History and update on host defense against vaginal candidiasis

PL Fidel Jr - American journal of reproductive immunology, 2007 - Wiley Online Library
American journal of reproductive immunology, 2007Wiley Online Library
Vulvovaginal candidiasis (VVC), caused by Candida albicans, remains a significant problem
in women of childbearing age. While cell‐mediated immunity is considered the predominant
host defense mechanism against mucosal candidal infections, two decades of research from
animal models and clinical studies have revealed a lack of a protective role for adaptive
immunity against VVC caused by putative immunoregulatory mechanisms. Moreover,
natural protective mechanisms and factors associated with susceptibility to infection have …
Vulvovaginal candidiasis (VVC), caused by Candida albicans, remains a significant problem in women of childbearing age. While cell‐mediated immunity is considered the predominant host defense mechanism against mucosal candidal infections, two decades of research from animal models and clinical studies have revealed a lack of a protective role for adaptive immunity against VVC caused by putative immunoregulatory mechanisms. Moreover, natural protective mechanisms and factors associated with susceptibility to infection have remained elusive. That is until recently, when through a live challenge model in humans, it was revealed that protection against vaginitis coincides with a non‐inflammatory innate presence, whereas symptomatic infection correlates with a neutrophil infiltrate in the vaginal lumen and elevated fungal burden. Thus, instead of VVC being caused by a putative deficient adaptive immune response, it is now being considered that symptomatic vaginitis is caused by an aggressive innate response.
Wiley Online Library