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Research Article Free access | 10.1172/JCI106114

Leukocyte myeloperoxidase deficiency and disseminated candidiasis: the role of myeloperoxidase in resistance to Candida infection

Robert I. Lehrer and Martin J. Cline

1Cancer Research Institute and the Department of Medicine, University of California Medical Center, San Francisco, California 94122

Find articles by Lehrer, R. in: JCI | PubMed | Google Scholar

1Cancer Research Institute and the Department of Medicine, University of California Medical Center, San Francisco, California 94122

Find articles by Cline, M. in: JCI | PubMed | Google Scholar

Published August 1, 1969 - More info

Published in Volume 48, Issue 8 on August 1, 1969
J Clin Invest. 1969;48(8):1478–1488. https://doi.org/10.1172/JCI106114.
© 1969 The American Society for Clinical Investigation
Published August 1, 1969 - Version history
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Abstract

The neutrophils and monocytes of a patient with disseminated candidiasis were found to lack detectable levels of the lysosomal enzyme myeloperoxidase (MPO), although they had normal levels of other granule-associated enzymes. Leukocytes from one of the patient's sisters also lacked detectable MPO; leukocytes from his four sons contained approximately one-third of mean normal peroxidase levels. Neither the patient nor his affected relatives had experienced frequent or unusual bacterial infections.

The phagocytic activity of the patient's MPO-deficient neutrophils was intact, and the cells displayed normal morphologic and metabolic responses to phagocytosis. In contrast to normal leukocytes which killed 30.5±7.3% of ingested Candida albicans in 1 hr, however, the patient's neutrophils killed virtually none. His leukocytes also failed to kill the strain of C. albicans recovered from his lesions, as well as other Candida species. These MPO-deficient neutrophils killed Serratia marcescens and Staphylococens aureus 502A at an abnormally slow rate, requiring 3-4 hr to achieve the bactericidal effect attained by normal leukocytes after 45 min. No other abnormalities in his cellular or humoral immune responses were demonstrated.

These findings suggest that hereditary MPO deficiency is transmitted as an autosomal recessive characteristic, that the homozygous state conveys enhanced susceptibility to disseminated candidiasis, and that MPO is necessary for candidacidal activity in human neutrophils. Although lending support to the suggested bactericidal role of MPO in leukocytes, the data indicate that alternative bactericidal mechanisms, effective in the absence of MPO, are functionally dominant in the human neutrophil.

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