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Papic MV, Ljujic B, Zivanovic S, Papic M, Vuletic M, Petrovic I, Gazdic Jankovic M, Virijevic K, Popovic M, Miletic Kovacevic M. Difference in immune responses to Candida albicans in two inbred strains of male rats. Arch Oral Biol 2023; 156:105808. [PMID: 37778290 DOI: 10.1016/j.archoralbio.2023.105808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/12/2023] [Accepted: 09/18/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE To 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. DESIGN Seventy 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. RESULTS Histopathological 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. CONCLUSION DA 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.
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Affiliation(s)
- Mirjana V Papic
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Biljana Ljujic
- Department of Genetics, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia; Center for Harm Reduction of Biological and Chemical Hazards, Faculty of Medical Sciences University of Kragujevac, Serbia.
| | - Suzana Zivanovic
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Milos Papic
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Miona Vuletic
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Ivana Petrovic
- Department of Clinical Microbiology, University of Kragujevac Clinical Centre, Kragujevac, Serbia
| | - Marina Gazdic Jankovic
- Department of Genetics, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia; Center for Harm Reduction of Biological and Chemical Hazards, Faculty of Medical Sciences University of Kragujevac, Serbia
| | - Katarina Virijevic
- Department of Natural Sciences, Institute for Information Technologies Kragujevac, University of Kragujevac, Serbia
| | - Milica Popovic
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Marina Miletic Kovacevic
- Center for Harm Reduction of Biological and Chemical Hazards, Faculty of Medical Sciences University of Kragujevac, Serbia; Department of Histology and Embryology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
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Patini R, Gioco G, Rupe C, Contaldo M, Serpico R, Giuliani M, Lajolo C. Oral Candida and psoriasis: Is there association? A systematic review and trial sequential analysis. Oral Dis 2023; 29:3121-3135. [PMID: 36324299 DOI: 10.1111/odi.14422] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 10/26/2022] [Accepted: 10/29/2022] [Indexed: 12/07/2023]
Abstract
To assess (i) the prevalence of oral colonization by Candida spp. in patients with psoriasis and (ii) the prevalence of oral lesions associated with Candida spp. in patients with psoriasis and identify the risk factors for oral lesions. A systematic review was conducted in accordance with PRISMA criteria. The PROSPERO registration code is CRD42019127178. PubMed, Scopus and Web of Science were used as search engines. Meta-analyses and trial sequential analyses were performed. Among the 5805 retrieved records, nine articles were included. Among 530 psoriatic patients, 255 patients had an oral Candida spp. colonisation with an odds ratio (OR) = 3.44 (95% CI:2.38-5.00). Among 490 psoriatic patients, 43 patients developed oral Candida spp. lesions with an OR = 5.31 (95% CI:1.04-27.23). Among the patients without the main predisposing factors for infections, psoriatic patients had a higher OR (3.48, 95% CI: 2.0-6.0) for Candida spp. colonization, but not for Candida spp. infection, when compared with healthy controls (p-value > 0.05). Meta-analysis showed a higher risk of Candida spp. colonisation in patients with psoriasis. Patients who received immunosuppressive therapies were also at higher risk of developing oral lesions. Further studies are needed to understand these associations.
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Affiliation(s)
- Romeo Patini
- Head and Neck Department, "Fondazione Policlinico Universitario A. Gemelli - IRCCS", School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gioele Gioco
- Head and Neck Department, "Fondazione Policlinico Universitario A. Gemelli - IRCCS", School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Cosimo Rupe
- Head and Neck Department, "Fondazione Policlinico Universitario A. Gemelli - IRCCS", School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Contaldo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Rosario Serpico
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Michele Giuliani
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Carlo Lajolo
- Head and Neck Department, "Fondazione Policlinico Universitario A. Gemelli - IRCCS", School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy
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Yamanaka-Takaichi M, Ghanian S, Katzka DA, Torgerson RR, Alavi A. Candida Infection Associated with Anti-IL-17 Medication: A Systematic Analysis and Review of the Literature. Am J Clin Dermatol 2022; 23:469-480. [PMID: 35428934 DOI: 10.1007/s40257-022-00686-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2022] [Indexed: 11/25/2022]
Abstract
Anti-interleukin (IL)-17 agents have shown excellent therapeutic efficacy in patients with psoriasis and are expected to be expanded to other chronic inflammatory diseases. However, patients receiving anti-IL-17 agents are at an increased risk of developing Candida infection, with some agents reported to increase the incidence in a dose-dependent manner. Interleukin-17 is secreted by the Th17 subset of CD4+ lymphocytes, CD8+ T cells, and innate cells, including natural killer T cells, lymphoid tissue inducer cells, innate lymphoid cells, and γδ-T cells, and plays an important role in antifungal defense. Genetic defects in the IL-17-signaling pathway in both humans and animal models render susceptibility to candidiasis caused by Candida albicans. The purpose of this narrative review is to evaluate the literature on the role of IL-17 in protection against candidiasis, the prevalence of candidiasis in anti-IL-17 agent use, and to offer clinical recommendations on the diagnosis and management of anti-IL-17 medication-associated candidiasis.
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Affiliation(s)
| | - Soha Ghanian
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - David A Katzka
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | | | - Afsaneh Alavi
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
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Armstrong AW, Blauvelt A, Mrowietz U, Strober B, Gisondi P, Merola JF, Langley RG, Ståhle M, Lebwohl M, Netea MG, Nunez Gomez N, Warren RB. A Practical Guide to the Management of Oral Candidiasis in Patients with Plaque Psoriasis Receiving Treatments That Target Interleukin-17. Dermatol Ther (Heidelb) 2022; 12:787-800. [PMID: 35167107 PMCID: PMC8941045 DOI: 10.1007/s13555-022-00687-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 01/22/2022] [Indexed: 12/21/2022] Open
Abstract
Plaque psoriasis is an immune-mediated inflammatory skin disease associated with the dysregulation of cytokines, especially those involved in the interleukin (IL)-23/IL-17 pathways. In recent years, there has been growing interest in developing biologic therapies that target these pathways. However, inhibition of the cytokines of the IL-23/IL-17 pathways may increase patients' risk of developing fungal infections, particularly oral candidiasis. Therefore, it is important that dermatology practitioners can effectively diagnose and treat oral candidiasis. In this review, we examine the role of the IL-23/IL-17 pathways in antifungal host defense, and provide a practical guide to the diagnosis and treatment of oral candidiasis in patients with psoriasis. Overall, while treatment with anti-IL-17 medications leads to an increased incidence of oral candidiasis in patients with psoriasis, these cases are typically mild or moderate in severity and can be managed with standard antifungal therapy without discontinuing treatment for psoriasis. If applicable, patients with psoriasis should also be advised to practice good oral hygiene and manage or control co-existing diabetes, and should be provided with information on smoking cessation to prevent oral candidiasis.
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Affiliation(s)
- April W Armstrong
- Department of Dermatology, Keck School of Medicine of USC, 1975 Zonal Ave, Los Angeles, CA, 90033, USA.
| | | | - Ulrich Mrowietz
- Psoriasis-Center at the Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Bruce Strober
- Yale University, New Haven, CT, USA
- Central Connecticut Dermatology Research, Cromwell, CT, USA
| | | | - Joseph F Merola
- Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Richard G Langley
- Division of Dermatology, Department of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Mona Ståhle
- Department of Medicine, Unit of Dermatology, Karolinska Institutet, Solna, Sweden
| | - Mark Lebwohl
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mihai G Netea
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Richard B Warren
- Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester NIHR Biomedical Research Centre, The University of Manchester, Manchester, UK
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5
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Elsner K, Holstein J, Hilke FJ, Blumenstock G, Walker B, Schmidt S, Schaller M, Ghoreschi K, Meier K. Prevalence of Candida species in Psoriasis. Mycoses 2021; 65:247-254. [PMID: 34787934 DOI: 10.1111/myc.13399] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 11/09/2021] [Accepted: 11/16/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Psoriasis patients are more frequently colonised with Candida species. The correlation between fungal colonisation and clinical severity is unclear, but may exacerbate psoriasis and the impact of antipsoriatic therapies on the prevalence of Candida is unknown. OBJECTIVES To examine the prevalence of C species in psoriasis patients compared to an age- and sex-matched control population, we investigated the influence of Candida colonisation on disease severity, immune cell activation and the interplay on psoriatic treatments. METHODS The prevalence of C species was examined in 265 psoriasis patients and 200 control subjects by swabs and stool samples for fungal cultures. Peripheral mononuclear blood cells (PBMCs) were collected from 20 fungal colonised and 24 uncolonised patients and stimulated. The expression of interferon (IFN)-γ, IL-17A, IL-22 and tumour necrosis factor (TNF)-α from stimulated PBMCs was measured by quantitative real-time polymerase chain reaction (qPCR). RESULTS A significantly higher prevalence for Candida was detected in psoriatic patients (p ≤ .001) compared to the control subjects; most abundant in stool samples, showing Candida albicans. Older participants (≥51 years) were more frequent colonised, and no correlation with gender, disease severity or systemic treatments like IL-17 inhibitors was found. CONCLUSIONS Although Candida colonisation is significantly more common in patients with psoriasis, it does not influence the psoriatic disease or cytokine response. Our study showed that Candida colonisation is particularly more frequent in patients with psoriasis ≥51 years of age. Therefore, especially this group should be screened for symptoms of candidiasis during treatment with IL-17 inhibitors.
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Affiliation(s)
- Kevin Elsner
- Department of Dermatology, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Julia Holstein
- Department of Dermatology, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Franz Joachim Hilke
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Gunnar Blumenstock
- Deptartment of Clinical Epidemiology and Biostatistics, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Birgit Walker
- Department of Dermatology, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Sybille Schmidt
- Department of Dermatology, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Martin Schaller
- Department of Dermatology, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Kamran Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Katharina Meier
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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de Jesús-Gil C, Sans-de San Nicolàs L, Ruiz-Romeu E, Ferran M, Soria-Martínez L, García-Jiménez I, Chiriac A, Casanova-Seuma JM, Fernández-Armenteros JM, Owens S, Celada A, Howell MD, Pujol RM, Santamaria-Babí LF. Interplay between Humoral and CLA + T Cell Response against Candida albicans in Psoriasis. Int J Mol Sci 2021; 22:ijms22041519. [PMID: 33546306 PMCID: PMC7913574 DOI: 10.3390/ijms22041519] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 01/28/2021] [Accepted: 01/29/2021] [Indexed: 12/15/2022] Open
Abstract
Candida albicans (CA) infections have been associated with psoriasis onset or disease flares. However, the integrated immune response against this fungus is still poorly characterized in psoriasis. We studied specific immunoglobulins in plasma and the CA response in cocultures of circulating memory CD45RA- cutaneous lymphocyte antigen (CLA)+/- T cell with autologous epidermal cells from plaque and guttate psoriasis patients (cohort 1, n = 52), and also healthy individuals (n = 17). A complete proteomic profile was also evaluated in plaque psoriasis patients (cohort 2, n = 114) regarding their anti-CA IgA levels. Increased anti-CA IgA and IgG levels are present in the plasma from plaque but not guttate psoriasis compared to healthy controls. CA cellular response is confined to CLA+ T cells and is primarily Th17. The levels of anti-CA IgA are directly associated with CLA+ Th17 response in plaque psoriasis. Proteomic analysis revealed distinct profiles in psoriasis patients with high anti-CA IgA. C-C motif chemokine ligand 18, chitinase-3-like protein 1 and azurocidin were significantly elevated in the plasma from plaque psoriasis patients with high anti-CA levels and severe disease. Our results indicate a mechanism by which Candida albicans exposure can trigger a clinically relevant IL-17 response in psoriasis. Assessing anti-CA IgA levels may be useful in order to evaluate chronic psoriasis patients.
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Affiliation(s)
- Carmen de Jesús-Gil
- Translational Immunology, Department of Cellular Biology, Physiology and Immunology, Faculty of Biology, Universitat de Barcelona, 08028 Barcelona, Spain; (C.d.J.-G.); (L.S.-d.S.N.); (E.R.-R.); (L.S.-M.); (I.G.-J.)
| | - Lídia Sans-de San Nicolàs
- Translational Immunology, Department of Cellular Biology, Physiology and Immunology, Faculty of Biology, Universitat de Barcelona, 08028 Barcelona, Spain; (C.d.J.-G.); (L.S.-d.S.N.); (E.R.-R.); (L.S.-M.); (I.G.-J.)
| | - Ester Ruiz-Romeu
- Translational Immunology, Department of Cellular Biology, Physiology and Immunology, Faculty of Biology, Universitat de Barcelona, 08028 Barcelona, Spain; (C.d.J.-G.); (L.S.-d.S.N.); (E.R.-R.); (L.S.-M.); (I.G.-J.)
| | - Marta Ferran
- Department of Dermatology, Hospital del Mar, 08003 Barcelona, Spain; (M.F.); (R.M.P.)
| | - Laura Soria-Martínez
- Translational Immunology, Department of Cellular Biology, Physiology and Immunology, Faculty of Biology, Universitat de Barcelona, 08028 Barcelona, Spain; (C.d.J.-G.); (L.S.-d.S.N.); (E.R.-R.); (L.S.-M.); (I.G.-J.)
| | - Irene García-Jiménez
- Translational Immunology, Department of Cellular Biology, Physiology and Immunology, Faculty of Biology, Universitat de Barcelona, 08028 Barcelona, Spain; (C.d.J.-G.); (L.S.-d.S.N.); (E.R.-R.); (L.S.-M.); (I.G.-J.)
| | - Anca Chiriac
- Department of Dermatophysiology, Apollonia University, 700613 Iasi, Romania;
| | - Josep Manel Casanova-Seuma
- Department of Dermatology, Hospital Universitari Arnau de Vilanova, 25198 Lleida, Spain; (J.M.C.-S.); (J.M.F.-A.)
| | | | - Sherry Owens
- Translational Sciences, Incyte Corporation, Wilmington, DE 19803, USA; (S.O.); (M.D.H.)
| | - Antonio Celada
- Macrophage Biology, Department of Cellular Biology, Physiology and Immunology, Faculty of Biology, Universitat de Barcelona, 08028 Barcelona, Spain;
| | - Michael D. Howell
- Translational Sciences, Incyte Corporation, Wilmington, DE 19803, USA; (S.O.); (M.D.H.)
| | - Ramòn María Pujol
- Department of Dermatology, Hospital del Mar, 08003 Barcelona, Spain; (M.F.); (R.M.P.)
| | - Luis Francisco Santamaria-Babí
- Translational Immunology, Department of Cellular Biology, Physiology and Immunology, Faculty of Biology, Universitat de Barcelona, 08028 Barcelona, Spain; (C.d.J.-G.); (L.S.-d.S.N.); (E.R.-R.); (L.S.-M.); (I.G.-J.)
- Correspondence: ; Tel.: +34-677375160
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Immunity to commensal skin fungi promotes psoriasiform skin inflammation. Proc Natl Acad Sci U S A 2020; 117:16465-16474. [PMID: 32601220 DOI: 10.1073/pnas.2003022117] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Under steady-state conditions, the immune system is poised to sense and respond to the microbiota. As such, immunity to the microbiota, including T cell responses, is expected to precede any inflammatory trigger. How this pool of preformed microbiota-specific T cells contributes to tissue pathologies remains unclear. Here, using an experimental model of psoriasis, we show that recall responses to commensal skin fungi can significantly aggravate tissue inflammation. Enhanced pathology caused by fungi preexposure depends on Th17 responses and neutrophil extracellular traps and recapitulates features of the transcriptional landscape of human lesional psoriatic skin. Together, our results propose that recall responses directed to skin fungi can directly promote skin inflammation and that exploration of tissue inflammation should be assessed in the context of recall responses to the microbiota.
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Galluzzo M, Talamonti M, De Simone C, D'Adamio S, Moretta G, Tambone S, Caldarola G, Fargnoli MC, Peris K, Bianchi L. Secukinumab in moderate-to-severe plaque psoriasis: a multi-center, retrospective, real-life study up to 52 weeks observation. Expert Opin Biol Ther 2018; 18:727-735. [PMID: 29798698 DOI: 10.1080/14712598.2018.1481503] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To evaluate efficacy and safety of the anti-IL-17 drug secukinumab in a real-life large cohort of patients with moderate-to-severe plaque psoriasis in Central Italy. METHODS Multicenter, retrospective study with an observation period of up to 52 weeks. Efficacy was assessed by Psoriasis Area and Severity Index (PASI) score; clinical and laboratory examinations were performed at baseline and at weeks 4, 12, 24, 36, and 52. RESULTS A 90% and a 100% PASI score reduction (PASI90 and PASI100) were reported in 67.5% and 55% of patients at week 12, respectively. A rapid improvement of skin lesions was observed particularly in young patients and in patients naïve to biologics: at week 4, the achievement of PASI90 and PASI100 was higher in younger patients (odds ratio [OR] 0.95, and 0.95; p = 0.003, and 0.005, respectively); PASI90 was achieved by 42.0% of patients naïve to biologics and by 17.0% of patients with prior exposure to biologics (PBT) (OR 0.24; p = 0.001); and PASI100 was reached by 25.5% of naïve patients and 9.8% of PBT (OR 0.28; p = 0.015).The drug was well tolerated. CONCLUSION Secukinumab was effective in this real-life analysis, with rapid clinical improvement and long-term maintenance of results.
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Affiliation(s)
- Marco Galluzzo
- a Dermatology, Department of "Medicina dei Sistemi" , University of Rome Tor Vergata , Rome , Italy
| | - Marina Talamonti
- a Dermatology, Department of "Medicina dei Sistemi" , University of Rome Tor Vergata , Rome , Italy
| | - Clara De Simone
- b Institute of Dermatology , Catholic University of the Sacred Heart , Rome , Italy
| | - Simone D'Adamio
- a Dermatology, Department of "Medicina dei Sistemi" , University of Rome Tor Vergata , Rome , Italy
| | - Gaia Moretta
- b Institute of Dermatology , Catholic University of the Sacred Heart , Rome , Italy
| | - Sara Tambone
- c Department of Dermatology , University of L'Aquila , L'Aquila , Italy
| | - Giacomo Caldarola
- b Institute of Dermatology , Catholic University of the Sacred Heart , Rome , Italy
| | | | - Ketty Peris
- b Institute of Dermatology , Catholic University of the Sacred Heart , Rome , Italy
| | - Luca Bianchi
- a Dermatology, Department of "Medicina dei Sistemi" , University of Rome Tor Vergata , Rome , Italy
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Pietrzak A, Grywalska E, Socha M, Roliński J, Franciszkiewicz-Pietrzak K, Rudnicka L, Rudzki M, Krasowska D. Prevalence and Possible Role of Candida Species in Patients with Psoriasis: A Systematic Review and Meta-Analysis. Mediators Inflamm 2018; 2018:9602362. [PMID: 29853795 PMCID: PMC5960518 DOI: 10.1155/2018/9602362] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 04/08/2018] [Indexed: 12/15/2022] Open
Abstract
Although fungal colonization is implicated in the pathogenesis of psoriasis, its prevalence remains unclear. The aim of this systematic review and meta-analysis was to provide an overview on the prevalence of Candida species in patients with psoriasis. We searched databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and http://clinicaltrials.gov) to identify studies involving subjects of any age with an established diagnosis of psoriasis and healthy controls, who were tested for carriage of Candida spp. on the skin or mucosal membranes (or saliva and stool), or presented with clinical candidiasis with microbiologically confirmed etiology. We identified nine cross-sectional studies including a total of 1038 subjects with psoriasis (psoriatics) and 669 controls. We found Candida species detection rates for psoriatics were significantly higher than those in the controls, especially in the oral mucosa milieux. These results suggest psoriasis may be one of the systemic diseases that predispose to oral Candida spp. carriage and infection.
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Affiliation(s)
- Aldona Pietrzak
- Department of Dermatology, Venereology and Pediatric Dermatology, Medical University of Lublin, Ul. Radziwillowska 13, 20-080 Lublin, Poland
| | - Ewelina Grywalska
- Department of Clinical Immunology and Immunotherapy, Medical University of Lublin, Ul. Chodźki 4a, 20-093 Lublin, Poland
| | - Mateusz Socha
- Department of Internal Medicine and Cardiology, First Military Clinical Hospital with the Outpatient Clinic, Al. Racławickie 23, 20-048 Lublin, Poland
| | - Jacek Roliński
- Department of Clinical Immunology and Immunotherapy, Medical University of Lublin, Ul. Chodźki 4a, 20-093 Lublin, Poland
| | | | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Ul. Koszykowa 82a, 02-008 Warsaw, Poland
| | - Marcin Rudzki
- Chair and Department of Jaw Orthopaedics, Medical University of Lublin, Ul. Karmelicka 7, 20-081 Lublin, Poland
| | - Dorota Krasowska
- Department of Dermatology, Venereology and Pediatric Dermatology, Medical University of Lublin, Ul. Radziwillowska 13, 20-080 Lublin, Poland
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10
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Lesan S, Toosi R, Aliakbarzadeh R, Daneshpazhooh M, Mahmoudi L, Tavakolpour S, Mahmoudi H. Oral Candida colonization and plaque type psoriasis: Is there any relationship? ACTA ACUST UNITED AC 2018; 9:e12335. [PMID: 29603683 DOI: 10.1111/jicd.12335] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Accepted: 02/01/2018] [Indexed: 12/19/2022]
Abstract
AIM The potential role of superantigens derived from microbial agents could be considered in the pathogenesis of psoriasis, but the association between Candida albicans and psoriasis severity is still controversial. The present study was designed to compare the prevalence of oral candidiasis in a group of psoriatic patients and healthy patients, and its correlation with psoriasis severity. METHODS Seventy psoriatic patients with no history of systemic treatment and 70 closely-matched control patients underwent oral examination. Scraping of oral mucosa to detect Candida species was done using a sterile cytobrush. RESULTS Candida was detected in the oral cavity of 20% of patients with psoriasis and 2.8% of control cases (P = .002), but none had clinical features of oral candidiasis. Candida albicans was the only species isolated from the oral cavity of both groups. No correlation was found between sex, age, phototherapy, and presence of oral candidiasis. There was a positive correlation between psoriasis severity and colony count (P < .001). CONCLUSIONS The prevalence of oral candidiasis is higher in psoriatic patients and is associated with disease severity. It is not exactly clear whether oral candidiasis can aggravate psoriasis or if psoriasis can predispose patients to oral candidiasis.
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Affiliation(s)
- Simin Lesan
- Department of Oral Disease and Diagnosis, Islamic Azad University, Tehran, Iran
| | - Roja Toosi
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Aliakbarzadeh
- Department of Oral Disease and Diagnosis, Islamic Azad University, Tehran, Iran
| | - Maryam Daneshpazhooh
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Mahmoudi
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Tavakolpour
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Mahmoudi
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Management of Moderate to Severe Plaque Psoriasis: The Emerging Role of IL-17 Inhibition. J Cutan Med Surg 2017; 21:2S-40S. [DOI: 10.1177/1203475417722552] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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12
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Saunte D, Mrowietz U, Puig L, Zachariae C. Candida
infections in patients with psoriasis and psoriatic arthritis treated with interleukin-17 inhibitors and their practical management. Br J Dermatol 2017; 177:47-62. [DOI: 10.1111/bjd.15015] [Citation(s) in RCA: 175] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2016] [Indexed: 12/13/2022]
Affiliation(s)
- D.M. Saunte
- Department of Dermatology; Zealand University Hospital; Roskilde Denmark
| | - U. Mrowietz
- Psoriasis Center; Department of Dermatology; University Medical Center Schleswig-Holstein; Campus Kiel Germany
| | - L. Puig
- Department of Dermatology; Hospital de la Santa Creu i Sant Pau; Universitat Autònoma de Barcelona; Barcelona Spain
| | - C. Zachariae
- Department of Dermatology and Allergy; Herlev and Gentofte Hospital; University of Copenhagen; Hellerup Denmark
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13
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14
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