Ageing exacerbates damage of systemic and salivary neutrophils from patients presenting Candida-related denture stomatitis

Abstract

BackgroundAgeing leads to a decline in the function of the immune system, increasing the body's susceptibility to infections through the impairment of T-cells, macrophages, neutrophils and dendritic cells Denture stomatitis is a primary oral disease affecting elderly denture wearers. The major etiologic factor involved in this pathology is the infection by Candida albicans, an opportunistic pathogen that causes local and disseminated diseases in immunosuppressed humans. Neutrophils play a critical role in the immune response against C. albicans and are continually present in the salivary fluid and in the blood. The aim of this study was to determine ageing-related changes in salivary and blood neutrophils and their potential implications in Candida-related denture stomatitis.ResultsOur results showed a lower number of neutrophils in the saliva from patients presenting Candida-related denture stomatitis in comparison to their matched controls. Furthermore, fewer neutrophils were isolated from the saliva of aged control individuals in comparison to matched younger subjects. CXCR1, CD62L and CD11b expression were significantly greater on systemic neutrophils from younger control individuals. Elderly individuals showed more apoptotic salivary neutrophils and lower GM-CSF levels than younger ones, regardless of the occurrence of Candida infection. On the other hand, CXCL-8 concentrations were higher in the saliva from elderly individuals. Besides, TNF-α was detected at elevated levels in the saliva from infected elderly subjects. Salivary neutrophils from elderly and young patients presented impaired phagocytic activity against C. albicans. However, just systemic neutrophils from elderly showed decreased phagocytosis when compared to the younger ones, regardless of the occurrence of infection. In addition, neutrophils from aged individuals and young patients presented low fungicidal activity.ConclusionThe data suggests that the Candida related-denture stomatitis is associated to neutrophils function deficiency, and ageing drastically appears to alter important characteristics of such cells, facilitating the establishment of this infection.

Denture-related oral mucosal lesions among farmers in a semi-arid Northeastern Region of Brazil

“…Such alterations seem to be more pronounced in the elderly ones than in young adults since aged subjects not infected by C. albicans presented impaired neutrophil function. In the present study, the results suggest that age is an important predictor for the development of DML, especially in female, which is in accordance to previous studies (8)(9)(10)(11)(12). Some studies have reported that there is a greater prevalence of lesions among CDW (4,8), since this type of denture covers a greater area of oral mucosa than PDW, and, therefore, a greater chance of plaque and yeast retention as well as mechanical injury is expected.…”

“…In perimenopausal and postmenopausal women, the atrophy of the oral mucosa and the decrease of the estrogen and progesterone can contribute to the exacerbation of the inflammatory response against chronic irritation caused by the use of removable dentures, thus increasing the incidence of DML in female patients (8). In addition, in a recent study (11), it was demonstrated that aged and denture stomatitis individuals show a lower number of salivary neutrophils than controls and present dysfunctions in the phagocytosis and killing of the C. albicans by both local and circulating neutrophils. Such alterations seem to be more pronounced in the elderly ones than in young adults since aged subjects not infected by C. albicans presented impaired neutrophil function.…”

Development of a Contemporary Animal Model of Candida albicans-Associated Denture Stomatitis Using a Novel Intraoral Denture System

“…Currently, it is unclear whether innate and/or adaptive immunity fuels the response and whether immune deficiency could exacerbate or alleviate disease. A report by Gasparoto and coworkers suggested that a deficiency in neutrophil function may play a role in DS because a lower number of neutrophils were found in the saliva of DS patients (25). This may also have been related to the reduced phagocytic activity of systemic neutrophils from elderly patients for Candida regardless of disease (24).…”

Predictors of oral mucosal lesions among removable prosthesis wearers

“…The immune system's defence is also weakened due to age and systemic diseases (like diabetes mellitus), and as a result, denturerelated oral mucosal lesions (DROMLs) caused by opportunistic pathogens (most commonly, Candida albicans) occur (7,(11)(12)(13). When patients wear dentures not only during the day but also at night, they additionally increase the potential incidence of DROMLs, due to the lack of the protective action of saliva on oral mucosa (14).…”