Development Of Oral Candidiasis Research Articles

Difference in immune responses to Candida albicans in two inbred strains of male rats

ObjectiveTo investigate the influence of strain differences in immune response on the pathogenesis of oral candidiasis in Dark Agouti (DA) and Albino Oxford (AO) inbred strains of rats. DesignSeventy male 8-weeks old DA and AO rats were inoculated with Candida albicans to induce three different experimental models of oral candidiasis, one immunocompetent and two immunocompromised models. The animals were sacrificed after 16 days from the beginning of the experiment followed by collecting the samples of the tongue dorsum and blood for histopathological (PAS and H&E staining), immunohistochemical, qRT-PCR, and oxidative stress analyses. ResultsHistopathological and immunohistochemical analyses revealed lower levels of epithelial colonization, epithelial damage, and inflammatory infiltration in DA compared to AO strain of rats. DA rats had fewer CD45, CD68, and CD3 positive cells but more HIS 48 positive cells than AO rats. The expressions of IL-1β, TNFα, IFN-γ, IL-10 and TGF-β1 were consistently higher in DA strain across all experimental models. However, the expressions of IL-4 and IL-17 differed inconsistently between DA and AO strain in various experimental models. Strain differences were observed in levels of prooxidative hydrogen peroxide and lipid peroxidation, with higher levels presented in AO rats compared to DA rats, while antioxidative parameters presented little yet inconsistent difference between strains. ConclusionDA strain of rats consistently presented lower susceptibility to oral infection with C. albicans compared to AO strain with robust Th1/Th17 immune response indicating the importance of the genetic background on the development of oral candidiasis.

Antimicrobial effect of Streptococcus salivarius outer membrane-coated nanocomplexes against Candida albicans and oral candidiasis

Oral mucosal infection, especially oral candidiasis, is currently the most common oral mucosal disease. Traditional drug treatment regimens have difficulty adhering to mucous membranes, coupled with the unique anatomical and physiological characteristics of the oral cavity, thus reducing drug availability and limiting the effective time of drug action. Inspired by cell membrane-coated nanoparticles, this study aimed to construct a bionic adherent oral mucosal drug delivery system and investigated its therapeutic potential for oral candidiasis. The system was obtained by encapsulating Streptococcus salivarius K12 membranes on triclosan-loaded PLGA nanoparticles using an extrusion method. The constructed nanocomplexes (K12/TCS@PLGA-NPs) inherited the properties of the source cell membrane, bionically adhering to the oral mucosa and binding to the candida albicans hypha. Our in vitro and in vivo experiments have confirmed that K12/TCS@PLGA-NPs nanocomplexes significantly inhibits the formation of C. albicans biofilms and the development of oral candidiasis by enhancing the accumulation of drugs in lesions, optimizing drug efficacy. Furthermore, the biomimetic nanocomplexes could be considered safe and effective drug delivery systems, which hold considerable therapeutic promise for oral mucosal infections including candidiasis.

PROSTHETIC STOMATITIS

Introduction: Candidiasis or Candidosis are designated names designated as infectious names for fungi of the genus Candida spp., which establish a commensal relationship with the immune system when the system is depressed or by some pathogenic infections. As proposals of oral candidiasis can be hyperplastic in primary and secondary cited by the following types: pseudoplastic, erythematous, pseudomembrane, erythematous; there is a category called “lesions also associated with Candida spp.”, which includes denture stomatitis (PE). Knowing the relationship between the development of the disease and the use of dental prosthesis, the present work aims to carry out a literature review on the subject. Methodology: This is a descriptive work with a qualitative aspect of literature review, where they were used as sources of scientific and scientific research. The search platforms used were PubMed, Scielo and the Virtual Health Library. Results and discussion: The presence of devices or devices such as appliances or orthodontic appliances can provoke or modify the best of the microbiota, due to the physical-bio oral environment. In addition, the prosthesis is often related to the use of oral prostheses, such as traumatic ulcers, mucogingival hyperplasia and many oral candidiasis. One of the causes of PE is the proper use of the prosthesis, which, associated with poor hygiene, can be a factor that potentiates the disease; therefore, it is extremely important that the patient is advised about the risk of developing the condition and how to avoid it. Final considerations: The relationship between the use of dental prosthesis and the development of oral candidiasis is well related in the literature. Therefore, dental professionals must take care of patients who use the device for disease care, seeking to improve the possibility of disease development.

Molecular Mapping of Antifungal Mechanisms Accessing Biomaterials and New Agents to Target Oral Candidiasis.

Oral candidiasis has a high rate of development, especially in immunocompromised patients. Immunosuppressive and cytotoxic therapies in hospitalized HIV and cancer patients are known to induce the poor management of adverse reactions, where local and systemic candidiasis become highly resistant to conventional antifungal therapy. The development of oral candidiasis is triggered by several mechanisms that determine oral epithelium imbalances, resulting in poor local defense and a delayed immune system response. As a result, pathogenic fungi colonies disseminate and form resistant biofilms, promoting serious challenges in initiating a proper therapeutic protocol. Hence, this study of the literature aimed to discuss possibilities and new trends through antifungal therapy for buccal drug administration. A large number of studies explored the antifungal activity of new agents or synergic components that may enhance the effect of classic drugs. It was of significant interest to find connections between smart biomaterials and their activity, to find molecular responses and mechanisms that can conquer the multidrug resistance of fungi strains, and to transpose them into a molecular map. Overall, attention is focused on the nanocolloids domain, nanoparticles, nanocomposite synthesis, and the design of polymeric platforms to satisfy sustained antifungal activity and high biocompatibility with the oral mucosa.

Fungal diseases: Oral dysbiosis in susceptible hosts.

The oral cavity is colonized by a large number of microorganisms that are referred to collectively as the oral microbiota. These indigenous microorganisms have evolved in symbiotic relationships with the oral mucosal immune system and are involved in maintaining homeostasis in the oral cavity. Although Candida species are commonly found in the healthy oral cavity without causing infection, these fungi can become pathogenic. Recents advances indicate that the development of oral candidiasis is driven both by Candida albicans overgrowth in a dysbiotic microbiome and by disturbances in the host's immune system. Perturbation of the oral microbiota triggered by host-extrinsic (ie, medications), host-intrinsic (ie, host genetics), and microbiome-intrinsic (ie, microbial interactions) factors may increase the risk of oral candidiasis. In this review, we provide an overview of the oral mycobiome, with a particular focus on the interactions of Candida albicans with some of the most common oral bacteria and the oral mucosal immune system. Also, we present a summary of our current knowledge of the host-intrinsic and host-extrinsic factors that can predispose to oral candidiasis.

The Anti-Biofilm Efficacy of Caffeic Acid Phenethyl Ester (CAPE) In Vitro and a Murine Model of Oral Candidiasis.

Candida albicans is the main fungal species associated with the development of oral candidiasis. Currently, therapeutic options for these infections are limited by the adverse effects of antifungal drugs and by the emergence of drug resistant strains. Thus, the development of new antifungal agents is needed for the prevention and treatment of oral Candida infections. Caffeic acid phenethyl ester (CAPE) is a natural compound from propolis polyphenolic groups that exhibits many pharmacological properties. In this study, we investigated whether CAPE can have antifungal and immunomodulatory effects on oral candidiasis. Preliminary tests to assess the antifungal activity of CAPE were performed using the Minimum Inhibitory Concentration (MIC) assay that demonstrated inhibition in a range from 16 to 32 μg/mL, confirming its antifungal activity on several C. albicans strains isolated from the oral cavity. Subsequently, we analyzed Candida spp biofilms formed in vitro, in which CAPE treatment at 5 x MIC caused a reduction of 68.5% in the total biomass and ~2.60 Log in the viable cell count (CFU/mL) in relation to the untreated biofilm (p<0.0001). Next, RNA was extracted from untreated and CAPE-treated biofilms and analyzed by real-time qPCR. A series of genes analyzed (ALS1, ECE1, EPA1, HWP1, YWP1, BCR1, BGR1, CPH1, EFG1, NDT80, ROB1, TEC1, UME6, SAP2, SAP5, PBL2, and LIP9) were downregulated by CAPE compared to the untreated control group (p<0.0001). In in vivo studies using Galleria mellonella, the treatment with CAPE prolonged survival of larvae infected by C. albicans by 44.5% (p < 0.05) and accompanied by a 2.07-fold increase in the number of hemocytes. Flow cytometry revealed the most prominent increases were in types P2 and P3 hemocytes, granular cells, which phagocytize pathogens. In addition, CAPE treatment decreased the fungal load in the hemolymph and stimulated the expression of antifungal peptide genes such as galiomicin and gallerimycin. The antifungal and immunomodulatory activities observed in G. mellonella were extended to a murine model of oral candidiasis, in which CAPE decreased the levels of C. albicans colonization (~2 log CFU/mL) in relation to the untreated control group. In addition, CAPE treatment significantly reduced pseudomembranous lesions, invasion of hyphae on epithelium surfaces, tissue damage and inflammatory infiltrate (p < 0.05). CAPE was also able to increase the expression of β-defensin 3 compared to the infected and untreated group by 3.91-fold (p < 0.0001). Taken together, these results show that CAPE has both antifungal and immunomodulatory effects, making it a promising natural antifungal agent for the treatment and prevention of candidiasis and shows impact to oral candidiasis.

Oral candidiasis is a significant predictor of subsequent severe infections during immunosuppressive therapy in anti-neutrophil cytoplasmic antibody-associated vasculitis

BackgroundSeveral studies have identified predictors of severe infections in antineutrophil cytoplasmic antibody-associated vasculitis (AAV). However, the development of oral candidiasis (OC) as a predictor of subsequent severe infections has not been evaluated. The aim of this study was to assess the association between OC and subsequent severe infection requiring hospitalization during immunosuppressive therapy in AAV.MethodsThis single-center retrospective cohort study included 71 consecutive patients with newly diagnosed AAV from Aichi Medical University Hospital, Japan, starting immunosuppressive therapy between March 2013 and December 2018. The relationships between OC and subsequent severe infections were assessed using multivariate Cox proportional hazards models, adjusted for clinically relevant factors.ResultsDuring the follow-up period (median, 23 months; interquartile range, 11–51 months), 25 severe infectious episodes occurred in 19 patients (26.8%) and OC occurred in 17 patients (23.9%). A log-rank test showed that the OC group was significantly associated with severe infection (P < 0.001). Multivariate Cox proportional hazards models identified lower serum albumin (per 1 g/dl adjusted hazard ratio (HR) = 0.38, 95% confidence interval (CI): 0.15–0.85; P = 0.018), use of methylprednisolone pulse (adjusted HR = 5.44, 95% CI: 1.54–20.0; P = 0.010), and OC (adjusted HR = 5.31, 95% CI: 1.86–15.8; P = 0.002) as significant predictors of severe infection. Furthermore, a significant effect modification of the use of methylprednisolone pulse on OC was observed (P < 0.001).ConclusionsOC is one of the predictors of subsequent severe infections. The results suggest the importance of prolonging infection surveillance, especially for patients who developed OC under strong immunosuppressive therapy.

Integrated Analysis of Clinical and Microbiome Risk Factors Associated with the Development of Oral Candidiasis during Cancer Chemotherapy.

Oral candidiasis is a common side effect of cancer chemotherapy. To better understand predisposing factors, we followed forty-five subjects who received 5-fluorouracil- or doxorubicin-based treatment, during one chemotherapy cycle. Subjects were evaluated at baseline, prior to the first infusion, and at three additional visits within a two-week window. We assessed the demographic, medical and oral health parameters, neutrophil surveillance, and characterized the salivary bacteriome and mycobiome communities through amplicon high throughput sequencing. Twenty percent of all subjects developed oral candidiasis. Using multivariate statistics, we identified smoking, amount of dental plaque, low bacteriome and mycobiome alpha-diversity, and the proportions of specific bacterial and fungal taxa as baseline predictors of oral candidiasis development during the treatment cycle. All subjects who developed oral candidiasis had baseline microbiome communities dominated by Candida and enriched in aciduric bacteria. Longitudinally, oral candidiasis was associated with a decrease in salivary flow prior to lesion development, and occurred simultaneously or before oral mucositis. Candidiasis was also longitudinally associated with a decrease in peripheral neutrophils but increased the neutrophil killing capacity of Candida albicans. Oral candidiasis was not found to be associated with mycobiome structure shifts during the cycle but was the result of an increase in Candida load, with C. albicans and Candida dubliniensis being the most abundant species comprising the salivary mycobiome of the affected subjects. In conclusion, we identified a set of clinical and microbiome baseline factors associated with susceptibility to oral candidiasis, which might be useful tools in identifying at risk individuals, prior to chemotherapy.

Effect of Mongolian Herbal Tea on Growth of Candida albicans.

Candida albicans, one of the main pathogens in the oral cavity, is involved in the development of oral candidiasis. Various components of tea, and especially polyphenols, are believed to be effective against the growth of yeast or bacteria. The purpose of this study was to investigate the effect of polyphenols in Mongolian herbal tea on growth of C. albicans. Tea extract was prepared from Mongolian herbal tea and diluted with distilled water (DW) at concentrations of 10, 20, 30, 40, or 50%. Distilled water was used as the control. Acidification of the medium was determined by measuring its pH; the presence of polyphenols by the Folin-Ciocalteau colorimetric method; and growth of C. albicans by absorbance at a wavelength of 630 nm at 0-, 6-, 12-, and 24-hr intervals. The pH of the medium was 5.2 to 5.27 in all experimental groups compared with 7.1 in the control group. Polyphenols were present in all experimental groups, and at significantly higher levels than in the control group. Growth of C. albicans showed a significant and time-dependent increase in the control and all experimental groups. Growth of C. albicans in all the experimental groups was higher than that in the control group. These results suggest that Mongolian herbal tea promotes the growth of C. albicans, despite the presence of polyphenols.

Antifungal activity of some toothpastes and antiseptic solutions against yeasts isolated from the oral cavity of cancer radiated patients

This study aimed to investigate the antifungal efficacy of different types of toothpaste andsome antiseptic solutions with varying concentrations against yeast isolated from the oral cavityof radiated patients suffering from head and neck cancer in radiotherapy unit in Suez CanalUniversity teaching’s hospital, Egypt. Eight different species of yeast were isolatedtaxonomically, assigned to 1 phylum, two classes, one order, and three families and identifiedphenotypically. The antifungal activity of five kinds of toothpaste and three antiseptic solutionswere investigated by agar well diffusion method against the eight isolated yeasts namely:Candida glabrata, C. albicans, C. tropicalis, C. kefyr, C. guilliermondii, C. parapsilosis,Dipodascus geotrichum and Geotrichum beigelii and expressed as the value of the clear zonediameter, however, Their activity was expressed by minimum inhibitory concentration (MIC).Results showed that toothpaste no 1, 3, 4 and 5 were effective against all tested taxa by variableinhibitory degrees. However, no. 2 showed efficacy only against C. glabrata, C. guilliermondii,and C. parapsilosis, Antiseptic solution no 1 showed the highest efficacy against all testedspecies except C. kefyr while no. 2 was effective against all the tested species except two taxaand finally no. 3 exhibited good antifungal activity against all the tested taxa. In conclusion, werecommended the use of toothpaste contained sodium monofluorophosphate, or sodium fluoride,as an active component followed by a mouthwash which contained Chlorohexidine orCetylpridinium or miswak as active components to prevent colonization and development of oralcandidiasis, especially in cancer patients.

Pathogenic characteristics of Candida albicans isolated from oral cavities of denture wearers and cancer patients wearing oral prostheses

Candida albicans cause opportunistic infections including oral candidiasis in immunocompromised patients. It has an ability to cause infection due to its virulence factors. This study investigated the pathogenic characteristics of C. albicans isolated from the oral cavities of healthy subjects and two vulnerable groups, denture wearers and cancer patients wearing oral prostheses.Oral rinse samples were collected and cultured for the quantitative and qualitative analysis of Candida. Twenty strains of C. albicans isolated from the healthy individuals and denture wearers and, 14 strains isolated from the cancer patients were selected and their pathogenic characteristics were measured. The results of the study groups were compared using a Scheffe test for pairwise comparison and a chi square test.Denture wearer and cancer patients with prostheses carried significantly higher number (p < 0.01) and a variety of Candida than the normal individuals. Denture wearer and cancer patients carried several Candida species. The adherence abilities (p = 0.01) as well as phospholipase (p < 0.01) and proteinase (p = 0.03) production were significantly higher in the strains from denture wearers. In addition, high number of isolates from the denture wearers produced phospholipase and proteinase (85% and 80% respectively) compared to the strains from normal subjects (25% and 60% respectively). Only the germ tube formation and adherence ability were significantly higher in the strains from the cancer patients with prostheses (p = 0.05 and p < 0.01 respectively).In conclusion, during the commensal state, the increased expression of virulence factors in the denture wearers suggests the readiness of these strains to cause infection in this group. The high number of C. albicans and their increased adherence ability in the two study groups suggest that hygiene of oral cavity and prostheses is important in the prevention of colonization of Candida and the development of oral candidiasis.

Antifungal Activity of Hydroalcoholic Extract of Chrysobalanus icaco Against Oral Clinical Isolates of Candida Species.

Background:Chrysobalanus icaco is a medicinal plant commonly used to treat fungal infections in Brazilian Amazonian region.Objective:This work aimed to evaluate the antifungal activity of the hydroalcoholic extract of C. icaco (HECi) against oral clinical isolates of Candida spp. and to determine the pharmacognostic parameters of the herbal drug and the phytochemical characteristics of HECi.Materials and Methods:The pharmacognostic characterization was performed using pharmacopoeial techniques. Phytochemical screening, total flavonoid content, and high-performance liquid chromatography (HPLC) analysis were used to investigate the chemical composition of the HECi. A broth microdilution method was used to determine the antifungal activity of the extract against 11 oral clinical isolates of Candida spp.Results:Herbal drug presented parameters which were within the limits set forth in current Brazilian legislation. A high amount of flavonoid content (132,959.33 ± 12,598.23 μg quercetin equivalent/g of extract) was found in HECi. Flavonoids such as myricetin and rutin were detected in the extract by HPLC analyses. HECi showed antifungal activity against oral isolates of Candida albicans and Candida parapsilosis (minimum inhibitory concentrations [MIC] 3.12 and 6.25 mg/mL, respectively), and C. albicans American American Type Culture Collection (MIC <1.56 mg/mL).Conclusion:HECi was shown to possess antifungal activity against Candida species with clinical importance in the development of oral candidiasis, and these activities may be related to its chemical composition. The antifungal activity detected for C. icaco against Candida species with clinical importance in the development of oral candidiasis can be attributed to the presence of flavonoids in HECi, characterized by chromatographic and spectroscopic techniques.SUMMARY Chrysobalanus icaco presents a high amount of flavonoids in its constitutionLC analysis was able to identify the flavonoids myricetin and rutin in C. icaco hydroalcoholic extractThe C. icaco hydroalcoholic extract inhibits the growth of oral clinical isolates of Candida spp. and Candida albicans American Type Culture Collection. Abbreviations Used: HECi: Hydroalcoholic extract of C. icaco; HPLC: High performance liquid chromatography; AlCl3: Aluminum chloride; DMSO: Dimethyl sulfoxide; CH3NOONa: Sodium acetate; MTT: 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide; ATCC: American Type Culture Collection; EMBRAPA: Brazilian Agricultural Research Corporation – Eastern Amazon; v/v: Volume per volume; SD: Standard deviation; TFC: Total flavonoid content; w/v: Weight per volume; ELSD: Evaporative light scattering detector; DAD: Diode-arrange detector; UFPA: Federal University of Pará; IEC: Evandro Chagas Institute; INCQS-FIOCRUZ: National Institute of Quality Control in Health – Fundação Oswaldo Cruz; SDA: Sabouraud Dextrose Agar; CFU: Colony-forming units; MIC: Minimum inhibitory concentrations; MFC: Minimum fungicidal concentrations

Development and In Vivo Evaluation of a Novel Histatin-5 Bioadhesive Hydrogel Formulation against Oral Candidiasis.

Oral candidiasis (OC), caused by the fungal pathogen Candida albicans, is the most common opportunistic infection in HIV(+) individuals and other immunocompromised populations. The dramatic increase in resistance to common antifungals has emphasized the importance of identifying unconventional therapeutic options. Antimicrobial peptides have emerged as promising candidates for therapeutic intervention due to their broad antimicrobial properties and lack of toxicity. Histatin-5 (Hst-5) specifically has exhibited potent anticandidal activity indicating its potential as an antifungal agent. To that end, the goal of this study was to design a biocompatible hydrogel delivery system for Hst-5 application. The bioadhesive hydroxypropyl methylcellulose (HPMC) hydrogel formulation was developed for topical oral application against OC. The new formulation was evaluated in vitro for gel viscosity, Hst-5 release rate from the gel, and killing potency and, more importantly, was tested in vivo in our mouse model of OC. The findings demonstrated a controlled sustained release of Hst-5 from the polymer and rapid killing ability. Based on viable C. albicans counts recovered from tongues of treated and untreated mice, three daily applications of the formulation beginning 1 day postinfection with C. albicans were effective in protection against development of OC. Interestingly, in some cases, Hst-5 was able to clear existing lesions as well as associated tissue inflammation. These findings were confirmed by histopathology analysis of tongue tissue. Coupled with the lack of toxicity as well as anti-inflammatory and wound-healing properties of Hst-5, the findings from this study support the progression and commercial feasibility of using this compound as a novel therapeutic agent.

Does Candidal Carriage Correlate With the Development of oral Candidiasis?

Does Candidal Carriage Correlate With the Development of oral Candidiasis?

Клинический случай проявления лептотрихоза языка

&lt;p&gt;Currently, the practice of doctors and dentists are increasingly found a variety of diseases of organs and tissues of the oral cavity associated with the weakening of local and humoral immunity, the development of oral candidiasis. One such disease is leptotrihoz language. The authors describe the clinical case of a 40 year-old woman referred to the clinic complaining of difficulty in swallowing food, presence of redness on the tongue. Microbiological studies revealed leptotrihii (Leptotrichia) – anaerobic gram-negative bacteria belonging to the family Fusobacteriaceae. The features of the therapy and prevention of this disease. &lt;/p&gt;

OI0288 Function of Toll-like receptors and natural killer activity in candidiasis

Although oral candidiasis is considered to be developed by a decline of the immunocompetence of the host, little is known about the details. Therefore, this study was designed to investigate the roles of the expression and function of Toll-like receptors (TLRs) and natural killer (NK) activity in the development of oral candidiasis and in the aging of healthy individuals.

Oral Candidiasis: An Opportunistic Infection of AIDS

Copyright: © 2014 Jabra-Rizk MA. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Candida albicans (C. albicans) is an opportunistic fungal species commonly colonizing human mucosal surfaces. However, when host defenses are weakened, C. albicans can proliferate causing an array of infections ranging from mucosal to systemic infections that are often life-threatening. Specifically, oral candidiasis is considered an AIDSdefining opportunistic infection with up to 80% of HIV+ individuals suffering recurrent episodes during the course of their HIV disease progression. As a dimorphic microbial species, C. albicans is capable of switching morphology between yeast and hyphal forms. Where the yeast form is responsible for systemic disease, hyphae are invasive filaments and therefore are adept at causing mucosal infections. The mouse model is the most suitable animal model to study the development of oral candidiasis due to the similarity to the disease process in humans. (A) Following anesthesia, animals are infected sublingually using swabs saturated with C. albicans cell suspensions. (B) Five days post-infection, white lesions are seen on tongue surface rapidly developing into overt candidiasis characterized by white plaques covering the tongue and other oral surfaces. In order to visualize the process of tissue invasion by C. albicans, animals are euthanized and the tongues are harvested and subjected to histopathology analysis where tongue tissue are embedded in paraffin, sectioned and stained with Periodic Acid Schiff stain then examined by light microscopy. (C) Microscopic images of tissue sections demonstrate the extensive presence and penetration of epithelial tissue by the invasive C. albicans hyphae (white arrows) with massive influx of host immune cells (yellow arrows). Tongues were also subjected to scanning electron microscopy analysis. (D) Magnified (5000x) images of the tongue surface demonstrate penetration of hyphae from the sublingual area where C. albicans is inoculated leaving sizable gaps at sites of emergence of the hyphae through the tongue surface (red arrows). This extensive tissue invasive process by C. albicans hyphal elements is manifested clinically as white lesions characterizing oral candidiasis. A

Smoking Is an Independent Risk Factor for the Development of Oral Candidiasis (OC) in HIV-1 Infected Persons

Article title and bibliographic information Smoking as a risk factor for oral candidiasis in HIV-infected adults. Chattopadhyay A, Patton LL. J Oral Pathol Med 2013;42(4):302-08 . Reviewers Caroline H. Shiboski, DDS, MPH, PhD, Stephen C. Shiboski, PhD Purpose/Question Is smoking an independent risk factor for OC among adults with HIV/AIDS, and does smoking modify the relationship between OC and other important risk factors like CD4 cell count? Source of funding This investigation was supported by USPHS Grant 5T32DE07191, P30-HD27360, and R29DE11369 from the National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD 20892, USA Type of study/Design Cohort study Level of evidence Level 2: Limited-quality, patient-oriented evidence Strength of recommendation grade Not applicable

English

BACKGROUND: Human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) are frequently associated with mucocutaneous manifestations. However, there is paucity of data on skin disorders and association with CD4 cell counts from India. OBJECTIVE: To evaluate the occurrence of mucocutaneous disorders and their relationship with CD4 count. METHODS: A cross-sectional study was performed at Government Medical College Kota from January 2011 to January 2012. Collected information included demographic data, HIV- associated mucocutaneous disorders, CD4 cell count and highly active antiretroviral therapy (HAART). RESULTS: One hundred cases (male: female, 1.7: 1) were enrolled. The most common mode of HIV transmission was heterosexual (89%), followed by homosexual/bisexual contacts (5%), perinatal (5%) and blood transfusion (1%). The distribution of patients in terms of CD4 cell counts was as follows: 30% with less than 200 × 10 6 /L, 55% with between 200 and 500 × 10 6 /L, and 15% with more than 500× 10 6 /L. Most common skin disorders were fungal infection (46%), followed by bacterial infection (30%), viral infection (26%). Pruritic papular eruption (13%) was most common non infectious dermatoses followed by seborrheic dermatitis (8%). A CD4 cell count of less than 200×106/L was significantly associated with a higher number of mucocutaneous disorders (P = 0.005) and the development of oral candidiasis (P = 0.005) and generalized seborrheic dermatitis ( P = 0.005). There was no case of cutaneous malignancy in our study. CONCLUSION: A wide range of mucocutaneous disorders were observed in HIV-infected cases which are the indicator of AIDS and overall survival. A preponderance of infectious and inflammatory dermatoses with an absence of skin tumors characterized this study.

CONSEQUENCES OF ORAL INFECTION WITH CANDIDA ALBICANS ON THE HISTOARCHITECTONICS OF ORGANS IN MALE RATS

Experiments were conducted to evaluate the immunosuppression’s effect on the development of oral candidiasis in Wistar rats. Animals were submitted to immunosuppression in order to facilitate the establishment and persistence of Candida albicans infection. Treatment with drugs (dexamethasone and tetracycline) was initiated 7 days before C. albicans inoculation and lasted until the end of the experiments, day 9 post-inoculation, but at a higher dose for dexamethasone and at a lower dose for tetracycline. The infection was done twice at a 24 hours difference. Establishment of C. albicans infection was done by oral inoculation with 0.1 ml of saline suspension containing 3.108 3,1 x 103 viable cells of C. albicans strain ATCC 10231. Tissue injury was determined by the hystological quantification of organs collected at days 3, 6 and respectively 9 of the experiment. Our results have shown that candidiasis affected organs in male rats in the following order: tongue, intestines, liver, spleen and kidney. There was a gradual evolution of the histological lesions severity in the tongue starting from the third day towards the end, but, in reverse, all the other organs affected started having regenerative healing processes at the end of the experiment.