Candidiasis, Oral ; diagnosis ; drug therapy ; microbiology ; Humans

ABSTRACT Methanolic extract from the leaves of Acanthus ilicifolius L. (A. ilicifolius L.) is a potent inhibitor of Candida albicans (C. albicans) growth and anti-inflammatory. C. albicans causes oral candidiasis in immunosuppressive condition. Mitogen-activated protein kinase (MAPK) signalling via p38 appears to discriminate between yeast and hyphal cells of C. albicans. Activation of p38 MAPK by hyphae results in the upregulation of proinflammatory cytokines. The p38 MAPK activation is known to impair corticosteroid action. The research was conducted to investigate the effect of methanolic extract A. ilicifolius L. treatment of oral candidiasis with the immunosuppressive condition through enhancement of p38 MAPK expression in the epithelial cells. Immunosuppressed conditions were obtained when 16 healthy male Rattus norvergicus (Wistar) was given oral administration of dexamethasone and tetracycline for 14 days and induced with C. albicans (ATCC-10231) 1 McFarland. The subjects were divided into four groups (n = 4/group): immunosuppression (IS), immunosuppression with oral candidiasis without treatment (ISC), immunosuppression with oral candidiasis and nystatin treatment (ISC+N), and immunosuppression with oral candidiasis and A. ilicifolius L. treatment (ISC+AI), and were treated for 14 days. Later, the rats were euthanised, and their tongue were biopsied. The p38 MAPK expression was subjected to immunohistochemical examination, observed under a microscope (400× magnification) and statistically analysed (one-way ANOVA, LSD-test, p < 0.05). The p38 MAPK expression of ISC+AI (36.05 ± 1.54) was higher than IS (26 ± 2.32), ISC (26.4 ± 3.71), IS+N (34.2 ± 0.99). Significant differences existed between ISC+AI and ISC+N to IS and ISC (p < 0.05). No significant differences were present between IS and ISC; ISC+AI and ISC+N (p > 0.05). Therefore, this treatment could enhance p38 MAPK expression in oral candidiasis with the immunosuppressed condition.
Acanthaceae ; Candidiasis, Oral ; Immunosuppression Therapy ; p38 Mitogen-Activated Protein Kinases

BACKGROUND: Recently, inireaing numbers of chemotherapeutic agens are being used to treat cancer patients. Mucocutaeous complications are commonly sen in association with the administration of these medicaticins. OBJECTIVE: We conducted a study in cancer chemotherapy patient so determine the suspected chemotherapeutic agents ancl frequency of various mucocutaneous side effects in these patients. METHODS: The study involved 140 patients admitted from Decerrae 1993 to September 1994 for cancer chemot herapy at Korea University Guro Hospital. RESULTS: The mucocutaneous side effects during chemotherapy were alopecia(55%), hyperpig mentation(32.9%), stomatitis(20%), phlebitis(12.9%), flushing(8.6%) descending order. Visual grade II, IV alopecia patients were most common, but as the chemot retpy cycle increased so, the severer the alopecia. Although the onset of the alopecia were variake many patients experienced alopcia within 17 to 24 days after the start of chemotherapy. Serpeitie supravenous fluorouracil hyperpigmentation were commor,(17.9%), Diffuse and longitudinal or horizontal band like nail pigmentation were observed, and, pigmented macules were also observei, epecially on the palms and digits. Stomatitis usually developed within 10 days after the start of chemotherapy and it persist ed for about 7 days and the most of the lesions were resolved spor Laeously. Other clinical manifestations accompanied with chmotherapy were tinea infection(16.4%), acne(7.1%), oral thrush (7%), white nail band(4.3%), pruritus(2.9%) in descending order. CONCLUSION: So, physiciars need to be aware of the widely divergnal cutaneous reactions which may occur with the use of antiancer medications.
Alopecia ; Candidiasis, Oral ; Drug Therapy* ; Fluorouracil ; Humans ; Hyperpigmentation ; Korea ; Pigmentation ; Stomatitis ; Tinea

Candida albicans is the most abundant fungal species in oral cavity. As a smart opportunistic pathogen, it increases the virulence by switching its forms from yeasts to hyphae and becomes the major pathogenic agent for oral candidiasis. However, the overuse of current clinical antifungals and lack of new types of drugs highlight the challenges in the antifungal treatments because of the drug resistance and side effects. Anti-virulence strategy is proved as a practical way to develop new types of anti-infective drugs. Here, seven artemisinins, including artemisinin, dihydroartemisinin, artemisinic acid, dihydroartemisinic acid, artesunate, artemether and arteether, were employed to target at the hyphal development, the most important virulence factor of C. albicans. Artemisinins failed to affect the growth, but significantly inhibited the hyphal development of C. albicans, including the clinical azole resistant isolates, and reduced their damage to oral epithelial cells, while arteether showed the strongest activities. The transcriptome suggested that arteether could affect the energy metabolism of C. albicans. Seven artemisinins were then proved to significantly inhibit the productions of ATP and cAMP, while reduced the hyphal inhibition on RAS1 overexpression strain indicating that artemisinins regulated the Ras1-cAMP-Efg1 pathway to inhibit the hyphal development. Importantly, arteether significantly inhibited the fungal burden and infections with no systemic toxicity in the murine oropharyngeal candidiasis models in vivo caused by both fluconazole sensitive and resistant strains. Our results for the first time indicated that artemisinins can be potential antifungal compounds against C. albicans infections by targeting at its hyphal development.
Animals ; Mice ; Candida albicans ; Candidiasis, Oral/drug therapy* ; Antifungal Agents/pharmacology* ; Hyphae ; Artemisinins/pharmacology*

ABSTRACT Hepatocellular utility is observed by measuring the hepatocellular enzymes. Changes in its serum levels are related to liver dysfunction. Liver is one of the immunoprotective organs. Continuous use of immunosuppressive drugs can cause oral candidiasis and give effects to liver function. Hyperbaric oxygen treatment (HBOT), while reducing fungal infections, can also repair the liver function. The aim of this study was to investigate the alanine transaminase (ALT) and aspartate transaminase (AST) levels of immunosuppressed rats with oral candidiasis treated with hyperbaric oxygen. Twelve Wistar rats were divided into three groups: K− (normal/ healthy), K+ (oral candidiasis immunosuppressed rats), and P (oral candidiasis immunosuppressed rats treated hyperbaric oxygen). K+ and P groups were immunosuppressed by giving dexamethasone 0.5 mg/day/rat orally for 14 days, added with tetracycline 1 mg/day/rat. HBOT was given in five days successively. Blood serum of rats in all groups were taken to calculate the ALT and AST levels. ALT and AST levels in K+ showed higher value than K− and P groups. The data were analysed with one-way ANOVA test and showed significant difference in ALT levels (p < 0.05), while in AST levels there was no significant difference among the groups (p > 0.05). This study showed that HBOT affected the ALT and AST levels of immunosuppressed rats with oral candidiasis.
Carcinoma, Hepatocellular ; Hyperbaric Oxygenation ; Immunocompromised Host ; Candidiasis, Oral--therapy ; Alanine Transaminase ; Aspartate Aminotransferases

Most clinicians dread seeing the patient presenting with a primary complaint of a burning pain on one or more oral mucosal surfaces. Unlike most other clinical conditions presenting in a dental office, burning mouth syndrome is recently, advances have been made towards clarifying the possible etiology of the disorder and testing the possible therapeutic modalities available. This article attempts to summarize the "state of the art" today.
Burning Mouth Syndrome ; diagnosis ; drug therapy ; etiology ; Candidiasis, Oral ; diagnosis ; Diagnosis, Differential ; Glossalgia ; diagnosis ; Humans ; Paresthesia ; diagnosis ; Xerostomia ; diagnosis

The incidence of oral complications among adult cancer patients undergoing chemotherapy varies from 12 to 80%. Adequate oral hygiene has been shown to be important in prevention of oral complication and an essential role is reserved for the nursing staff. These considerations prompted the decision to survey by means of a questionaire, the nurses who give care to cancer patients. The Questions were included multidisciplinary treatment, inspection skill, nursing intervention, nursing education, problem in mouth care, solution for problem solving. Results are follow : 1. A total of 116 the nurses returned the questionaire. 2. According to 88.2% of the respondents, the policy with regard to oral hygine in determined by the physician and the nurse. 62.1% of nurses do not consult the dentist When oral complication is occurred. 3. In only 34.5% of case was a penlight used to provide the necessary extra illumination nursing Inspection of oral cavity. 4. Frequency of oral complication observed by the respondents is that they observed complications in < 25% of patients. The nature of the complication varied from ulcer, stomatitis, infection, dry mouth, candidiasis, herpes simplix, bleeding. 5. Percentages of respondents who use the intervention indicated 1) to prevent oral complication : 0.9% normal saline gargling(44%), 0.02% chlorhexidine gargling, oral dressing(38.8%), observation, nutrition, restriction of alcohol and tabaco(23.2%) 2) to deal with the early symptoms : 0.9% normal saline gargling(47.4%), cryotherapy(37.9%), 0.02% chlorhexidine gargling(20.7%) 3) to help alleviate severe complications : dental consult, holding the chemotherapy(34.5%), 0.9% normal saline gargling(31.1%), cryotherapy(18.0%) 6. According to 70% of the respondents, insufficient attention is given to oral complication during nursing education classes only 8.6% said that both the theory and the practical aspects had been deal with in sufficient detail during their training. The results of the survey indicate that oral care in cancer patients undergoing chemotherapy has a number of problem. There are not enough dentist to provide the necessary care for patients undergoing chemotherapy. The expertise of the nurses with respect to the pathogenesis of the complication is limited. In the training of nurses, additional attention to oral examinations and oral hygine is warranted. The care of patients should be the responsibility of a multidisciplinary team approach. The nurse occupies a key position with in this team, which includes the medical oncologist, a dentist.
Adult ; Candidiasis ; Chlorhexidine ; Surveys and Questionnaires ; Dentists ; Diagnosis, Oral ; Drug Therapy* ; Education, Nursing ; Hemorrhage ; Humans ; Incidence ; Lighting ; Mouth* ; Nursing ; Nursing Staff ; Oral Hygiene ; Problem Solving ; Stomatitis ; Ulcer

BACKGROUND: Skin disorders are common in human immunodeficiency virus (HIV)-infected patients in Korea. However, introduction of highly active antiretroviral therapy (HAART) has changed the skin manifestations of HIV infection. OBJECTIVE: We evaluated the frequency of skin disorders and their immune status using CD4+ T lymphocyte counts in HIV infected patients. METHODS: A retrospective study of 134 HIV-infected patients who visited in our clinic was carried out from September 2008 to July 2011. All subjects underwent complete physical examination to detect their skin disorders as well as necessary diagnostic procedures by consultation with the dermatologist. RESULTS: Tinea infection (including tinea corporis, tinea pedis and onychomycosis) was the most common skin disorder identified. Patients with a CD4+ T lymphocyte count of less than 200 cells/mm3 showed a significantly higher prevalence of syphilis, oral candidiasis and drug eruption compared with patients with a CD4+ T lymphocyte count of over 200 cells/mm3. CONCLUSION: Numerous skin disorders were demonstrated in HIV-infected patients. Among them, tinea infection was the most common skin manifestation in 134 HIV-infected patients. Moreover, Syphilis, oral candidiasis and drug eruption were associated with low CD4+ T lymphocyte counts. Further evaluation is necessary to confirm the trend towards changes in skin manifestations in HIV infected patients.
Antiretroviral Therapy, Highly Active ; Candidiasis, Oral ; Drug Eruptions ; HIV ; HIV Infections ; Humans ; Korea ; Lymphocyte Count* ; Lymphocytes* ; Physical Examination ; Prevalence ; Retrospective Studies ; Skin Manifestations ; Skin* ; Syphilis ; Tinea ; Tinea Pedis

OBJECTIVETo observe the effect of xiaomi granules (XMG) for treatment of HIV/AIDS oral candidiasis.

METHODSForty patients in the treated group were treated by XMG and 40 patients in the control group were treated with anticandine. The therapeutic course for both groups was two weeks. Changes of clinical symptoms, oral candida microscopic examination and cultured before and after treatment as well as the safety of treatment were observed, and a follow-up study was implemented two weeks after ending medication to compare the relapse rate between groups.

RESULTSSymptoms as oral greasy-sticky, thirsty, asthenia, abdominal distension and anorexia were improved after treatment in both groups (P < 0.05). The improvements of oral greasy-sticky and thirsty in the treated group were better than those in the control group (P < 0.05). The effective rate and relapse rate in the treated group was 90.0% (36/40) and 11.1% (4/36) respectively, while in the control group, 72. 5% (29/40) and 31.0% (9/29) respectively.

CONCLUSIONXMG could improve the clinical symptoms with high efficacy and low relapse rate, shows a better effect than that of anticandine in treating HIV/AIDS oral candidiasis.

AIDS-Related Opportunistic Infections ; drug therapy ; Acquired Immunodeficiency Syndrome ; microbiology ; Adult ; Candidiasis, Oral ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Follow-Up Studies ; HIV Infections ; microbiology ; Humans ; Male ; Middle Aged ; Treatment Outcome

The hyphal development of Candida albicans (C. albicans) has been considered as an essential virulent factor for host cell damage. However, the missing link between hyphae and virulence of C. albicans is also been discovered. Here, we identified that the null mutants of ERG3 and ERG11, two key genes in ergosterol biosynthesis pathway, can form typical hyphae but failed to cause the oral mucosal infection in vitro and in vivo for the first time. In particular, the erg3Δ/Δ and erg11Δ/Δ strains co-cultured with epithelial cells significantly reduced the adhesion, damage, and cytokine (interleukin-1α (IL-1α)) production, whereas the invasion was not affected in vitro. Importantly, they were incapable of extensive hyphal invasion, formation of micro-abscesses, and tongue epithelium damage compared to wild type due to the decrease of the colonization and epithelial infection area in a murine oropharyngeal candidiasis model. The fluconazole (FLC), an antifungal targeted at ergosterol biosynthesis, relieved the epithelial infection of C. albicansin vitro and in vivo even under non-growth inhibitory dosage confirming the virulent contribution of ergosterol biosynthesis pathway. The erg3Δ/Δ and erg11Δ/Δ strains were cleared by macrophages similar to wild type, whereas their virulence factors including agglutinin-like sequence 1 (Als1), secreted aspartyl proteinase 6 (Sap6), and hyphal wall protein-1 (Hwp1) were significantly reduced indicated that the non-toxicity might not result from the change on immune tolerance but the defective virulence. The incapacity of erg3Δ/Δ and erg11Δ/Δ in epithelial infection highlights the contribution of ergosterol biosynthesis pathway to C. albicans pathogenesis and fluconazole can not only eliminate the fungal pathogens but also reduced their virulence even at low dosage.
Animals ; Antifungal Agents ; pharmacology ; Candida albicans ; drug effects ; genetics ; pathogenicity ; Candidiasis, Oral ; drug therapy ; genetics ; microbiology ; Fluconazole ; pharmacology ; Genes, Fungal ; genetics ; Mice ; Microscopy, Electron, Scanning ; Potassium Channels ; genetics ; Virulence