title: Evaluation of the relationship between fungal infection, neutrophil leukocytes and macrophages in cervicovaginal smears: Light microscopic examination.
abstract: BACKGROUND
  Right after opportunistic fungi become pathogenic, they face immune system cells including macrophages and neutrophil leukocytes. Although the relationship between fungi and immune cells are being widely studied by using animal models and culture techniques, cervicovaginal smears have not been used to evaluate this interaction yet.
  
  
  OBJECTIVE
  The aim of this study was to investigate the interactions between fungal infection, macrophages and neutrophil leukocytes in cervicovaginal smear.
  
  
  METHODS
  Papanicolaou-stained cervicovaginal smears from 2307 women, aged between 18 and 73 years, were examined by light microscopy. Periodic acid-Schiff stain was also used to confirm the presence of fungal cell walls.
  
  
  RESULTS
  Fungal infections were detected in 239 of 2307 patients (10.4%), and these cases were taken as the study group. Cases without any infectious agents (n = 1800, 78%) were considered as the control group. When the study and control groups were statistically compared in view of macrophages and neutrophil leukocytes, a significant relationship between presence of fungal infection, macrophages and neutrophil leukocytes was detected (P < 0.05). Furthermore, macrophages and neutrophil leukocytes were found to work against the fungal infection together (P < 0.05). Additionally, when the relationship between the existence of yeast or filamentous forms and these immune cells were evaluated, a significant correlation was not found (P > 0.05).
  
  
  CONCLUSIONS
  Our findings indicate that macrophages and neutrophils may play a determining role in host defense against fungal infection together, but neither yeast nor filamentous forms affect the presence of neutrophil leukocytes and macrophages. As a result of this, both yeast and filamentous forms may have pathogenic effects.
authors.affiliation: Department of Biology, Faculty of Science, Hacettepe University, Beytepe, Ankara, Turkey.
authors.forename: Şayeste
authors.initials: Ş
authors.lastname: Demirezen
authors.affiliation: Department of Biology, Faculty of Science, Hacettepe University, Beytepe, Ankara, Turkey.
authors.forename: Hanife Güler
authors.initials: HG
authors.lastname: Dönmez
authors.affiliation: Department of Biology, Faculty of Science, Hacettepe University, Beytepe, Ankara, Turkey ; Department of Molecular Biology and Genetic, Necmettin Erbakan University, Konya, Turkey.
authors.forename: Merve
authors.initials: M
authors.lastname: Özcan
authors.affiliation: Department of Gynecology and Obstetrics, Faculty of Medicine, Hacettepe University, Sıhhiye, Ankara, Turkey.
authors.forename: Mehmet Sinan
authors.initials: MS
authors.lastname: Beksaç
keywords: Candida; cervicovaginal smear; fungal infection; innate immune system; macrophage; neutrophil