[Frontiers in Bioscience 14, 4363-4375, January 1, 2009]

How the host fights against Candida infections

Malcolm Richardson1,2 , Riina Rautemaa1,2,3

1Department of Bacteriology & Immunology, University of Helsinki, Finland, 2Helsinki University Central Hospital Laboratory Diagnostics, Helsinki, Finland, 3Department of Oral and Maxillofacial Diseases, Surgical Hospital, Helsinki University Central Hospital, Helsinki, Finland

TABLE OF CONTENTS

1. Abstract
2. Introduction
2.1 .Virulence of Candida
2.2. Tissue interactions
2.3. Epithelial cell endocytosis
2.4. Endothelial cell invasion.
2.5. Spectrum of immune responses
3. Immunity in systemic candidosis
3.1. Toll-like receptor signaling
3.2. Cellular-dependent responses
3.3. Are specific antibodies important?
4. The role of dentritic cells at mucosal surfaces
5. Defensins and lipases in gastrointestinal C. albicans infection
6. Exogenous and endogenous factors for vaginal candidosis
7. C. albicans as a cause of oral inflammation
8. Resistance to Candida infections
9. Destructive immune responses in Candida infections
10. Perspective
11. Acknowledgements
12. References

1. ABSTRACT

Candida albicans is the predominant cause of both superficial and invasive forms of candidosis, although the proportion of serious infections attributed to other members of the genus is rising.. The spectrum of host defences include cell mediated immunity which is comprised of cytokine release by lymphocytes and activation of natural killer cells and lymphocytes by interleukins.. An increasing body of evidence supports a role for specific antibody in protection against invasive Candida infection. Clinical observations indicate that mucocutaneous Candida infections are commonly associated with defective cell-mediated immune responses. Innate immunity is the dominant protective mechanism against disseminated candidosis. Quantitative and qualitative abnormalities of neutrophils and monocytes are associated with systemic candidosis. In the present review virulence factors and the spectrum of immune responses are discussed in relation to the perspective for the development of appropriate vaccines against Candida. Here we present an overview of toll-like receptor signalling, cellular-dependent responses, the role of specific antibodies in protection against Candida, and the array of immune mechanisms that operate in gastrointestinal, vaginal and oral candidosis.