Bronchial hypersensitivity to extract of Candida albicans

Eighty-one inpatients, 14 years of age and older, were challenged qualitatively with aerosols of physiological saline, 30 per cent glycerine, extracts of common inhalant allergens, and extracts of Candida albicans (Hollister-Stier) at concentrations up to 10,000 PNU per milliliter delivered through a hand nebulizer. The same patients were tested intradermally and conjunctivally with C. albicans extract. Sputum specimens were obtained from each patient and cultured for the Candida group of organisms. Passive transfer studies for the presence of reagin to C. albicans were made between the effects of inhalation of C. albicans extract and Escherichia coli endotoxin in six patients. Fifteen patients were given control injections and hyposensitization treatment with C. albicans extract and observations were made of bronchial sensitivity by means of either qualitative or quantitative inhalation challenge. The results indicate that C. albicans hypersensitivity is a factor of importance in some patients with severe asthma. The immediate skin response to 1:1,000 extract and reaction of the bronchial tree to other mold extracts were correlated with a positive bronchial reaction to C. albicans extract in the patients studied; the conjunctival test, the delayed skin response to 1:1,000 extract, the bronchial reaction to extract of house dust or pollens, positive sputum cultures, and a history of long-term corticosteroid or antibiotic administration were not so correlated. The mechanism of response differs from that to E. coli endotoxin.