Oral Candida colonization and plaque type psoriasis: Is there any relationship?

Lesan, Simin; Toosi, Roja; Aliakbarzadeh, Reza; Daneshpazhooh, Maryam; Mahmoudi, Laleh; Tavakolpour, Soheil; Mahmoudi, Hamidreza

doi:10.1111/jicd.12335

Cited by 15 publications

(52 citation statements)

References 22 publications

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“…For example, rates were reported as 69% versus 44% for those without psoriasis in a study conducted in Jordan [28], and 47.2% versus 19.5% in a study conducted in Germany [29]. This trend was consistent with another study where patients with psoriasis receiving systemic treatment were excluded (20.0% versus 2.8%) [30]. The reason for this association is unclear.…”

Section: Epidemiology Of Candida Colonization and Infection In Psoriasissupporting

confidence: 63%

A Practical Guide to the Management of Oral Candidiasis in Patients with Plaque Psoriasis Receiving Treatments That Target Interleukin-17

Armstrong

Blauvelt

Mrowietz

et al. 2022

Dermatol Ther (Heidelb)

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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

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Section: Epidemiology Of Candida Colonization and Infection In Psoriasissupporting

confidence: 63%

A Practical Guide to the Management of Oral Candidiasis in Patients with Plaque Psoriasis Receiving Treatments That Target Interleukin-17

Armstrong

Blauvelt

Mrowietz

et al. 2022

Dermatol Ther (Heidelb)

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“…Therefore, the group of psoriasis patients was examined for a correlation between the prevalence of Candida and patients’ characteristics like age, gender, therapy and disease severity. Unlike previous studies, who did not observe a correlation between age and fungal colonisation, we found a substantially higher prevalence of C species in psoriasis patients and control subjects older than a median age of 51 years 13,20,21 . Consistent to previous examinations, we did not find any significant difference between the sexes 13,20,21 …”

Section: Discussionsupporting

confidence: 77%

Prevalence of Candida species in Psoriasis

Elsner

Holstein

Hilke

et al. 2021

Mycoses

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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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“…For instances, a high rate of concomitant fungal infections was found in psoriatic nail patients (64,65) and enhanced Candida colonization was associated with more severe disease states (28). Further, Candida species detection rates for psoriatic patients have been shown to be significantly higher than in healthy individuals (29), especially in the oral mucosa (33,66,67). These observations together with our present data support the idea that fungal colonization and/or infection at various sites including the oral mucosa may predispose to psoriasis or amplify this disorder via systemic enrichment of fungal reactive Th17 cells.…”

Section: Discussionmentioning

confidence: 99%

Immunity to commensal skin fungi promotes psoriasiform skin inflammation

Hurabielle

Link

Bouladoux

et al. 2020

Proc. Natl. Acad. Sci. U.S.A.

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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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Oral Candida colonization and plaque type psoriasis: Is there any relationship?

Abstract: 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.

Cited by 15 publications

References 22 publications

A Practical Guide to the Management of Oral Candidiasis in Patients with Plaque Psoriasis Receiving Treatments That Target Interleukin-17

A Practical Guide to the Management of Oral Candidiasis in Patients with Plaque Psoriasis Receiving Treatments That Target Interleukin-17

Prevalence of Candida species in Psoriasis

Immunity to commensal skin fungi promotes psoriasiform skin inflammation

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