Peterson P K, Lee D, Suh H J, Devalon M, Nelson R D, Keane W F
Am J Kidney Dis. 1986 Feb;7(2):146-52. doi: 10.1016/s0272-6386(86)80136-6.
Candidal peritonitis is a tenacious infection in patients undergoing chronic peritoneal dialysis. Since little is known about host defenses of the human peritoneal cavity against fungi, we investigated the interaction of peritoneal macrophages (PM phi) from uninfected dialysis patients with Candida albicans blastospores. Chemiluminescence (CL) techniques were used to assess the respiratory burst activity of these cells, and candidacidal activity was evaluated with a fluorochrome microassay. In sharp contrast to peripheral blood polymorphonuclear leukocytes (PMNs) from healthy donors, which gave a brisk luminol-enhanced CL response to opsonized blastospores and killed 35% of cell-associated organisms, PM phi produced barely detectable luminol-enhanced CL and killed only 13% of intracellular Candida. These findings appeared to be associated with a decreased level of myeloperoxidase in PM phi. The mechanism of intracellular survival of C albicans also appeared to be related to relatively poor triggering of superoxide production during phagocytosis of viable blastospores. The CL response of PMNs to C albicans was opsonin-dependent, and peritoneal dialysis effluent was devoid of opsonic activity. These studies suggest that local cellular and humoral mechanisms of defense are inadequate for protection of peritoneal dialysis patients against candidal peritonitis.
念珠菌性腹膜炎是慢性腹膜透析患者中一种顽固的感染。由于对人类腹膜腔针对真菌的宿主防御了解甚少，我们研究了未感染透析患者的腹膜巨噬细胞（PM phi）与白色念珠菌芽生孢子之间的相互作用。采用化学发光（CL）技术评估这些细胞的呼吸爆发活性，并用荧光染料微量分析法评估杀念珠菌活性。与健康供体的外周血多形核白细胞（PMN）形成鲜明对比，健康供体的PMN对调理后的芽生孢子产生强烈的鲁米诺增强CL反应，并杀死35%的细胞相关生物体，而PM phi产生的鲁米诺增强CL几乎检测不到，仅杀死13%的细胞内念珠菌。这些发现似乎与PM phi中髓过氧化物酶水平降低有关。白色念珠菌细胞内存活的机制似乎也与吞噬活芽生孢子过程中超氧化物产生的触发相对较差有关。PMN对白色念珠菌的CL反应是调理素依赖性的，而腹膜透析流出液缺乏调理活性。这些研究表明，局部细胞和体液防御机制不足以保护腹膜透析患者免受念珠菌性腹膜炎的侵害。
