Data_Sheet_1_Differences in Ocular Complications Between Candida albicans and Non-albicans Candida Infection Analyzed by Epidemiology and a Mouse Ocular Candidiasis Model.docx

Objectives:Candida species are a major cause of hospital infections, including ocular candidiasis, but few studies have examined the propensities of specific species to invade the eye or the unique immunological responses induced. This study examined the frequency and characteristics of species-specific Candida eye infections by epidemiology and experiments using a mouse ocular candidiasis model.
Methods: We reviewed medical records of candidemia patients from January 2012 to March 2017. We also evaluated ocular fungal burden, inflammatory cytokine and chemokine profiles, and inflammatory cell profiles in mice infected with Candida albicans, Candida glabrata, or Candida parapsilosis.
Results: During the study period, 20 ocular candidiasis cases were diagnosed among 99 candidemia patients examined by ophthalmologists. Although C. parapsilosis was the most frequent candidemia pathogen, only C. albicans infection was significantly associated with ocular candidiasis by multivariate analysis. In mice, ocular fungal burden and inflammatory mediators were significantly higher during C. albicans infection, and histopathological analysis revealed invading C. albicans surrounded by inflammatory cells. Ocular neutrophil and inflammatory monocyte numbers were significantly greater during C. albicans infection.
Conclusion:Candida albicans is strongly associated with ocular candidiasis due to greater capacity for invasion, induction of inflammatory mediators, and recruitment of neutrophils and inflammatory monocytes.

研究目的：念珠菌属（Candida）是医院感染的主要致病菌之一，可引发眼念珠菌病（ocular candidiasis），但目前针对特定菌种侵袭眼部的倾向及其诱导的独特免疫应答的相关研究较为匮乏。本研究通过流行病学分析结合小鼠眼念珠菌病模型实验，探究了念珠菌属眼部感染的菌种特异性发生频率与特征。
研究方法：本研究回顾性分析了2012年1月至2017年3月期间的念珠菌血症（candidemia）患者病历资料；同时利用白假丝念珠菌（Candida albicans）、光滑假丝念珠菌（Candida glabrata）以及近平滑假丝念珠菌（Candida parapsilosis）感染的小鼠模型，评估眼部真菌负荷、炎性细胞因子与趋化因子谱，以及炎性细胞浸润特征。
研究结果：本研究期间，经眼科医师检查的99例念珠菌血症患者中，共确诊20例眼念珠菌病病例。尽管近平滑假丝念珠菌是最常见的念珠菌血症致病菌，但多变量分析显示，仅白假丝念珠菌感染与眼念珠菌病存在显著相关性。小鼠实验结果表明，白假丝念珠菌感染组的眼部真菌负荷与炎性介质水平均显著升高；组织病理学分析显示，入侵眼部的白假丝念珠菌被炎性细胞所包裹。此外，白假丝念珠菌感染组小鼠眼部的中性粒细胞与炎性单核细胞数量显著增加。
研究结论：白假丝念珠菌因其更强的侵袭能力、诱导炎性介质释放的能力，以及招募中性粒细胞与炎性单核细胞的特性，与眼念珠菌病存在显著关联。