Skip to main content

Candida albicans: from commensal to pathogen

  • Chapter

Abstract

Candida albicans is a ubiquitous fungal organism that is part of the normal microflora of most, if not all, individuals. However, it is also an opportunistic pathogen and can quickly transform from a harmless inhabitant of mucocutaneous tissues to a highly pathogenic organism capable of killing its host under the appropriate conditions. Candida species are dimorphic organisms that can grow as a yeast or as a multi-nucleated hyphal form. Innate and acquired host defense mechanisms are responsible for keeping the organism in the commensal state. However, when the organism overwhelms these defenses or the defenses become deficient or lost, an infection will incur. Infections can be acute, chronic or recurrent and affect cutaneous or mucocutaneous tissues as well as systemic blood/organs. This chapter reviews the properties of C. albicans as a commensal organism and as a pathogen. The respective protective host defense mechanisms responsible for keeping the organism in the commensal state are included, together with immunological changes that occur, or are postulated to occur, to initiate an infectious condition. In some cases, current data are used to formulate hypotheses regarding the initiation of infection and potential immune-based therapies. Finally, the incidence and potentia mechanisms associated with candidiasis in the HIV patient are reviewed.

Keywords

  • Candida Albicans
  • Candida Species
  • Germ Tube
  • Mucosal Tissue
  • Vaginal Mucosa

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

This is a preview of subscription content, access via your institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • DOI: 10.1007/978-1-4757-3021-0_18
  • Chapter length: 36 pages
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
eBook
USD   269.00
Price excludes VAT (USA)
  • ISBN: 978-1-4757-3021-0
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
Softcover Book
USD   349.99
Price excludes VAT (USA)
Hardcover Book
USD   349.99
Price excludes VAT (USA)

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Balish, E., Vazquez-Torres, A., Jones-Carson, J. et al. (1996) Importance of 32microglobulin in murine resistance to mucosal and systemic candidiasis. Infection and Immunity, 64, 5092–5097.

    PubMed  CAS  Google Scholar 

  • Bart-Delabesse, E., Boiron, P., Carlotti, A. and Dupont, B. (1993) Candida albicans genotyping in studies with patients with AIDS developing resistance to fluconazole. Journal of Clinical Microbiology, 32, 2933–2937.

    Google Scholar 

  • Bendel, C. M., St Sauver, J., Carlson, S. and Hostetter, M. K. (1995) Epithelial adhesion in yeast species: correlation with surface expression of the integrin analog. Journal of Infectious Diseases, 171, 1660–1663.

    PubMed  CrossRef  CAS  Google Scholar 

  • Beno, D. W. A., Stover, A. G. and Mathews, H. L. (1995) Growth inhibition of Candida albicans hyphae by CDS+ lymphocytes. Journal of Immunology, 154, 5273–5281.

    CAS  Google Scholar 

  • Boom, W. H., Liebster, L., Abbas, A. K. and Titus, R. G. (1990) Patterns of cytokine secretion in murine leishmaniasis: correlation with disease progression or resolution. Infection and Immunity, 58, 3863–3870.

    PubMed  CAS  Google Scholar 

  • Cain, T. K. and Rank, R. G. (1995) Local Th1-like responses are induced by intravaginal infection of mice with the mouse pneumonitis biovar of Chlamydia trachomatis. Infection and Immunity, 63, 1784–1789.

    CAS  Google Scholar 

  • Cantorna, M. T. and Balish, E. (1990) mucosal and systemic candidiasis in congenitally immunodeficient mice. Infection and Immunity, 58, 1093–1100.

    Google Scholar 

  • Caroline, L., Taschdjian, C. L., Kozinn, P. J. and Schade, A. L. (1964) Reversal of serum fungistasis by addition of iron. Journal of Investigative Dermatology, 42, 415–419.

    PubMed  CAS  Google Scholar 

  • Carrow, E. W. and Domer, J. E. (1985) Immunoregulation in experimental murine candidiasis: specific suppression induced by Candida albicans cell wall glycoprotein. Infection and Immunity, 49, 172–181.

    PubMed  CAS  Google Scholar 

  • Casadevall, A. (1995) Antibody immunity and invasive fungal infections. Infection and Immunity, 63, 4211–4218.

    PubMed  CAS  Google Scholar 

  • Cassone, A., Boccanera, M., Adriani, D. A. et al. (1995) Rats clearing a vaginal infection by Candida albicans acquire specific, antibody-mediated resistance to vaginal infection. Infection and Immunity, 63, 2619–2624.

    PubMed  CAS  Google Scholar 

  • Cenci, E., Mencacci, A., Spaccapelo, R. et al. (1994) T helper cell type 1 (Th1)- and Th2-like responses are present in mice with gastric candidiasis but protective immunity is associated with Th1 development. Journal of Infectious Diseases, 171, 1279–1288.

    CrossRef  Google Scholar 

  • Chakir, J., Cote, L., Coulombe, C. and Deslauriers, N. (1994) Differential pattern of infection and immune response during experimental oral candidiasis in BALB/c and DBA/2 (H-2d) mice. Oral Microbiology and Immunology, 9, 88–94.

    PubMed  CrossRef  CAS  Google Scholar 

  • Clerici, M. and Shearer, G. M. (1993) A TH1–TH2 switch is a critical step in the etiology of HIV infection. Immunology Today, 14, 107–111.

    PubMed  CrossRef  CAS  Google Scholar 

  • Clerici, M., Lucey, D. R., Berzofsky, J. A. et al. (1993) Restoration of HIV-specific cell mediated immune responses by interleukin-12 in vitro. Science, 262, 17211724.

    Google Scholar 

  • Clift, R. A. (1984) Candidiasis in the transplant patient. American Journal of Medicine, 77 (Suppl. 4D), 34–38.

    PubMed  CAS  Google Scholar 

  • Cole, G. T. (1986) Preparation of microfungi for scanning electron microscopy, in Ultrastructure Techniques for Microorganisms, Plenum Press, New York.

    Google Scholar 

  • DeBernardis, F., Molinari, A., Boccanera, M. et al. (1994) Modulation of cell surface-associated mannoprotein antigen expression in experimental candidal vaginitis. Infection and Immunity 62, 509–519.

    CAS  Google Scholar 

  • De Bernardis, F., Chiani, P., Ciccozzi, M. et al. (1996) Elevated aspartic proteinase secretion and experimental pathogenicity of Candida albicans isolates from oral cavities of subjects infected with human immunodeficiency virus. Infection and Immunity, 64, 466–471.

    PubMed  Google Scholar 

  • Diamond, R. D., Krzesicki, R. and Wellington, J. (1978) Damage to pseudohyphal forms of Candida albicans by neutrophils in the absence of serum in vitro. Journal of Clinical Investigation, 61, 349–359.

    CrossRef  CAS  Google Scholar 

  • Djeu, J. Y. (1993) Modulators of immune response to fungi, in Fungal Infections and Immune Responses, (eds J. W. Murphy, H. Friedman and M. Bendinelli ), Plenum Press, New York, p. 521.

    Google Scholar 

  • Domer, J. E., Garner, R. E. and Befidi-Mengue, R. N. (1989) Mannan as an antigen in cell-mediated immunity (CMI) assays and as a modulator of mannan-specific CMI. Infection and Immunity, 57, 693–700.

    PubMed  CAS  Google Scholar 

  • Edwards, J. E. Jr, Gaither, T. A., O’Shea, J. J. et al. (1986) Expression of specific binding sites on Candida with functional and antigenic characteristics of human complement receptors. Journal of Immunology, 137, 3577–3583.

    CAS  Google Scholar 

  • Fidel P. L. Jr and Sobel, J. D. (1996) Immunopathogenesis of recurrent vulvovaginal candidiasis. Clinical Microbiology Reviews, 9, 335–348.

    PubMed  Google Scholar 

  • Fidel, P. L. Jr, Lynch, M. E. and Sobel, J. D. (1993) Candida-specific Th1-type responsiveness in mice with experimental vaginal candidiasis. Infection and Immunity, 61, 4202–4207.

    PubMed  Google Scholar 

  • Fidel, P. L. Jr, Lynch, M. E. and Sobel, J. D. (1994) Effects of preinduced Candida-specific systemic cell-mediated immunity on experimental vaginal candidiasis. Infection and Immunity, 62, 1032–1038.

    PubMed  Google Scholar 

  • Fidel, P. L. Jr, Wolf, N. A. and KuKuruga, M. A. (1996) T lymphocytes in the murine vaginal mucosa are phenotypically distinct from those in the periphery. Infection and Immunity, 64, 3793–3799.

    PubMed  CAS  Google Scholar 

  • Fidel, P. L., Lynch, M. E., Redondo-Lopez, V. et al. (1993) Systemic cell-mediated immune reactivity in women with recurrent vulvovaginal candidiasis (RVVC). Journal of Infectious Diseases, 168, 1458–1465.

    PubMed  CrossRef  Google Scholar 

  • Fidel, P. L. Jr, Lynch, M. E., Conaway, D. H. et al. (1995) Mice immunized by primary vaginal C. albicans infection develop acquired vaginal mucosal immunity. Infection and Immunity, 63, 547–553.

    PubMed  CAS  Google Scholar 

  • Fidel, P. L. Jr, Wolf, N. A., Cutright, J. L. et al. (1996) Candida-specific Th1/Th2 reactivity in HIV+ women. Paper given at the ASM Conference on Candida and Candidiasis: Biology, Pathogenesis, and Management (abstract).

    Google Scholar 

  • Fisher-Hoch, S. P. and Hutwagner, L. (1995) Opportunistic candidiasis: an epidemic of the 1980s. Clinical Infectious Diseases, 21, 897–904.

    PubMed  CrossRef  CAS  Google Scholar 

  • Gamer, R. E. and Domer, J. E. (1994) Lack of effect of Candida albicans mannan on development of protective immune responses in experimental murine candidiasis. Infection and Immunity, 62, 738–741.

    Google Scholar 

  • Garner, R. E., Childress, A. M., Human, L. G. and Domer, J. E. (1990) Characterization of Candida albicans mannan-induced, mannan-specific delayed hypersensitivity suppressor cells. Infection and Immunity, 58, 2613–2620.

    PubMed  CAS  Google Scholar 

  • Giger, D. K., Domer, J. E., Moser, S. A. and McQuitty, J. T. Jr (1978) Experimental murine candidiasis: pathological and immune responses in T-lymphocytedepleted mice. Infection and Immunity, 21, 729–737.

    PubMed  CAS  Google Scholar 

  • Han, Y. and Cutler, J. E. (1995) Antibody response that protects against disseminated candidiasis. Infection and Immunity, 63, 2714–2719.

    PubMed  CAS  Google Scholar 

  • Hasenclever, H. F., Mitchell, W. O. and Loewe, J. (1961) Antigenic studies of Candida. II. Antigenic relation of Candida albicans Group A and Group B to Candida stellatoidea and Candida tropicalis. Journal of Bacteriology, 82, 570–573.

    CAS  Google Scholar 

  • Heidenreich, F. and Dierich, M. P. (1985) Candida albicans and Candida stellatoidea, in contrast to other Candida species, bind iC3b and C3d but not C3b. Infection and Immunity, 50, 598–600.

    PubMed  CAS  Google Scholar 

  • Kirkpatrick, C. H., Rich, R. R. and Bennett, J. E. (1971) Chronic mucocutaneous candidiasis: model building in cellular immunity. Annals of Internal Medicine, 75, 955–978.

    Google Scholar 

  • Kozel, T. R., Brown, R. R. and Pfrommer, G. S. T. (1987) Activation and binding of C3 by Candida albicans. Infection and Immunity, 55, 1890–1894.

    CAS  Google Scholar 

  • Kreger-van Rij, N. J. W. (1984) A taxonomic study, in The Yeasts, Elsevier Science Publishers, Amsterdam, p. 584.

    Google Scholar 

  • Kwon-Chung, K. J. and Bennett, J. E. (1992) Candidiasis, in Medical Mycology, (ed. C. Cann ), Lea & Febiger, Philadelphia, PA, p. 280.

    Google Scholar 

  • LaForce, F. M., Mills, D. M., Iverson, K. et al. (1975) Inhibition of leukocyte candidacidal activity by serum from patients with disseminated candidiasis. Journal of Laboratory and Clinical Medicine, 86, 657–666.

    PubMed  CAS  Google Scholar 

  • Lamster, I. B., Begg, M. D., Mitchell-Lewis, D. et al. (1994) Oral manifestations of HIV infection in homosexual men and intravenous drug users. Oral Surgery, Oral Medicine, and Oral Pathology, 78, 163–174.

    CrossRef  CAS  Google Scholar 

  • Lehner, T. (1997) Serum fluorescent antibody and immunoglobulin estimations in candidosis. Journal of Medical Microbiology, 3, 475–481.

    CrossRef  Google Scholar 

  • Lehrer, R. I. and Cline, M. J. (1969) Interaction of Candida albicans with human leukocytes and serum. Journal of Bacteriology, 98, 996–1004.

    PubMed  CAS  Google Scholar 

  • Liljemark, W. F. and Gibbons, R. J. (1973) Suppression of Candida albicans by human oral streptococci in gnotobiotic mice. Infection and Immunity 8, 846–849.

    PubMed  CAS  Google Scholar 

  • Maggi, E., Mazzetti, M., Ravina, A. (1994) Ability of HIV to promote a Th1 to The shift and to replicate preferentially in Th2 and Th0 cells. Science, 265, 244–248.

    PubMed  CrossRef  CAS  Google Scholar 

  • Mathur, S., Virella, G., Koistinen, J. et al. (1977) Humoral immunity in vaginal candidiasis. Infection and Immunity, 15, 287–294.

    PubMed  CAS  Google Scholar 

  • Matthews, R. C., Burnie, J. P. and Tabaqchali, S. (1984) Immunoblot analysis of the serological response in systemic candidosis. Lancet, ii, 1415–1418.

    Google Scholar 

  • Matthews, R., Burnie, J., Smith, D. et al. (1988) Candida and AIDS: evidence for protective antibody. Lancet,ii, 263–265.

    Google Scholar 

  • Matthews, R. C., Burnie, J. P., Howat, D. et al. (1995) Preliminary assessment of a human recombinant antibody fragment to hsp90 in murine invasive candidiasis. Journal of Infectious Diseases, 171, 1668–1771.

    PubMed  CrossRef  CAS  Google Scholar 

  • Mosman, T. R. and Coffman, R. L. (1989) Th1 and Th2 cells: different patterns of lymphokine secretion lead to different functional properties. Annual Reviews of Immunology, 7, 145–173.

    CrossRef  Google Scholar 

  • Mourad, S. and Friedman, L. (1968) Passive immunization of mice against Candida albicans. Sabouraudia, 6, 103–105.

    CrossRef  CAS  Google Scholar 

  • Nandi, D. and Allison, J. P. (1991) Phenotypic analysis and gamma/delta-T cell receptor repertoire of murine T cells associated with the vaginal epithelium. Journal of Immunology, 147, 1773–1778.

    CAS  Google Scholar 

  • Odds, F. C. (1988) Chronic mucocutaneous candidiosis, in Candida and Candidosis, University Park Press, Baltimore, MD, p. 104.

    Google Scholar 

  • Polonelli, L., De Bernardis, F., Conti, S. et al. (1994) Idiotypic intravaginal vaccination to protect against candidal vaginitis by secretory, yeast killer toxin-like anti-idiotypic antibodies. Journal of Immunology, 152, 3175–3182.

    CAS  Google Scholar 

  • Quinti, I., Palma, C., Guerra, E. C. et al. (1991) Proliferative and cytotoxic responses to mannoproteins of Candida albicans by peripheral blood lymphocytes of HIV-infected subjects. Clinical and Experimental Immunology, 85, 1–8.

    Google Scholar 

  • Rhoads, J. L., Wright, D. C., Redfield, R. R. and Burke, D. S. (1987) Chronic vaginal candidiasis in women with human immunodeficiency virus infection. Journal of the American Medical Association, 257, 3105–3107.

    PubMed  CrossRef  CAS  Google Scholar 

  • Rogers, T. J. and Balish, E. (1980) Immunity to Candida albicans. Microbiological Reviews, 44, 660–682.

    CAS  Google Scholar 

  • Romagnani, S. and Maggi, E. (1994) Th1 versus Th2 responses in AIDS. Current Opinions in Immunology, 4, 616–622.

    CrossRef  Google Scholar 

  • Romani, L., Puccetti, P. and Bistoni, F. (1996) Biological role of Th cell subsets in candidiasis. Chemical Immunology, 63, 115–137.

    PubMed  CrossRef  CAS  Google Scholar 

  • Ross, I. K., DeBernardis, F., Emerson, G. W. et al. (1990) The secreted aspartate proteinase of Candida albicans: physiology of secretion and virulence of a proteinase-deficient mutant. Journal of General Microbiology, 136, 687–694.

    PubMed  CrossRef  CAS  Google Scholar 

  • Sobel, J. D. (1988) Pathogenesis and epidemiology of vulvovaginal candidiasis. Annals of the New York Academy of Science, 544, 547–557.

    CrossRef  CAS  Google Scholar 

  • Soll, D. R. (1992) High-frequency switching in Candida albicans. Clinical Microbiology Reviews, 5, 183–203.

    CAS  Google Scholar 

  • Soll, D. R., Galask, R., Schmid, J. et al. (1991) Genetic dissimilarity of commensal strains of Candida spp. carried in different anatomical locations of the same healthy women. Journal of Clinical Microbiology, 29, 1702–1710.

    PubMed  CAS  Google Scholar 

  • Sweet, S. P., Cookson, S. and Challacombe, S. J. (1995) Candida albicans isolates from HIV-infected and AIDS patients exhibit enhanced adherence to epithelial cells. Journal of Medical Microbiology, 43, 452–457.

    CAS  Google Scholar 

  • Tascini, C., Baldelli, F., Monari, C. et al. (1996) Inhibition of fungicidal activity of polymorphonuclear leukocytes from HIV-infected patients by interleukin (IL)-4 and IL-10. Acquired Immune Deficiency Syndrome, 10, 477–483.

    PubMed  CAS  Google Scholar 

  • Vazquez, J. A., Sobel, J. D., Demitriou, R. et al. (1994) Karyotyping of Candida albicans isolates obtained longitudinally in women with recurrent vulvovaginal candidiasis. Journal of Infectious Diseases, 170, 1566–1569.

    PubMed  CrossRef  CAS  Google Scholar 

  • Vecchiarelli, A., Monari, C., Baldelli, F. et al. (1995) Beneficial effect of recombinant human granulocyte colony-stimulating factor on fungicidal activity of polymorphonuclear leukocytes from patients with AIDS. Journal of Infectious Diseases, 171, 1448–1454.

    PubMed  CrossRef  CAS  Google Scholar 

  • Wagner, R. D., Vazquez-Torres, A., Jones-Carson, J. and Balish, E. (1996) B cell knockout mice are resistant to mucosal and systemic candidiasis of endogenous origin but susceptible to experimental systemic candidasis. Journal of Infectious Diseases, 174, 589–597.

    PubMed  CrossRef  CAS  Google Scholar 

  • White, M. H. (1996) Is vulvovaginal candidiasis an AIDS-related illness. Clinical Infectious Diseases, 22 (Suppl. 2), S124 - S127.

    PubMed  CrossRef  Google Scholar 

  • Witkin, S. S. (1991) Immunologic factors influencing susceptibility to recurrent candidal vaginitis. Clinical Obstetrics and Gynecology, 34, 662–668.

    PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and Permissions

Copyright information

© 1999 Springer Science+Business Media Dordrecht

About this chapter

Cite this chapter

Fidel, P.L. (1999). Candida albicans: from commensal to pathogen. In: Tannock, G.W. (eds) Medical Importance of the Normal Microflora. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-3021-0_18

Download citation

  • DOI: https://doi.org/10.1007/978-1-4757-3021-0_18

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4419-4730-7

  • Online ISBN: 978-1-4757-3021-0

  • eBook Packages: Springer Book Archive