Candida attachment to oral epithelium

Breaking the Gingival Barrier in Periodontitis

The break of the epithelial barrier of gingiva has been a subject of minor interest, albeit playing a key role in periodontal pathology, transitory bacteraemia, and subsequent systemic low-grade inflammation (LGI). The significance of mechanically induced bacterial translocation in gingiva (e.g., via mastication and teeth brushing) has been disregarded despite the accumulated knowledge of mechanical force effects on tight junctions (TJs) and subsequent pathology in other epithelial tissues. Transitory bacteraemia is observed as a rule in gingival inflammation, but is rarely observed in clinically healthy gingiva. This implies that TJs of inflamed gingiva deteriorate, e.g., via a surplus of lipopolysaccharide (LPS), bacterial proteases, toxins, Oncostatin M (OSM), and neutrophil proteases. The inflammation-deteriorated gingival TJs rupture when exposed to physiological mechanical forces. This rupture is characterised by bacteraemia during and briefly after mastication and teeth brushing, i.e., it appears to be a dynamic process of short duration, endowed with quick repair mechanisms. In this review, we consider the bacterial, immune, and mechanical factors responsible for the increased permeability and break of the epithelial barrier of inflamed gingiva and the subsequent translocation of both viable bacteria and bacterial LPS during physiological mechanical forces, such as mastication and teeth brushing.

Osteocytic Pericellular Matrix (PCM): Accelerated Degradation under In Vivo Loading and Unloading Conditions Using a Novel Imaging Approach

The proteoglycan-containing pericellular matrix (PCM) controls both the biophysical and biochemical microenvironment of osteocytes, which are the most abundant cells embedded and dispersed in bones. As a molecular sieve, osteocytic PCMs not only regulate mass transport to and from osteocytes but also act as sensors of external mechanical environments. The turnover of osteocytic PCM remains largely unknown due to technical challenges. Here, we report a novel imaging technique based on metabolic labeling and “click-chemistry,” which labels de novo PCM as “halos” surrounding osteocytes in vitro and in vivo. We then tested the method and showed different labeling patterns in young vs. old bones. Further “pulse-chase” experiments revealed dramatic difference in the “half-life” of PCM of cultured osteocytes (~70 h) and that of osteocytes in vivo (~75 d). When mice were subjected to either 3-week hindlimb unloading or 7-week tibial loading (5.1 N, 4 Hz, 3 d/week), PCM half-life was shortened (~20 d) and degradation accelerated. Matrix metallopeptidase MMP-14 was elevated in mechanically loaded osteocytes, which may contribute to PCM degradation. This study provides a detailed procedure that enables semi-quantitative study of the osteocytic PCM remodeling in vivo and in vitro.

Quantification of Oral Candidal Carriage Rate and Prevalence of Oral Candidal Species in HIV Patients with and Without Highly Active Antiretroviral Therapy

BACKGROUND

Most documents review decrease in the prevalence of HIV related oral lesions to the tune of 10-50% following the advent of HAART. However long term use of HAART on oral health status of HIV infected subjects is poorly documented. Also antifungal agents can effectively treat mucosal candidiasis. However their use can lead to colonization with less susceptible strains among normal susceptible strains.

AIMS AND OBJECTIVES

To know the candidal carriage rate (i.e. presence/absence of candidal growth), candidal density(CFUs/ml) & species variations (species diversity) in HIV positive individuals with and without highly active anti-retroviral therapy (HAART), attending the regional voluntary Counselling and Confidential Testing Centre (VCCTC).

MATERIALS AND METHODS

The study population were categorized into 3 groups. Method followed were Germ tube test, Chlamydospore formation test, CHROM-Agar test.

RESULTS

Quantification comparison study of candidal carriage rate, density with detection of various candidal species in the oral cavity of HIV-positive individuals with and without HAART therapy was conducted.

CONCLUSION

HIV positive individuals with HAART therapy treatment prooved higher candidal carriage rate and lower density than Non-HAART category.

Preventive Applications of Polyphenols in Dentistry-A Review

Polyphenols are natural substances that have been shown to provide various health benefits. Antioxidant, anti-inflammatory, and anti-carcinogenic effects have been described. At the same time, they inhibit the actions of bacteria, viruses, and fungi. Thus, studies have also examined their effects within the oral cavity. This review provides an overview on the different polyphenols, and their structure and interactions with the tooth surface and the pellicle. In particular, the effects of various tea polyphenols on bioadhesion and erosion have been reviewed. The current research confirms that polyphenols can reduce the growth of cariogenic bacteria. Furthermore, they can decrease the adherence of bacteria to the tooth surface and improve the erosion-protective properties of the acquired enamel pellicle. Tea polyphenols, especially, have the potential to contribute to an oral health-related diet. However, in vitro studies have mainly been conducted. In situ studies and clinical studies need to be extended and supplemented in order to significantly contribute to additive prevention measures in caries prophylaxis.

Connection between Periodontitis-Induced Low-Grade Endotoxemia and Systemic Diseases: Neutrophils as Protagonists and Targets

Periodontitis is considered a promoter of many systemic diseases, but the signaling pathways of this interconnection remain elusive. Recently, it became evident that certain microbial challenges promote a heightened response of myeloid cell populations to subsequent infections either with the same or other pathogens. This phenomenon involves changes in the cell epigenetic and transcription, and is referred to as ''trained immunity''. It acts via modulation of hematopoietic stem and progenitor cells (HSPCs). A main modulation driver is the sustained, persistent low-level transmission of lipopolysaccharide from the periodontal pocket into the peripheral blood. Subsequently, the neutrophil phenotype changes and neutrophils become hyper-responsive and prone to boosted formation of neutrophil extracellular traps (NET). Cytotoxic neutrophil proteases and histones are responsible for ulcer formations on the pocket epithelium, which foster bacteremia and endoxemia. The latter promote systemic low-grade inflammation (SLGI), a precondition for many systemic diseases and some of them, e.g., atherosclerosis, diabetes etc., can be triggered by SLGI alone. Either reverting the polarized neutrophils back to the homeostatic state or attenuation of neutrophil hyper-responsiveness in periodontitis might be an approach to diminish or even to prevent systemic diseases.

Influence of melaleuca and copaiba oils on Candida albicans adhesion

OBJECTIVE

To evaluate the efficacy of Melaleuca alternifolia and Copaifera officinalis in inhibiting the adhesion of Candida albicans biofilm.

BACKGROUND

Over 65% of denture wearers suffer from denture stomatitis, which is one of the most prevalent forms of oral candidiasis. This disease is characterised by the inflammation of the oral mucosa in contact with the contaminated denture. The contaminated denture contributes to the switch of C. albicans from yeast to its pathogenic hyphal form. Candida albicans adheres and colonises the polymethylmethacrylate resin surfaces and thus contributes to the development of denture stomatitis.

MATERIALS AND METHODS

The minimal inhibitory concentration (MIC) of M. alternifolia and Co. officinalis was assessed by the agar dilution method. Sixty-six thermopolymerised acrylic resin squares were used and treated with phosphate-buffered saline, sodium hypochlorite 1%, melaleuca 0.75%, melaleuca 0.375%, melaleuca 0.188% and copaiba 10%. For adherence and biofilm formation, the treated squares were placed in six-well tissue culture plates containing 1 × 10(7)  cells/ml of ATCC1023 or SC5314 in Roswell Park Memorial Institute (RPMI) medium, and after 12 h, the planktonic cells were counted.

RESULTS

Copaiba oil did not inhibit C. albicans growth. However, melaleuca oil showed an MIC value of 0.375% (3.4 mg/ml) for ATCC10231 and 0.093% (0.84 mg/ml) for SC5314.

CONCLUSIONS

Our results demonstrated that M. alternifolia oil inhibited the growth of C. albicans. Moreover, both oils promoted significant adhesion reduction in the tested strains. These findings suggest the possibility of using these oils in prophylaxes against candidiasis.

Determination of Candida species nestled in denture fissures

With the growing number of elderly individuals, Candida is occasionally recognised as a fungal cause of aspiration pneumonia. In addition, there are numerous investigational reports on oral candidiasis. However, there are currently no reports on Candida contamination of denture base materials. This study was conducted to investigate Candida species in the oral cavity, denture parts and oral lesions of older/elderly subjects with oral candidiasis. The Candida strains were isolated and the species identified. Candida was also cultured in a medium with sample of denture resin and observed under an electron microscope. The results demonstrated the presence of several Candida species in the lesions of the oral mucosa and the surface and inner portions of the dentures. The following species of Candida were detected: Candida albicans, Candida glabrata, Candida tropicalis and Candida parapsilosis. Using electron microscopy, the invasion of Candida was observed in the incomplete polymerized resin base material and/or through microcracks (fissures) that have a tendency to form in used dentures. It was concluded that Candida may be present on the surface as well as the deeper portions of dentures. In addition, it appeared necessary to consider denture and oral cavity cleaning and the risks of remaking old dentures.

A review of the ultrastructural features of superficial candidiasis

Commensal yeast Candida causes opportunistic infections ranging from superficial lesions to disseminated mycoses in compromised patients. Superficial candidiasis, the commonest form of candidal infections, primarily affects the mucosa and the skin where Candida lives as a commensal. Conversion of candidal commensalism into opportunism at the fungal-epithelial interface is still ill-defined. Nevertheless, fungal virulence mechanisms such as adhesion to epithelia, morphogenesis, production of secretory hydrolytic enzymes, and phenotypic switching are thought to contribute in the process of pathogenesis. On the other hand, host responses in terms of immunity and local epithelial responses are actively involved in resisting the fungal challenge at the advancing front of the infection. Ultrastructural investigations using electron microscopy along with immunohistochemistry, cytochemistry, etc. have helped better viewing of Candida-host interactions. Thus, studies on the ultrastructure of superficial candidiasis have revealed a number of fungal behaviors and associated host responses such as adhesion, morphogenesis (hyphae and appresoria formation), thigmotropism, production and distribution of extracellular enzymes, phagocytosis, and epithelial changes. The purpose of this review is to sum up most of the ultrastructural findings of Candida-host interactions and to delineate the important pathological processes underlying superficial candidiasis.

Ultrastructural imaging of Candida albicans adhesion to rat genital epithelium through scanning and transmission electron microscopy

The adhesion of Candida albicans to the genital epithelium has not been fully investigated in vivo. The objective of this study was to evaluate the ultrastructural aspects of C. albicans adhesion in the lower genital system of female Wistar rats through scanning and transmission electron microscopy. The genital infection persisted until the end of the experiment, and all rats showed the same adhesion aspects. Various associated yeast/hyphae were observed in the lumen and adhered both at the vaginal and endocervical levels where the fungal filamentation process occurred. In the vaginal epithelium, closely adhered yeasts were observed as stretched strands bridging between yeasts and the epithelium surface. Different stages of the adhesion, where yeasts internalized into the epithelial cell inside a cytoplasmic vacuole, resembling endocytosis, and a wide fibrillar-floccular, glycocalyx-like layer on the yeasts were observed. On the endocervix, the adhesion occurred between the cilia. In the uterine body, only a yeast-like form was observed with superficial contact. This study reached the initial goal of demonstrating an experimental model for in vivo studies. Continuation of this line of research is important for studies of vulvovaginal candidiasis.

IL-1alpha, IL-1ra and IL-8 are differentially induced by Candida in experimental oral candidiasis

OBJECTIVE

To investigate the expression of interleukin-1alpha (IL-1alpha), IL-1ra and IL-8 by the oral epithelium challenged by various Candida species.

MATERIALS AND METHODS

In vitro candidiasis was induced by C. albicans wild type SC5314, its EFG1, CPH1 and secretory aspartyl proteinase (SAP) mutants and, ATCC isolates of C. albicans, C. tropicalis and C. dubliniensis using a reconstituted human oral epithelium (RHOE) model. IL-1alpha, IL-1ra and IL-8 levels in culture media were quantified by an enzyme-linked immunosorbent assay at 12, 24 and 48 h. Fungal invasion and IL-1ra expression in RHOE were detected by periodic acid-Schiff staining and immunohistochemistry.

RESULTS

Overall, the invasive Candida induced relatively higher levels of IL-1alpha, IL-1ra and IL-8 in the culture media than the noninvasive isolates. IL-1alpha and IL-1ra levels induced by Candida with hyphal invasion were significantly higher (P < 0.05) than those induced by the isolates without hyphal invasion at 12, 24 and 48 h. Candida albicans SC5314 induced IL-1ra expression in RHOE at 12 and 24 h but not at 48 h consistent with its hyphal invasion; while the noninvasive mutants and non-albicans Candida induced IL-1ra expression at 48 h.

CONCLUSIONS

The cytokine expression profiles in experimental oral candidiasis may be associated with the invasive potential of Candida.

Ultrastructural and chemotaxonomic analysis of a xylanolytic strain of Cryptococcus adeliensis isolated from sheep droppings in Spain

Cryptococcus adeliensis was initially described as a psycrophilic species containing a single strain CBS 8351(T) isolated from decayed algae in Terre Adelie (Antartida). Later, a second strain of this species was isolated from an immunosuppressed patient affected by leukaemia in Germany and recently several strains from this species have been found in human patients and pigeon droppings of the same country. In this study, we isolated from sheep droppings in Spain a xylanolytic strain named LEVX01 that was phenotypically related to the strain CBS 8351(T) and showed a 100% similarity in the D1/D2 domain and 5.8S-ITS region sequences with respect to the remaining described strains of C. adeliensis. These findings suggest that this species has a wide geographical distribution and that the animal faeces are a common habitat for C. adeliensis. The chemotaxonomic analyses showed the absence of detectable amounts of xylose in the cell walls of the strains LEVX01 and CBS8351(T) in contrast to other Cryptococcus species. Interestingly, the ultrastructural study showed the presence of fimbriae in these two strains that could be involved in the attachment to the host cells and, as occurs in Candida albicans, they could also be a pathogenicity factor for the man.

Bacterial internalization in periodontitis

BACKGROUND

Bacterial invasion of host epithelial cells plays an important role in the pathogenesis of periodontitis; however, the exact mechanism of the invasion has not been investigated.

METHODS

Pocket epithelium biopsies in periodontitis were analysed via scanning and transmission electron microscopy using ultra-histochemical staining with ruthenium red for glycocalyx visualization.

RESULTS

We demonstrated that oral bacteria adhered via fimbriae-mediated adhesion only. The bacterial internalization in periodontitis was marked by the hallmark of the fimbriae-induced zipper mechanism--the phagocytic cup formation--but we found no sign of the trigger mechanism of internalization. In addition, we frequently observed apoptosis in the phagocytizing epithelial cells.

CONCLUSION

Fimbriae-mediated adhesion is a prerequisite for bacterial invasion in periodontitis. This occurs by the fimbriae-induced zipper mechanism of internalization. As internalization induces apoptosis, the subsequent exfoliation might play a significant role in the clearance of periodontal pathogens.

Efficacy of the antiadhesin octyl O-(2-acetamido-2-deoxy-beta-D-galactopyranosyl)-(1-4)-2-O-propyl-beta-D-galactopyranoside (Fimbrigal-P) in a rat oral candidiasis model

Adherence of Candida albicans to buccal epithelial cells via its fimbrial subunit requires the minimal disaccharide sequence beta-GalNAc(1-4)-beta-galactosidase in host cell receptors asialo-GM1 or asialo-GM2. This and other disaccharides and some of its synthetic derivatives have been shown to inhibit purified fimbrial or pathogen binding in vitro. This study evaluates the in vivo efficacy of the propyl derivative of this disaccharide, octyl O-(2-acetamido-2-deoxy-beta-D-galactopyranosyl)-(1-4)-2-O-propyl-beta-D-galactopyranoside, or Fimbrigal-P, incorporated into a mucoadhesive polymer formulation in a rat oral candidiasis model. Colony counts of microcurette samples from the oral cavity and tongue homogenates were used to estimate the effectiveness of four treatment modalities to reduce oral fungal burden. All treatment modalities (preventative, premixing with the Candida inoculant, drinking water, and treatment) significantly reduced fungal burden compared to untreated control animals by day 9; however, the preventative and pre-mixing approaches provided a faster rate of fungal clearance. The low toxicity and immunogenicity of this synthetic carbohydrate and its stability in saliva, as demonstrated by high-performance liquid chromatography, make it a promising candidate for the prevention and treatment of microbial infections in which the pathogen relies on the beta-GalNAc(1-4)-beta-galactosidase disaccharide to establish adherence.

Cytochemical differences in bacterial glycocalyx

To examine new cytochemical aspects of the bacterial adhesion, a strain 41452/01 of the oral commensal Streptococcus sanguis and a wild strain of Staphylococcus aureus were grown with and without sucrose supplementation for 6 days. Osmiumtetraoxyde (OsO4), uranyl acetate (UA), ruthenium red (RR), cupromeronic blue (CB) staining with critical electrolytic concentrations (CECs), and the tannic acid-metal salt technique (TAMST) were applied for electron microscopy. Cytochemically, only RR-positive fimbriae in S. sanguis were visualized. By contrast, some types of fimbriae staining were observed in S. aureus glycocalyx: RR-positive, OsO4-positive, tannophilic and CB-positive with ceasing point at 0.3 M MgCl2. The CB staining with CEC, used for the first time for visualization of glycoproteins of bacterial glycocalyx, also reveals intacellular CB-positive substances-probably the monomeric molecules, that is, subunits forming the fimbriae via extracellular assembly. Thus, glycosylated components of the biofilm matrix can be reliably related to single cells. The visualization of intracellular components by CB with CEC enables clear distinction between S. aureus and other bacteria, which do not produce CB-positive substances. The small quantities of tannophilic substances found in S. aureus makes the use of TAMST for the same purpose difficult. The present work protocol enables, for the first time, a partial cytochemical differentiation of the bacterial glycocalyx.

Glycocalyx morphology of Candida albicans

In this study, we examine new cytochemical aspects of the fimbria-mediated adhesion of the oral facultative pathogen Candida albicans. A wild-type strain of the yeast was grown with and without sucrose supplementation for 8 days. Osmium tetroxide, uranyl acetate (UA), ruthenium red (RR), and cupromeronic blue (CB) staining with critical electrolytic concentrations (CECs) and tannic acid-metal salt technique (TAMST) were applied to specimens separately or in combination for transmission electron microscopy (TEM) examination. Cytochemically, two types of fimbriae of C. albicans were distinguished: RR-positive fimbriae of polyanionic glycoconjugates and CB-positive fimbriae with a ceasing point of 0.3 M MgCl2 where no staining of sulfated carboxyl-rich and/or phospho-glycoconjugates occurred. Additionally, CB-positive intercellular fibers were observed, which seemed to be involved in intercellular adhesion. The present protocol enables, for the first time, a partial cytochemical differentiation between at least two kinds of yeast fimbriae.