Features of local immunity in hematological patients with oropharyngeal candidiasis

Danilovа E.Y., Shabashova N.V., Frolova E.V., Uchevatkina A.E., Filippova L.V.

North-West State Medical University named after I.I. Mechnikov (Kashkin Research Institute of Medical Mycology), Saint Petersburg, Russia

Candida alb. is an opportunistic fungal pathogen that is a leading cause for oropharyngeal candidiasis in people with compromised local and acquired immunity systems. Mechanisms of immune interactions with fungi and immunopathogenesis of this complication have been intensively studied in patients, those infected with the human immunodeficiency virus. However, in the world literature there is not enough information about the immunological defense against fungi and the causes of oropharyngeal candidiasis in hematological patients. We studied the features of the synthesis of important soluble immune factors in oral fluid samples from hematological patients, depending on the presence or absence of oropharyngeal candidiasis. Before chemotherapy was increased local synthesis of TNF-α, IL17 and G-CSF in all patients, showed the early activation of protective inflammation. After the courses of treatment significantly have reduced the activity of the local synthesis of TNF-α, found tends to reduce the G-CSF and IL17 in all hematological patients. It was found, that in hematological patients with OFC reduced levels of MCP-1, IFNγ and there was no adequate response IL-17, because of the violation of the main types of antifungal protection in oral mucosa. Excess of β-defensin-2 and increase the levels of secretory leukocyte protease inhibitor, is likely to reflect the severity of the local manifestations of the inflammatory response, which facilitates invasion of fungi.