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• W2083661857 abstract "No AccessJournal of UrologyClinical Urology: Original Articles1 Oct 1999IMMUNE RESPONSE IN PATIENTS WITH PERSISTENT CANDIDURIA AND OCCULT CANDIDEMIA GIRIDHAR TALLURI, VENKATA K. MARELLA, DJAMSHID SHIRAZIAN, and GILBERT J. WISE GIRIDHAR TALLURIGIRIDHAR TALLURI More articles by this author , VENKATA K. MARELLAVENKATA K. MARELLA More articles by this author , DJAMSHID SHIRAZIANDJAMSHID SHIRAZIAN More articles by this author , and GILBERT J. WISEGILBERT J. WISE More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)68288-2AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated the immunological response in patients with persistent candiduria with or without occult candidemia. Materials and Methods: Levels of Th1 (pro-inflammatory interleukin [IL]-1, IL-2 and tumor necrosis factor-α) and Th2 (anti-inflammatory IL-4 and IL-10) cytokines were measured in the sera of patients with persistent candiduria. Polymerase chain reaction assessment of the 158 base pair candidal actin gene was used to detect Candida albicans in blood to identify occult candidemia. Results: During a 14-month period 66 hospitalized patients with a mean age of 63 years (range 44 to 80) with persistent candiduria were evaluated. Occult candidemia developed in 27 patients (41%) as evidenced by detection of candidal actin gene in the sera by polymerase chain reaction. Risk factors included antibiotics in 27 patients (100%), central venous catheter in 22 (81%), urinary catheter in 21 (78%), total parenteral nutrition in 18 (66%), diabetes mellitus in 16 (59%) and abdominal surgery in 14 (52%). A total of 17 age matched patients with a mean age of 59 years hospitalized for elective general or vascular surgical procedures with no clinical or laboratory evidence of urinary or hematogenous fungal or bacterial infection served as controls. Serum levels of Th2 cytokines were elevated in 18 of 39 patients with persistent candiduria alone, and in 22 of 27 patients with candiduria and occult candidemia compared to controls (p < 0.002). Th1 cytokines were within normal limits or slightly decreased in all patients with persistent candiduria with or without candidemia. Conclusions: These observations indicate that an abnormal immune response develops in patients with persistent candiduria with or without candidemia. References 1 : Predominant pathogens in hospital infections. J. Antimicrob. Chemother.1992; 29: 19. Google Scholar 2 : National Nosocomial Infections Surveillance System: Secular trends in the epidemiology of nosocomial fungal infections in the United States, 1980-1990. J. 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Google Scholar 16 : Candidemia in a tertiary care hospital: epidemiology, risk factors, and predictors of mortality. Clin. Infect. Dis.1992; 15: 414. Google Scholar 17 : Role of cytokines and CD4 T cell subsets in the regulation of parasite immunity and disease. Immunol. Rev.1989; 112: 161. Google Scholar 18 : Proinflammatory cytokines and immunity. In: Fundamental Immunology, 3rd ed. Edited by . New York: Raven Press1993: 801. chapt. 21. Google Scholar 19 : Th1 and Th2 cells: different patterns of lymphokine secretion lead to different functional peptides. Ann. Rev. Immunol.1989; 7: 145. Google Scholar 20 : Interleukin-4 and -10 exacerbate candidiasis in mice. Eur. J. Immunol.1995; 25: 1559. Google Scholar 21 : Neutralizing antibody to IL-4 induces systemic protection and Th1 associated immunity in murine candidiasis. J. Exp. Med.1992; . Google Scholar 22 : Candida infection following severe trauma exacerbates Th2 cytokines and increases mortality. J. Surg. Res.1997; 699: 399. Google Scholar 23 : CD4 T-helper-cell responses in mice with low-level candida albicans infection. Infect. Immun.1996; 64: 4907. Google Scholar 24 : Neutralizing antibody to Interleukin-4 induces systemic protection and T helper type1-associated immunity in murine candidiasis. J. Exp. Med.1992; 176: 19. Google Scholar 25 : IL-4 & IL-10 inhibit nitric oxide dependent macrophage killing of Candida albicans. Eur. J. Immunol.1993; 23: 1034. Google Scholar From the Division of Urology, Division of Urological Research, Maimonides Medical Center, Brooklyn, New York© 1999 by American Urological Association, Inc.FiguresReferencesRelatedDetails Volume 162Issue 4October 1999Page: 1361-1364 Advertisement Copyright & Permissions© 1999 by American Urological Association, Inc.KeywordscytokinesCandidaMetricsAuthor Information GIRIDHAR TALLURI More articles by this author VENKATA K. MARELLA More articles by this author DJAMSHID SHIRAZIAN More articles by this author GILBERT J. WISE More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W2083661857 title "IMMUNE RESPONSE IN PATIENTS WITH PERSISTENT CANDIDURIA AND OCCULT CANDIDEMIA" @default.
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