THE SECRETION OF ASPARTYL PROTEINASE, A VIRULENCE ENZYME, BY ISOLATES OF CANDIDA-ALBICANS FROM THE ORAL CAVITY OF HIV-INFECTED SUBJECTS

被引:33
作者
DEBERNARDIS, F
BOCCANERA, M
RAINALDI, L
GUERRA, CE
QUINTI, I
CASSONE, A
机构
[1] Laboratory of Bacteriology and Medical Mycology, Istituto Superiore di Sanità Viale Regina Elena, Roma
[2] Department of Clinical Immunology, University of Rome 'La Sapienza', Rome
关键词
PROTEINASE; CANDIDA; CANDIDIASIS; HIV; AIDS;
D O I
10.1007/BF00158569
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 [公共卫生与预防医学]; 120402 [社会医学与卫生事业管理];
摘要
Prevalence, serotype and in vitro secretion of aspartyl proteinase, a virulence enzyme, were studied in Candida isolates from the oral cavity of 337 HIV-infected subjects. Controls were 95 age-sex-matched HIV- (seronegative) subjects, belonging to either HIV-risk categories (47) or to the normal, general population (48). Fungi were isolated from 155 HIV+ subjects. C albicans was the most prevalent species (85.8% of all isolates). 94.6% of C albicans isolates were serotype A and all were agglutinated by a monoclonal antibody (AF1) directed against a major mannoprotein immunogen of the candidal cell wall, confirming previous results with C. albicans isolates from non-immunodeficient subjects. With regard to the stage of HIV infection, there were no statistically significant differences in the incidence of oral Candida carriage between asymptomatic (stage II) HIV+ and HIV- subjects, and between stage II and lymphadenopathic (stage III) individuals. Also, the low (3.8%) incidence of oral candidiasis in the subjects of the latter stage was insignificant with respect to stage II subjects. However, the incidence of C albicans in stage IV (AIDS) subjects (46.8%) was significantly higher than in all other subjects, and in almost all cases, fungal isolation was accompanied by oral thrush and lower CD4+ lymphocyte counts (< 400 x 10(6)/L). All isolates of C albicans were proteolytic in vitro, as assessed by scoring the proteinase activity on BSA agar and monitoring the secreted proteinase antigen by a highly sensitive (1 ng) and specific immunoenzymatic assay. However, by both methods, the isolates from subjects at stages III and IV of infection produced more secretory proteinase than the isolates from either HIV+ asymptomatic subjects or HIV- controls. The differences could not be attributed to particular culture media or source of Candida isolation (carriage versus active infection). Thus, the isolates of C albicans from advanced HIV infection are serologically similar but more proteolytic than the isolates from earlier stages of HIV infection or those from HIV-uninfected subjects. The apparently higher virulence of C albicans from AIDS subjects may represent a co-factor in determining and/or aggravating oral candidiasis in these patients.
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页码:362 / 367
页数:6
相关论文
共 19 条
[1]
Agatensi L., Franchi F., Mondello F., Bevilacqua R.L., Ceddia T., De Bernardis F., Cassone A., Vaginopathic and proteolytic Candida species in outpatients attending a gynaecology clinic, J. Clin. Pathol., 44, pp. 826-830, (1991)
[2]
Angiolella L., De Bernardis F., Bromuro C., Mondello F., Ceddia T., Cassone A., The effects of antimycotics on secretory acid proteinase of Candida albicans, J. Chemoter, 5, pp. 1-7, (1990)
[3]
Brawner D.L., Cutler J.E., Oral Candida albicans isolates from nonhospitalized normal carriers, immunocompetent hospitalized patients and immunocompromised patients with or without acquired immunodeficiency syndrome, J. Clin. Microbiol., 27, pp. 1335-1341, (1989)
[4]
Cantorna M.B., Balish E., Mucosal and systemic candidiasis in congenitally immunodeficient mice, Infect. Immun., 58, pp. 1093-1100, (1990)
[5]
Cassone A., De Bernardis F., Mondello F., Ceddia T., Agatensi L., Evidence for a correlation between proteinase secretion and vulvovaginal candidosis, J. Infect. Dis., 156, pp. 777-783, (1987)
[6]
Cassone A., Torosantucci A., Boccanera M., Pellegrini G., Palma C., Malavasi F., Production and characterization of a monoclonal antibody to a cell surface, glucomannoprotein constituent of Candida albicans and other pathogenic Candida species, J. Med. Microbiol., 27, pp. 233-238, (1988)
[7]
Cenci E., Romani L., Vecchiarelli A., Puccetti P., Bistoni F., Role of L3T4 lymphocytes in protective immunity to systemic Candida albicans infection in mice, Infect. Immun., 57, pp. 3581-3587, (1989)
[8]
De Bernardis A., Agatensi L., Ross I.K., Emerson G.W., Lorenzini R., Sullivan A., Cassone A., Evidence for a role for secreted aspartate proteinase of Candida albicans in vulvovaginal candidosis, J. Infect. Dis., 161, pp. 1276-1283, (1990)
[9]
Holmberg K., Meyer R.D., Fungal infections in patients with AIDS and AIDS-related complex, Scand. J. Infect. Dis., 18, pp. 179-185, (1986)
[10]
Klein R.S., Harris C.A., Butkus Small C., Moll B., Lesser M., Friedland G.H., Oral candidiasis in high risk patients as the initial manifestation of the acquired immunodefciency syndrome, N. Engl. J. Med., 311, pp. 354-357, (1984)