DYSREGULATION OF THE POLYMORPHONUCLEAR LEUKOCYTE - CANDIDA SPP, INTERACTION IN HIV-POSITIVE PATIENTS

Objective: In HIV-infected patients there is an increased frequency of fungal infections. Dysregulation of the response of phagocytic cells to fungal pathogens may be involved. Design: Phagocytosis of Candida s pp., consecutive intracellular production of reactive oxygen species, and candicidal activity were analysed in polymorphonuclear leukocytes (PML) from HIV-1-infected patients, who were at stage C3 of the 1993 r evised Centers for Disease Control and Prevention classification syste m, by means of flow cytometry. Methods: Phagocytic ability was assesse d by measuring uptake of fluorescein isothiocyanate-labelled Candida a lbicans, C. krusei and C. glabrata. Reactive oxygen intermediate produ ction was estimated by the quantity of dihydrorhodamine-123 converted to rhodamine-123 intracellularly. The candicidal effect was assessed b y the propidium iodide uptake of killed yeast cells. Results: As compa red to PML of healthy, HIV-negative controls, PML of AIDS patients exh ibited an increased phagocytic activity and a similar ability to gener ate reactive oxygen products. In contrast, PML of AIDS patients displa yed a decreased candicidal activity (P<0.05 compared to controls). Con clusion: These results suggest that in patients with advanced HIV-1 in fection the impairment of non-oxidative killing mechanisms of phagocyt ic cells may contribute to the high incidence of fungal infections.