THE ROLE OF THE GASTROINTESTINAL-TRACT IN HEMATOGENOUS CANDIDIASIS - FROM THE LABORATORY TO THE BEDSIDE

The gastrointestinal (GI) tract is a frequent source of hematogenous c andidiasis in humans. Animal models of GI and hematogenous candidiasis have provided insights into the nature of candidal infection of host mucosal tissue, mechanisms of fungal dissemination to body organs, and features of host response to candidal infections, Biological systems such as these that simulate human candidiasis can be used for testing novel antifungal drugs, We have focused on two murine models of candid iasis with similarities to this fungal disease in humans. The first mo del simulates a commensal association of Candida albicans with the GI tract of immunocompetent hosts; it has permitted studies of innate and immune cell response to long-term (>60 days) infection of the esophag eal, gastric, and intestinal mucosa, The second model simulates candid al infection in granulocytopenic patients with invasive candidiasis th at originated from sites of colonization in the gut. Both models are w ell suited for investigating new approaches to prevention and treatmen t of hematogenous candidiasis, A review of the data on the role of GI candidiasis in hematogenous candidal infections is presented.