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In a previous paper, we presented a basic study of an enzyme-linked immunosorbent assay with avidin-biotin system (A-B ELISA) for the detection of serum Candida antigen. In this report, the usefulness of A-B ELISA was evaluated in experimental systemic candidiasis of rabbits and patients with candidiasis.The serum Candida antigen was detected from the first day until death (7 days after inoculation) in a fetal rabbit. However, in non-fetal rabbits, the antigen was detected only on the early stage of infection.In clinical cases, the antigen was detected in 5 patients with candidiasis by the assay. They all were compromised hosts, neonates 2, acute lymphocytic leukemia 2 and one suspected of acute myelofibrosis.Blood samples from the 3 patients grew Candida. In one of them, the antigen had been detected while C. albicans was recovered from her blood. In another case, the antigen was detected persistently even after C. tropicalis disappeared from her blood due to a treatment with antifungal agents.Candida was not recovered from blood samples of the other two. However, we succeeded to detect the antigen from them. Judging from this result in addition to their clinical features and laboratory data, they were suspected of systemic candidiasis. When they were treated with antifungal agents, their clinical symptoms and laboratory findings were improved, and antigen disappeared.These results seem to suggest that A-B ELISA is useful for the early diagnosis of systemic candidiasis.
Most of our knowledge concerning the virulence determinants of pathogenic fungi comes from the infected host, mainly from animal models and more recently from in vitro studies with cell cultures. The fungi usually present intra- and/or extracellular host-parasite interfaces, with the parasitism phenomenon dependent on complementary surface molecules. Among living organisms, this has been characterized as a cohabitation event, where the fungus is able to recognize specific host tissues acting as an attractant, creating stable conditions for its survival. Several fungi pathogenic for humans and animals have evolved special strategies to deliver elements to their cellular targets that may be relevant to their pathogenicity. Most of these pathogens express surface factors that mediate binding to host cells either directly or indirectly, in the latter case binding to host adhesion components such as extracellular matrix (ECM) proteins, which act as 'interlinking' molecules. The entry of the pathogen into the host cell is initiated by fungal adherence to the cell surface, which generates an uptake signal that may induce its cytoplasmic internalization. Once this is accomplished, some fungi are able to alter the host cytoskeletal architecture, as manifested by a rearrangement of microtubule and microfilament proteins, and this can also induce epithelial host cells to become apoptotic. It is possible that fungal pathogens induce modulation of different host cell pathways in order to evade host defences and to foster their own proliferation. For a number of pathogens, the ability to bind ECM glycoproteins, the capability of internalization and the induction of apoptosis are considered important factors in virulence. Furthermore, specific recognition between fungal parasites and their host cell targets may be mediated by the interaction of carbohydrate-binding proteins, e.g., lectins on the surface of one type of cell, probably a parasite, that combine with complementary sugars on the surface of host-cell. These interactions supply precise models to study putative adhesins and receptor-containing molecules in the context of the fungus-host interface. The recognition of the host molecules by fungi such as Aspergillus fumigatus, Paracoccidioides brasiliensis and Histoplasma capsulatum, and their molecular mechanisms of adhesion and invasion, are reviewed in this paper.
Japanese society needs the comprehensive medical services on the basis of various medical information and their management network. We discuss feasible rules and regulations of Personal Health Data (PHD) management based on surveys concerning the situation among facilities, social consciousness, and through experimental study of a model community health care in Japan. Surveys were conducted in 1994 among citizens and medical specialists on their consciousness to data protection as they have to consider how they manage their facilities and whether to have certain rules or regulations. We also discuss points of view on definite data management based on privacy protection; for instance investigated experimental study of the community model health care system. During such a process, we propose the classifications of PHD to use them from two view points as follows;
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