[The influence of Candida albicans on the course of ulcerative colitis].
The influence of microbiological factor is taken into consideration in the pathogenesis of ulcerative colitis (UC). The aim of studies was to: 1.evaluate the presence of significant fungal colonization, over 10(5) CFU/ml in patients with UC and the control group (irritable colon syndrome, IBS); 2. estimate the influence of antifungal treatment in the activity of UC.


METHODS
We evaluated 72 patients aged from 18-72 years, 60 patients with UC, 12 with IBS. Clinical investigation: initially and after 4 weeks interview and colonoscopy with colon biopsies for histology and mycology were taken. Activity of UC was evaluated according to: clinical, endoscopic and histological IACH criteria. 13 patients with significant fungal colonization were given antifungal treatment. Biopsies for histology were stained with hematoxylin-epsin (H-E). Qualitative and quantitative mycolo-gical evaluation was performed according to Muller method.


RESULTS
1. Significant fungal colonization was more frequent in patients with UC history over 5 years, in comparison with shorter disease history and IBS, in 33.3%, 13.8% and 1.3% respectively. 2. Candida albicans was most often isolated in 91.7% of cases. 3. Initial analysis of the activity index of UC in patients with significant and non-significant fungal colonization did not revealed differences between these groups, 13.84 and 14.0 respectively. 3. After 4 weeks stronger decrease of the UC activity index was observed in patients with significant fungal colonization treated with antifungal treatment, in comparison with patients not given antifungal therapy: 8.0 and 10.41 respectively, p<0.01. Differences were significant according to clinical 2.23 (C) -3.33 (D), p<0.05 and endoscopic cryteria: 3.46 (C) -4.84 (D), p<0.01.


CONCLUSIONS
1. Significant fungal colonization of colon may influence the activation of UC. 2. Longer disease history may be the risk factor of significant fungal colonization in colon. 3. Antifungal treatment in patients with significant colonization caused clinical improvement of UC.
Zwolińska-Wcisło
Małgorzata
M
Katedra Gastroenterologii, Hepatologii i Chorób Zakaźnych Collegium Medicum, Uniwersytetu Jagiellonskiego w Krakowie, Kierownik.
Budak
Alicja
A
Trojanowska
Danuta
D
Mach
Tomrasz
T
Rudnicka-Sosin
Lucyna
L
Galicka-Latała
Danuta
D
Nowak
Paweł
P
Cibor
Dorota
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D001706:Biopsy; D002176:Candida albicans / Q000302:isolation & purification*; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000382:microbiology* / Q000473:pathology; D003113:Colonoscopy; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000188:drug therapy* / Q000382:microbiology* / Q000473:pathology; D008297:Male; D019804:Mesalamine / Q000627:therapeutic use; D008875:Middle Aged; D012720:Severity of Illness Index
D000935:Antifungal Agents; D019804:Mesalamine