Candida, are seen on smears, but not on biopsy.
Healing is rapid and complete well before the
antibody response is detectable. This is the pattern
that might be considered the normal response in a
When, however, the initial response is one of rapid
and strong antibody formation without a detectable
response of the cellular immune system, thrushlike infection occurs, characterized histologically
by marked Depression of the normal influx of
inflammatory cells. The finding of hyphae
indicates a transition from the yeast to the mycelial
phase, typically seen with invasive candidiasis.
The infection is able to persist and spread despite
high antibody levels.
Only when the suppressive influence of
azathioprine is removed is the cellular immune
system able to mount an effective response. As
this becomes progressively stronger, the palatal
lesions begin to heal concomitantly with a
falling antibody titer.
These findings in general support the findings in humans with candidiasis in various
sites of the body. In the syndromes with the
most extensive yeast colonization (chronic
mucocutaneous candidiasis) we find the
association of high antibody levels with poor
cellular immune response, as measured in vitro
by the MIF and lymphocyte transformation
tests, and in vivo by the delayed skin test. (The
MIF test is the most consistently abnormal. In
certain instances a positive transformation test
or delayed skin test may be found despite the
absence of MIF production.)
In clinical conditions that are characterized
by intermittency, e.g., vaginitis, lower humoral
and higher cellular immunity is found. As long
as this immunologic pattern persists, the host
seems to be able to eradicate the infection.
When one of the factors favoring yeast growth
again exerts its influence, the cycle repeats
At such point that the colonization of the
tissues becomes sufficiently extensive to
produce a state of tolerance in the T-cell
response, the situation becomes analagous to
that in the azathioprine-treated monkeys. The
yeast transforms to the mycelial phase, and the
lesions become thrush-like. As the area of
colonization increases, so will the antigenic
load. In addition, antigens characteristic of the
mycelial phase increasingly exert their
influence on the immune response. Assuming
that as the condition progresses, cells still in the
yeast phase begin to rupture, then the large
number of soluble cytoplasmic antigens
heretofore shielded within the yeast membrane
enter the blood stream to further stimulate or
compromise the immune response of the host.
Thus is the immune system presented with
an antigenic load of great complexity that is
subject to wide fluctuation, both quantitatively
and qualitatively. Among the better known
factors that favor yeast growth .
If someone is interested, I can comment this fragment or discuss it here.
It is very important for those suffering chronic candidiasis.