Abstract
Mucosal barrier integrity is vital for homeostasis with commensal organisms while preventing pathogen invasion. Here we show that fungal-induced immunosurveillance enhances resistance to fungal outgrowth and tissue invasion by remodeling the oral mucosal epithelial barrier in mouse models of adult and neonatal Candida albicans colonization. Epithelial subset expansion and tissue remodeling are dependent on interleukin-22 and signal transducer and activator of transcription 3 signaling, through a non-canonical receptor complex composed of glycoprotein 130 coupled with the interleukin-22 receptor subunit alpha-1 and the interleukin-10 receptor subunit beta. Epithelial proliferation enhanced antifungal host defenses through the upregulation of antimicrobial peptide expression. Immunosurveillance-induced epithelial remodeling is restricted to the oral mucosa, whereas barrier architecture is reset once fungal-specific immunity developed. Collectively, these findings identify fungal-induced transient mucosal remodeling as a critical determinant of resistance to mucosal fungal infection during early stages of microbial colonization.
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The authors declare that the data supporting the findings of this study are available within the paper and the accompanying supplementary information files. Source data are provided with this paper. The high-throughput sequencing data from this study have been deposited with links to BioProject accession number PRJNA1176644 in the NCBI BioProject database https://www.ncbi.nlm.nih.gov/bioproject/PRJNA1176644. Source data are provided with this paper.
References
Moutsopoulos, N. M. & Konkel, J. E. Tissue-specific immunity at the oral mucosal barrier. Trends Immunol. 39, 276–287 (2018).
Zheng, D., Liwinski, T. & Elinav, E. Interaction between microbiota and immunity in health and disease. Cell Res. 30, 492–506 (2020).
Gaffen, S. L. & Moutsopoulos, N. M. Regulation of host-microbe interactions at oral mucosal barriers by type 17 immunity. Sci. Immunol. 5, https://doi.org/10.1126/sciimmunol.aau4594 (2020).
Swidergall, M. & LeibundGut-Landmann, S. Immunosurveillance of Candida albicans commensalism by the adaptive immune system. Mucosal Immunol. 15, 829–836 (2022).
Mayer, F. L., Wilson, D. & Hube, B. Candida albicans pathogenicity mechanisms. Virulence 4, 119–128 (2013).
Swidergall, M. & Filler, S. G. Oropharyngeal candidiasis: fungal invasion and epithelial cell responses. PLoS Pathog. 13, e1006056 (2017).
Shao, T. Y. et al. Commensal Candida albicans positively calibrates systemic Th17 immunological responses. Cell Host Microbe 25, 404–417.e406 (2019).
Netea, M. G. et al. Trained immunity: a program of innate immune memory in health and disease. Science 352, aaf1098 (2016).
Netea, M. G. et al. Defining trained immunity and its role in health and disease. Nat. Rev. Immunol. 20, 375–388 (2020).
Iliev, I. D. & Leonardi, I. Fungal dysbiosis: immunity and interactions at mucosal barriers. Nat. Rev. Immunol. 17, 635–646 (2017).
Conti, H. R. et al. Th17 cells and IL-17 receptor signaling are essential for mucosal host defense against oral candidiasis. J. Exp. Med. 206, 299–311 (2009).
Conti, H. R. et al. IL-17 receptor signaling in oral epithelial cells is critical for protection against oropharyngeal candidiasis. Cell Host Microbe 20, 606–617 (2016).
Swidergall, M., Solis, N. V., Lionakis, M. S. & Filler, S. G. EphA2 is an epithelial cell pattern recognition receptor for fungal β-glucans. Nat. Microbiol. 3, 53–61 (2018).
Swidergall, M. et al. EphA2 is a neutrophil receptor for Candida albicans that stimulates antifungal activity during oropharyngeal infection. Cell Rep. 28, 423–433 e425 (2019).
Millet, N., Solis, N. V. & Swidergall, M. Mucosal IgA prevents commensal Candida albicans dysbiosis in the oral cavity. Front. Immunol. 11, 555363 (2020).
Schonherr, F. A. et al. The intraspecies diversity of C. albicans triggers qualitatively and temporally distinct host responses that determine the balance between commensalism and pathogenicity. Mucosal Immunol. 8, 2 (2017).
Kirchner, F. R. et al. Persistence of Candida albicans in the oral mucosa induces a curbed inflammatory host response that is independent of immunosuppression. Front. Immunol. 10, 330 (2019).
Bissell, M. J., Rizki, A. & Mian, I. S. Tissue architecture: the ultimate regulator of breast epithelial function. Curr. Opin. cell Biol. 15, 753–762 (2003).
Okumura, R. & Takeda, K. Roles of intestinal epithelial cells in the maintenance of gut homeostasis. Exp. Mol. Med. 49, e338–e338 (2017).
Break, T. J. et al. Aberrant type 1 immunity drives susceptibility to mucosal fungal infections. Science 371 (2021). https://doi.org/10.1126/science.aay5731
Krausgruber, T. et al. Structural cells are key regulators of organ-specific immune responses. Nature 583, 296–302 (2020).
Frazer, L. C. & Good, M. Intestinal epithelium in early life. Mucosal Immunol. 15, 1181–1187 (2022).
Torow, N., Hand, T. W. & Hornef, M. W. Programmed and environmental determinants driving neonatal mucosal immune development. Immunity 56, 485–499 (2023).
Agaronyan, K. et al. Tissue remodeling by an opportunistic pathogen triggers allergic inflammation. Immunity 55, 895–911.e810 (2022).
Beppu, A. K. et al. Epithelial plasticity and innate immune activation promote lung tissue remodeling following respiratory viral infection. Nat. Commun. 14, 5814 (2023).
Hayes, C. L. et al. Commensal microbiota induces colonic barrier structure and functions that contribute to homeostasis. Sci. Rep. 8, 14184 (2018).
Dudakov, J. A., Hanash, A. M. & van den Brink, M. R. Interleukin-22: immunobiology and pathology. Annu. Rev. Immunol. 33, 747–785 (2015).
Solis, N. V. & Filler, S. G. Mouse model of oropharyngeal candidiasis. Nat. Protoc. 7, 637–642 (2012).
Presland, R. B. & Dale, B. A. Epithelial structural proteins of the skin and oral cavity: function in health and disease. Crit. Rev. Oral. Biol. Med. 11, 383–408 (2000).
Presland, R. B. & Jurevic, R. J. Making sense of the epithelial barrier: what molecular biology and genetics tell us about the functions of oral mucosal and epidermal tissues. J. Dent. Educ. 66, 564–574 (2002).
Lionakis, M. S., Drummond, R. A. & Hohl, T. M. Immune responses to human fungal pathogens and therapeutic prospects. Nat. Rev. Immunol. 23, 433–452 (2023).
Hernández-Santos, N. & Gaffen, S. L. Th17 cells in immunity to Candida albicans. Cell Host Microbe 11, 425–435 (2012).
Lindemans, C. A. et al. Interleukin-22 promotes intestinal-stem-cell-mediated epithelial regeneration. Nature 528, 560–564 (2015).
Mock, J. R. et al. Foxp3+ regulatory T cells promote lung epithelial proliferation. Mucosal Immunol. 7, 1440–1451 (2014).
Hur, J. et al. Identification of a novel role of T cells in postnatal vasculogenesis: characterization of endothelial progenitor cell colonies. Circulation 116, 1671–1682 (2007).
Aggor, F. E. Y. et al. Oral epithelial IL-22/STAT3 signaling licenses IL-17-mediated immunity to oral mucosal candidiasis. Sci. Immunol. 5, https://doi.org/10.1126/sciimmunol.aba0570 (2020).
Bichele, R. et al. IL-22 neutralizing autoantibodies impair fungal clearance in murine oropharyngeal candidiasis model. Eur. J. Immunol. 48, 464–470 (2018).
Kaleviste, E. et al. IL-22 paucity in APECED is associated with mucosal and microbial alterations in oral cavity. Front. Immunol. 11, 838 (2020).
Plank, M. W. et al. Th22 cells form a distinct Th lineage from Th17 cells in vitro with unique transcriptional properties and Tbet-dependent Th1 plasticity. J. Immunol. 198, 2182–2190 (2017).
Keir, M., Yi, Y., Lu, T. & Ghilardi, N. The role of IL-22 in intestinal health and disease. J. Exp. Med. 217, e20192195 (2020).
Mossner, S. et al. Synthetic interleukin 22 (IL-22) signaling reveals biological activity of homodimeric IL-10 receptor 2 and functional cross-talk with the IL-6 receptor gp130. J. Biol. Chem. 295, 12378–12397 (2020).
Rose-John, S., Jenkins, B. J., Garbers, C., Moll, J. M. & Scheller, J. Targeting IL-6 trans-signalling: past, present and future prospects. Nat. Rev. Immunol. 23, 666–681 (2023).
Swidergall, M. & Ernst, J. F. Interplay between Candida albicans and the antimicrobial peptide armory. Eukaryot. Cell 13, 950–957 (2014).
Aggor, F. E. Y. et al. Combinatorial actions of IL-22 and IL-17 drive optimal immunity to oral candidiasis through SPRRs. PLoS Pathog. 20, e1012302 (2024).
Taylor, T. C. et al. IκBζ is an essential mediator of immunity to oropharyngeal candidiasis. Cell Host Microbe 31, 1700–1713.e1704 (2023).
Puel, A. et al. Inborn errors of human IL-17 immunity underlie chronic mucocutaneous candidiasis. Curr. Opin. Allergy Clin. Immunol. 12, 616–622 (2012).
Jameson, S. C. & Masopust, D. Diversity in T cell memory: an embarrassment of riches. Immunity 31, 859–871 (2009).
Korn, L. L. et al. Conventional CD4+ T cells regulate IL-22-producing intestinal innate lymphoid cells. Mucosal Immunol. 7, 1045–1057 (2014).
Wolk, K. et al. IL-22 increases the innate immunity of tissues. Immunity 21, 241–254 (2004).
Zenewicz, L. A. et al. Innate and adaptive interleukin-22 protects mice from inflammatory bowel disease. Immunity 29, 947–957 (2008).
Zheng, Y. et al. Interleukin-22, a T(H)17 cytokine, mediates IL-23-induced dermal inflammation and acanthosis. Nature 445, 648–651 (2007).
Hornef, M. W. & Torow, N. Layered immunity’ and the ‘neonatal window of opportunity’ - timed succession of non-redundant phases to establish mucosal host-microbial homeostasis after birth. Immunology 159, 15–25 (2020).
Patil, S., Rao, R. S., Majumdar, B. & Anil, S. Clinical appearance of oral candida infection and therapeutic strategies. Front. Microbiol. 6, 1391 (2015).
Razzaghian, H. R. et al. Neonatal T helper 17 responses are skewed towards an immunoregulatory interleukin-22 phenotype. Front. Immunol. 12, 655027 (2021).
Oikonomou, V. et al. The role of interferon-γ in autoimmune polyendocrine syndrome type 1. N. Engl. J. Med. 390, 1873–1884 (2024).
Swidergall, M. Candida albicans at host barrier sites: pattern recognition receptors and beyond. Pathogens 8, 40 (2019).
Schirmer, M. et al. Linking the human gut microbiome to inflammatory cytokine production capacity. Cell 167, 1125–1136.e1128 (2016).
Arshad, T., Mansur, F., Palek, R., Manzoor, S. & Liska, V. A double edged sword role of interleukin-22 in wound healing and tissue regeneration. Front. Immunol. 11, 2148–2148 (2020).
Korol, C. B. et al. Fulminant viral hepatitis in two siblings with inherited IL-10RB deficiency. J. Clin. Immunol. 43, 406–420 (2023).
Béziat, V. et al. Dominant-negative mutations in human IL6ST underlie hyper-IgE syndrome. J. Exp. Med. 217, e20191804 (2020).
Arlabosse, T. et al. New dominant-negative IL6ST variants expand the immunological and clinical spectrum of GP130-dependent hyper-IgE syndrome. J. Clin. Immunol. 43, 1566–1580 (2023).
Qin, Z. et al. TCR signaling induces STAT3 phosphorylation to promote TH17 cell differentiation. J. Exp. Med. 221, e20230683 (2024).
Pandiyan, P. et al. CD4(+)CD25(+)Foxp3(+) regulatory T cells promote Th17 cells in vitro and enhance host resistance in mouse Candida albicans Th17 cell infection model. Immunity 34, 422–434 (2011).
Kirchner, F. R. & LeibundGut-Landmann, S. Tissue-resident memory Th17 cells maintain stable fungal commensalism in the oral mucosa. Mucosal Immunol. https://doi.org/10.1038/s41385-020-0327-1 (2020).
Fujita, H. et al. Human Langerhans cells induce distinct IL-22-producing CD4+ T cells lacking IL-17 production. Proc. Natl. Acad. Sci. USA 106, 21795–21800 (2009).
Verma, A. H. et al. Oral epithelial cells orchestrate innate type 17 responses to Candida albicans through the virulence factor candidalysin. Sci. Immunol. 2, https://doi.org/10.1126/sciimmunol.aam8834 (2017).
Trautwein-Weidner, K. et al. Antigen-specific Th17 cells are primed by distinct and complementary dendritic cell subsets in oropharyngeal candidiasis. PLoS Pathog. 11, e1005164 (2015).
Koren, N. et al. Maturation of the neonatal oral mucosa involves unique epithelium-microbiota interactions. Cell Host Microbe 29, 197–209.e195 (2021).
Zubeidat, K. & Hovav, A. H. Shaped by the epithelium - postnatal immune mechanisms of oral homeostasis. Trends Immunol. 42, 622–634 (2021).
Rudd, B. D. Neonatal T cells: a reinterpretation. Annu. Rev. Immunol. 38, 229–247 (2020).
White, T. C. Increased mRNA levels of ERG16, CDR, and MDR1 correlate with increases in azole resistance in Candida albicans isolates from a patient infected with human immunodeficiency virus. Antimicrob. Agents Chemother. 41, 1482–1487 (1997).
Rahman, D., Mistry, M., Thavaraj, S., Challacombe, S. J. & Naglik, J. R. Murine model of concurrent oral and vaginal Candida albicans colonization to study epithelial host-pathogen interactions. Microbes Infect. 9, 615–622 (2007).
Liu, J. et al. Rapid hypothesis testing in Candida albicans clinical isolates using a cloning-free, modular, and recyclable system for CRISPR-Cas9 mediated mutant and revertant construction. Microbiol Spectr. 10, e0263021 (2022).
Gerwien, F. et al. Clinical Candida albicans vaginal isolates pand a laboratory strain show divergent behaviors during macrophage interactions. mSphere 5, e00393-20 (2020).
Iwanaga, N. et al. Vaccine-driven lung TRM cells provide immunity against Klebsiella via fibroblast IL-17R signaling. Sci. Immunol. 6, eabf1198 (2021).
Shen, W., Hixon, J. A., McLean, M. H., Li, W. Q. & Durum, S. K. IL-22-expressing murine lymphocytes display plasticity and pathogenicity in reporter mice. Front. Immunol. 6, 662 (2015).
Spencer, S. D. et al. The orphan receptor CRF2-4 is an essential subunit of the interleukin 10 receptor. J. Exp. Med. 187, 571–578 (1998).
Ahlfors, H. et al. IL-22 fate reporter reveals origin and control of IL-22 production in homeostasis and infection. J. Immunol. 193, 4602–4613 (2014).
Kühn, R., Löhler, J., Rennick, D., Rajewsky, K. & Müller, W. Interleukin-10-deficient mice develop chronic enterocolitis. Cell 75, 263–274 (1993).
Mombaerts, P. et al. RAG-1-deficient mice have no mature B and T lymphocytes. Cell 68, 869–877 (1992).
Millet, N. et al. IL-23 signaling prevents ferroptosis-driven renal immunopathology during candidiasis. Nat. Commun. 13, 5545 (2022).
Mortazavi, A., Williams, B. A., McCue, K., Schaeffer, L. & Wold, B. Mapping and quantifying mammalian transcriptomes by RNA-Seq. Nat. Methods 5, 621–628 (2008).
Solis, N. V., Swidergall, M., Bruno, V. M., Gaffen, S. L. & Filler, S. G. The aryl hydrocarbon receptor governs epithelial cell invasion during Oropharyngeal Candidiasis. mBio 8, 00025–00017 (2017).
Kapitan, M. et al. Synergistic interactions between Candida albicans and Enterococcus faecalis promote toxin-dependent host cell damage. Proc. Natl. Acad. Sci. USA 122, e2505310122 (2025).
Szafranski-Schneider, E. et al. Msb2 shedding protects Candida albicans against antimicrobial peptides. PLoS Pathog. 8, e1002501 (2012).
Rueden, C. T. et al. ImageJ2: ImageJ for the next generation of scientific image data. BMC Bioinforma. 18, 529 (2017).
Acknowledgements
We thank Jay K. Kolls (Tulane University) for providing the Il22ra1E2a-cre mice, Salomé LeibundGut-Landmann (University of Zurich) for the Candida albicans commensal-like strain CA101, James G. Rheinwald (Dana-Farber/Harvard Cancer Center) for providing the OKF6/TERT-2 cell line, and members of the Division of Infectious Diseases at Harbor-UCLA Medical Center for critical suggestions. NIH grant R01DE031382, R21AI187999 (M.S.), R01AI177254 (S.G.F.), U19AI172713 (M.S., S.G.F.), R21AI159221, R56AI175328 (N.J.), F32AI186291 (M.E.C.), R01AI134796 (B.M.P.), R37DE022550 (S.L.G.), Division of Intramural Research of the NIAID (M.S.L.), California Institute for Regenerative Medicine Stem Cell Biology Training Grant EDUC4-12837 (N.M.).
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Conceptualization: M.S. Methodology: N.M., J.S., N.S., A.M., F.A., A.W., M.E.C., A.D., B.M.P., M.S.L., S.L.G., N.J., S.G.F., M.S. Investigation: N.M., J.S., N.S., J.M., A.M., F.A., A.W., M.S. Visualization: N.M., J.S., F.A., A.W., M.S. Funding acquisition: N.M., M.E.C., N.J., B.M.P., S.L.G., S.G.F., M.S. Project administration: M.S. Supervision: M.S. Writing – original draft: M.S. Writing – review & editing: N.M., J.S., N.S., J.M., A.M., F.A., A.W., M.S.L., B.M.P., S.L.G., N.J., S.G.F., M.S.
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Millet, N., Sekar, J., Solis, N.V. et al. Non-canonical IL‑22 receptor signaling remodels the oral mucosal barrier during Candida albicans immunosurveillance. Nat Commun (2026). https://doi.org/10.1038/s41467-026-71459-z
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DOI: https://doi.org/10.1038/s41467-026-71459-z


