接受化疗的恶性肿瘤患者口腔念珠菌分离株的毒力研究

目的研究接受化疗的恶性肿瘤患者口腔念珠菌分离株的细胞外磷脂酶活性、分泌型酸性蛋白酶活性及溶血活性。方法采用含漱法收集258例恶性肿瘤患者的漱口液标本,运用念珠菌分离鉴定方法,了解接受化疗的恶性肿瘤患者口腔念珠菌的检出及分布情况;并将分离鉴定的念珠菌分别接种在蛋黄培养基、BSA-琼脂培养基及羊血琼脂培养基,检测这些口腔分离株的胞外磷脂酶活性、蛋白酶活性以及溶血活性。结果接受化疗的恶性肿瘤患者口腔念珠菌检出率为38.4%。99株分离鉴定的念珠菌中,白色念珠菌67株,近平滑念珠菌16株,热带念珠菌5株,克柔念珠菌5株,光滑念珠菌3株,葡萄牙念珠菌3株。在99株念珠菌中细胞外磷脂酶、分泌型酸性蛋白酶及溶血性,检出率分别为74.7%、87.9%、86.9%。这三种毒力因子在白色念珠菌中的检出率分别为92.5%、100%、98.5%,在非白色念珠菌中分别为37.5%、62.5%、62.5%,两者比较差异具有统计学意义(P<0.001)。在67株白色念珠菌分离株中,92.5%的菌株同时产生了蛋白酶和磷脂酶,且半数以上为蛋白酶高活力。在非白色念珠菌中,62.5%(10/16)的近平滑念珠菌检出磷脂酶、蛋白酶、溶血性,具有最高的检出率;而5株克柔念珠菌均未产生胞外磷脂酶、蛋白酶、溶血性。白色念珠菌与非白色念珠菌的毒力因子比较中,白色念珠菌的磷脂酶活性(PZ=0.74±0.12)、蛋白酶活性(PA=0.37±0.33)、溶血指数(HI=0.36±0.10)明显高于非白色念珠菌(PZ=0.92±0.13、PA=0.73±0.24、HI=0.65±0.29)(P<0.001)。结论细胞外磷脂酶、分泌型酸性蛋白酶、溶血性是白色念珠菌的重要毒力因子。在接受化疗的恶性肿瘤患者口腔念珠菌分离株中,白色念珠菌的致病性明显高于非白色念珠菌。     

白色念珠菌蛋白酶与其毒力关系的研究

目的 探讨白色念珠菌蛋白酶活动与其毒力关系。方法的采用牛奶平地检测５４株白色念珠菌蛋白酶的分泌能力,然后选择６侏菌分别经摇瓶培养测定其蛋白酶活力,并以静脉内注射方式感染小鼠进行毒力试验,以小鼠平均生存时间来评价菌株毒力。结果 ５４株白色念珠菌全部能分泌蛋白酶,检出率为１００％。动物试验表明蛋白酶活力愈高的菌株,相应小鼠平均生存时间愈短;蛋白酶活力与菌株毒力直接正相关（γ＝０．９３４,Ｐ＜０．０１）     

脱氧胆酸钠体外对白色念珠菌菌丝相胞外磷脂酶抑制作用研究

目的观察脱氧胆酸钠体外对致病株白色念珠菌菌丝相胞外磷脂酶的抑制作用。方法在37℃下,用蛋黄平板法培养并测量菌株产生沉淀圈的大小,用沉淀圈比值（PZ值）比较磷脂酶活力的变化。结果对照组与脱氧胆酸钠不同浓度组（依次为0.1%、0.2%、0.3%和0.4%）的PZ值分别为0.389±0.049、0.778±0.098、0.882±0.077、0.912±0.049和0.888±0.093;脱氧胆酸钠各浓度组与对照组比较差异均有非常显著性（P〈0.001）。脱氧胆酸钠不同浓度组间PZ值比较,0.1%和0.2%、0.1%和0.3%、0.1%和0.4%组间差异有显著性（P〈0.05）。结论脱氧胆酸钠体外对白色念珠菌菌丝相胞外磷脂酶具有抑制作用。     

白色念珠菌对人口腔黏膜上皮角质细胞凋亡和增殖的影响

目的:探索白色念珠菌对人口腔黏膜上皮角质细胞(KB细胞)凋亡和增殖的影响。方法:分别培养孢子型白色念珠菌和菌丝型白色念珠菌,取健康志愿者的颊粘膜制备KB细胞,分别加入孢子型白色念珠菌(孢子组)和菌丝型白色念珠菌(菌丝组),另外取单纯KB细胞作为对照组。对比分析各组细胞凋亡率及各个周期的细胞数,统计分析各组细胞增殖指数(PI)。结果:菌丝组凋亡率显著高于对照组及孢子组(P0.05);菌丝组在G0/G1期的细胞比例均显著低于对照组及孢子组(P0.05);菌丝组在S期和G2/M期的细胞比例均显著高于对照组及孢子组(P0.05);菌丝组的PI显著高于孢子组和对照组(P0.05)。结论:菌丝型白色念珠菌可诱导KB细胞凋亡率的上升及改变KB细胞周期变化,并引起KB细胞的PI升高,对于临床上治疗口腔念珠菌病具有重要的指导意义。     

呼吸道感染中白假丝酵母菌的致病性与细胞外水解酶关系

将84株呼吸道分离的白假丝酵母菌分为致病组和非致病组,采用卵黄培养基法检测细胞外磷脂酶的活力,用牛血清白蛋白琼脂培养基法检法分泌型天冬氨酸蛋白酶的活力,并用RT-PCR的方法检测这2种酶相关基因PLB1和SAP2的表达情况,分析其组间差别,结果表明致病组菌株的分泌型天冬氨酸蛋白酶的活力要高于非致病组(P=0.034<0.05),细胞外磷脂酶活力二组未见差别,致病组的PLB1和SAP2基因的表达均高于非致病组(P<0.05),PLB1和SAP2的表达存在着明显的正相关(r=0.776,P<0.01),提示分泌型天冬氨酸蛋白酶是呼吸道白假丝酵母菌重要的毒力因子,PLB1和SAP2的表达上调可能影响菌株的毒力,这2个基因的表达量有正相关的关系。     

主要病原念珠菌蛋白酶分泌水平的比较

目的了解不同病原念珠菌蛋白酶分泌情况,探讨蛋白酶活性与菌种致病力的关系.方法 采用牛血清白蛋白(BSA)琼脂平板检测7种(共286株)念珠菌酸性蛋白酶的分泌;将菌株分别经摇瓶液体培养测定胞外蛋白水解活力.结果7种念珠菌蛋白酶分泌水平的高低关系为白色念珠菌＞热带念珠菌＞近平滑念珠菌＞季也蒙念珠菌＞其他3种念珠菌,与菌种致病力强弱关系基本一致;白色念珠菌、热带念珠菌菌株平均产酶能力是光滑念珠菌、乳淋念珠菌的17.4～36.3倍.各种念珠菌产生的蛋白酶均属天冬氨酸蛋白酶类.结论蛋白酶与念珠菌致病性关系密切.     

白带中白色念珠菌致病性的研究

目的探讨女性生殖道分泌物(白带)中白色念珠菌的致病性,评价其在白带中分离的临床意义.方法对重庆医科大学第二临床学院2002年1月～2003年12月300株白带分离的白色念珠菌进行蛋白酶测定,并从蛋白酶活力高、中、低中分别选2株作血管内皮细胞毒力和粘附性测定.结果 300株白色念珠菌全部检出蛋白酶,其中蛋白酶活力高为249株,占83.0%;中等活力38株,占12.7%;低等活力13株,占4.3%.细胞毒力试验表明蛋白酶活力高,细胞毒性强,蛋白酶活力与毒力呈正相关(r=0.9946、P＜0.01);细胞粘附试验表明蛋白酶活力高,粘附能力强,蛋白酶活力与粘附呈正相关(r=0.9944、P＜0.01).结论蛋白酶是白色念珠菌重要的毒力因子,蛋白酶活力可直接反映其毒力,蛋白酶活力与其粘附直接相关.白带中白色念珠菌具有致病性,临床应对其引起的感染密切关注.     

临床常见致病念珠菌的毒力研究现状

目的 随着恶性肿瘤化疗等免疫抑制药物的应用,临床中发现念珠菌的发病率呈上升趋势,非白色念珠菌与白色念珠菌的比例有所增加,这与抗真菌药物的选择性压力有关.临床常见致病念珠菌中以白色念珠菌与热带念珠菌毒力最强,念珠菌的致病力不是由单一因素决定的,而是由一组因素决定,包括二相性转换、疏水性、粘附性、磷脂酶活性、天冬氨酸蛋白酶活性、溶血性等.念珠菌的毒力因子和致病机制非常复杂,对这些致病菌的致病性的了解,必将有助于对念珠菌感染的预防和治疗.     

婴儿双歧杆菌对花生过敏小鼠模型肠道Th2反应的调节

目的研究婴儿型双歧杆菌对花生过敏小鼠肠道Th2型反应的调节作用。方法通过应用花生蛋白诱导肠道的Th2型反应,建立食物过敏小鼠模型。过敏小鼠灌胃给予婴儿型双歧杆菌（ATCC菌或CGMCC0313-2）或不做处理。然后分离小鼠小肠黏膜CD4＋T细胞或DC,另取肠黏膜组织进行石蜡包埋甲苯胺蓝染色肥大细胞计数,HE染色进行嗜酸细胞和单个核细胞计数,流式细胞检测CD4＋T中Th2（CD4＋IL4＋T）细胞和Treg（CD4＋CD25＋Foxp3＋T）比例,另取CD4＋T进行CFSE标记,与DC共培养4d后流式细胞检测CD4＋T增殖反应,收集细胞培养液ELISA检测IL-4、IL-5和IL—13分泌水平。结果过敏组小鼠Th2型细胞数,CD4＋T细胞增殖反应,IL4、IL-5和IL-13水平,肠黏膜中肥大细胞、嗜酸性细胞和单个核细胞数均明显高于对照组（P〈0．01）,而Treg数目低于对照组（P〈0．01）,婴儿双歧杆菌干预后,婴儿双歧杆菌组Th2型细胞数,IL4、IL-5和IL-13水平,肠黏膜中肥大细胞、嗜酸性细胞和单个核细胞数均明显低于过敏组（P〈0．01）,而Treg数目高于过敏组（P〈0．01）。结论口服婴儿型双歧杆菌可以抑制花生过敏导致的肠道Th2型反应。     

近平滑念珠菌形态多样性及毒力因子的分泌活性研究

目的比较近平滑念珠菌不同临床分离株的菌落和细胞形态及其分泌型天冬氨酸蛋白酶(SAP)酶活性,阐明该病原真菌的形态多样性及毒力差异。方法分别用Lee’s Glc NAc、Lee’s glucose、Spider 3种培养基于37℃培养7株近平滑念珠菌临床分离株,观察各菌株的菌落及细胞形态;用牛血清白蛋白培养基(BSA)于30℃培养7株近平滑念珠菌,通过观察形成晕圈能力的强弱确定其毒力因子(SAP)的分泌活性。结果 7株近平滑念珠菌临床分离株在不同条件下菌落表型有较明显的不同,菌落有光滑型、皱褶型及火山口样型,且染色程度不同,各分离株细胞在形成酵母相或菌丝相的能力方面呈现出不同程度的差异;SAP酶活性观察实验中检测到各菌株水解晕圈大小从2.55 cm到1.55 cm各不相等。结论近平滑念珠菌临床分离株具有形态多样性,各菌株SAP酶活性明显不同,提示菌株间的毒力有明显差异。     

Extracellular proteinase and phospholipase activity of three genotypic strains of a human pathogenic yeast,Candida albicans

Strains of a human pathogenic yeast, Candida albicans, have (A) intronless, (B) intron-containing, and (C) a mixture of intron-containing and intronless 26S rRNA genes. To elucidate the significance of these three genotypes in pathogenesis, we measured two major virulence factors, extracellular proteinase and phospholipase activity, in 56 clinical isolates of C. albicans, and investigated the relationship between genotype and enzymatic activity. The genotype B strains had significantly higher proteinase and phospholipase activities than genotypes A or C. These results suggest that to understand the pathogenesis of C. albicans, the genotypes should be considered.     

Candida proteinases and candidosis

Infections caused by the opportunistic yeast pathogen, Candida albicans, are becoming increasingly important. Superficial Candida infections, particularly those of the mouth and vagina, are very common; for example, candidal vaginitis plaques millions of women worldwide, often proving refractory to treatment. Systemic candidosis is much rarer, but it is an important hazard of modern medical procedures such as transplant surgery, i.v. hyperalimentation, and immunosuppressive therapy. One significant virulence factor of C. albicans is its ability to secrete extracellular acid proteinase. This attribute is shared by C. tropicalis and C. parapsilosis, but not by other less pathogenic Candida species. The enzymes produced by these yeasts are all carboxyl proteinases capable of degrading secretory IgA, the major immunoglobulin of mucous membranes. Some have keratino- or collagenolytic activity. Two secretory proteinases of C. albicans have been purified and characterized; their properties are reviewed. Possible applications of this work to the treatment and diagnosis of candidosis are discussed.     

Correlation between virulence of Candida albicans mutants in mice and Galleria mellonella larvae

Candida albicans is a dimorphic human pathogen in which the yeast to hyphal switch may be an important factor in virulence in mammals. This pathogen has recently been shown to also kill insects such as the Greater Wax Moth Galleria mellonella when injected into the haemocoel of the insect larvae. We have investigated the effect of previously characterised C. albicans mutations that influence the yeast to hyphal transition on virulence in G. mellonella larvae. There is a good correlation between the virulence of these mutants in the insect host and the virulence measured through systemic infection of mice. Although the predominant cellular species detected in G. mellonella infections is the yeast form of C. albicans, mutations that influence the hyphal transition also reduce pathogenicity in the insect. The correlation with virulence measured in the mouse infection system suggests that Galleria may provide a convenient and inexpensive model for the in vivo screening of mutants of C. albicans.     

Proteinase production and pathogenicity of Candida albicans. II. Virulence for mice of C. albicans strains of different proteinase activity

We have studied the virulence for mice of Candida albicans strains with different proteinase activity in the culture. The mortality rates for mice infected with the type Ia strains, which secrete proteinase whose activity porsisted for a week in vitro, were higher than those infected with the type Ib strains, which secrete proteinase whose activity declined at 2 or 3 days in vitro and the type II proteinase-deficient strains. This was substantiated by the number of colony-forming units (CFU) recovered from kidneys of mice infected with C. albicans. In the kidney tissues of mice infected with the type Ia strains, extensive invasion by fungal cells and the secretion of proteinase were histologically demonstrated, while in those infected with the type Ib and II strains fungal cells were rarely found. However, the mice infected with the type Ib strain NUM 978 were an exception; the recovery of CFU from the kidney was high, but the animals survived longer. Histologically, Candida cells were not colonized but interspersed in the tissue. Type II strain NUM 584 was found to be moderately virulent when infected at a high dose. These observations indicate that the proteinase plays a role in type Ia strains but that other factors are involved in the type Ib or II strains for the establishment of pathogenicity of C. albicans.     

白假丝酵母菌耐药与抗氰呼吸的相关性研究

目的探讨白假丝酵母菌的耐药情况及其与抗氰呼吸的相关性。方法用真菌药敏测定试剂盒测定从临床分离出来的37株白假丝酵母菌的耐药性,并从中选出5株耐药菌和5株敏感菌进行抗氰呼吸的研究。结果白假丝酵母菌对益康唑的耐药率最高,达54.1%,耐药白假丝酵母菌的抗氰呼吸速率均值为(17.56±6.75)nmol/(min.A620),敏感白假丝酵母菌的抗氰呼吸速率均值为(7.99±5.80)nmol/(min.A620),耐药白假丝酵母菌的抗氰呼吸速率明显升高,且耐药菌株抗氰呼吸速率占总呼吸的比例明显高于敏感菌株(P0.05),差异具有显著性。结论兰州市区白假丝酵母菌对益康唑耐药性较高,且白假丝酵母菌的耐药与抗氰呼吸途径相关。     

Purification and characterization of secretory proteinase of Candida albicans.

Proteolytic activity of medically important yeasts was tested in both YCB-BSA agar and medium. All of 134 strains of Candida albicans, 13 of 18 strains of Candida tropicalis and 11 of 18 strains of Candida parapsilosis had this activity, while none of 52 Candida glabrata strains or of 11 Cryptococcus neoformans strains tested had proteolytic activity. Strains of C. albicans fell into five groups based on the level and time-course of in vitro proteinase productivity. Five strains randomly selected from each group were tested for pathogenicity in mice. The strain possessing the strongest pathogenicity was used to purify proteinase. The molecular weight of the proteinase was approximately 44,000 daltons and its isoelectric point was pH 4.2. Optimal pH of the proteinase was 3.2 and the enzyme was stable below pH 7.0 and lost its activity above pH 8.0 at 37 C in a 60-min incubation. The 23 amino acid sequence of the proteinase N-terminus was determined.     

复发性外阴阴道念珠菌病的致病菌种鉴定及药敏分析

目的：探究复发性外阴阴道念珠菌病致病菌的菌种分布及耐药情况,指导临床治疗。方法：收集210例念珠菌性外阴阴道炎患者阴道分泌物标本,其中复发性外阴阴道念珠菌病（RVVC）组76例,外阴阴道念珠菌病（VVC）组134例。运用科玛嘉显色培养基法进行菌种鉴定和药物敏感试验。结果：在210例病例中,RVVC组中白色念珠菌54株（71.05%）,光滑念珠菌15株（19.74%）,热带念珠菌4株（5.26%）,克柔念珠菌2株（2.63%）,近平滑念珠菌1株（1.32%）。非白色念珠菌中以光滑念珠菌为主,在RVVC组中的比例明显高于VVC组,有显著性差异（P〈0.05）。药敏试验显示,RVVC的念珠菌株中仅8株对7种药物全部敏感,23株敏感药物〈5种,其中1株仅对制霉菌素敏感;对药物的敏感率为制霉菌素（97.37%）〉克霉唑（60.52%）〉酮康唑（51.32%）〉伊曲康唑（36.84%）〉咪康唑（35.53%）〉氟康唑（23.68%）〉特比奈芬（10.53%）。结论：白色念珠菌仍是RVVC的主要致病菌,非白色念珠菌比例在RVVC组中显著高于VVC组,其中以光滑念珠菌为主。念珠菌对制霉菌素敏感率最高,对唑类药物耐药性有增加趋势。     

A yeast by any other name: Candida glabrata and its interaction with the host

Well-characterized traits important to Candida albicans virulence, such as hyphal formation or secreted proteinase activity, play no known role in Candida glabrata virulence. Likewise, some C. glabrata characteristics, such as chromatin-based regulation of the large telomeric family of lectins encoded by the EPA (epithelial adhesin) genes, have no precise parallels in C. albicans. However, similarities between the two species, for example in population structure, in the large numbers of (putative) adhesins that they encode, and in phenotypic plasticity conferred by phenotypic switching, suggest that they share general strategies in adaptation to an opportunistic lifestyle.