Oropharyngeal Candidosis in HIV-Infected Patients—An Update

Patil, Shankargouda; Majumdar, Barnali; Sarode, Sachin C.; Sarode, Gargi S; Awan, Kamran Habib

doi:10.3389/fmicb.2018.00980

Cited by 69 publications

(78 citation statements)

References 57 publications

(131 reference statements)

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“…However, it was not until 1954 that the binomial Candida albicans was formally endorsed. In the 1980s, there was a clear surge of interest in oral candidal infections largely due to the increased incidence of OC because of the escalation in the acquired immune deficiency syndrome (AIDS) epidemic, and, to date, OC remains the most common oral opportunistic infection in human immunodeficiency virus (HIV)-positive individuals and in individuals with weakened immune systems [9][10][11][12][13]. In fact, the opportunistic nature of the infection was first highlighted by Hippocrates, who referred to this malady as "a disease of the diseased" [14].…”

Section: Candida and Candidiasis Etymology And Historical Perspectivementioning

confidence: 99%

Oral Candidiasis: A Disease of Opportunity

Vila

Sultan

Montelongo-Jauregui

et al. 2020

JoF

279

241

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Oral candidiasis, commonly referred to as “thrush,” is an opportunistic fungal infection that commonly affects the oral mucosa. The main causative agent, Candida albicans, is a highly versatile commensal organism that is well adapted to its human host; however, changes in the host microenvironment can promote the transition from one of commensalism to pathogen. This transition is heavily reliant on an impressive repertoire of virulence factors, most notably cell surface adhesins, proteolytic enzymes, morphologic switching, and the development of drug resistance. In the oral cavity, the co-adhesion of C. albicans with bacteria is crucial for its persistence, and a wide range of synergistic interactions with various oral species were described to enhance colonization in the host. As a frequent colonizer of the oral mucosa, the host immune response in the oral cavity is oriented toward a more tolerogenic state and, therefore, local innate immune defenses play a central role in maintaining Candida in its commensal state. Specifically, in addition to preventing Candida adherence to epithelial cells, saliva is enriched with anti-candidal peptides, considered to be part of the host innate immunity. The T helper 17 (Th17)-type adaptive immune response is mainly involved in mucosal host defenses, controlling initial growth of Candida and inhibiting subsequent tissue invasion. Animal models, most notably the mouse model of oropharyngeal candidiasis and the rat model of denture stomatitis, are instrumental in our understanding of Candida virulence factors and the factors leading to host susceptibility to infections. Given the continuing rise in development of resistance to the limited number of traditional antifungal agents, novel therapeutic strategies are directed toward identifying bioactive compounds that target pathogenic mechanisms to prevent C. albicans transition from harmless commensal to pathogen.

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Section: Candida and Candidiasis Etymology And Historical Perspectivementioning

confidence: 99%

Oral Candidiasis: A Disease of Opportunity

Vila

Sultan

Montelongo-Jauregui

et al. 2020

JoF

279

241

View full text Add to dashboard Cite

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“…This suggests that oral fungal microbiota could be modulated in such patients both by the causative pathogen (HIV) and its treatment. OPC in HIV-infected individuals is not only caused by Candida albicans, but also other species from this genus such as Candida glabrata and Candida tropicalis, which have been isolated in various studies [20].…”

Section: Introductionmentioning

confidence: 99%

Oral mycobiome identification in atopic dermatitis, leukemia, and HIV patients – a systematic review

Sodré

Rodrigues

Vieira

et al. 2020

Journal of Oral Microbiology

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Introduction: Oral mycobiome profiling is important to understand host-pathogen interactions that occur in various diseases. Invasive fungal infections are particularly relevant for patients who have received chemotherapy and for those who have HIV infection. In addition, changes in fungal microbiota are associated with the worsening of chronic conditions like atopic dermatitis (AD). This work aims, through a systematic review, to analyze the methods used in previous studies to identify oral fungi and their most frequent species in patients with the following conditions: HIV infection, leukemia, and atopic dermatitis. Methods: A literature search was performed on several different databases. Inclusion criteria were: written in English or Portuguese; published between September 2009 and September 2019; analyzed oral fungi of HIV-infected, leukemia, or AD patients. Results: 21 studies were included and the most identified species was Candida. The predominant methods of identification were morphological (13/21) and sugar fermentation and assimilation tests (11/21). Polymerase chain reaction (PCR) was the most used molecular method (8/21) followed by sequencing techniques (3/21). Conclusions: Although morphological and biochemical tests are still used, they are associated with high-throughput sequencing techniques, due to their accuracy and time saving for profiling the predominant species in oral mycobiome.

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“…All aspects of C. albicans virulence and pathogenesis must be examined in the context of the specific host immune status, since most mucosal infections with this organism afflict immunocompromised hosts. Three well-recognized human immunodeficient states that are risk factors for candidiasis are chronic use of corticosteroids, intensive cancer chemotherapy, and advanced AIDS [3,7,[35][36][37]. In addition to allowing C. albicans overgrowth leading to infection, immunosuppression may change the overall microbial equilibrium by allowing certain bacterial species to overgrow as well.…”

Section: Immunocompomised Hosts Have Altered Oral Bacterial Microbiommentioning

confidence: 99%

The Dysbiosis and Inter-Kingdom Synergy Model in Oropharyngeal Candidiasis, a New Perspective in Pathogenesis

Bertolini

Dongari-Bagtzoglou

2019

JoF

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As more information emerges on oral microbiota using advanced sequencing methodologies, it is imperative to examine how organisms modulate the capacity of each other to colonize or trigger infection. Most mouse models of oral C. albicans infection have focused on interactions with single bacterial species. Thus, little is known about the microbiome-mediated interactions that control the switch of C. albicans from commensalism to infection. Evidence is accumulating that in immunosuppression where mucosal candidiasis is more prevalent, there is an altered oral bacterial microbiome with reduced diversity, but not an altered mycobiome. Oropharyngeal candidiasis in immunosuppressed humans and mice is associated with a further reduction in oral bacterial diversity and a dysbiotic shift with significant enrichment of streptococcal and enterococcal species. Our recent studies in a cancer chemotherapy mouse model supported the combined profound effect of immunosuppression and C. albicans in reducing oral bacterial diversity and provided the first direct evidence that these changes contribute to pathogenesis, representing dysbiosis. There is still a gap in understanding the relationship between Candida and the oral bacterial microbiome. We propose that certain oral commensal bacteria contribute to fungal pathogenesis and we identify gaps in our understanding of the mechanisms involved in this cooperative virulence.

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Oropharyngeal Candidosis in HIV-Infected Patients—An Update

Cited by 69 publications

References 57 publications

Oral Candidiasis: A Disease of Opportunity

Oral Candidiasis: A Disease of Opportunity

Oral mycobiome identification in atopic dermatitis, leukemia, and HIV patients – a systematic review

The Dysbiosis and Inter-Kingdom Synergy Model in Oropharyngeal Candidiasis, a New Perspective in Pathogenesis

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