Risk factors related to oral candidiasis in patients with primary Sjögren’s syndrome

Candida albicans is a common commensal fungus that colonizes the oropharyngeal cavity, gastrointestinal and vaginal tract, and healthy individuals’ skin. In 50% of the population, C. albicans is part of the normal flora of the microbiota. The various clinical manifestations of Candida species range from localized, superficial mucocutaneous disorders to invasive diseases that involve multiple organ systems and are life-threatening. From systemic and local to hereditary and environmental, diverse factors lead to disturbances in Candida’s normal homeostasis, resulting in a transition from normal flora to pathogenic and opportunistic infections. The transition in the pathophysiology of the onset and progression of infection is also influenced by Candida’s virulence traits that lead to the development of candidiasis. Oral candidiasis has a wide range of clinical manifestations, divided into primary and secondary candidiasis. The main supply of C. albicans in the body is located in the gastrointestinal tract, and the development of infections occurs due to dysbiosis of the residential microbiota, immune dysfunction, and damage to the muco-intestinal barrier. The presence of C. albicans in the blood is associated with candidemia–invasive Candida infections. The commensal relationship exists as long as there is a balance between the host immune system and the virulence factors of C. albicans. This paper presents the virulence traits of Candida albicans and clinical manifestations of specific candidiasis.

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“…), autoimmune diseases (Sjögren syndrome, etc. ), HIV, and primary immunodeficiencies [ 57 , 58 , 59 ].…”

Section: Clinical Manifestations Of Candidiasismentioning

confidence: 99%

Candida albicans—The Virulence Factors and Clinical Manifestations of Infection

Talapko

Juzbašić

Matijević³

et al. 2021

JoF

302

238

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“…Additionally, studies have shown that most patients with COVID-19 have one or more systemic (e.g., use of broad-spectrum antibiotics, use of corticosteroids, immunosuppression) or local (e.g., use of dental prostheses, reduced salivary flow due to use of medication) risk factors that favor Candida proliferation. 23 – 25 …”

Section: Discussionmentioning

confidence: 99%

ACE2 expression in saliva of patients with COVID-19 and its association with Candida albicans and Aggregatibacter actinomycetemcomitans

Bachtiar

Kusumaningrum

et al. 2022

F1000Res

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Background: A relationship between oral microbiota and susceptibility to SARS-CoV-2 infection has been extensively studied. However, the relationship between oral commensal flora and expression of angiotensin-converting enzyme 2 (ACE2) remains to be established. In this observational study, we collected saliva from patients with COVID-19 and evaluated the relationship between ACE2 expression and Candida albicans as well as with selected gram-negative bacteria (Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, and Veillonella parvula). We investigated how this may be directly or indirectly involved in oral dysbiosis in patients with COVID-19. Methods: We included 23 hospitalized patients admitted to Universitas Indonesia Hospital with PCR-confirmed COVID-19, with six healthy participants serving as controls. Saliva and tongue surface swabs were collected from patients with diabetes (DG) and without diabetes (NDG) and subject controls. Using quantitative PCR (qPCR) we assessed the mRNA expression of ACE2, the abundance of C. albicans, and the transcription levels of its biofilm-associated genes, agglutinin-like protein 3 (ALS3), hyphal wall protein 1 (HWP1), and yeast-form wall protein 1 (YWP1). We also counted the relative proportion of the three selected gram-negative oral bacteria in saliva. All analyses were performed to determine the relationship between ACE2 expression and C. albicans and gram-negative bacteria. Results: ACE2 mRNA expression was significantly higher in tongue swab samples than in saliva. However, no significant difference was observed between the patient groups. Conversely, DG patients had a significantly higher abundance of C. albicans in saliva compared to NDG patients and control group patients. The correlation and sensitivity/specificity relationship between ACE2 expression and C. albicans or the selected oral bacteria were also observed. Conclusions: The data show that ACE2 expression can be detected in saliva of patients with COVID-19 and its association with C. albicans and gram-negative oral bacteria might contribute toward developing an oral dysbiosis based predictor for prognosis of COVID-19 severity.

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“…To the best of our knowledge, the only other study to measure both the unstimulated and stimulated salivary flow rate in SS patients was that of Serrano et al . [2020] ( 19 ). Their analysis showed that 60.7% of SS patients had a decreased UWSFR.…”

Section: Discussionmentioning

confidence: 99%

Stimulated whole salivary flow rate: The most appropriate technique for assessing salivary flow in Sjögren syndrome

Alvariño

Bagán²,

Calvo³

et al. 2021

Med Oral

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Background We sought to determine the most appropriate method for measuring salivary flow to aid the diagnosis of Sjögren's syndrome (SS). Specifically, we compared the unstimulated whole salivary flow rate (UWSFR) with the stimulated whole salivary flow rate (SWSFR). Material and Methods This case-control study comprised one group of 103 patients with SS and a control group of 50 healthy people. We measured the UWSFR and SWSFR in both groups according to the guidelines established by Navacet (1993). Results The UWSFR and SWSFR were significantly lower in the patient group compared with the controls ( p < 0.01). Among the participants in the patient group, we found a decreased UWSFR in 84 individuals (81.5%) and a decreased SWSFR in 90 individuals (87.4%). We encountered difficulties obtaining saliva in 37 (35.9%) patients during the UWSFR test, and in 12 (11.7%) patients during the SWSFR test. There was no significant statistical difference in the UWSFR or SWSFR between patients with primary and secondary SS. Conclusions Compared with the UWSFR, the SWSFR is a more suiTable and effective method for measuring salivary flow in patients with SS, as well as for qualitative analysis of the obtained saliva. Key words: Sjögren syndrome, xerostomia, salivary glands.

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Risk factors related to oral candidiasis in patients with primary Sjögren’s syndrome

Cited by 22 publications

References 28 publications

Candida albicans—The Virulence Factors and Clinical Manifestations of Infection

Candida albicans—The Virulence Factors and Clinical Manifestations of Infection

ACE2 expression in saliva of patients with COVID-19 and its association with Candida albicans and Aggregatibacter actinomycetemcomitans

Stimulated whole salivary flow rate: The most appropriate technique for assessing salivary flow in Sjögren syndrome

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