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Kühbacher A, Henkel H, Stevens P, Grumaz C, Finkelmeier D, Burger-Kentischer A, Sohn K, Rupp S. Central Role for Dermal Fibroblasts in Skin Model Protection against Candida albicans. J Infect Dis 2017; 215:1742-1752. [PMID: 28368492 DOI: 10.1093/infdis/jix153] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 03/23/2017] [Indexed: 01/09/2023] Open
Abstract
The fungal pathogen Candida albicans colonizes basically all human epithelial surfaces, including the skin. Under certain conditions, such as immunosuppression, invasion of the epithelia occurs. Not much is known about defense mechanisms against C. albicans in subepithelial layers such as the dermis. Using immune cell-supplemented 3D skin models we defined a new role for fibroblasts in the dermis and identified a minimal set of cell types for skin protection against C. albicans invasion. Dual RNA sequencing of individual host cell populations and C. albicans revealed that dermal invasion is directly impeded by dermal fibroblasts. They are able to integrate signals from the pathogen and CD4+ T cells and shift toward an antimicrobial phenotype with broad specificity that is dependent on Toll-like receptor 2 and interleukin 1β. These results highlight a central function of dermal fibroblasts for skin protection, opening new possibilities for treatment of infectious diseases.
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Affiliation(s)
- Andreas Kühbacher
- Department of Molecular Biotechnology, Fraunhofer Institute for Interfacial Engineering and Biotechnology
| | - Helena Henkel
- Department of Molecular Biotechnology, Fraunhofer Institute for Interfacial Engineering and Biotechnology
| | - Philip Stevens
- Department of Molecular Biotechnology, Fraunhofer Institute for Interfacial Engineering and Biotechnology.,Center for Integrative Bioinformatics Vienna, Max F. Perutz Laboratories, University of Vienna, Medical University of Vienna, Austria
| | - Christian Grumaz
- Department of Molecular Biotechnology, Fraunhofer Institute for Interfacial Engineering and Biotechnology
| | - Doris Finkelmeier
- Department of Molecular Biotechnology, Fraunhofer Institute for Interfacial Engineering and Biotechnology
| | - Anke Burger-Kentischer
- Department of Molecular Biotechnology, Fraunhofer Institute for Interfacial Engineering and Biotechnology.,Institute of Interfacial Process Engineering and Plasma Technology, University of Stuttgart, Germany
| | - Kai Sohn
- Department of Molecular Biotechnology, Fraunhofer Institute for Interfacial Engineering and Biotechnology.,Institute of Interfacial Process Engineering and Plasma Technology, University of Stuttgart, Germany
| | - Steffen Rupp
- Department of Molecular Biotechnology, Fraunhofer Institute for Interfacial Engineering and Biotechnology.,Institute of Interfacial Process Engineering and Plasma Technology, University of Stuttgart, Germany
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Dongari-Bagtzoglou A, Fidel PL. The Host Cytokine Responses and Protective Immunity in Oropharyngeal Candidiasis. J Dent Res 2016; 84:966-77. [PMID: 16246925 DOI: 10.1177/154405910508401101] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Over the last three decades, the prevalence of oropharyngeal fungal infections has increased enormously, mainly due to an increasing population of immunocompromised patients, including individuals with HIV infection, transplant recipients, and patients receiving cancer therapy. The vast majority of these infections are caused by Candida species. The presence of cytokines in infected tissues ultimately dictates the host defense processes that are specific to each pathogenic organism. During oral infection with Candida, a large number of pro-inflammatory and immunoregulatory cytokines are generated in the oral mucosa. The main sources of these cytokines are oral epithelial cells, which maintain a central role in the protection against fungal organisms. These cytokines may drive the chemotaxis and effector functions of innate and/or adaptive effector cells, such as infiltrating neutrophils and T-cells in immunocompetent hosts, and CD8+ T-cells in HIV+ hosts. Epithelial cells also have direct anti- Candida activity. Several studies have provided a potential link between lower levels of certain pro-inflammatory cytokines and susceptibility to oral C. albicans infection, suggesting that such cytokines may be involved in immune protection. The exact role of these cytokines in immune protection against oropharyngeal candidiasis is still incompletely understood and requires further investigation. Identification of such cytokines with the ability to enhance anti-fungal activities of immune effector cells may have therapeutic implications in the treatment of this oral infection in the severely immunocompromised host.
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Affiliation(s)
- A Dongari-Bagtzoglou
- School of Dental Medicine, Department of Oral Health and Diagnostic Sciences, University of Connecticut, 263 Farmington Ave., Farmington, CT 06030-1710, USA.
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Bruno VM, Shetty AC, Yano J, Fidel PL, Noverr MC, Peters BM. Transcriptomic analysis of vulvovaginal candidiasis identifies a role for the NLRP3 inflammasome. mBio 2015; 6:e00182-15. [PMID: 25900651 PMCID: PMC4453569 DOI: 10.1128/mbio.00182-15] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 03/26/2015] [Indexed: 01/11/2023] Open
Abstract
UNLABELLED Treatment of vulvovaginal candidiasis (VVC), caused most frequently by Candida albicans, represents a significant unmet clinical need. C. albicans, as both a commensal and a pathogenic organism, has a complex and poorly understood interaction with the vaginal environment. Understanding the complex nature of this relationship is necessary for the development of desperately needed therapies to treat symptomatic infection. Using transcriptome sequencing (RNA-seq), we characterized the early murine vaginal and fungal transcriptomes of the organism during VVC. Network analysis of host genes that were differentially expressed between infected and naive mice predicted the activation or repression of several signaling pathways that have not been previously associated with VVC, including NLRP3 inflammasome activation. Intravaginal challenge of Nlrp3(-/-) mice with C. albicans demonstrated severely reduced levels of polymorphonuclear leukocytes (PMNs), alarmins, and inflammatory cytokines, including interleukin-1β (IL-1β) (the hallmarks of VVC immunopathogenesis) in vaginal lavage fluid. Intravaginal administration of wild-type (WT) mice with glyburide, a potent inhibitor of the NLRP3 inflammasome, reduced PMN infiltration and IL-1β to levels comparable to those observed in Nlrp3(-/-) mice. Furthermore, RNA-seq analysis of C. albicans genes indicated robust expression of hypha-associated secreted aspartyl proteinases 4, 5, and 6 (SAP4-6), which are known inflammasome activators. Despite colonization similar to that of the WT strain, ΔSAP4-6 triple and ΔSAP5 single mutants induced significantly less PMN influx and IL-1β during intravaginal challenge. Our findings demonstrate a novel role for the inflammasome in the immunopathogenesis of VVC and implicate the hypha-associated SAPs as major C. albicans virulence determinants during vulvovaginal candidiasis. IMPORTANCE Vaginitis, most commonly caused by the fungus Candida albicans, results in significant quality-of-life issues for all women of reproductive age. Recent efforts have suggested that vaginitis results from an immunopathological response governed by host innate immunity, although an explanatory mechanism has remained undefined. Using comprehensive genomic, immunological, and pharmacological approaches, we have elucidated the NLRP3 inflammasome as a crucial molecular mechanism contributing to host immunopathology. We have also demonstrated that C. albicans hypha-associated secreted aspartyl proteinases (SAP4-6 and SAP5, more specifically) contribute to disease immunopathology. Ultimately, this study enhances our understanding of the complex interplay between host and fungus at the vaginal mucosa and provides proof-of-principle evidence for therapeutic targeting of inflammasomes for symptomatic vulvovaginal candidiasis.
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Affiliation(s)
| | - Amol C Shetty
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Junko Yano
- Department of Oral Biology, School of Dentistry, LSU Health Sciences Center, New Orleans, Louisiana, USA
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Vaginal epithelial cell-derived S100 alarmins induced by Candida albicans via pattern recognition receptor interactions are sufficient but not necessary for the acute neutrophil response during experimental vaginal candidiasis. Infect Immun 2013; 82:783-92. [PMID: 24478092 DOI: 10.1128/iai.00861-13] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Vulvovaginal candidiasis (VVC), caused by Candida albicans, affects women worldwide. Animal and clinical studies suggest that the immunopathogenic inflammatory condition of VVC is initiated by S100 alarmins in response to C. albicans, which stimulate polymorphonuclear neutrophil (PMN) migration to the vagina. The purpose of this study was to extend previous in vitro data and determine the requirement for the alarmin S100A8 in the PMN response and to evaluate pattern recognition receptors (PRRs) that initiate the response. For the former, PMN migration was evaluated in vitro or in vivo in the presence or absence of S100 alarmins initiated by several approaches. For the latter, vaginal epithelial cells were evaluated for PRR expression and C. albicans-induced S100A8 and S100A9 mRNAs, followed by evaluation of the PMN response in inoculated PRR-deficient mice. Results revealed that, consistent with previously reported in vitro data, eukaryote-derived S100A8, but not prokaryote-derived recombinant S100A8, induced significant PMN chemotaxis in vivo. Conversely, a lack of biologically active S100A8 alarmin, achieved by antibody neutralization or by using S100A9(-/-) mice, had no effect on the PMN response in vivo. In PRR analyses, whereas Toll-like receptor 4 (TLR4)- and SIGNR1-deficient vaginal epithelial cells showed a dramatic reduction in C. albicans-induced S100A8/S100A9 mRNAs in vitro, inoculated mice deficient in these PRRs showed PMN migration similar to that in wild-type controls. These results suggest that S100A8 alarmin is sufficient, but not necessary, to induce PMN migration during VVC and that the vaginal PMN response to C. albicans involves PRRs in addition to SIGNR1 and TLR4, or other induction pathways.
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The prevalence of urogenital infections in pregnant women experiencing preterm and full-term labor. Infect Dis Obstet Gynecol 2012; 2012:878241. [PMID: 22505801 PMCID: PMC3296138 DOI: 10.1155/2012/878241] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Accepted: 11/21/2011] [Indexed: 11/18/2022] Open
Abstract
Urogenital infections are extremely prevalent during pregnancy and are an important cause of premature labor. However, the prevalence of urogenital infections during childbirth is not well known. Objective. Identify urogenital infections present at the beginning of labor in both full-term and preterm pregnancies. Study Design. Ninety-four women were admitted to the inpatient maternity clinic of the Federal University of Rio Grande do Norte (UFRN). In total, 49 women in preterm labor and 45 women in full-term labor were included in the study, and samples of urinary, vaginal, and perianal material were collected for microbiological analysis. Results. The prevalences of general infections in the preterm labor group and the full-term labor group were 49.0% and 53.3% (P = 0.8300), respectively. Urogenital infections in the preterm and full-term labor groups included urinary tract infection in 36.7% and 22.2% of women, vaginal candidiasis in 20.4% and 28.9% of women, bacterial vaginosis in 34.7% and 28.9% of women, and group B streptococcus in 6.1% and 15.6% of women, respectively. Conclusions. Urogenital infections were prevalent in women in preterm labor and full-term labor; however, significant differences between the groups were not observed.
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Mucosal immunity and Candida albicans infection. Clin Dev Immunol 2011; 2011:346307. [PMID: 21776285 PMCID: PMC3137974 DOI: 10.1155/2011/346307] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2011] [Accepted: 05/27/2011] [Indexed: 02/06/2023]
Abstract
Interactions between mucosal surfaces and microbial microbiota are key to host defense, health, and disease. These surfaces are exposed to high numbers of microbes and must be capable of distinguishing between those that are beneficial or avirulent and those that will invade and cause disease. Our understanding of the mechanisms involved in these discriminatory processes has recently begun to expand as new studies bring to light the importance of epithelial cells and novel immune cell subsets such as T(h)17 T cells in these processes. Elucidating how these mechanisms function will improve our understanding of many diverse diseases and improve our ability to treat patients suffering from these conditions. In our voyage to discover these mechanisms, mucosal interactions with opportunistic commensal organisms such as the fungus Candida albicans provide insights that are invaluable. Here, we review current knowledge of the interactions between C. albicans and epithelial surfaces and how this may shape our understanding of microbial-mucosal interactions.
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Chen S, Li S, Wu Y, Liu Z, Li J. Local expression of vaginal Th1 and Th2 cytokines in murine vaginal candidiasis under different immunity conditions. ACTA ACUST UNITED AC 2008; 28:476-9. [PMID: 18704316 DOI: 10.1007/s11596-008-0423-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2008] [Indexed: 11/29/2022]
Abstract
To investigate the expression of vaginal Th1 and Th2 cytokines in rats with experimental vaginal candidiasis under different immune conditions, ICR murine vaginal candidiasis model was established and immno-suppressed murine models of vaginal cadidiasis were established in estrogen-treated mice. Non-estrogen-treated mice were used as controls. The mRNA level of Th1 (IL-2)/Th2 (IL-4, IL-10, TGF-beta1) cytokines in murine vaginal tissues was determined by RT-PCR. The cykotine in local tissues was increased to different extent under normal immune condition. IL-2 mRNA was increased during early stage of infection, while IL-10 was increased transiently during late stage of infection. TGF-beta1 production was found to be increased persistently. At same time, the expression of IL-2 mRNA was suppressed in immno-suppressed group, and the level of IL-4, IL-10, and TGF-beta1 were higher than the normal immunity group to different degree during infection. The high level of IL-2 mRNA during early stage of infection was associated with clearance of mucosal Candidia albicans (C. albicans), and its expression suppressed leading to decreased clearance of mucosal C. albican in immuno-suppression. The over-expression of IL-4 and IL-10 could significantly enhance the susceptibility to C. albicans infection in mice.
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Affiliation(s)
- Shanjuan Chen
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
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Leigh JE, McNulty KM, Fidel PL. Characterization of the immune status of CD8+ T cells in oral lesions of human immunodeficiency virus-infected persons with oropharyngeal Candidiasis. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2006; 13:678-83. [PMID: 16760327 PMCID: PMC1489553 DOI: 10.1128/cvi.00015-06] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Oropharyngeal candidiasis (OPC) remains the most common oral infection in human immunodeficiency virus (HIV) disease. In a high percentage of HIV(+) persons with reduced CD4(+) T cells, oral lesions with Candida present at the outer epithelium have an accumulation of CD8(+) T cells at the epithelium-lamina propria interface associated with reduced expression of the mucosal cell-trafficking adhesion molecule E-cadherin. The purpose of the present study was to characterize the immune status of these CD8(+) T cells. Immunohistochemical staining for phenotypic and activation and costimulation markers was performed on frozen biopsy tissue sections from HIV(+) OPC(+) persons with accumulated CD8(+) T cells. CD8(+) T cells consisted primarily of central memory cells by virtue of positive CD45RO (memory) and CD27 (central memory) expression. However, concomitant negative expression of CD62L and CCR7 (effector memory) was suggestive of a transitioning memory phenotype within the tissue. Despite this, the cells are considered to be activated on the basis of positive expression of CD69. The CD8(+) T cells are not considered to be NK T cells or anti-HIV CD8(+) T cells because of negative or low expression of CD161 and vascular cell adhesion molecule, respectively. These results suggest that the accumulated mucosal migratory-challenged CD8(+) T cells are otherwise normal memory T cells in an activated state.
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Affiliation(s)
- Janet E Leigh
- Department of General Dentistry, Louisiana State University School of Dentistry, 1100 Florida Avenue, New Orleans, 70119, USA
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9
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Abstract
Oropharyngeal candidiasis (OPC) caused by the commensal organism, Candida albicans, is the most common oral infection in HIV disease. Although cell-mediated immunity (CMI) by Th1-type CD4+ T-cells is considered the predominant host defense mechanism against OPC, other systemic or local immune mechanisms are critical when blood CD4+ T-cells are reduced below a protective threshold. For example, the Th cytokine profile in saliva may influence resistance or susceptibility to OPC. In OPC lesions, CD8+ T-cells become accumulated at the lamina propria-epithelium interface, suggesting some role for CD8+ T-cells against OPC. However, the absence of CD8+ T-cells close to Candida at the outer epithelium indicates that susceptibility to OPC involves a dysfunction in the CD8+ T-cells or in the micro-environment. Further evaluation of the buccal mucosa lesion showed that CD8 T-cell-associated cytokine and chemokine mRNA is increased compared with buccal mucosa from lesion-negative matched controls. The majority of CD8+ T-cells present possess the alphabeta T-cell receptor and several homing receptors (i.e., 4beta7, 4beta1, ebeta7). While several adhesion molecules are similar in OPC+ vs. OPC- persons, E-cadherin is reduced in the tissue of OPC+ persons. These results support evidence for a role for CD8+ T-cells against OPC, but suggest that a putative dysfunction in mucosal T-cell trafficking may be associated with susceptibility to infection. Similar levels of Candida-specific antibodies in persons with and without OPC confirmed a limited role for humoral immunity. Finally, oral epithelial cells inhibit the growth of Candida in vitro in a static rather than a cidal manner. Clinically, oral epithelial cell anti-Candida activity is reduced in HIV+ persons with OPC, compared with controls. The mechanism of action includes a strict requirement for cell contact by an acid-labile moiety on intact, but not necessarily live, epithelial cells, with no role for soluble factors. Taken together, host defense against OPC involves several levels of activity. The status and efficiency of local host defenses when blood CD4+ T-cells are not available appear to play a role in protection against or susceptibility to OPC.
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Affiliation(s)
- P L Fidel
- Department of Microbiology, Immunology, and Parasitology, Louisiana State University Health Sciences Center, New Orleans, LA 70112-1393, USA.
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Tongchusak S, Chaiyaroj SC, Veeramani A, Koh JLY, Brusic V. CandiVF – Candida albicans Virulence Factor Database. Int J Pept Res Ther 2005. [DOI: 10.1007/s10989-005-9268-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Braun BR, van het Hoog M, d'Enfert C, Martchenko M, Dungan J, Kuo A, Inglis DO, Uhl MA, Hogues H, Berriman M, Lorenz M, Levitin A, Oberholzer U, Bachewich C, Harcus D, Marcil A, Dignard D, Iouk T, Zito R, Frangeul L, Tekaia F, Rutherford K, Wang E, Munro CA, Bates S, Gow NA, Hoyer LL, Köhler G, Morschhäuser J, Newport G, Znaidi S, Raymond M, Turcotte B, Sherlock G, Costanzo M, Ihmels J, Berman J, Sanglard D, Agabian N, Mitchell AP, Johnson AD, Whiteway M, Nantel A. A human-curated annotation of the Candida albicans genome. PLoS Genet 2005; 1:36-57. [PMID: 16103911 PMCID: PMC1183520 DOI: 10.1371/journal.pgen.0010001] [Citation(s) in RCA: 252] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2005] [Accepted: 03/14/2005] [Indexed: 11/24/2022] Open
Abstract
Recent sequencing and assembly of the genome for the fungal pathogen Candida albicans used simple automated procedures for the identification of putative genes. We have reviewed the entire assembly, both by hand and with additional bioinformatic resources, to accurately map and describe 6,354 genes and to identify 246 genes whose original database entries contained sequencing errors (or possibly mutations) that affect their reading frame. Comparison with other fungal genomes permitted the identification of numerous fungus-specific genes that might be targeted for antifungal therapy. We also observed that, compared to other fungi, the protein-coding sequences in the C. albicans genome are especially rich in short sequence repeats. Finally, our improved annotation permitted a detailed analysis of several multigene families, and comparative genomic studies showed that C. albicans has a far greater catabolic range, encoding respiratory Complex 1, several novel oxidoreductases and ketone body degrading enzymes, malonyl-CoA and enoyl-CoA carriers, several novel amino acid degrading enzymes, a variety of secreted catabolic lipases and proteases, and numerous transporters to assimilate the resulting nutrients. The results of these efforts will ensure that the Candida research community has uniform and comprehensive genomic information for medical research as well as for future diagnostic and therapeutic applications.
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Affiliation(s)
- Burkhard R Braun
- Department of Microbiology and Immunology, University of California, San Francisco, California, United States of America
| | - Marco van het Hoog
- Biotechnology Research Institute, National Research Council Canada, Montreal, Quebec, Canada
| | - Christophe d'Enfert
- Unité Postulante Biologie et Pathogénicité Fongiques, INRA USC 2019, Institut Pasteur, Paris, France
| | - Mikhail Martchenko
- Biotechnology Research Institute, National Research Council Canada, Montreal, Quebec, Canada
| | - Jan Dungan
- Department of Stomatology, University of California, San Francisco, California, United States of America
| | - Alan Kuo
- Department of Stomatology, University of California, San Francisco, California, United States of America
| | - Diane O Inglis
- Department of Microbiology and Immunology, University of California, San Francisco, California, United States of America
| | - M. Andrew Uhl
- Department of Microbiology and Immunology, University of California, San Francisco, California, United States of America
| | - Hervé Hogues
- Biotechnology Research Institute, National Research Council Canada, Montreal, Quebec, Canada
| | | | - Michael Lorenz
- Department of Microbiology and Molecular Genetics, Utah-Houston Medical School, Houston, Texas, United States of America
| | - Anastasia Levitin
- Biotechnology Research Institute, National Research Council Canada, Montreal, Quebec, Canada
| | - Ursula Oberholzer
- Biotechnology Research Institute, National Research Council Canada, Montreal, Quebec, Canada
| | - Catherine Bachewich
- Biotechnology Research Institute, National Research Council Canada, Montreal, Quebec, Canada
| | - Doreen Harcus
- Biotechnology Research Institute, National Research Council Canada, Montreal, Quebec, Canada
| | - Anne Marcil
- Biotechnology Research Institute, National Research Council Canada, Montreal, Quebec, Canada
| | - Daniel Dignard
- Biotechnology Research Institute, National Research Council Canada, Montreal, Quebec, Canada
| | - Tatiana Iouk
- Biotechnology Research Institute, National Research Council Canada, Montreal, Quebec, Canada
| | - Rosa Zito
- Biotechnology Research Institute, National Research Council Canada, Montreal, Quebec, Canada
| | - Lionel Frangeul
- Plate-Forme Intégration et Analyse Génomique, Institut Pasteur, Paris, France
| | - Fredj Tekaia
- Unité de Génétique Moléculaire des Levures, Institut Pasteur, Paris, France
| | | | - Edwin Wang
- Biotechnology Research Institute, National Research Council Canada, Montreal, Quebec, Canada
| | - Carol A Munro
- School of Medical Sciences, University of Aberdeen, Institute of Medical Sciences, Foresterhill, Aberdeen, United Kingdom
| | - Steve Bates
- School of Medical Sciences, University of Aberdeen, Institute of Medical Sciences, Foresterhill, Aberdeen, United Kingdom
| | - Neil A Gow
- School of Medical Sciences, University of Aberdeen, Institute of Medical Sciences, Foresterhill, Aberdeen, United Kingdom
| | - Lois L Hoyer
- Department of Veterinary Pathobiology, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Gerwald Köhler
- Department of Stomatology, University of California, San Francisco, California, United States of America
| | - Joachim Morschhäuser
- Institut für Molekulare Infektionsbiologie, Universität Wurzburg, Wurzburg, Germany
| | - George Newport
- Department of Stomatology, University of California, San Francisco, California, United States of America
| | - Sadri Znaidi
- Institut de Recherches Cliniques de Montreal, Montreal, Quebec, Canada
| | - Martine Raymond
- Institut de Recherches Cliniques de Montreal, Montreal, Quebec, Canada
| | - Bernard Turcotte
- Department of Medicine, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada
| | - Gavin Sherlock
- Department of Genetics, Stanford University School of Medicine, Palo Alto, California, United States of America
| | - Maria Costanzo
- Department of Genetics, Stanford University School of Medicine, Palo Alto, California, United States of America
| | - Jan Ihmels
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot, Israel
| | - Judith Berman
- Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Dominique Sanglard
- Institute of Microbiology, University Hospital Lausanne, Lausanne, Switzerland
| | - Nina Agabian
- Department of Stomatology, University of California, San Francisco, California, United States of America
| | - Aaron P Mitchell
- Department of Microbiology and Institute of Cancer Research, Columbia University, New York, New York, United States of America
| | - Alexander D Johnson
- Department of Microbiology and Immunology, University of California, San Francisco, California, United States of America
| | - Malcolm Whiteway
- Biotechnology Research Institute, National Research Council Canada, Montreal, Quebec, Canada
| | - André Nantel
- Biotechnology Research Institute, National Research Council Canada, Montreal, Quebec, Canada
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McNulty KM, Plianrungsi J, Leigh JE, Mercante D, Fidel PL. Characterization of CD8+ T cells and microenvironment in oral lesions of human immunodeficiency virus-infected persons with oropharyngeal candidiasis. Infect Immun 2005; 73:3659-67. [PMID: 15908395 PMCID: PMC1111879 DOI: 10.1128/iai.73.6.3659-3667.2005] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Oropharyngeal candidiasis (OPC), the most common oral infection in human immunodeficiency virus-positive persons, correlates with reduced blood CD4+ T cells. In those with OPC, CD8+ T cells accumulate at the lamina propria-epithelium interface at a distance from the organism at the outer epithelium. The present study aimed to characterize the tissue-associated CD8+ T cells and tissue microenvironment in both OPC+ and OPC- persons. The results show that the majority of CD8+ T cells possess the alphabeta T-cell receptor, the thymus-derived alphabeta CD8 antigen heterodimer, and similar levels of the alpha(4)beta(7), alpha(4)beta(1), and alpha(e)beta(7) homing receptors. Studies to evaluate the tissue microenvironment showed that in OPC+ persons, the adhesion molecule for T cells to enter mucosa, mucosal addressin cell adhesion molecule, is significantly increased, whereas E-cadherin, which allows T cells to migrate through mucosa, is significantly decreased compared to OPC- persons. These results continue to support a role for CD8+ T cells against OPC under conditions of reduced numbers of CD4+T cells, with susceptibility to infection potentially associated with a dysfunction in mucosal CD8+ T-cell migration by reduced tissue-associated E-cadherin.
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Affiliation(s)
- Kelly M McNulty
- Center of Excellence in Oral and Craniofacial Biology, Louisiana State University School of Dentistry, 1100 Florida Avenue, New Orleans, LA 70119, USA
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de Repentigny L, Lewandowski D, Jolicoeur P. Immunopathogenesis of oropharyngeal candidiasis in human immunodeficiency virus infection. Clin Microbiol Rev 2004; 17:729-59, table of contents. [PMID: 15489345 PMCID: PMC523562 DOI: 10.1128/cmr.17.4.729-759.2004] [Citation(s) in RCA: 144] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Oropharyngeal and esophageal candidiases remain significant causes of morbidity in human immunodeficiency virus (HIV)-infected patients, despite the dramatic ability of antiretroviral therapy to reconstitute immunity. Notable advances have been achieved in understanding, at the molecular level, the relationships between the progression of HIV infection, the acquisition, maintenance, and clonality of oral candidal populations, and the emergence of antifungal resistance. However, the critical immunological defects which are responsible for the onset and maintenance of mucosal candidiasis in patients with HIV infection have not been elucidated. The devastating impact of HIV infection on mucosal Langerhans' cell and CD4(+) cell populations is most probably central to the pathogenesis of mucosal candidiasis in HIV-infected patients. However, these defects may be partly compensated by preserved host defense mechanisms (calprotectin, keratinocytes, CD8(+) T cells, and phagocytes) which, individually or together, may limit Candida albicans proliferation to the superficial mucosa. The availability of CD4C/HIV transgenic mice expressing HIV-1 in immune cells has provided the opportunity to devise a novel model of mucosal candidiasis that closely mimics the clinical and pathological features of candidal infection in human HIV infection. These transgenic mice allow, for the first time, a precise cause-and-effect analysis of the immunopathogenesis of mucosal candidiasis in HIV infection under controlled conditions in a small laboratory animal.
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Affiliation(s)
- Louis de Repentigny
- Department of Microbiology and Immunology, Faculty of Medicine, University of Montreal, 3175 Côte Sainte-Catherine, Montreal, Quebec H3T 1C5, Canada.
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Fidel PL, Barousse M, Espinosa T, Ficarra M, Sturtevant J, Martin DH, Quayle AJ, Dunlap K. An intravaginal live Candida challenge in humans leads to new hypotheses for the immunopathogenesis of vulvovaginal candidiasis. Infect Immun 2004; 72:2939-46. [PMID: 15102806 PMCID: PMC387876 DOI: 10.1128/iai.72.5.2939-2946.2004] [Citation(s) in RCA: 175] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Acute and recurrent vulvovaginal candidiasis (VVC) remains a significant problem in women of childbearing age. While clinical studies of women with recurrent VVC (RVVC) and animal models have provided important data about a limited protective role of adaptive immunity, there remains a paucity of information on the protective mechanisms or factors associated with susceptibility to infection. In the present study, an intravaginal live Candida challenge in healthy adult women showed a differential susceptibility to symptomatic VVC, where 3 (15%) of 19 women with no history of VVC acquired a symptomatic infection compared to 6 (55%) of 11 women with an infrequent history of VVC. Furthermore, these studies revealed that protection against infection is noninflammatory while symptomatic infection correlates with a vaginal infiltration of polymorphonuclear neutrophils (PMNs) and a high vaginal fungal burden. Thus, the presence of symptomatic infection appears more dependent on host factors than on properties of the organism. Finally, vaginal lavage fluid from women with a symptomatic infection, but not those asymptomatically colonized, promoted the chemotaxis of PMNs. These results suggest that rather than RVVC/VVC being caused by an aberrant adaptive immune response, symptoms that define infection appear to be due to an aggressive innate response by PMNs.
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Affiliation(s)
- Paul L Fidel
- Department of Microbiology, Louisiana State University Health Sciences Center, New Orleans, Louisiana 70112, USA.
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Lattif AA, Banerjee U, Prasad R, Biswas A, Wig N, Sharma N, Haque A, Gupta N, Baquer NZ, Mukhopadhyay G. Susceptibility pattern and molecular type of species-specific Candida in oropharyngeal lesions of Indian human immunodeficiency virus-positive patients. J Clin Microbiol 2004; 42:1260-2. [PMID: 15004088 PMCID: PMC356856 DOI: 10.1128/jcm.42.3.1260-1262.2004] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A study of oropharyngeal candidiasis (OPC) in Indian human immunodeficiency virus (HIV)/AIDS patients was conducted over a period of 15 months. This study revealed that 75% of the HIV/AIDS patients had OPC. MIC testing revealed that 5% of the Candida isolates were fluconazole resistant. A correlation between CD4(+)-T-cell counts and development of OPC in HIV/AIDS patients was also observed. Molecular typing of C. albicans isolates showed that all were genetically unrelated.
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Affiliation(s)
- Ali Abdul Lattif
- School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
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