The polymorphic commensal fungus Candida albicans causes life-threatening disease via bloodstream and intra-abdominal infections in immunocompromised and transplant patients. Although host immune evasion is a common strategy used by successful human fungal pathogens, C. albicans provokes recognition by host immune cells less capable of destroying it. To accomplish this, C. albicans white cells secrete a low-molecular-weight chemoattractive stimulant(s) of macrophages, a phagocyte that they are able to survive within and eventually escape from. C. albicans opaque cells do not secrete this chemoattractive stimulant(s). We report here a physiological mechanism that contributes to the differences in the interaction of C. albicans white and opaque cells with macrophages. E,E-Farnesol, which is secreted by white cells only, is a potent stimulator of macrophage chemokinesis, whose activity is enhanced by yeast cell wall components and aromatic alcohols. E,E-farnesol results in up to an 8.5-fold increase in macrophage migration in vitro and promotes a 3-fold increase in the peritoneal infiltration of macrophages in vivo. Therefore, modulation of farnesol secretion to stimulate host immune recognition by macrophages may help explain why this commensal is such a successful pathogen.
Candida albicans is a serious fungal pathogen for humans (1). C. albicans is a dimorphic fungus and it has long been recognized that the ability to interconvert between the yeast and filamentous forms is essential for its pathogenicity. Thus, when we discovered that E,E-farnesol (referred to here as farnesol) is a quorum sensing molecule (QSM) for C. albicans which acts by blocking the conversion of yeasts to mycelia (2), we thought that farnesol would be an attractive lead compound in the design of novel antifungal drugs. However, this goal was not realized when we showed that farnesol itself acted as a virulence factor for C. albicans in a mouse intravenous infection model (3). These observations presented a dilemma: how can farnesol act as a virulence factor when part of its mode of action is to block the yeast-mycelium morphogenesis, which is necessary for its pathogenicity? We resolve this conundrum here by showing that farnesol is also a potent stimulator of macrophage migration both in vitro and in vivo.C. albicans is one of the best studied examples of an opportunistic fungal pathogen. It is a normal member of the human microbiota where it is found as a commensal primarily in the gastrointestinal and genitourinary tracts and on the skin of healthy individuals without causing significant disease. In healthy individuals, C. albicans commensals are controlled but tolerated while C. albicans pathogens are eliminated (reviewed in reference 4). The presence of innate immune phagocytes, which include both macrophages and neutrophils, is critical for early detection and elimination of C. albicans that have made the transition from commensal to an opportunistic pathogen (5-9; reviewed in reference 10). Thus, when normal immune responses are com...