Fungal Adherence to the Vascular Compartment: A Critical Step in the Pathogenesis of Disseminated Candidiasis

The importance of adherence of Candida albicans to the vascular structures in the pathogenesis of disseminated candidiasis is discussed. The evidence for adherence of this fungus to endothelial cells and to the subendothelial basement membrane in vivo is reviewed, as are the data documenting these events in vitro. Information on the subcellular interactions of the host’s vascular structures with this pathogen is presented. For example, the C. albicans surface receptors for iC3b, laminin, and fibronectin are discussed in light of their possible ability to mediate the adherence of the fungus to vascular structures. The review is concluded with a potentially unifying concept of integrin-like receptors on Candida that bind arginine-glycine-aspartic acid- containing peptides that may account for the binding of numerous human proteins to C. albicans.