PREVENTION OF CANDIDIASIS IN PATIENTS USING REMOVABLE DENTURES

Despite innovations in orthopedic dentistry, removable dentures belong to the most popular orthopedic care category. Removable dentures are combined stimuli that affect the mucous membrane and neuro-receptor apparatus. Acrylic plastic prostheses, widely used in prosthetic dentistry, have a negative side mechanical, chemical-toxic, sensitizing, and thermal insulating effect on oral tissue and prosthetic impression area. This is often complicated by a violation of the biocenosis of the oral cavity, the growth of pathogenic microflora that releases toxins, especially an increase in the number of yeast colonies that irritate the oral mucosa and prosthetic stomatitis. It was observed 100 patients with oral candidiasis of various age groups from 45 to 65 years. Of these, 60 patients with removable plate prostheses; 40 patients with partially removable prostheses. Chronic forms of candidiasis were diagnosed in 40 patients and with exacerbation of chronic forms of candidiasis in 60 people. The number of untreated carious cavities and poor hygienic condition of the oral cavity directly affects the severity of candidiasis. Acute forms of candidiasis were observed mainly in patients with high DMF and PMA indices. The severity of candidiasis depends on the degree and duration of wearing dentures and hygienic conditions - the most severe forms of invasive candidiasis were observed in the presence of removable plate prostheses, the complete absence of teeth, and the use of a prosthesis for more than 10-15 years. A combined lesion of the oral mucosa and the red border of the lips was observed mainly in patients older than 60 years. The presence of candidiasis in the oral cavity in patients with removable plate prostheses leads to a statistically significant change in the indicators of local immunity of the oral cavity: an increase in the concentration of serum IgG and IgA and the values of the coefficient of the balance of local immunity factors.

Severe COVID-19 illness in an Indian adolescent with autoimmune polyendocrinopathy syndrome-1

Autoimmune polyglandular syndrome-1 (APS-1)also known as autoimmune polyendocrinopathy candidiasis ectodermal dystrophy is a rare autosomal recessive disorder caused by mutation of AIRE gene on chromosome 21q22.3 with an overall prevalence of <1:100,000. Here, we present a 16-year-old male having clinical history of evolution of symptoms for oral candidiasis, hypoparathyroidism, and adrenal insufficiency (AI). He developed rare endocrine and non-endocrine manifestations such as type-1 diabetes (T1D) and autoimmune hepatitis, respectively. The patient while on hormone replacement therapy along with immunosuppressants developed liver cirrhosis and portal hypertension with esophageal varices and candidiasis. Subsequently, he was admitted for complaints of cough, cold and fever and was confirmed to be affected by SARS-CoV-2 by reverse transcription-polymerase chain reaction method. In his prolonged ICU stay of 26 days, he required oxygen therapy, intravenous glucocorticoids, remdesivir, low molecular weight heparin, and hemodynamic support with inotropes. His medical management with subcutaneous insulin therapy and azathioprine was continued. He was discharged after complete resolution of symptoms and negative tests for SARS-CoV-2 and was advised radiological and clinical follow-up. Reports suggest that risk of severe COVID does not increase in patients with AI or autoimmunity. However, our patient possibly developed severe COVID not only due to AI and autoimmunity but also associated rare manifestations like hyperglycemia due to T1D and cirrhosis. Thus, good glycemic control and well-tolerated modern immunosuppressant therapy may be useful in improving prognosis of severe COVID-19 illness in patients with APS-1.

Systematic Genetic Interaction Analysis Identifies a Transcription Factor Circuit Required for Oropharyngeal Candidiasis

The pathology of oral candidiasis has features of biofilm formation, a well-studied process in vitro . Based on that analogy, we hypothesized that the network of transcription factors that regulates in vitro biofilm formation has similarities and differences during oral infection.

The effect of iron dextran injection on oral candidiasis symptoms in experimental iron deficiency anemia of laboratory rats

Iron deficiency anemia (IDA) is the most common type of anemia that causes various health problems and is commonly companied by oral symptoms, including oral thrush from Candida infection. The study assessed the role of iron status in the pathogenicity of oral candidiasis in an animal model. IDA in rats was produced by feeding on iron-free diet (five weeks), followed by inducing oral candidiasis by Candida albicans suspension. After the infection, animal subgroups were treated by intramuscular injection (IM) of iron dextran (ID) at 2 and 4 mg/kg once a week for three weeks and normal saline injection for comparison. Blood parameters test and tongue histopathological study were conducted. The IDA parameters and the oral thrush lesions were detected in experimental rats. IM of 2 mg ID diminished oral white patches and improved blood hemoglobin (14.533 g/dl), serum iron (109.177 μg/dl), and serum ferritin (5.276 ng/ml) and decreased total iron-binding capacity (377.000 μg/dl). Tongue sections showed normal tongue papillae, reduced inflammation and regular keratin deposition on papillae. At a 4 mg dose, despite the improvement in the blood parameters, a mild reduction was found in tongue thrush by less normal appearance of tongue papillae sections, mild inflammatory cells and hyperplasia of squamous epithelium. The study findings indicate that iron status plays a critical role in the treatment of oral thrush infection.

The Prevalence, Etiological Agents, Clinical Features, Treatment, and Diagnosis of HIV-Associated Oral Candidiasis in Pediatrics Across the World: A Systematic Review and Meta-Analysis

In HIV-infected pediatrics, oral candidiasis (OC) is a global issue of concern due to its association with dysphagia, malnutrition, and mortality. The present systematic review and meta-analysis are the first to determine the prevalence of OC in HIV-infected pediatrics worldwide. We searched international (PubMed, Web of Science, Scopus, and Embase) databases for studies published between January 2000 to May 2020 reporting the epidemiologic features of OC in HIV-infected pediatrics. Inclusion and exclusion criteria were defined to select eligible studies. Data were extracted and presented according to PRISMA guidelines. The results of the meta-analysis were visualized as a forest plot. Heterogeneity was also analyzed using the I2, and τ2 statistics. The publication bias was evaluated using Egger test. The literature search revealed 1926 studies, of which 34 studies met the eligibility criteria, consisting of 4,474 HIV-infected pediatrics from 12 different countries. The overall prevalence of OC among HIV-infected pediatrics was 23.9% (95% CI 17.3–32.0%), and Candida albicans was the most prevalent etiologic agent. Pseudomembranous candidiasis was the predominant clinical manifestation in HIV-infected pediatrics suffering from OC. Thirty articles involving 4,051 individuals provided data on HIV treatment status. Among the 4,051 individuals, 468 (11.53%) did not receive HIV treatment. The data from 11 articles demonstrated that HIV treatment was significantly associated with a reduction in oral Candida colonization or infection. In contrast, others showed the opposite relationship or did not report any statistical data. A high level of I2 (I2 = 96%, P &lt; 0.01) and τ2 (τ2 = 1.36, P &lt; 0.01) was obtained among studies, which provides evidence of notable heterogeneity between studies. OC is approximately frequent in HIV-positive children. Therefore, efforts should be made to teach dental and non-dental clinicians who care for HIV-infected pediatrics to diagnose and treat this infection.

The Relationship Between Salivary Candida Albicans Colony Count and Blood Group Antigens in Dentistry Students

Background and Aims: Candida albicans is the most prevalent opportunistic fungal species in the oral cavity. To date, several studies have been investigated the various factors associated with oral candidiasis. On the other hand, it has been proven that blood types antigens lead to some infectious factors. This study aimed to evaluate Candida albicans colonies in the saliva of dentistry students based on their blood type to detect a relationship between blood group and incidence of oral candidiasis. Materials and Methods: In this descriptive cross-sectional study, 200 dentistry students were selected by a simple sampling method, including 100 individuals with blood type O and 100 with other blood types. The unstimulated salivary samples of all the participants were collected by spitting, cultured on Sabouraud medium, and then the isolated Candida albicans colonies were enumerated and recorded. Results: In the present study, samples comprised 77 males and 123 females, of whom 15.5% (31 individuals) carried colony-forming units > 40. The mean of Candida albicans colonies in the individuals' saliva with blood type O was 21.55, and it was 10.68 in the other groups. Besides, the differences were statistically significant (p = 0.024). There was no significant difference in Candida albicans colony count between O positive and O negative blood groups. Conclusions: The result of this study showed a significant relationship between the number of Candida albicans colonies of saliva and the individual’s blood type.

Physical-chemical and microbiological stability of biotherapy Candida albicans RC in different potencies

Introduction: Oral Candidiasis is an opportunist fungal infection, with high incidence in HIV and immunosuppressed patients and Candida albicans is the most common causing agent. In some cases, it can evolve to resistant injuries to antifungal conventional therapy. According to Brazilian Homeopathic Pharmacopeia (BHP) [1], biotherapic medicines are prepared from chemically undefined biological products. Biotherapics created by Brazilian doctor Roberto Costa (RC) have a different homeopathic compounding technique, as its dynamization starts from the ethiologic agent of the illness in its alive form, which present higher capability to stimulate the host immunological system [2,3]. Aim: The goal of this study was evaluate the physical-chemical and microbiological stability of Candida albicans RC potencies under different conditions of storage. Methodology: To prepare the biotherapics, one part of Candida albicans yeast suspension (109 cell/ml) was diluted in 9 parts of sterile distillated water. After preparing this 1:10 dilution, the sample was undergone 100 succussions, resulting in the first decimal dilution (1x). Then, one part of this solution was diluted in 9 parts of sterile distillated water and submitted to 100 succussions, generating the 2x. This process was successively repeated following BHP, until 30x. Water 30x was prepared by the same technique, as control. All the solutions were prepared in aseptic and sterile conditions. Biotherapics 6x, 12x, 18x, 24x, 30x and water 30x were storage under refrigeration (2 to 8°C) and at room temperate (25°C) during 8 weeks. Every 15 days, the following parameters were analyzed: pH, electrical conductivity, UV absorbance (260 and 280 nm). Microbiological analyses were performed after 3 weeks by colony forming unit (CFU) method [4]. Results: The preliminary analyses performed at times zero, 15, 30 and 45 days suggest that electrical conductivity of these solutions tend to increase proportionally to storage time without significant differences due to temperature storage conditions. There was no statistically significant difference detected in pH values. Measures of absorbance of different biotherapic potencies under both conditions of storage are in course. Microbiological analyses showed no colony growth, but in the 1x sample analyzed at time zero, indicating the viability of the fungus. Conclusion: Further experiments are being carried out in order to confirm the preliminary data obtained.

Treatment with Candida albicans biotherapic influences in vitro fungal adhesion to Ma-104 cells

Background: Oral candidiasis is an opportunist fungal infection in humans, mainly caused by Candida albicans. It occurs when the host presents an imbalance in the immune system and Candida spp., normally found in human flora, become able to develop the infection [1]. This disease is very common in HIV patients, and in all individuals that present immunossupression, such as patients treated with chemotherapy. Considering this scenario, the development of new medicines to treat oral candidiasis is mandatory. Aims: The aim of this study was to evaluate citotoxicity, morphology and quantify the adhesion rates of C. albicans to biotherapic-treated Ma104 cells. Methodology: The biotherapic was prepared following the Roberto Costa technique and Brazilian Homeopathic Pharmacopeia protocol [2]. Briefly, biotherapic 1X was prepared with 1 mL of aqueous solution containing 108 yeasts of living Candida albicans plus 9 ml of sterile distilled water. This solution was submmited to 100 mechanical succussions. Biotherapic 2X was obtained after addition of 1 ml of 1X solution in 9 ml of sterile distilled water and it was also submitted to 100 mechanical succussions. This procedure was repeated until biotherapic 30X was obtained. As a control, sterile dynamized water (30X) was used. The inhibition of fungal growth induced by biotherapic was evaluated by MTT method after 24 hours of treatment. The morphological aspects of Ma104-biotherapic-treated cells were analyzed by Giemsa staining after 5, 10 and 60 days, and compared with control groups (water 30X and untreated cells). Additionally, Ma104 cells were treated during 5 and 30 days with biotherapic in parallel with respective controls, and the index adhesion of yeast cells was quantified. Results: The biotherapic was not able to reduce the viability of treated C. albicans when compared with controls. On the other hand, Ma104 treated cells presented important morphological alterations after 60 days, such as: cytoplasmic vacuoles, halos around the nucleolus and elongation of the plasmatic membrane. These changes were not observed in ,untreated cells nor in ones treated with water 30X. The adhesion index to Ma104 cells was reduced around 27% after 5 and 30 days of treatment when compared to controls. Conclusion: These results showed that the biotherapic did not present any citotoxicity, but was able to modify the morphological aspects of Ma-104 cells. Additionally, the interaction between host cells and ethilogic agent is directly influenced by biotherapic treatment, suggesting a promising antifungal potential of this medicine.