SKIN SURFACE-LIPIDS INHIBIT ADHERENCE OF CANDIDA-ALBICANS TO STRATUM-CORNEUM

Background: Candida albicans (CA) infections represent a significant t hreat to the health of immunocompromised individuals. The initial step in the establishment of a CA infection is adherence of the organism t o an epithelial surface. Methods: An in vitro model for studies on adh erence of CA to keratinized surfaces has been developed and used to te st the hypothesis that specific lipids can modulate adherence of this organism. Porcine stratum corneum (SC) disks were incubated with candi dal suspensions, after which unattached cells were washed away. Adhere nt cells were stained and counted using light microscopy. Results: Att achment of three pathogenic CA isolates was significantly greater than attachment of commensal strains of either CA or Candida parapsilosis. Removal of lipid from the SC lead to a doubling of the number of adhe rent organisms, whereas additional skin lipid inhibited adherence. Squ alene, wax esters, cholesterol esters and triglycerides had no effect on adherence, but fatty acids, sterols and ceramides inhibited adheren ce significantly. Conclusions: Specific epithelial lipids can modulate adherence of CA to keratinized epithelial surfaces.