[Candida albicans: the relationship between morphotypes and in-vitro adhesivity to the oral mucosa cells of HIV-positive and AIDS patients. I]. / Candida albicans: relazione tra morfotipi e adesività in vitro a cellule della mucosa orale di pazienti HIV-positivi e con AIDS. Parte I.

BACKGROUND: The significant frequency of oropharyngeal candidiasis due to C. albicans in HIV-infected and AIDS patients and the undoubted differences in pathogenicity among strains, lead us to study whether a possible correlation exists between the phenotypic characteristics of the fungal strain and the blastospores adhesivity to the human buccal epithelial cells. METHODS: From 203 oro-pharyngeal swabs of HIV-infected patients, 133 C. albicans were identified among 159 yeast strains. Analytical strains delineation below the species level was made by the morphotyping method, assigning a morphotype code of three digits, each of which being expressive of one colonial fringe characteristic. To study the possible blastospores adhesivity differences, we have isolated 10 strains of C. albicans, chose according to the more significant colonial morphologies; they were mixed with oral epithelial cells obtained by scraping of 36 HIV-positive patients and 2 volunteer donors HIV-negative at the rate cells/blastospores of 1:20. Suspensions were filtered, fixed and examined by optical microscope (MO) for counting the number of blastospores adhering to 100 epithelial cells and the number of cells with adhering blastospores. RESULTS: The index obtained by comparing the two qualitative analysis was higher for these isolates producing a rough or very coarse lateral fringes. CONCLUSIONS: This finding suggests that these strains may possess the highest adhesive properties, in fact the index decreases progressively to reach lower values for the strain not producing fringe.

[Candida albicans morphotypes and in vitro adhesivity to cells of the human oral mucosa in HIV-positive and AIDS patients after exposure of blastospores to fluconazole. II]. / Morfotipi di Candida albicans e adesività in vitro a cellule della mucosa orale di pazienti HIV-positivi e con AIDS dopo esposizione delle blastospore al fluconazolo. Parte II.

BACKGROUND: Oro-pharyngeal candidosis is a frequently initial clinical manifestation of HIV infection and the adhesive properties of Candida spp. represent a very important pathogenicity factor. METHODS: In this study the adhesivity rate of Candida albicans to the oral epithelial cells of 33 HIV-positive patients and 12 healthy volunteers, have been assessed before and after the exposure of blastospores to inhibitory concentrations of fluconazole, in relation to 11 morphotypes obtained from 13 C. albicans strains. RESULTS: Results can be summarized as follows: 1) the number of blastospores adhering to the HIV-positive donor' cells is higher than that of blastospores adhering to the healthy donors' cells (rate is 2.7:1); 2) blastospores from strains producing rough or very coarse fringes show adhesive properties higher than those of strains with different morphology; 3) in the group of HIV-positive patients the adhesivity inhibition of blastospores from strains producing rough or very coarse fringes was higher (38.3%) than that of strains with different morphology (33.8%); 4) overall, adhesivity inhibition due to exposure to fluconazole is higher for epithelial cells from healthy donors. CONCLUSIONS: These results can suggest the validity of an antimycotic pretreatment of persons at risk of oro-pharyngeal candidiasis.