Candidiasis--do we need to fight or to tolerate the Candida fungus?
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.
Raska
M
M
Department of Immunology, Medical Faculty, Palacký University, 772 00 Olomouc, Czechia. raskamil@uab.edu
Bĕláková
J
J
Krupka
M
M
Weigl
E
E
D000935:Antifungal Agents / Q000627:therapeutic use*; D002175:Candida / Q000145:classification / Q000276:immunology / Q000472:pathogenicity*; D002177:Candidiasis / Q000188:drug therapy / Q000276:immunology*; D002353:Carrier State / Q000276:immunology; D006801:Humans; D007111:Immunity, Cellular; D007113:Immunity, Innate / Q000276:immunology; D010587:Phagocytosis; D013601:T-Lymphocytes / Q000276:immunology
D000935:Antifungal Agents
Folia Microbiol (Praha). 2006;51(1):3-20
16821705
J Med Vet Mycol. 1997 May-Jun;35(3):197-203
9229336
J Infect Dis. 2000 Nov;182(5):1479-85
11023471
Mycoses. 2005;48 Suppl 1:3-11
15887329
J Reticuloendothel Soc. 1976 Feb;19(2):121-4
772202
Curr Mol Med. 2005 Jun;5(4):377-82
15977993
Med Sci Monit. 2004 Aug;10(8):BR239-49
15277983
Microbiology (Reading). 1999 Jul;145 ( Pt 7):1631-1640
10439402
Infect Immun. 2000 Oct;68(10):5771-7
10992484
J Infect Dis. 2001 Jan 15;183(2):277-285
11120933
Med Mycol. 2002 Aug;40(4):359-75
12230215
J Clin Microbiol. 1983 May;17(5):774-80
6345575
Sex Transm Infect. 2004 Feb;80(1):48-53
14755036
Infect Immun. 1996 Aug;64(8):3360-8
8757876
Curr Mol Med. 2005 Jun;5(4):393-401
15977995
J Exp Med. 1994 Feb 1;179(2):589-600
7905019
Annu Rev Immunol. 2003;21:335-76
12524386
Infect Immun. 1995 Nov;63(11):4506-14
7591093
J Immunol. 2004 Mar 1;172(5):3059-69
14978111
Infect Immun. 2004 May;72(5):2939-46
15102806
Infect Immun. 1976 Jul;14(1):33-8
780278
Ceska Gynekol. 2005 Nov;70(6):453-9
17955799
Blood. 1990 Oct 1;76(7):1405-9
2207315
Microb Pathog. 2003 Feb;34(2):103-13
12623278
Res Immunol. 1998 May-Jun;149(4-5):361-73; discussion 510-2
9720954
Microbiol Immunol. 1977;21(12):703-25
347226
Eur J Immunol. 1993 May;23(5):1034-8
8477799
Clin Infect Dis. 2003 Nov 1;37(9):1172-7
14557960
Curr Mol Med. 2005 Jun;5(4):383-92
15977994
Antimicrob Agents Chemother. 2000 Oct;44(10):2653-8
10991839
Trends Microbiol. 2001 Jul;9(7):327-35
11435107
J Dent Res. 2005 Nov;84(11):966-77
16246925
Folia Microbiol (Praha). 2005;50(1):77-82
15954537
Folia Microbiol (Praha). 2005;50(3):255-61
16295665
Infect Immun. 2002 Dec;70(12):7081-8
12438389
Infect Immun. 2002 May;70(5):2725-9
11953420
Infect Control Hosp Epidemiol. 2005 Jun;26(6):540-7
16018429
Infect Immun. 1995 Jul;63(7):2403-8
7790050
Infect Immun. 2001 Nov;69(11):7162-4
11598094
Trends Microbiol. 2002 Nov;10(11):508-14
12419615
Genes Immun. 2005 Dec;6(8):672-82
16079897
Br J Haematol. 2005 Jun;129(5):569-82
15916679
Folia Microbiol (Praha). 2005;50(5):409-13
16475500
Infect Immun. 1996 Sep;64(9):3793-9
8751931
Folia Microbiol (Praha). 2002;47(2):179-81
12058398
Folia Microbiol (Praha). 2002;47(3):302-4
12094743
Clin Infect Dis. 2005 Nov 1;41(9):1232-9
16206095
J Infect Dis. 2001 Dec 1;184(11):1489-93
11709796
Infect Immun. 2000 Jul;68(7):3840-7
10858192
Folia Microbiol (Praha). 2005;50(3):263-7
16295666
Rev Assoc Med Bras (1992). 2003 Oct-Dec;49(4):434-8
14963598
Infect Immun. 1995 Jul;63(7):2714-9
7790089
Am J Reprod Immunol. 2001 Apr;45(4):200-4
11327546
J Clin Microbiol. 1993 May;31(5):1354-7
8501241
Chem Immunol. 1996;63:115-37
8934834
Pediatr Infect Dis J. 2001 Feb;20(2):197-206
11224843
J Infect Dis. 1992 Nov;166(5):1103-12
1402022
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2005 Dec;149(2):243-9
16601763
Med Mycol. 2000 Dec;38(6):419-31
11204879
Science. 1994 Aug 26;265(5176):1237-40
7520605
Curr Mol Med. 2005 Jun;5(4):443-52
15978000
Proc Natl Acad Sci U S A. 1994 Jul 5;91(14):6688-92
8022835
Infect Immun. 2002 Sep;70(9):4791-7
12183521
Folia Microbiol (Praha). 2002;47(2):182-4
12058399
Infect Immun. 1998 Dec;66(12):5771-6
9826353
Infect Immun. 2002 Oct;70(10):5790-9
12228309
Clin Infect Dis. 2003 Sep 1;37(5):634-43
12942393
Infect Immun. 1997 Aug;65(8):3399-405
9234804
Trends Immunol. 2004 Mar;25(3):150-7
15036043
Mycopathologia. 1986 Nov;96(2):103-7
3796712
Curr Mol Med. 2005 Jun;5(4):403-11
15977996
Infect Immun. 2001 Aug;69(8):5072-9
11447188
Curr Opin Infect Dis. 2005 Apr;18(2):107-11
15735412
Oral Dis. 2002;8 Suppl 2:69-75
12164664
J Cell Sci. 1999 Oct;112 ( Pt 19):3237-48
10504329
New Microbiol. 2005 Oct;28(4):299-309
16386014
Folia Microbiol (Praha). 1999;44(5):561-6
10997137
Nat Biotechnol. 2000 Oct;18(10):1060-4
11017043
J Exp Med. 1996 Apr 1;183(4):1345-55
8666893
Infect Immun. 2002 Feb;70(2):724-31
11796605
Clin Microbiol Rev. 1997 Oct;10(4):585-96
9336663
J Immunol. 2000 Nov 1;165(9):5077-83
11046038
Vaccine. 2004 Feb 17;22(7):865-71
15040939
J Immunol. 1994 Apr 1;152(7):3514-21
7908304
Curr Mol Med. 2002 Sep;2(6):507-24
12243244
Clin Infect Dis. 2006 May 15;42(10):1404-13
16619152
J Exp Med. 2005 Sep 5;202(5):597-606
16147975