Contributions of specific cellular or humoral immunity as well as to defense mechanisms against experimental C. albicans infection in mice were studied, using its highly virulent strain and also its less-virulent strain in comparison, and the following results were obtained.
1) Non-specific resistance of mice against infections with either of the two C. albicans strains was not affected by genetic controls.
2) Sublethal irradiation or cyclophosphamide administration enhanced the susceptibility of mice to infection with the highly virulent strain.
3) Immunization with living cells of the highly virulent strain markedly protected cyclophosphamide-treated mice against infection with the same microorganism. An intravenous injection of live cells of the less-virulent strain endowed the mice with protective immunity not only by the same strain but also the highly virulent strain.
Both cellular and humoral types of immunity to C. albicans were obviously demonstrated in mice after the immunization with the highly virulent strain. In contrast, when mice were immunized with less-virulent strain, only a transient increase of the population of B cells and plaque-forming cells in the spleen of the animals was detected while no DTH was demonstrated.
Although cellular immunity appeared to play an important role in protecting mice against C. albicans infection, other specific and non-specific defense mechanisms should also be considered as far as this type of fungal infections are concerned at least.

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Much attention has paied to cellular immunity in microbial infection. On mycotic infection, many clinical case reports suggest that the immunity would be due to cellular immunity in which the thymus dependent lymphocytes (T-cell) are principally involved and play a major role in protective immunity. In order to make clear the relationship between the mycotic infection and cellular immunity, we studied on the experimental candidiasis in immunosuppressive animals administering azathioprine, predonisolone or anti-lymphocyte serum (ALS). In such animals, the virulence of Candida albicans amplified, Macrophage Migration Inhibition Test (MIT) and Delayed Type Hypersensitivity (DTH) for Candida specific antigen showed a little response. The defects of these responses on sensitized lymphocyte cause much damage to the registance to infection.

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Effect of lymphokines on the defence mechanisms against Candida infection was studied in guinea pigs.
Guinea pigs sensitized with heat killed C. albicans in complete Freund adjuvant exhibited positive delayed type skin reaction. Their macrophage migration inhibition test (MIT) revealed both inhibition and stimulation of macrophage migration.
Lymphocytes of guinea pigs sensitized with viable C. albicans were cultured with solubilized Candida antigen, and their supernatants were named as lymphokines.
The lymphokines showed inhibition or stimulation in the MIT using peritoneal exudative cells from nonsensitized guinea pigs.
The lymphokines distinctly enhanced adherence of alveolar macrophages from a normal guinea pigs, but had no effect on their phagocytosis to C. albicans.
The lymphokines did not directly inhibit the growth of C. albicans.
Alveolar macrophages cultured in the presence of lymphokines had no effect on the growth of C. albicans.

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Specific and non-specific host defence mechanisms against Candida albicans infection, cell mediated immunity in particular, were investigated with mice. Susceptibility of mice to the infection with age was first studied. Transitory increase in resistance was observed with 4-week-old mice. The resistance to the infection was reinstated and maintained relatively constant after 5th week. Synthetic and cytotoxic antitumor agents which apparently impair immunocompetent cells suppressed host defence, while PICIBANIL, streptococcal immunopotentiator, enhanced the resistance. Congenitally athymic nude mice showed almost the same resistance as that of their heterozygotes with a heavy inoculum, and decreased resistance with a smaller inoculum. No significant difference in the function of macrophages from both mice was also noticed. Peritoneal macrophages obtained from the mice intraperitoneally immunized with living cells showed enhanced phagocytosis, but intracellular cell killing remained unchanged so far as viable counts are concerned. These experimental results indicated the important role of macrophage in fungal infection.

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The study of phagocytosis of Candida albicans and Cryptococcus neoformans by human, guinea pig and mouse peripheral blood leukocytes (PBL) and guinea pig and mouse peritoneal macrophages (PMP) in vitro has been performed to elucidate the role of phagocytosis in host defense mechanism against systemic mycoses. Although C. albicans was ingested by guinea pig and mouse PBL and PMP in the same rates in the presense of fresh serum, the killing rates of intracellular C. albicans in these phagocytes were not the same showing a high ability of guinea pig and a low of mouse phagocytes. The human PBL showed an intermediate killing ability between them. Moreover, intracellular killing abilities of guinea pig and mouse PMP were lower than those of PBL. The killing capacity of mouse PMP increased remarkably when the PMP had been cultured previousely with lymphokines for 3 days. The PBL and PMP ingested C. albicans almost completely in the presense of fresh serum alone, and no more enhancement of ingestion was shown when specific antibody was added to this system. The results of phagocytosis in vitro using EGTA and Mg⁺⁺ indicate that normal opsonin for C. albicans is factors of properdin system in fresh serum. Guinea pig PBL and PMP ingested encapsulated strain of C. neoformans more effectively than nonencapsulated strain, and specific antibody did not enhance ingestion of both strains of C. neoformans. It might been suggested that properdin system and PMP play an important role at the primary stage of Candida or Cryptococcal infections and that activated macrophages participate in the host defense mechanism after induction of sensitized lymphocytes.

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Chronic mucocutaneous candidiasis (CMCC) is a syndrome characterized by persistent or recurrent Candida infection involving mucous membranes, contiguous and distant skin areas, and nails; it is often associated with an endocrinopathy (endocrine-candidiasis syndrome). There are several forms of this syndrome. Whether these clinical variants and the presence or absence of endocrinopathy represent different forms of a single disease or separate entities is not yet known. Several immunologic defects have been described, but no consistent abnormality has been noted. The author has proposed the hypothesis “immune deviation theory” in the pathogenesis of CMCC.
The efficacy of restoration of cellular immunity in therapy of patients with certain chronic infectious or neoplastic diseases is under evaluation in several centers. Theoretically, a substance such as transfer factor (TF) is an ideal candidate for this therapy. TF, a dialyzable substance from blood leukocytes, selectively endows recipients with the cellular immune responses of the leukocyte donors. Moreover, it does not contain intact leukocytes and therefore does not sensitize the recipient to HL-A antigens and cannot induce graft-versus-host disease.
Twelve patients with CMCC were treated with TF from randomly selected donors in conjugation with administration of certain antifungal agents such as clotrimazole or amphotericin-B. Mucocutaneous symptoms and signs were predominant at the time that the TF injections were started. Six patients showed remarkable improvement both immunologically and clinically. Patients with CMCC in association with endocrinopathy are unlikely to respond clinically to TF administration although in vitro and/or in vivo changes in cell-mediated immunity may be observed. These results indicate that TF therapy may be beneficial in some cases with CMCC.

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A nine-year-old boy with tinea corporis was reported. He had an opportunity to contact with a cattle which had some heavily crusted lesions on the face. Thereafter he noticed annular erythematous plaques on the left thigh and the left leg. The lesions were accompanied with reddish papules, pustules and scales without central healing. Waxy, heaped, glabrous colonies were obtained from the scrapings of the skin lesions using brain heart infusion agar with thiamine HCl. Same colonies were also obtained from the infected cattle. Mycological studies led to the identification of Trichophyton verrucosum Bodin, 1902.
Histologic picture showed inflammatory infiltrations composed of lymphocytes, plasma cells and eosinophiles throughout the dermis. Microabscesses were also observed within the epidermis and the hair follicles. Fungal elements were demonstrated in these microabscesses. Local applications of clotrimazole cream led the skin lesions cleared up within two months.

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There are a few reports about the lipid metabolism of dermatophytes. In this communication, the qualitative and quantitative changes of lipid composition during the growth stages were studied principally with Epidermophyton floccosum. The acyl group composition of total lipids of Trichophyton rubrum and Microsporum cookei were also examined. The lipids of E. floccosum amounted to approximately 4% of the dry cell weight. Neutral lipids consisted of mainly triglycerides and sterols, and major polar lipids were phosphatidylcholine, phosphatidylethanolamine, and an unusual lipid “X” which has not been identified yet. The fatty acids found in triglycerides and phospholipids were palmitic, palmitoleic, stearic, oleic, linoleic acids. The unusual polar lipid “X” which appeared between phosphatidylethanolamine and cardiolipin on TLC plate was found to contain no phosphorus. The acyl group composition of this lipid “X” was markedly different from those of triglycerides, phosphatidylcholine and phosphatidylethanolamine.
There was no significant changes in the fatty acid composition of E. floccosum and T. rubrum during the cell growth, while M. cookei revealed its profound changes. The sterol composition of E. floccosum showed striking, qualitative as well as quantitative changes depending on the growth stage.

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A 76 days-old female baby was hospitalized to the Pediatric Clinic of the Tajimi Prefectual Hospital on January 31 in 1973, because of “Cerebral cry”, anemia, vomitting, diarrhea and fever. She was kept in incubator and treated with infusion of balanced salt solution and antibiotics.
Several days after removal of the splint for infusion, a crateriform ulcer covered with brownish black necrotic tissue and two erythematous nodules were noticed, close to the site of infusion on the left leg.
Microscopical examination of the ulcer revealed necrosis in the dermis and subcutis surrounded with leucocytic infiltrate, and in the necrotic tissue many large non-septate mycelial fragments were observed. The fungus isolated from the lesion was identified as Rhizopus oryzae.
The lesions were resected surgically followed by compress of Amphotericin B solution with satisfactory result. But, she accidentaly died of dyspnoe on March 18. Autopsy findings revealed no fungus infection in the internal organs.
Intravenous and intraperitoneal inoculation of the fungus to guinea pigs and rabbits revealed same kinds of necrotic lesions and fungus proliferations in the liver, kidney, small intestine and colon as the patients.

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A 42-year-old man had some erythematous, firmly indurated plaques which persisted for 4 months on the lower abdomen, loins and both thighs. These plaques were diagnosed as Weber Christian disease histologically in August, 1973.
His identical twin also had Weber Christian disease and was cured by corticosteroid injection.
After a second admission on April 27, 1974, the patient's disease was controlled with high doses of systemic steroid therapy. As a result of long term use of systemic steroids, disseminated intravascular coagulopathy (DIC), herpes zoster, compression fracture of the lumbar vertebra, pleuritis, diabetes mellitus, and diabetic cataract appeared during his hospital stay.
Since January, 1975, the patient has been suffering from a ringworm infection of Trichophyton rubrum on the buttocks, groin and both lower extremities. In July, 1975, he noticed a few furuncle-like erythematous nodules on the left leg and the dorsal side of the left ring finger.
The biopsy specimens were obtained from the skin lesions three times and the deeper portion of each specimen was cultured on Sabouraud's dextrose agar, which allowed only one type of fungus. It was identified Trichophyton rubrum.
The trichophytin test, tuberculin (PPD) and DNCB sensitizing test were negative respectively. Griseofulvin therapy was effective.
No case of Trichophyton rubrum granuloma associated with Weber Christian disease has yet been reported in the Japanese literature.

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Analysis was made in the correlation between vaginal fungi at the 10th month of pregnancy and various changes resulting from pregnancy. At the same time, the onset of vaginal mycosis was studied from the aspects of fungus type and the number of colonies formed on Mizuno-Takada medium, which resulted as in the followings. The identification of species of fungi was conducted by serological, biological and morphological methods.
Out of 272 cases of pregnant women to be subjects, 78 cases (28.7%) were vaginal fungus-positive, and mycosis was found in 14 cases (17.9%) out of vaginal fungus-positive cases.
The kinds of vaginal fungi were Candida albicans 74.4%, Torulopsis glabrata 21.8% and Candida krusei 3.8%.
The vaginal fungus-positive rate was 25.2% in primipara and 31.7% in multipara, which tended to be higher in multipara. But no singificant difference was observed.
The vaginal fungus-positive rate was 33.6% in gestosis-complicated group and 24.7% in non-complicated group, which tended to be higher in gestosis-complicated group.
Little or no difference between urine sugar & anemia of pregnancy and vaginal fungus-positive rate was found.
The incidence rate of mycosis with Candida albicans was 5.6% in case of not more than 50 colonies and 25% in case of not less than 51 colonies.

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