miercuri, 30 aprilie 2008

Candida Albicans

CANDIDA ALBICANS a dominant cause of allergy?

Ionel Dinu, Monica Esanu-Dinu, Zorica Langa, Maria Tcaciuc
Medical Center Halcis , Timisoara / Romania

ABSTRACT
In the last years, the theme of Candida albicans, a saprophyte fungus with pathogenic potential, appeared often in scientific studies.
Candida albicans can be found especially in the intestines due to its development as a saprophyte at 37°C (Drouhet) [1]. Under some circumstances, i.e. modern therapies, it can become pathogenic.
Following these facts and in order to create an objective image about the role that Candida plays in the appearance and maintenance of allergies, we chose a significant number of patients to be tested for allergies. The tests performed were intradermic tests and the immunoglobulins E and G4 were determined.

INTRODUCTION
The important role that infections play in the appearance of allergies was already shown in 1906 by Pirquet, who described the symptomatology and suggested a name for this disease. Further on, many scientific studies have dealt with the same theme: The allergy rises, develops and disappears along with the infection. (Bernard) [2]. Wolfrom [3] supports this theory, according to which infections cause allergies. Peumeri [4] believes that the infection does not represent an involvement, but a causal factor of bronchial asthma in children.
As far as the bacteria are concerned, Gillisenn [5] thinks that the endotoxines, the staphylococcic toxines and the streptolysine activate the mediators of bronchospasmus.
In the last years, the theme of Candida albicans, a saprophyte fungus with pathogenic potential, appeared often in scientific studies.
Candida albicans can be found especially in the intestines due to its development as a saprophyte at 37°C (Drouhet) [1]. Under some circumstances, i.e. modern therapies, it can become pathogenic.
According to Helga und R. Hauss [6], there are, in Germany only, 30-40 millions of patients infected with Candida albicans, 30% of whom don’t show any special symptoms, but eliminate Candida through the stool.
A study made by Meier [7] on 600 patients with asthma has shown that 30% of them showed a sensitivity to Candida. The authors are amazed over the sceptisism of allergists, who either don’t know the importance of Candida albicans, or minimize it.

Because of the duality of the fungus, saprophytic as well as pathogenic, the diseases provoked by Candida cannot be easily diagnosed. Positive cultures are not a criterion of the diagnose, but an indirect method for it.
Marthens-Berens [8] and Simon [9] noticed the important role that Candida plays in type I allergy; therefore, Subbi Mathur [10] and Longbottom [11] determined the specific immunoglobulins E .
Following these facts and in order to create an objective image about the role that Candida plays in the appearance and maintenance of allergies, we chose a significant number of patients to be tested for allergies. The tests performed were intradermic tests and the immunoglobulins E and G4 were determined.


MATERIAL AND METHOD
We studied 800 patients, aged between 7 and 60 years old, with different allergic skin and respiratory diseases. A smaller amount of cases with symptomatic Candida diseases was also examined (i.e. Stomatitis, Vaginitis, Eczema), those however showing no significant allergic symptoms.
We tested the patients intradermically with Candidine 0,5% and interpreted the results after 20 minutes.
The IgE und IgG4 were also determined for these patients and repeated after the administration of the sublingual vaccine Candida (Halcis laboratory, Timisoara/ Romania) every 60 days, for 1-2 years. The immunoglobulins were determined using the immunoenzymic method (Dexal Set).

RESULTS
717 of 800 allergic patients were sensitive to Candida albicans.

Table I.
* Sensitivity only to Candida albicans: 159
* Sensitivity to Candida albicans and environmental allergens: 558
Table II.
717 of 800 patients showed the following symptoms:
123 chronical urticaria (rash)
132 urticaria and angioedema
143 chronical rhinitis
98 bronchial asthma
141 bronchial asthma and rhinitis
50 pollinosis
26 candidosis
4 conjunctivitis
Table III.
Examples of the disease development after the sublingual vaccination, regularly after 60 days.
IgE normal 0,75AU. IgG4 20AU
S.P., 34 years: Bronchial Asthma
IgE
IgG4
7,7 AU
30,4 AU
6,4 AU
51,7 AU

5,8 AU
62,3 AU
5,0 AU
67,0 AU
4,2 AU
70,0 AU

S.V., 41 years: Angioedema
IgE
IgG4
10,9 AU
48,5 AU
8,3 AU
62,3 AU
7,8 AU
65,0 AU
7,2 AU
67,4 AU

M.R.,46 years: Bronchial Asthma
IgE
IgG4
11,2 AU
30,4 AU
10,8 AU
50,3 AU
8,3 AU
64,7 AU
8,0 AU
70,2 AU
7,6 AU
81,7 AU
7,5 AU
88,4 AU

These results prove clearly the important role that Candida albicans plays in a high percentage of cases.
The extant data about the biology of Candida albicans and its persistant presence in the human body as a saprophyte with great pathogenic potential, could explain its role in the allergy.
Inner factors like endocrinal diseases, immunodeficiency etc. must be treated because they all favor an infection with Candida.
External factors, like the modern therapies with antibiotics, cortison, or antiovulants also favor the infection with Candida.
The repeated determination of IgE and IgG4 after a sublingual vaccination eliminates the possibility of nonspecific positive tests.
The constant improvement of the patients status 60 days after the vaccination, when the IgE were still high, proves the protective role that the IgG4 antibody plays.
In the cases where the environmental factors interfere, the injection of two vaccines led to very good results. Surprisingly enough, we discovered that the injection of the Candida vaccine had also good results. However, we must observe further on the results at a greater number of patients.
In an early stage of the treatment of multiple-attacks asthmatics, we introduced an aerosol called EPUROX. This medicine contains superoxyddismutase and catalase. We already described the bronchodilatory and antiinflammatory effect of these two enzymes in 1989, at the National Symposium in Craiova, Romania.
More studies regarding a greater number of patients will give us more information about the influence of Candida albicans on allergies.
Until now, the results show that the development of the allergy undergoes two phases:
* The infection prepares the field, and sometimes it, per se, develops
a specific simptomatology
* The allergy caused by environmental allergens appeares
on the field that was prepared by the infection

CONCLUSION
The role that Candida albicans plays in the preparation of the allergic field can be proved by clinical tests, which should be repeated every 60 days.
The patients recovery after the vaccination proves the veracity of the statement, according to which Candida albicans per se or in combination with environmental allergens can determine the outbreak of allergies.

CONTENT
The study was made on 800 patients with different allergic symptoms, 712 patients showed a sensitivity for Candida albicans with immediate reaction.
The dermatological tests were completed with IgE and IgG4 tests. The sublingual treatment with Candidine had very good results already at the first control, 60 days after the beginning of the therapy. The patients were kept under clinical observation for 1-2 years and other tests were made. If the patient was sensitive to Candida albicans, but also to other allergens, a double treatment was made. Most of the patients with bronchial asthma were treated first with superoxyddismutase, showing very good results.

REFERENCES
1. Drouhet E. Biologie des Candida. Rappel mycrobiologiques et physiologiques. Rev. franc. D’allergie, 1976; 5, 233-237.
2. Bernard J. Introduction clinique et physiopatologique. Rev. Franc. D’allergie, 1967; 5: 285-289.
3. Wolfrom R, Vallery-Radot C. Essai de desensibilisation microbienne. Sem.Des Hop., 1964, 40, 307-308.
4. Paumery JJ. Asthme infantile: Allergie ou infection? Rev. franc. D’allergie, 1968; 3, 172.
5. Gilisen G, Susanne Pusztai Marcos. Möglichkeiten einer ätiologischen oder modulatorischen Bedeutung von microbiellen Infektionenbei allergischen von Soforttyp. Allerg., 1987; 10, 437- 446.
6. Hauss H, Hauss R. Hefen im Darm. Die heimliche Gefahr. Hauptmah.päd., 1994; 6, 56-57.
7. Maier A, Kien T, Orion B. La sensibilisation a Candida albicans dans l’asthme et les bronchopneumathies chroniques. Rev. franc. D’allergie, 1978; 1, 11-17.
8. Marthens BMP, Berens L. Activite immunologiques de Candida albicans. Rev. franc. D’allergie, 1976; 5, 233-237.
9. Simon MR, Tubergen D, Cassidy J, Silva JJR, Magilavy D. Chronic Mucocutaneaus Candidiasis Clinically Exacerbated by Type I Hipersensitivity. Clinical Immunology and Immunopathology, 14, 56-63.
10. Subbi Mathur, Gonst JM, Horger DE, Hugh H. Infection and Immun., 1977; Vol. 18, 1, 257-259.
11. Longbottom JL, Brigton WD, Edge G, Pepys J. Antibodies Mediating Type I Skin Test Reaction to Polysaccharide and Protein Antigen of Candida Albicans. Chim.Allerg., 1976; Bd.6, 41-49.

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