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Erythematous Oral Candidiasis in Patients with Controlled Type II Diabetes Mellitus and Complete Dentures

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Abstract

Diabetes mellitus (DM) is a systemic condition characterized by a deficient sugar metabolism, which affects the immune system and favors the development of yeasts. The aim of the present study was to perform biochemical, morphological, exoenzyme analyses of Candida species and the molecular identification (DNA) of C. albicans in patients with type II diabetes mellitus. The exoenzyme quantification was compared to non-diabetic patients as controls. Two hundred and seventy-four patients who make use of complete dentures were evaluated, 28 of whom had diabetes and erythematous oral candidiasis. Other thirty patients presented the same clinical feature but without diabetes. Samples were isolated for biochemical identification (auxonogram), morphological identification (production of germ tubes) and PCR molecular identification (DNA). The capability of the Candida samples in producing phospholipases and proteinases was also determined. The diabetic patients had a greater diversity of Candida species (Fischer’s exact test, P = 0.04). The production of proteinases by C. albicans in patients with diabetes was greater than in the control group (unpaired “t” test P < 0.003). However, there was no difference between groups for phospholipase production (unpaired “t” test P > 0.05). It was concluded that patients with controlled DM exhibited systemic conditions predisposing C. albicans proteinase increased production.

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References

  1. Aleva NA, Birman EG, Afonso W Jr, Chavasco JK, Paula CR, Ribeiro A, et al. Erythematous candidosis in patients with complete dentures and HIV+/AIDS. Mycoses. 2007;50:407–11.

    Article  CAS  PubMed  Google Scholar 

  2. Perezous LF, Flaitz CM, Goldschmidt ME, Engelmeier RL. Colonization of Candida species in denture wearers with emphasis on HIV infection: a literature review. J Prosthet Dent. 2005;93:288–93.

    Article  PubMed  Google Scholar 

  3. Kulak Y, Arikan A, Kazazoglu E. Existence of Candida albicans and microorganisms in denture stomatitis patients. J Oral Rehabil. 1997;24:788–90.

    Article  CAS  PubMed  Google Scholar 

  4. White TC, Agabian N. Candida albicans secreted aspartyl proteinases: isoenzyme pattern is determined by cell type, and levels are determined by environmental factors. J Bacteriol. 1995;177:5215–21.

    CAS  PubMed  Google Scholar 

  5. Borg M, Rüchel R. Expression of extracellular acid proteinase by proteolytic Candida spp. during experimental infection of oral mucosa. Infect Immun. 1988;56:626–31.

    CAS  PubMed  Google Scholar 

  6. Ghannoum M, Radwan SS. Candida adherence to epithelial cells. 8th ed. ed. New York: CRC Press; 1990.

    Google Scholar 

  7. Rotrosen D, Calderone RA, Edwards JE Jr. Adherence of Candida species to host tissues and plastic surfaces. Rev Infect Dis. 1986;8:73–85.

    CAS  PubMed  Google Scholar 

  8. Novaes AB Jr, Gonzalez Gutierrez F, Grisi MF, Novaes AB. Periodontal disease progression in type II non-insulin-dependent diabetes mellitus patients (NIDDM). Part II–microbiological analysis using the BANA test. Braz Dent J. 1997;8:27–33.

    PubMed  Google Scholar 

  9. Zachariasen RD. Diabetes mellitus and xerostomia. Compendium Contin Educ Dent. 1992; 13: 314, 316, 318–322 Passim Review.

  10. Magee BB, D’Souza TM, Magee PT. Strain and species identification by restriction fragment length polymorphisms in the ribosomal DNA repeat of Candida species. J Bacteriol. 1987;169:1639–43.

    CAS  PubMed  Google Scholar 

  11. Smith RA, Hitchcock CA, Evans EG, Lacey CJ, Adams DJ. The identification of Candida albicans strains by restriction fragment length polymorphism analysis of DNA. J Med Vet Mycol. 1989;27:431–4.

    Article  CAS  PubMed  Google Scholar 

  12. Pfaller MA, Hollis RJ, Sader HS. Chromosomal restriction fragment analysis by pulsed-field gel electrophoresis. In: Isenberg HD, editor. Clinical microbiology procedures handbook, suppl 1. Washington: American Society for Microbiology; 1994. p. 10.5.c.1–10.5.c.12.

    Google Scholar 

  13. Price MF, Wilkinson ID, Gentry LO. Plate method for detection of phospholipase activity in Candida albicans. Sabouraudia. 1982;20:7–14.

    CAS  PubMed  Google Scholar 

  14. Rüchel R, Tegeler R, Trost M. A comparison of secretory proteinases from different strains of Candida albicans. Sabouraudia. 1982;20:233–44.

    PubMed  Google Scholar 

  15. Gonçalves RH, Miranda ET, Zaia JE, Giannini MJ. Species diversity of yeast in oral colonization of insulin-treated diabetes mellitus patients. Mycopathologia. 2006;162(2):83–9.

    Article  PubMed  Google Scholar 

  16. Galili D, Findler M, Garfunkel AA. Oral and dental complications associated with diabetes and their treatment. Compendium. 1994; 15: 496, 498, 500–9.

    Google Scholar 

  17. Oztürkcan S, Oztürkcan S, Topçu S, Akinci S, Bakici MZ, Yalçin N. Incidence of oral candidiasis in diabetic patients. Mikrobiyol Bul. 1993;27:352–6. (Abstract).

    PubMed  Google Scholar 

  18. Iacopino AM. Diabetic periodontitis: possible lipid-induced defect in tissue repair through alteration of macrophage phenotype and function. Oral Dis. 1995;1:214–29.

    Article  CAS  PubMed  Google Scholar 

  19. Guggenheimer J, Moore PA, Rossie K, Myers D, Mongelluzzo MB, Block HM, et al. Insulin-dependent diabetes mellitus and oral soft tissue pathologies: II. Prevalence and characteristics of Candida and Candidal lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;89:570–6.

    Article  CAS  PubMed  Google Scholar 

  20. Peters RB, Bahn AN, Barens G. Candida albicans in the oral cavities of diabetics. J Dent Res. 1966;45:771–7.

    CAS  PubMed  Google Scholar 

  21. Lucas VS. Association of psychotropic drugs, prevalence of denture-related stomatitis and oral candidosis. Community Dent Oral Epidemiol. 1993;21:313–6.

    Article  CAS  PubMed  Google Scholar 

  22. Dorko E, Jenca A, Pilipcinec E, Danko J, Svický E, Tkáciková L. Candida-associated denture stomatitis. Folia Microbiol (Praha). 2001;46:443–6.

    Article  CAS  Google Scholar 

  23. Odds FC. Candida and candidosis. 2nd ed. London: Bailliere Tyndall; 1988.

    Google Scholar 

  24. Barbeau J, Séguin J, Goulet JP, de Koninck L, Avon SL, Lalonde B, et al. Reassessing the presence of Candida albicans in denture-related stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95:51–9.

    Article  PubMed  Google Scholar 

  25. Kadir T, Pisiriciler R, Akyüz S, Yarat A, Emekli N, Ipbüker A. Mycological and cytological examination of oral Candidal carriage in diabetic patients and non-diabetic control subjects: thorough analysis of local aetiologic and systemic factors. J Oral Rehabil. 2002;29:452–7.

    Article  CAS  PubMed  Google Scholar 

  26. Crockett DN, O’Grady JF, Reade PC. Candida species and Candida albicans morphotypes in erythematous candidiasis. Oral Surg Oral Med Oral Pathol. 1992;73:559–63.

    Article  CAS  PubMed  Google Scholar 

  27. Webb BC, Thomas CJ, Willcox MD, Harty DW, Knox KW. Candida-associated denture stomatitis. Aetiology and management: a review. Part 1. Factors influencing distribution of Candida species in the oral cavity. Aust Dent J. 1998;43:45–50.

    Article  CAS  PubMed  Google Scholar 

  28. Fradin C, Hube B. Tissue infection and site-specific gene expression in Candida albicans. Adv Appl Microbiol. 2003;53:271–90.

    Article  CAS  PubMed  Google Scholar 

  29. Pires FR, Santos EB, Bonan PR, De Almeida OP, Lopes MA. Denture stomatitis and salivary Candida in Brazilian edentulous patients. J Oral Rehabil. 2002;29:1115–9.

    Article  CAS  PubMed  Google Scholar 

  30. Zegarelli DJ. Fungal infections of the oral cavity. Otolaryngol Clin North Am. 1993;26:1069–89.

    CAS  PubMed  Google Scholar 

  31. Wendt S, Glass RT. The infected denture: how long does it take? Quintessence Int. 1987;18:855–8.

    CAS  PubMed  Google Scholar 

  32. Arendorf TM, Walker DM, Kingdom RJ, Roll JR, Newcombe RG. Tobacco smoking and denture wearing in oral candidal leukoplakia. Br Dent J. 1983;155:340–3.

    Article  CAS  PubMed  Google Scholar 

  33. Budtz-Jørgensen E. Oral mucosal lesions associated with the wearing of removable dentures. J Oral Pathol. 1981;10:65–80.

    Article  PubMed  Google Scholar 

  34. Trotta M, Difonzo EM, Palleschi GM, Vannini P, Guadagni R, Panconesi E. Mycologic findings in persons wearing dental prostheses. G Ital Dermatol Venereol. 1987;122:91–5. Italian.

    CAS  PubMed  Google Scholar 

  35. McMullan-Vogel CG, Jüde HD, Ollert MW, Vogel CW. Serotype distribution and secretory acid proteinase activity of Candida albicans isolated from the oral mucosa of patients with denture stomatitis. Oral Microbiol Immunol. 1999;14:183–9.

    Article  CAS  PubMed  Google Scholar 

  36. Joly S, Pujol C, Rysz M, Vargas K, Soll DR. Development and characterization of complex DNA fingerprinting probes for the infectious yeast Candida dubliniensis. J Clin Microbiol. 1999;37:1035–44.

    CAS  PubMed  Google Scholar 

  37. Sullivan DJ, Westerneng TJ, Haynes KA, Bennett DE, Coleman DC. Candida dubliniensis sp. nov.: phenotypic and molecular characterization of a novel species associated with oral candidosis in HIV-infected individuals. Microbiology. 1995;141:1507–21.

    Article  CAS  PubMed  Google Scholar 

  38. Gruber A, Speth C, Lukasser-Vogl E, Zangerle R, Borg-von Zepelin M, Dierich MP, et al. Human immunodeficiency virus type 1 protease inhibitor attenuates Candida albicans virulence properties in vitro. Immunopharmacology. 1999;41:227–34.

    Article  CAS  PubMed  Google Scholar 

  39. Budtz-Jörgensen E. Etiology, pathogenesis, therapy, and prophylaxis of oral yeast infections. Acta Odontol Scand. 1990;48:61–9.

    Article  PubMed  Google Scholar 

  40. Naglik JR, Challacombe SJ, Hube B. Candida albicans secreted aspartyl proteinases in virulence and pathogenesis. Microbiol Mol Biol Rev. 2003;67:400–28.

    Article  CAS  PubMed  Google Scholar 

  41. Sweet SP. Selection and pathogenicity of Candida albicans in HIV infection. Oral Dis. 1997;3(Suppl 1):S88–95.

    PubMed  Google Scholar 

  42. Brawner D, Cutler JE. Oral Candida albicans isolates from nonhospitalized normal carriers, immunocompromised patients with or without acquired immunodeficiency syndrome. J Clin Microbiol. 1989;27:1335–41.

    CAS  PubMed  Google Scholar 

  43. Naglik JR, Newport G, White TC, et al. In vivo analysis of secreted aspartyl proteinase expression in human oral candidiasis. Infect Immun. 1999;67:2482–90.

    CAS  PubMed  Google Scholar 

  44. Fiske J. Diabetes mellitus and oral care. Dent Update. 2004; 31: 190–6, 198.

    Google Scholar 

  45. Karjalainen KM, Knuuttila ML, von Dickhoff KJ. Association of the severity of periodontal disease with organ complications in type 1 diabetic patients. J Periodontol. 1994;65:1067–72.

    CAS  PubMed  Google Scholar 

  46. Tsang CS, Chu FC, Leung WK, Jin LJ, Samaranayake LP, Siu SC. Phospholipase, proteinase and haemolytic activities of Candida albicans isolated from oral cavities of patients with type 2 diabetes mellitus. J Med Microbiol. 2007;56:1393–8.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Luciano José Pereira.

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Motta-Silva, A.C., Aleva, N.A., Chavasco, J.K. et al. Erythematous Oral Candidiasis in Patients with Controlled Type II Diabetes Mellitus and Complete Dentures. Mycopathologia 169, 215–223 (2010). https://doi.org/10.1007/s11046-009-9240-6

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  • DOI: https://doi.org/10.1007/s11046-009-9240-6

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