Hypha essential genes in Candida albicans pathogenesis of oral lichen planus: an in-vitro study

Clinical and mycological analysis of colonization by Candida spp. in oral leukoplakia and oral lichen planus

OBJECTIVE

This study aims to analyze the prevalence of Candida spp. colonization in oral leukoplakia and oral lichen planus lesions, verify the influence of systemic and local factors, besides identify and determine the in vitro antifungal susceptibility profile of Candida species.

MATERIALS AND METHODS

Samples were collected by swabbing from oral lesions and healthy mucosa and cultured on Sabouraud Dextrose and CHROMagar® Candida plates. Species identification was confirmed with MALDI-TOF MS analysis.

RESULTS

Candida spp. was found in 36.8% of cases of oral leukoplakia and 18.2% of cases of oral lichen planus. Candida albicans was the only species found in oral lichen planus lesions (n = 2, 100%) and the most prevalent in oral leukoplakia (n = 5, 76.4%). Among the non-albicans Candida species found in oral leukoplakia were C. parapsilosis (n = 2, 25.5%) and C. tropicalis (n = 1, 14.1%). Candida isolates were susceptible to all antifungals tested.

CONCLUSION

C. albicans was the most commonly found species in the studied lesions. No correlation was found between systemic and local factors with positive cases of oral lichen planus. However, smoking and alcohol consumption may be associated with positive cases of oral leukoplakia, especially the non-homogeneous clinical form. In addition, there is a possible predisposition to associated Candida colonization in cases of epithelial dysplasia found in oral leukoplakia. The antifungal medications tested showed excellent efficacy against isolates.

Combating polymicrobial biofilm: recent approaches

The polymicrobial biofilm (PMBF) is formed when microbes from multiple species co-aggregate into an envelope made of extra polymeric substances (EPS) that keep the microbes safe from external stresses. The formation of PMBF has been linked to a variety of human infections, including cystic fibrosis, dental caries, urinary tract infections, etc. Multiple microbial species co-aggregation during an infection results in a recalcitrant biofilm formation, which is a seriously threatening phenomenon. It is challenging to treat polymicrobial biofilms since they contain multiple microbes which show drug resistance to various antibiotics/antifungals. The present study discusses various approaches by which an antibiofilm compound works. Depending on their mode of action, antibiofilm compounds can block the adhesion of cells to one another, modify membranes/walls, or disrupt quorum-sensing systems.

Targeting Virulence Factors of Candida albicans with Natural Products

Natural products derived from natural resources, including nutritional functional food, play an important role in human health. In recent years, the study of anti-fungal and other properties of agri-foods and derived functional compounds has been a hot research topic. Candida albicans is a parasitic fungus that thrives on human mucosal surfaces, which are colonized through opportunistic infection. It is the most prevalent cause of invasive fungal infection in immunocompromised individuals, resulting in a wide variety of clinical symptoms. Moreover, the efficacy of classical therapeutic medications such as fluconazole is often limited by the development of resistance. There is an ongoing need for the development of novel and effective antifungal therapy and medications. Infection of C. albicans is influenced by a great quantity of virulence factors, like adhesion, invasion-promoting enzymes, mycelial growth, and phenotypic change, and among others. Furthermore, various natural products especially from food sources that target C. albicans virulence factors have been researched, providing promising prospects for C. albicans prevention and treatment. In this review, we discuss the virulence factors of C. albicans and how functional foods and derived functional compounds affect them. Our hope is that this review will stimulate additional thoughts and suggestions regarding nutritional functional food and therapeutic development for patients afflicted with C. albicans.

Candida species colonization in oral lichen planus: A meta-analysis

OBJECTIVE

Oral lichen planus (OLP) is a common chronic inflammatory disease that affects 1%-2% of the population. Candida species superinfection can aggravate the symptoms of OLP, especially of the erosive forms, and promote malignant transformation by producing carcinogenics as nitrosamines or acetaldehyde. On the other hand, antifungal treatment of Candida-infected OLPs improves the clinical symptoms of the disease. The objective of this study is to assess the possible influence of Candida species colonization in oral lichen planus.

METHODS

A search for studies on Candida and oral lichen planus was performed in the following databases: PubMed (MEDLINE, Cochrane Library), Web of Science (WoS), and Scopus. Data analysis: The estimated prevalence of Candida detection in OLP was calculated according to the DerSimonian and Laird random model. For dichotomous outcomes, the estimates of effects of an intervention were expressed as odds ratio (OR) using Mantel-Haenszel (M-H) method with 95% confidence intervals.

RESULTS

Twenty-four studies were included in this meta-analysis. The estimated prevalence of Candida species detection in oral lichen planus (OLP) lesions was 37.00% (95% CI: 30.52-43.72%). OLP patients were almost 2½ times more likely to be infected by Candida species compared to healthy controls (OR: 2.48, P < 0.001). Likewise, Candida species superinfection was more likely in erosive OLP forms (OR: 2.53, P < 0.001), and by non-albicans Candida species (OR: 2.33, P = 0.02).

CONCLUSIONS

More than one-third of OLP lesions are infected by Candida species, modifying their biological behavior.