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

  1. Julia Serrano 1
  2. Rosa Mª López-Pintor Muñoz 2
  3. Lucía Ramírez Martínez Acitores 2
  4. Mónica Fernández Castro 3
  5. Mariano Sanz Alonso 2
  6. Sheila Melchor 4
  7. Diana Peiteado López 5
  8. Gonzalo Hernández Vallejo 2
  1. 1 Department of Dental Clinical Specialties, ORALMED research group, School of Dentistry, Complutense University, Madrid, Spain; PhD Student, Research training fellow, Complutense University, Madrid
  2. 2 Department of Dental Clinical Specialties, ORALMED research group, School of Dentistry, Complutense University, Madrid, Spain
  3. 3 Rheumatology Service, Hospital Puerta de Hierro, Madrid, Spain
  4. 4 Rheumatology Service, Hospital Doce de Octubre, Madrid, Spain
  5. 5 Rheumatology Service, Hospital La Paz, Madrid, Spain
Mostrar afiliaciones +
Revista:
Medicina oral, patología oral y cirugía bucal. Ed. inglesa

ISSN: 1698-6946

Año de publicación: 2020

Volumen: 25

Número: 5

Páginas: 12

Tipo: Artículo

DOI: 10.4317/MEDORAL.23719 DIALNET GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Medicina oral, patología oral y cirugía bucal. Ed. inglesa

Resumen

Candidiasis is the most frequent mycotic infection of the oral cavity. The aim of this study was to investigate the presence of clinical oral candidiasis and Candida albicans yeast in a population diagnosed of primary Sjögren’s syndrome (pSS) and to study the possible factors associated with this infection. An observational cross-sectional study was conducted in 61 pSS patients (60 women, 1 man, mean age 57.64±13.52) where patient based information (demographic and medical, tobacco and alcohol consumption history), intraoral parameters (presence of dentures, clinical signs of candidiasis), salivary analytical information (number of Candida albicans as colony-forming units per millilitre (CFU/mL), salivary pH levels, unstimulated whole saliva (UWS) and stimulated whole saliva (SWS) were collected. 13.1% of pSS patients presented oral signs of candidiasis. Denture stomatitis and angular cheilitis were the most common lesions. 87.5% of patients with clinical candidiasis presented reduced pH levels and salivary flow in both UWS and SWS. A significant statistical negative correlation was found between CFU/mL of Candida albicans and levels of UWS and SWS. A negative correlation was found between pH levels and CFU/mL, although not statistically significant. A reduced salivary flow may predispose pSS patients to Candida albicans overgrowth, which may show with clinical signs. Preventive measures are of great importance to avoid and to treat this condition promptly.

Referencias bibliográficas

  • Patel, R,Shahane, A. (2014). The epidemiology of Sjögren's syndrome. Clin Epidemiol. 6. 247
  • Medeiros, CCG,Borges, LGDA,Cherubini, K,Salum, FG,Silva, RMD,de Figueiredo, MAZ. (2018). Oral yeast colonization in patients with primary and secondary Sjögren's syndrome. Oral Dis. 24. 1367
  • Likar-Manookin, K,Stewart, C,Al-Hashimi, I,Curtis, W,Berg, K,Cherian, K. (2013). Prevalence of oral lesions of autoimmune etiology in patients with primary Sjogren's syndrome. Oral Dis. 6. 598-603
  • Shinozaki, S,Moriyama, M,Hayashida, JN,Tanaka, A,Maehara, T,Ieda, S. (2012). Close association between oral Candida species and oral mucosal disorders in patients with xerostomia. Oral Dis. 18. 667
  • Leung, KC,McMillan, AS,Leung, WK,Wong, MC,Lau, CS,Mok, TM. (2004). Oral health condition and saliva flow in southern Chinese with Sjögren's syndrome. Int Dent J. 54. 159
  • Torres, SR,Peixoto, CB,Caldas, DM,Silva, EB,Akiti, T,Nucci, M. (2002). Relationship between salivary flow rates and Candida counts in subjects with xerostomia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 93. 149-154
  • Billings, M,Dye, BA,Iafolla, T,Grisius, M,Alevizos, I. (2017). Elucidating the role of hyposalivation and autoimmunity in oral candidiasis. Oral Dis. 23. 387
  • Millsop, JW,Fazel, N. (2016). Oral candidiasis. Clin Dermatol. 34. 487
  • Hertel, M,Schmidt-Westhausen, AM,Strietzel, FP. (2016). Local, systemic, demographic, health-related factors influencing pathogenic yeast spectrum and antifungal drug administration frequency in oral candidiasis: a retrospective study. Clin Oral Investig. 20. 1477
  • Oliveira, MA,Carvalho, LP,Gomes, MdeS,Bacellar, O,Barros, TF,Carvalho, EM. (2007). Microbiological and immunological features of oral candidiasis. Microbiol Immunol. 51. 713
  • Williams, D,Lewis, M. (2011). Pathogenesis and treatment of oral candidosis. J Oral Microbiol. 3. 1-11
  • Leung, KC,McMillan, AS,Cheung, BP,Leung, WK. (2008). Sjögren's syndrome sufferers have increased oral yeast levels despite regular dental care. Oral Dis. 14. 163
  • Fernández-Castro, M,López-Pintor, RM,Serrano, J,Ramírez, L,Sanz, M,Andreu, JL. (2019). Evaluación protocolizada odontológica en el paciente con síndrome de Sjögren primario. Proyecto EPOX-SSp: metodología y objetivos. Reumatol Clin.
  • Serrano, J,López-Pintor, RM,Fernández-Castro, M,Ramírez, L,Sanz, M,Casañas, E. (2020). Oral lesions in patients with primary Sjögren's syndrome. A case-control cross-sectional study. Med Oral Patol Oral Cir Bucal. 25. 137
  • Vitali, C,Bombardieri, S,Jonsson, R,Moutsopoulos, HM,Alexander, EL,Carsons, SE. (2002). Classification criteria for Sjogren's syndrome: A revised version of the European criteria proposed by the American-European Consensus Group. Ann Rheum Dis. 61. 554
  • López-Pintor, RM,Hernández, G,de Arriba, L,de Andrés, A. (2013). Oral candidiasis in patients with renal transplants. Med Oral Patol Oral Cir Bucal. 18. 381
  • MacFarlane, TW,Mason, DK. (1974). Changes in the oral flora in Sjogren's syndrome. J Clin Path. 27. 416
  • Shimizu, C,Kuriyama, T,Williams, DW. (2008). Association of oral yeast carriage with specific host factors and altered mouth sensation. Oral Surg Oral Med Oral Pathol Oral Radiol. 105. 445
  • Sweet, SP,Denbury, AN,Challacombe, SJ. (2001). Salivary calprotectin levels are raised in patients with oral candidiasis or Sjögren's syndrome but decreased by HIV infection. Oral Microbiol Immunol. 16. 119
  • Ergun, S,Cekici, A,Topcuoglu, N,Migliari, DA,Külekçi, G,Tanyeri, H. (2010). Oral status and Candida colonization in patients with Sjögren's Syndrome. Med Oral Patol Oral Cir Bucal. 1. 310
  • Serrano, J,López-Pintor, RM,González-Serrano, J,Fernandez-Castro, M,Casanas, E,Hernandez, G. (2018). Oral lesions in Sjögren's syndrome: a systematic review. Med Oral Patol Oral Cir Bucal. 23. 391-400
  • Lundström, IM,Lindström, FD. (1995). Subjective and clinical oral symptoms in patients with primary Sjögren's syndrome. Clin Exp Rheumatol. 13. 725
  • Abraham, MC,A1-Hashimi, aI,Nasser Haghighat, N. (1998). Evaluation of the levels of oral Candida in patients with Sjögren's syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol. 86. 65
  • Rhodus, NL,Bloomquist, C,Liljemark, W,Bereuter, J. (1997). Prevalence, density, and manifestations of oral Candida albicans in patients with Sjögren's syndrome. J Otolaryngol. 26. 300
  • Yan, Z,Young, LA,Hua, H,Xu, Y. (2011). Multiple Oral Candida Infections in Patients with Sjögren's syndrome- Prevalence and Clinical and Drug Susceptibility Profiles. J Rheum. 38. 2428
  • Radfar, L,Shea, Y,Fischer, SH,Sankar, V,Leakan, RA,Baum, BJ. (2003). Fungal load and candidiasis in Sjögren's syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol. 96. 283
  • Kindelan, SA,Yeoman, CM,Douglas, CWI,Franklin, C. (1998). A comparison of intraoral Candida carriage in Sjögren's syndrome patients with healthy xerostomic controls. Oral Surg Oral Med Oral Pathol. 85. 162
  • MacFarlane, TW. (1984). The oral ecology of patients with severe Sjögren's syndrome. Microbios. 41. 99-106
  • Zhou, PR,Hua, H,Liu, XS. (2017). Quantity of Candida colonies in Saliva: A Diagnostic Evaluation for Oral Candidiasis. Chin J Dent Res. 20. 27-32
Fuente de los datos: Dialnet