IMMUNOLOGICAL ASPECTS OF ORAL CANDIDIASIS
IMMUNOLOGICAL ASPECTS OF ORAL CANDIDIASIS
复制标题
DOI：
10.1016/0030-4220(94)90148-1
复制
发表时间：
1994-08-01
影响因子：
--
通讯作者：
CHALLACOMBE, SJ
中科院分区：
文献类型：
--
作者：
CHALLACOMBE, SJ
由于不同类型的念珠菌感染、不同形式的念珠菌本身以及粘膜和全身免疫系统之间的相互关系，人类对念珠菌感染的免疫是复杂的。粘膜感染是目前为止最常见的念珠菌病，但也可能发生全身感染，每种感染的机制可能大不相同。在口腔中有四种主要类型的念珠菌病，菌丝和酵母形式的念珠菌可能存在共同和独特的抗原。体液免疫是由粘膜免疫系统的唾液抗体和粘膜中的血清抗体代表的。细胞介导的免疫可能在慢性增生性念珠菌病中发挥作用。唾液抗体已被证明可以抑制念珠菌粘附于口腔上皮细胞，并在动物模型中具有保护作用。针对47kD抗原的血清抗体已被证明与全身念珠菌病的保护和恢复有关，但很少有证据表明血清抗体在防止口腔感染方面的作用。在体外研究中，巨噬细胞和多形核白细胞都能杀死酵母菌并抑制菌丝形式的念珠菌，因为慢性增生性念珠菌病与上皮内多形核白细胞有关，这些细胞在体内可能起作用。唾液含有许多抗真菌蛋白，包括组他汀类和钙保护蛋白，它们可以与特定因子协同作用。这是可能的，细胞因素提供了主要形式的防御粘膜皮肤感染，而体液因素在预防念珠菌感染的传播发挥更大的作用。非特异性机制如巨噬细胞和多形核白细胞可能在这两种类型的感染中发挥支持作用。
Immunity to Candida infections in human beings is complex because of the different types of candidiasis, the different forms of Candida itself, and the interrelationships between the mucosal and systemic immune systems. Mucosal infection is by far the most common type of candidiasis, but systemic infection can also occur and the mechanisms for each may be quite different. In the oral cavity there are four main types of candidiasis, and hyphal and yeast forms of Candida may be present with both common and unique antigens. Humoral immunity is represented by salivary antibodies of the mucosal immune system and serum antibodies in the mucosa. Cell-mediated immunity may play a role particularly in chronic hyperplastic candidiasis. Salivary antibodies have been shown to inhibit adherence of Candida to buccal epithelial cells and to be protective in animal models. Serum antibodies against a 47kD antigen have been shown to correlate with protection and recovery from systemic candidiasis, but there is little evidence for a role of serum antibody in protection against infection of the oral cavity. In in vitro studies, both macrophages and polymorphonuclear leukocytes can kill yeast forms and inhibit hyphal forms of Candida and because chronic hyperplastic candidiasis is associated with intraepithelial polymorphonuclear leukocytes, these cells could be operative in vivo. Saliva contains a number of antifungal proteins including histatins and calprotectin that could act synergistically with specific factors. It is possible that cellular factors provide the main form of defense against mucocutaneous infection, whereas humoral factors play a larger role in the prevention of dissemination of Candida infections. Nonspecific mechanisms such as macrophage and polymorphonuclear leukocytes may play a supporting role in both types of infection.