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Lam PPY, Zhou N, Yiu CKY, Wong HM. Impact of Antiretroviral Therapy on Oral Health among Children Living with HIV: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191911943. [PMID: 36231240 PMCID: PMC9565507 DOI: 10.3390/ijerph191911943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 05/11/2023]
Abstract
Oral health is an integral component of general health and well-being but might be undermined among children living with HIV (CLWH) due to the condition itself or the antiretroviral therapy (ART) received. This review summarises the current evidence and compares the oral health status of the CLWH who were treatment-naïve with those undergoing different ART medications. Fourteen studies were included in the final qualitative and quantitative analyses. This review identified no significant difference in the prevalence of caries, periodontal conditions, and tooth development between both groups. Orofacial opportunistic infections were more prevalent in the CLWH without ART. Children undergoing ART with a duration longer than 3 years had a significantly lower prevalence of oral candidiasis and CD4+ T-cell counts. However, due to the insufficient number of well-administered case-control studies with adequate sample size, the quality of the evidence in all outcomes was of very low certainty.
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Affiliation(s)
- Phoebe Pui Ying Lam
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong
| | - Ni Zhou
- School of Stomatology, Kunming Medical University, Kunming 650032, China
| | - Cynthia Kar Yung Yiu
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong
| | - Hai Ming Wong
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong
- Correspondence: ; Tel.: +852-2859-0261
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Fukui K, Nakamura K, Kuwashima H, Majima T. White-to-opaque switching is involved in the phospholipase B production of Candida dubliniensis on Price's egg yolk agar. Odontology 2018; 107:174-185. [PMID: 30083973 DOI: 10.1007/s10266-018-0382-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 07/20/2018] [Indexed: 01/12/2023]
Abstract
Measuring the production of Candida dubliniensis (C. dubliniensis) phospholipase B (PLase B) by the Price's method has long been considered to be unattainable because the levels of PLase produced are undetectable. In this study, C. dubliniensis, C. glabrata, C. guilliermondii, C. krusei, C. parapsilosis and C. tropicalis were shown to produce PLase B and form clear white zones around their colonies when peptone, a component of the original Price's egg yolk (OP) agar, is replaced with a yeast nitrogen base (YNB). This new medium is named modified Price's (MP) agar. Based on this finding, we propose a new modified Price's (NMP) agar containing 0.75% peptone and 0.25% YNB, which enabled measurement of PLase B production by C. dubliniensis and C. albicans with results consistent with those obtained for C. albicans grown on OP agar. We strongly believe that the MP and NMP agars are very useful for screening PLase B production by C. dubliniensis and non-albicans Candida spp. Moreover, the addition of several bioactive agents (the proteinase inhibitors pepstatin A and saquinavir, the calcineurin inhibitors cyclosporine A and tacrolimus, the cell-permeable cAMP analog dBcAMP, and the quorum-sensing molecule farnesol) to the OP agar enhanced PLase B production by C. dubliniensis. During the course of our study to clarify the reason why PLase B was not produced, we found that C. dubliniensis cells grown on OP agar undergo a white-to-opaque transition, which may explain why they showed minimal production of PLase B on this medium.
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Affiliation(s)
- Kayoko Fukui
- Department of Pharmacology, The Nippon Dental University School of Life Dentistry at Niigata, 1-8 Hamaura-cho, Chuo-ku, Niigata, 951-8580, Japan
| | - Kenjirou Nakamura
- Department of Pharmacology, The Nippon Dental University School of Life Dentistry at Niigata, 1-8 Hamaura-cho, Chuo-ku, Niigata, 951-8580, Japan.
| | - Haruhiro Kuwashima
- Department of Pharmacology, The Nippon Dental University School of Life Dentistry at Niigata, 1-8 Hamaura-cho, Chuo-ku, Niigata, 951-8580, Japan
| | - Toshiro Majima
- Department of Pharmacology, The Nippon Dental University School of Life Dentistry at Niigata, 1-8 Hamaura-cho, Chuo-ku, Niigata, 951-8580, Japan
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Gaitán-Cepeda LA, Sánchez-Vargas O, Castillo N. Prevalence of oral candidiasis in HIV/AIDS children in highly active antiretroviral therapy era. A literature analysis. Int J STD AIDS 2015; 26:625-32. [PMID: 25156369 DOI: 10.1177/0956462414548906] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 08/03/2014] [Indexed: 02/05/2023]
Abstract
SummaryHighly active antiretroviral therapy has decreased the morbidity and mortality related to HIV infection, including oral opportunistic infections. This paper offers an analysis of the scientific literature on the epidemiological aspects of oral candidiasis in HIV-positive children in the combination antiretroviral therapy era. An electronic databases search was made covering the highly active antiretroviral therapy era (1998 onwards). The terms used were oral lesions, oral candidiasis and their combination with highly active antiretroviral therapy and HIV/AIDS children. The following data were collected from each paper: year and country in which the investigation was conducted, antiretroviral treatment, oral candidiasis prevalence and diagnostic parameters (clinical or microbiological). Prevalence of oral candidiasis varied from 2.9% in American HIV-positive children undergoing highly active antiretroviral therapy to 88% in Chilean HIV-positive children without antiretroviral therapy. With respect to geographical location and antiretroviral treatment, higher oral candidiasis prevalence in HIV-positive children on combination antiretroviral therapy/antiretroviral therapy was reported in African children (79.1%) followed by 45.9% reported in Hindu children. In HIV-positive Chilean children on no antiretroviral therapy, high oral candidiasis prevalence was reported (88%) followed by Nigerian children (80%). Oral candidiasis is still frequent in HIV-positive children in the highly active antiretroviral therapy era irrespective of geographical location, race and use of antiretroviral therapy.
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Affiliation(s)
- Luis Alberto Gaitán-Cepeda
- Laboratory of Oral Pathology, Postgraduate and Research Division, Dental School, National Autonomous University of Mexico, Coyoacan, México
| | - Octavio Sánchez-Vargas
- Laboratory of Microbiology, Pathology and Biochemical, Faculty of Stomatology, Autonomous University of San Luis Potosi, San Luis Potosí, México
| | - Nydia Castillo
- Microbiology area, Health Sciences Center, Autonomous University of Baja California, Valle de las Palmas, Tijuana, Baja California, México
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Stergiopoulou T, Walsh TJ. Clinical pharmacology of antifungal agents to overcome drug resistance in pediatric patients. Expert Opin Pharmacother 2015; 16:213-26. [PMID: 25579070 DOI: 10.1517/14656566.2015.1000302] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Antifungal resistance is an emerging problem that increases morbidity and mortality in immunosuppressed pediatric patients, who suffer from invasive fungal diseases. Optimal pharmacological management is critical for the successful treatment of invasive fungal infections by resistant strains. AREAS COVERED This paper reviews the mechanisms of resistance of different classes of antifungal agents and the current understanding of pediatric antifungal pharmacology for overcoming antifungal resistance in children based on laboratory and clinical studies in the English literature. The therapeutic choices against fungal pathogens with intrinsic or acquired resistance are further reviewed. EXPERT OPINION There is a paucity of data in the pediatric population regarding the epidemiology of the resistant organisms to different antifungal agents. It is also unknown if there are more prevalent molecular mechanisms that promote antifungal resistance. Selection and dosages of the most effective antifungal agent for overcoming the antifungal resistance is crucial. However, there are limited studies guiding the optimal dosage and duration of treatment for management of emergent antifungal resistance. Further studies are warranted to elucidate the optimal pharmacology of the current antifungal agents against resistant organisms and to advance the development of new antifungal agents.
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Kneist S, Borutta A, Sigusch BW, Nietzsche S, Küpper H, Kostrzewa M, Callaway A. First-time isolation of Candida dubliniensis from plaque and carious dentine of primary teeth. Eur Arch Paediatr Dent 2015; 16:365-70. [DOI: 10.1007/s40368-015-0180-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 03/04/2015] [Indexed: 11/30/2022]
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Bhai N, Tendolkar U, Baradkar V, Mathur M, Kulkarni M. Paediatric oropharyngeal and cutaneous candidiasis with special reference to Candida dubliniensis. J Med Microbiol 2014; 63:518-521. [DOI: 10.1099/jmm.0.060236-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Mucocutaneous and cutaneous candidiasis, though common in children, is often under-reported. The prevalence of Candida dubliniensis in causing these infections in this age group is also largely unknown. A prospective epidemiological cross-sectional study for candidiasis was performed in paediatric patients clinically suspected of candidiasis with oropharyngeal lesions (75 patients), cutaneous lesions (18 patients) and lesions at both sites (2 patients). Candida species were identified by conventional tests. For C. dubliniensis, chlamydospore production, growth on tobacco agar and growth at 45 °C were performed. Nine isolates were confirmed at a reference centre. The rates of candidiasis were 77.3 % (58 out of 75 patients clinically suspected of candidiasis) and 83.3 % (15/18) in oropharyngeal and cutaneous lesions respectively, and 1 of the 2 children with lesions at both sites was diagnosed as having chronic mucocutaneous candidiasis due to C. dubliniensis. The commonest species isolated was Candida albicans, in 41 (70.7 %) patients with oropharyngeal candidiasis and 11 (73.3 %) with cutaneous lesions; C. dubliniensis was isolated from 11 and 3 children respectively. In the paediatric population, C. albicans predominates in mucocutaneous and cutaneous candidiasis, with C. dubliniensis also contributing substantially.
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Affiliation(s)
- Niti Bhai
- Department of Microbiology, Lokmanya Tilak Municipal Medical College & General Hospital, Sion, Mumbai 400 022, India
| | - Uma Tendolkar
- Department of Microbiology, Lokmanya Tilak Municipal Medical College & General Hospital, Sion, Mumbai 400 022, India
| | - Vasant Baradkar
- Department of Microbiology, Lokmanya Tilak Municipal Medical College & General Hospital, Sion, Mumbai 400 022, India
| | - Meenakshi Mathur
- Department of Microbiology, Lokmanya Tilak Municipal Medical College & General Hospital, Sion, Mumbai 400 022, India
| | - Madhuri Kulkarni
- Department of Microbiology, Lokmanya Tilak Municipal Medical College & General Hospital, Sion, Mumbai 400 022, India
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de Melo NR, Abdrahman A, Greig C, Mukherjee K, Thornton C, Ratcliffe NA, Vilcinskas A, Butt TM. Myriocin significantly increases the mortality of a non-mammalian model host during Candida pathogenesis. PLoS One 2013; 8:e78905. [PMID: 24260135 PMCID: PMC3829820 DOI: 10.1371/journal.pone.0078905] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Accepted: 09/17/2013] [Indexed: 12/14/2022] Open
Abstract
Candida albicans is a major human pathogen whose treatment is challenging due to antifungal drug toxicity, drug resistance and paucity of antifungal agents available. Myrocin (MYR) inhibits sphingosine synthesis, a precursor of sphingolipids, an important cell membrane and signaling molecule component. MYR also has dual immune suppressive and antifungal properties, potentially modulating mammalian immunity and simultaneously reducing fungal infection risk. Wax moth (Galleria mellonella) larvae, alternatives to mice, were used to establish if MYR suppressed insect immunity and increased survival of C. albicans-infected insects. MYR effects were studied in vivo and in vitro, and compared alone and combined with those of approved antifungal drugs, fluconazole (FLC) and amphotericin B (AMPH). Insect immune defenses failed to inhibit C. albicans with high mortalities. In insects pretreated with the drug followed by C. albicans inoculation, MYR+C. albicans significantly increased mortality to 93% from 67% with C. albicans alone 48 h post-infection whilst AMPH+C. albicans and FLC+C. albicans only showed 26% and 0% mortalities, respectively. MYR combinations with other antifungal drugs in vivo also enhanced larval mortalities, contrasting the synergistic antifungal effect of the MYR+AMPH combination in vitro. MYR treatment influenced immunity and stress management gene expression during C. albicans pathogenesis, modulating transcripts putatively associated with signal transduction/regulation of cytokines, I-kappaB kinase/NF-kappaB cascade, G-protein coupled receptor and inflammation. In contrast, all stress management gene expression was down-regulated in FLC and AMPH pretreated C. albicans -infected insects. Results are discussed with their implications for clinical use of MYR to treat sphingolipid-associated disorders.
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Affiliation(s)
| | - Ahmed Abdrahman
- Department of Biosciences, College of Science, Swansea University, Singleton Park, Swansea, United Kingdom
| | - Carolyn Greig
- Department of Biosciences, College of Science, Swansea University, Singleton Park, Swansea, United Kingdom
| | - Krishnendu Mukherjee
- Institut für Phytopathologie und Angewandte Zoologie, Abteilung Angewandte Entomologie, Gieβen, Germany
| | - Catherine Thornton
- College of Medicine, Swansea University, Singleton Park, Swansea, United Kingdom
| | - Norman A. Ratcliffe
- Department of Biosciences, College of Science, Swansea University, Singleton Park, Swansea, United Kingdom
- Department of Biological Sciences, Universidade Federal Fluminense, Rio de Janeiro, Brazil
| | - Andreas Vilcinskas
- Institut für Phytopathologie und Angewandte Zoologie, Abteilung Angewandte Entomologie, Gieβen, Germany
| | - Tariq M. Butt
- Department of Biosciences, College of Science, Swansea University, Singleton Park, Swansea, United Kingdom
- * E-mail:
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Junqueira JC, Vilela SFG, Rossoni RD, Barbosa JO, Costa ACBP, Rasteiro VMC, Suleiman JMAH, Jorge AOC. Oral colonization by yeasts in HIV-positive patients in Brazil. Rev Inst Med Trop Sao Paulo 2012; 54:17-24. [DOI: 10.1590/s0036-46652012000100004] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Accepted: 12/15/2011] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION: In HIV-infected patients, colonization of the oral cavity by potential pathogenic yeast may lead to development of systemic fungemia. We evaluated the prevalence of yeast in the oral cavity of Brazilian HIV-positive patients and verified whether or not the species characterized were enzymatically active. Furthermore, the species identified were tested for their susceptibility to antifungal treatment. METHODS: Patient saliva and oropharyngeal candidiasis samples were collected from 60 seropositive HIV patients and identified by the API20C system. Enzymatic activity was evaluated by the production of proteinase and phospholipase. Susceptibility to antifungal treatments were determined using the broth microdilution method. RESULTS: the most commonly isolated species were C. albicans (51.56%) followed by non-albicans Candida species (43.73%), Trichosporon mucoides (3.12%) and Kodamaea ohmeri (1.56%). Oral colonization by association of different species was observed in 42% of the patients. Enzymatic activity was verified in most of species isolated, except for C. glabrata, C. lusitaniae and C. guilliermondii. Resistance to Fluconazole and Amphotericin B was observed in isolates of C. albicans, C. glabrata, C. parapsilosis, C. krusei, and K. ohmeri. CONCLUSION: HIV-positive patients are orally colonized by single or multiple species of yeast that are occasionally resistant to Fluconazole or Amphotericin B.
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Agwu E, Ihongbe JC, McManus BA, Moran GP, Coleman DC, Sullivan DJ. Distribution of yeast species associated with oral lesions in HIV-infected patients in Southwest Uganda. Med Mycol 2011; 50:276-80. [PMID: 21905950 DOI: 10.3109/13693786.2011.604862] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Oropharyngeal candidiasis remains a significant clinical problem in HIV-infected and AIDS patients in regions of Africa where anti-retroviral therapy isn't readily available. In this study we identified the yeast populations associated with oral lesions in HIV-infected patients in Southwest Uganda who were receiving treatment with nystatin and topical clotrimazole. Samples were taken from 605 patients and 316 (52%) of these yielded yeast growth following incubation on Sabouraud dextrose agar. Samples were subsequently re-plated on CHROMagar Candida medium to facilitate identification of the yeast species present. The majority (56%) of culture-positive samples yielded a mix of two or more species. Candida albicans was present in 87% (274/316) of patient samples and accounted for 87% (120/138) of single species samples. Candida glabrata, Candida tropicalis and Candida norvegensis were also found in cultures that yielded a single species. No Candida dubliniensis isolates were identified in this population.
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Affiliation(s)
- Ezera Agwu
- School of Allied Health Sciences, Kampala International University, Republic of Uganda
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Harish NM, Prabhu P, Charyulu RN, Gulzar MA, Subrahmanyam EVS. Formulation and Evaluation of in situ Gels Containing Clotrimazole for Oral Candidiasis. Indian J Pharm Sci 2011; 71:421-7. [PMID: 20502548 PMCID: PMC2865814 DOI: 10.4103/0250-474x.57291] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2008] [Revised: 07/28/2009] [Accepted: 07/31/2009] [Indexed: 11/16/2022] Open
Abstract
Gel dosage forms are successfully used as drug delivery systems to control drug release and protect the medicaments from a hostile environment. The main objective is to formulate and evaluate in situ oral topical gels of clotrimazole based on the concept of pH triggered and ion activated systems. The system utilizes polymers that exhibit sol-to-gel phase transition due to change in specific physico-chemical parameters. A pH triggered system consisting of carbopol 934P (0.2-1.4% w/v) and ion triggered system using gellan gum (0.1-0.75% w/v) along with hydroxylpropylmethylcelluose E50LV was used to prolong the release of clotrimazole (0.1% w/v). Formulations were evaluated for gelling capacity, viscosity, gel strength, bioadhesive force, spreadability, microbiological studies and in vitro release. The use of carbopol as in situ gel forming system was substantiated by the property to transform into stiff gels when the pH was raised, whereas in gellan gum this transformation occurred in the presence of monovalent/divalent cations. Effect of calcium carbonate and other process parameters optimized and found that increase in calcium ions produced stronger gels. The drug content, clarity, and pH of the formulation were found to be satisfactory. The viscosity was found to be in the range 5 to 85 centipoise for the sol, whereas for the gels it was up to 16000 centipoise. The formulation showed pseudoplastic flow with thixotrophy. The maximum gel strength (using texture analyzer) and bioadhesion was found to be up to 6.5 g and 4 g, respectively. The optimized formulations were able to release the drug up to 6 h. The formulation containing gellan gum showed better sustained release compared to carbopol based gels.
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Affiliation(s)
- N M Harish
- NGSM Institute of Pharmaceutical Sciences, Paneer, Deralakatte Post, Mangalore-574 160, India
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Oral mucosal lesions in children from 0 to 12 years old: ten years' experience. ACTA ACUST UNITED AC 2010; 110:e13-8. [DOI: 10.1016/j.tripleo.2010.02.025] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2009] [Revised: 02/15/2010] [Accepted: 02/19/2010] [Indexed: 11/22/2022]
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Liu Y, Kang Y, Yokoyama K, Gonoi T, Mikami Y. Molecular Differentiation and Antifungal Susceptibility of Candida albicans Isolated from Patients with Respiratory Infections in Guiyang Medical College Hospital, China. ACTA ACUST UNITED AC 2009; 50:175-8. [DOI: 10.3314/jjmm.50.175] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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