Abstract

The presence of Candida albicans in the biofilm underlying the dental prosthesis is related to denture stomatitis (DS), an inflammatory reaction of the oral mucosa. The oral epithelium, a component of the innate immune response, has the ability to react to fungal invasion. In this study, we evaluated the in vitro effect of viable C. albicans on the apoptosis, nitric oxide (NO) production, and β-defensin 2 (hBD-2) expression and production of human palate epithelial cells (HPECs). We further determined whether or not these effects were correlated with fungal invasion of epithelial cells. Interaction between HPEC primary culture and C. albicans was obtained through either direct or indirect cell–cell contact with a supernatant from a hyphal fungus. We found that the hyphae supernatants were sufficient to induce slight HPEC apoptosis, which occurred prior to the activation of the specific mechanisms of epithelial defense. The epithelial defense responses were found to occur via NO and antimicrobial peptide hBD-2 production only during direct contact between C. albicans and HPECs and coincided with the fungus’s intraepithelial invasion. However, although the hBD-2 levels remained constant in the HPEC supernatants over time, the NO release and hBD-2 gene expression were reduced at a later time (10 h), indicating that the epithelial defense capacity against the fungal invasion was not maintained in later phases. This aspect of the immune response was associated with increased epithelial invasion and apoptosis maintenance.

Highlights

  • Denture stomatitis (DS) is an inflammatory reaction of the oral mucosa underlying removable dental prostheses, mainly upper dentures [1,2]

  • Characterization of Candida/human palate epithelial cells (HPECs) Proportion and Experimental Time by Cell Viability In Figure 1a, viable HPECs are highlighted by calcein absorption and dead cells by ethidium bromide linked to DNA, resulting in a cell viability index

  • Regarding the DC assay (Figure 1b), the cell viability assay showed that the HPECs maintained viability for over 12 h when challenged with the lowest fungal proportions (1/100, 1/40, and 1/25 Candida/HPEC)

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Summary

Introduction

Denture stomatitis (DS) is an inflammatory reaction of the oral mucosa underlying removable dental prostheses, mainly upper dentures [1,2]. Individuals in the 50–80 year age group most frequently suffer from DS, with greater involvement of the palatal mucosa [3]. It is a disease of multifactorial etiology, DS is strongly related to the fungus Candida albicans, which is commonly found in the biofilm that forms on the inner surface of acrylic dentures [1,2]. C. albicans is a commensal fungus constituent of the normal mucosal microbiota in humans [8]. Under suitably predisposing conditions, it is able to cause several mucosal diseases, including Systemic factors are involved in the pathogenesis of DS, such as immune response depression [4,5], which is common in elderly people [6,7].

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