Ollert M W, Wende C, Görlich M, McMullan-Vogel C G, Borg-von Zepelin M, Vogel C W, Korting H C
Department of Dermatology, Ludwig-Maximilians-Universität München, Germany.
J Clin Microbiol. 1995 Oct;33(10):2543-9. doi: 10.1128/jcm.33.10.2543-2549.1995.
The increased prevalence and the severity of oropharyngeal candidiasis in human immunodeficiency virus (HIV)-positive patients are attributed exclusively to the virus-induced immune deficiency of the host. The present study was aimed at answering the question of whether Candida albicans secretory proteinase, a putative virulence factor of the opportunistic C. albicans yeast, has any potential influence on the clinical manifestation of oropharyngeal candidiasis in HIV-positive patients. We measured the secretory proteinase activities of clinical C. albicans isolates from the oropharynges of either HIV-positive individuals (n = 100) or a control group (n = 122). The mean secretory proteinase activity of C. albicans isolates from the HIV-positive group (4,255 +/- 2,372 U/liter) was significantly higher compared with that of isolates from the control group (2,324 +/- 1,487 U/liter) (P < 0.05). The higher level of secretory proteinase activity in the culture supernatants of individual C. albicans isolates correlated with the increased level of proteinase expression on the cell surface, as revealed by cytofluorometry, and with higher levels of secretion of the immunodetectable protein, as shown by Western blotting (immunoblotting). Proteinase activity within the population of C. albicans isolates from HIV-positive individuals was independent of the patient's clinical disease stage and the CD4+/CD8+ cell numbers. Furthermore, no correlation of the proteinase activities with the C. albicans serotype was found, although C. albicans serotype B was significantly more frequent in the HIV-positive group (40%) compared with that in the control group (12%). However, a positive correlation of proteinase activity to antifungal susceptibility was evident. The C. albicans isolates from the HIV-positive group that were characterized by higher levels of proteinase activity were also less susceptible to the widely used azole antifungal ketoconazole and fluconazole. Collectively, the present data are consistent with a concept of early preferential selection of a subpopulation of C. albicans in HIV-infected patients.
人类免疫缺陷病毒（HIV）阳性患者口咽念珠菌病的患病率和严重程度增加完全归因于病毒诱导的宿主免疫缺陷。本研究旨在回答白色念珠菌分泌蛋白酶（机会性白色念珠菌酵母的一种假定毒力因子）是否对HIV阳性患者口咽念珠菌病的临床表现有任何潜在影响这一问题。我们测量了来自HIV阳性个体（n = 100）或对照组（n = 122）口咽的临床白色念珠菌分离株的分泌蛋白酶活性。HIV阳性组白色念珠菌分离株的平均分泌蛋白酶活性（4,255 +/- 2,372 U/升）显著高于对照组分离株（2,324 +/- 1,487 U/升）（P < 0.05）。如细胞荧光测定法所示，单个白色念珠菌分离株培养上清液中较高水平的分泌蛋白酶活性与细胞表面蛋白酶表达水平的增加相关，如蛋白质印迹法（免疫印迹法）所示，也与免疫可检测蛋白的较高分泌水平相关。HIV阳性个体白色念珠菌分离株群体中的蛋白酶活性与患者的临床疾病阶段和CD4+/CD8+细胞数量无关。此外，尽管HIV阳性组中白色念珠菌B血清型（4０%）明显比对照组（12%）更常见，但未发现蛋白酶活性与白色念珠菌血清型之间存在相关性。然而，蛋白酶活性与抗真菌药敏性呈正相关。蛋白酶活性水平较高的HIV阳性组白色念珠菌分离株对广泛使用的唑类抗真菌药酮康唑和氟康唑也较不敏感。总体而言，目前的数据与HIV感染患者中早期优先选择白色念珠菌亚群的概念一致。
