Candida albicans is a dimorphic fungus to which human subjects are exposed early in life, and by adulthood, it is part of the mycobiome of skin and other tissues. Neonatal skin lacks resident memory T (T_RM) cells, but in adults the C albicans skin test is a surrogate for immunocompetence. Young adult mice raised under specific pathogen-free conditions are naive to C albicans and have been shown recently to have an immune system resembling that of neonatal human subjects.

We studied the evolution of the adaptive cutaneous immune response to Candida species.

We examined both human skin T cells and the de novo and memory immune responses in a mouse model of C albicans skin infection.

In mice the initial IL-17–producing cells after C albicans infection were dermal γδ T cells, but by day 7, αβ T_H17 effector T cells were predominant. By day 30, the majority of C albicans–reactive IL-17–producing T cells were CD4 T_RM cells. Intravital microscopy showed that CD4 effector T cells were recruited to the site of primary infection and were highly motile 10 days after infection. Between 30 and 90 days after infection, these CD4 T cells became increasingly sessile, acquired expression of CD69 and CD103, and localized to the papillary dermis. These established T_RM cells produced IL-17 on challenge, whereas motile migratory memory T cells did not. T_RM cells rapidly clear an infectious challenge with C albicans more effectively than recirculating T cells, although both populations participate. We found that in normal human skin IL-17–producing CD4⁺ T_RM cells that responded to C albicans in an MHC class II–restricted fashion could be identified readily.

These studies demonstrate that C albicans infection of skin preferentially generates CD4⁺ IL-17–producing T_RM cells, which mediate durable protective immunity.