity and nonspecific defense factors as a rule.