Host defence against disseminated and invasive candida albicans infections.

Abstract

The yeast Candida albicans is the primary etiologic agent of disseminated and invasive candidiasis. The incidence of disseminated and invasive candidiasis has paralleled the use of modern medical procedures that adversely affect the immune system, and highlights the difficulty of treating disseminated and invasive candidiasis. Overcoming these difficulties requires an improved understanding of host - C. albicans interactions. The most important aspect of these interactions is the host defence system. The nature and extent of the impairment of the host resistance determines the pattern of candidiasis. A better understanding of the mechanisms responsible for the defence against disseminated and invasive Candida infection is needed, in order to develop strategies aimed to enforce the anticandidal actions of the immune system. In this thesis, studies on host defence against disseminated and invasive candidiasis (intra-abdominal Candida abscesses) are described. Central to these studies are the contribution of phagocytes and lymphocytes to host defence, the mechanisms through which endogenous pro-inflammatory cytokines exert their effects, and the influence of antifungal agents with or without immunomudolating substances such as granulocyte colony stimulating factor on host defence. The results of these studies aid in predicting the impact of the current immonotherapies and the development of future immunomodulating strategies.