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YEASTS ISOLATED FROM PATIENTS IN THE CORONARY AND SURGICAL INTENSIVE CARE UNITS AND THEIR SUSCEPTIBILITIES TO FLUCONAZOLE AND AMPHOTERICIN B

also observed in epithelial infection with the less virulent species C. tropicalis and C. glabrata. Heat-killed C. albicans failed to induce epithelial immune response. By the use of the proteinase inhibitor pepstatin A we could demonstrate that expression of the chemokines IL-8 and GM-CSF is modulated by the proteolytic activity of C. albicans. At the protein level, expression of IL-8 protein was strongly enhanced during the course of C. albicans infection while lower levels were seen with C. tropicalis and C. glabrata. The different expression patterns of cytokines were associated with differences in virulence of the Candida strains. Our data therefore show a correlation between the virulence potential of pathogenic fungi, possible mediated by specific virulence factors (such as proteinases), and the secretion of epithelial cytokines and chemokines, which may initiate in vivo a protective Th-1 immunoresponse and contribute to the recruitment of activated leucocytes and lymphocytes to the site of mucosal infection.