Experimental candidiasis in liver injury

In an attempt to evaluate effects of liver injury and roles of iron metabolism on systemic fungal infection, experimental systemicCandida infection was produced in mice with galactosamine-induced liver injury. Survival rate and extent of fungal lesion are compared between mice with liver injury (Group 1) and ones without liver injury (Group 2). Median survival was 7 and 18 days in Group 1 and 2 respectively after 21 days observation. Mortality rate of Group 1 was significantly higher (P=0.05) than that of Group 2. This difference was reflected to the extent of fungal lesions in that they were extensive and disseminated, involving the multiple organs in Group 1 but predominantly localized to the kidneys in Group 2. UIBC (unbound iron binding capacity) and TIBC (total iron binding capacity), i.e., serum transferrin as well as serum iron levels were significantly lower in Group 1 as compared with those in Group 2. These results indicate that hepatic injury promotesCandida infectionin vivo and suggest that increased susceptibility toCandida in the presence of liver injury is, at least partially, attributable to low UIBC and/or TIBC.     

Cytological changes in oral mucosa in denture stomatitis

The cytological patterns associated with the atrophic and hyperplastic forms of denture stomatitis (DS) were studied in 94 patients with DS and 33 controls. Forty percent of patients with DS and 30% of patients in the control group had a positive culture for Candida. When compared to the smears from the control group patients, the smears from patients with DS presented a higher amount of: i) cytological cellular material; ii) fungal cells; iii) cells of the intermediate and parabasal types; iv) cells of the intermediate type with a positive culture for Candida; and v) polymorphonuclear leukocytes, preferentially in association with a positive culture for Candida. Conversely, smears from the control group showed a higher percentage of cells of the superficial type than those of the patients with DS. Although no specific changes in the DS-affected mucosa have been observed by cytology, we consider that this is a useful, easy and inexpensive technique that gives important information about the inflamed mucosa it can be used in the treatment and control of these patients.     

Antifungal effect and action mechanism of antimicrobial peptide polybia‐CP

The incidence of life‐threatening invasive fungal infections increased significantly in recent years. However, the antifungal therapeutic options are very limited. Antimicrobial peptides are a class of potential lead chemical for the development of novel antifungal agents. Antimicrobial peptide polybia‐CP was purified from the venom of the social wasp Polybia paulista. In this study, we synthesized polybia‐CP and determined its antifungal effects against a series of Candidian species. Our results showed that polybia‐CP has potent antifungal activity and fungicidal activity against the tested fungal cells with a proposed membrane‐active action mode. In addition, polybia‐CP could induce the increase of cellular reactive oxygen species production, which would attribute to its antifungal activity. In conclusion, the present study suggests that polybia‐CP has potential as an antifungal agent or may offer a new strategy for antifungal therapeutic option. Copyright © 2015 European Peptide Society and John Wiley & Sons, Ltd.     

Enfermedades invasoras por hongos levaduriformes en pacientes neutropénicos

Invasive fungal diseases caused by yeasts still play an important role in the morbidity and mortality in neutropenic patients with haematological malignancies. Although the overall incidence of invasive candidiasis has decreased due to widespread use of antifungal prophylaxis, the incidence of non-Candida albicans Candida species is increasing compared with that of C. albicans, and mortality of invasive candidiasis continues to be high. In addition, there has been an increase in invasive infections caused by an array of uncommon yeasts, including species of the genus Malassezia, Rhodotorula, Trichosporon and Saprochaete, characterised by their resistance to echinocandins and poor prognosis.     

Enfermedades invasoras por hongos levaduriformes en el receptor de un trasplante de órgano sólido

Invasive yeast diseases are uncommon nowadays in solid organ transplant recipients. Invasive candidiasis (2%) usually presents during the first month after transplantation in patients with risk factors. Both common and transplant-specific risk factors have been identified, allowing very efficacious targeted prophylaxis strategies. The most common clinical presentations are fungaemia and local infections near the transplantation area. Cryptococcosis is usually a late infection. Its incidence remains stable and the specific risk factors have not been identified. When cryptococcosis is detected very early, transmission with the allograft should be considered. The most common clinical presentations include meningitis, pneumonia, and disseminated infection. Intracranial hypertension and immune reconstitution syndrome have to be considered.No therapeutic clinical trials have been conducted in solid organ transplant recipients, thus treatment recommendations are derived from data obtained from the general population. It is particularly important to consider the possibility of drug-drug interactions, mainly between azoles and calcineurin inhibitors. Both invasive candidiasis and cryptococcosis increase the mortality significantly in solid organ transplant recipients.     

Diagnostic potential of IgA coated Candida cells in mucous membrane candidiasis

The significance of in vivo IgA coated yeast cells for the diagnosis of candidiasis of the oral and vaginal mucosal membranes was evaluated by direct immunofluorescence in 70 patients with or without clinical symptoms, shown to be positive for yeast growth in the cultural test. Most of the patients with clinically suspected candidiasis of the mucosal membranes gave positive results by serologic assays in contrast to the majority of symptomless patients. The diagnostic approach proved to be essentially consistent with the clinical signs, persistance of infection, response to antifungal therapy and quantitative cultural data.     

Intestinal candidiasis. A clinical report and comments about this opportunistic pathology

An eight-years-old girl, who presented with recurrent upper respiratory tract infections, was treated with broad-spectrum antibiotics. Afterward she presented with intestinal candidiasis. The isolated species was identified as Candida albicans by differential tests. Treatment given was with 500,000 IU of oral nystatin every 8 hours for 10 days and intestinal normal microbiota restoratives. Evolution has been satisfactory, although concomitantly type A hepatitis developed. Rest and a soft diet were recommended. The child is now perfectly healthy with normal liver function tests. Conclusion: Prolonged treatments with broad-spectrum antibiotics destroyed the indigenous intestinal microbiota, which provoked intestinal C. Albicans proliferation and adversely affected the immunological system of the patient, thus facilitating the establishment of a viral infection.This revised version was published online in October 2005 with corrections to the Cover Date.     

Comparison of therapeutic effect of aqueous extract of garlic and nystatin mouthwash in denture stomatitis

doi: 10.1111/j.1741‐2358.2011.00544.x Comparison of therapeutic effect of aqueous extract of garlic and nystatin mouthwash in denture stomatitis Introduction: Denture stomatitis (DS) is the most common form of chronic oral candidiasis. The standard treatment for DS is nystatin, which is accompanied with complications such as a bitter taste. The aim of this study was to compare the effect of garlic with nystatin in DS. Material and Methods: This randomised clinical trial study was performed on 40 patients with DS. After obtaining written consent, patients were divided into two groups while members of each group were given either nystatin or garlic extract for 4 weeks. The length and width of erythema area was measured at the end of the first, second, third, and the fourth weeks using a calliper. Data were analysed by SPSS and statistical tests including variance analysis with anova repeated measures, chi‐square, and least square differences. Results: The changes in the length and width of erythema at different times according to the type of treatment were found to be significant while an accelerated recovery was demonstrated for nystatin (p < 0.001). Both regimens resulted in significant recovery (p < 0.0001). Greater satisfaction with the use of garlic rather than nystatin was mentioned (p < 0.0001). Conclusion: Considering the efficacy of garlic and lack of side effects for this compound and also regarding the nystatin‐associated complications, garlic extract can be introduced as a substitution for standard treatment in DS.     

Evaluation of the usefulness of anti-glyceraldehyde-3-phosphate dehydrogenase antibodies as a treatment for invasive candidiasis in a murine model

We have evaluated the effect of antibodies against the Candida albicans glyceraldehyde-3-phosphate dehydrogenase (GAPDH) as a potential immunotherapeutic treatment for acute invasive candidiasis in a murine model of infection. Three different approaches were assayed: (i) active immunization of mice using recombinant His-tagged GAPDH, (ii) treatment of fungal yeast cells with anti-GAPDH antibodies prior to infection, and (iii) passive transfer of polyclonal anti-GAPDH antibodies. Results showed that all three approaches, although tending to show a slight beneficial effect in some instances, fail to have a relevant and statistically significant effect on the infection course, determined by survival curves and fungal burden in kidneys. This suggests that the cell wall-associated GAPDH of C. albicans, despite its potential role in virulence, does not appear to be a suitable target protein for the development of immunotherapeutic strategies against candidiasis, although further studies may be required to confirm this observation.