       Document 0333
 DOCN  M9610333
 TI    Pseudomembranous oral candidiasis in HIV infection: ultrastructural
       findings.
 DT    9601
 AU    Reichart PA; Philipsen HP; Schmidt-Westhausen A; Samaranayake LP;
       Abteilung fur Oralchirurgie und Zahnarztliche Rontgenologie,; Germany.
 SO    J Oral Pathol Med. 1995 Jul;24(6):276-81. Unique Identifier : AIDSLINE
       MED/96045018
 AB    A light and electron microscopic investigation of pseudomembranous
       candidiasis in HIV infection was undertaken as there is little data
       available on the ultrastructural features of the invasive phase of
       Candida in this disease. On examination of biopsy specimens of four
       patients, histopathology revealed the classic features of superficial
       candidiasis, including hyphal penetration down to the spinous cell
       layer, parakeratosis, acanthosis and spongiosis of the infected,
       superficial epithelium. However, in one case, hyphae traversed the
       entire epithelium and crossed the basal membrane, invading the adjacent
       connective tissue. Ultrastructural investigations revealed initial
       hyphal penetration through the intercellular spaces, possibly
       demonstrating thigmotropism. However, hyphal penetration was not solely
       confined to intercellular spaces, as some specimens demonstrated hyphal
       elements traversing both the cytoplasm and the nuclei of the spinous
       cells. In these areas of the epithelium appressoria-like appendages were
       often found at the hyphal tip. These phenomena, commonly described in
       plant fungi, have rarely been described in human material. Pools of
       desmosomes were seen in the vicinity of the hyphal pathways, implying
       that the penetration procedure is associated with detachment and
       congregation of desmosomes, possibly by enzymatic means. Interestingly,
       the host immune response to fungal invasion appeared to be minimal, as
       no immune-effector cells were seen closely associated with either the
       blastospores or the hyphae in any of the tissues examined. Whether the
       foregoing events are exaggerated by the abortive immune response seen in
       HIV-infected patients, or common in immunocompetent individuals during
       candidal invasion of epithelia, needs to be ascertained by further
       studies.
 DE    Adult  AIDS-Related Opportunistic Infections/IMMUNOLOGY/*PATHOLOGY
       Basement Membrane/MICROBIOLOGY/ULTRASTRUCTURE  Candida/ULTRASTRUCTURE
       Candidiasis, Oral/IMMUNOLOGY/*PATHOLOGY  Cell
       Nucleus/MICROBIOLOGY/ULTRASTRUCTURE  Connective
       Tissue/MICROBIOLOGY/ULTRASTRUCTURE
       Cytoplasm/MICROBIOLOGY/ULTRASTRUCTURE
       Desmosomes/MICROBIOLOGY/ULTRASTRUCTURE
       Epithelium/MICROBIOLOGY/ULTRASTRUCTURE  Human  Immunity, Cellular
       Intercellular Junctions/MICROBIOLOGY/ULTRASTRUCTURE
       Keratosis/MICROBIOLOGY/PATHOLOGY  Microscopy, Electron  Microscopy,
       Electron, Scanning  Mouth Mucosa/MICROBIOLOGY/ULTRASTRUCTURE  JOURNAL
       ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

