Abstract
Immunological defense mechanisms were studied in 3 patients with chronic mucocutaneous candidiasis of at least 9 years duration. None had systemic candidiasis or increased susceptibility to other infections.
Agglutination titers of standardized, suspensions of heat-killed Candida albicans were measured in concentrated parotid duct saliva samples. Two patients' samples contained no agglutinating antibodies and one had a titer of only 1:4, in spite of gross oral infection. In contrast, parotid fluid from 6 patients who had recovered from C. albicans oral infection had titers ranging from 1:16 to 1:400. Despite the absence of agglutinating antibodies to C. albicans, isohemagglutinins and sheep cell agglutinins were present, and a normal immunoglobulin pattern was found (IgA present in normal amounts, IgG and IgM not detected).
The patients' sera, however, contained levels of agglutinating antibody ranging from 1:64 to 1:256 and had normal amounts of immunoglobulins. These findings are consistent with the known lack of correlation between local and circulating antibody levels and further suggest a specific deficiency in local antibody response to Candida.
Furthermore, the chronically infected patients failed to demonstrate delayed hypersensitivity to 2,4-DNFB, Candida, OT, SKSD, mumps and Trichophy ton, whereas controls reacted to at least two of the antigens. Since IgA is the predominant salivary immunoglobulin, these patients may present another example of IgA deficiency in association with abnormalities of cellular immunity. Similar observations have been reported in ataxia-telangiectasia and thymectomized rodents. (SPR)
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Chilgren, R., Hong, R. & Quie, P. 68 Specific Local Antibody Defect in Chronic Mucocutaneous Candidiasis. Pediatr Res 1, 217–218 (1967). https://doi.org/10.1203/00006450-196705000-00075
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DOI: https://doi.org/10.1203/00006450-196705000-00075