Bugs as Drugs by Robert A. Britton

Author:Robert A. Britton
Language: eng
Format: epub
Publisher: Wiley
Published: 2017-12-20T00:00:00+00:00

Microbial Therapeutics for Oral Candidiasis

Several in vitro studies show that probiotics may affect the virulence potential of C. albicans. Lactobacillus spp. and S. salivarius have been shown to negatively impact C. albicans yeast-to-hypha differentiation and/or biofilm formation (259, 260). The mechanism of action would not depend on probiotic-yeast contact, because the use of sterile-filtered supernatant obtained from S. salivarius and Lactobacillus spp. significantly downregulates, in C. albicans, genes critical for the yeast-hypha transition, biofilm formation, host cell invasion, and virulence (261, 262). Also, the treatment of an engineered human oral mucosa tissue model with Bacillus subtilis has been shown to decrease C. albicans attachment (263).

Animal models have been used to demonstrate potential antagonistic effects of probiotic-like strains on C. albicans. L. acidophilus protected Galleria mellonella larvae against experimental candidiasis (262), while in immunosuppressed mice, L. rhamnosus reduced oral C. albicans colonization to a higher extent than the antifungal nystatin (264). Moreover, oral administration of L. acidophilus to mice has been shown to significantly shorten the duration of C. albicans colonization in the mouth, possibly due to an immunomodulatory effect (265). It has also been shown that the application of heat-killed Enterococcus faecalis to the tongue of immunosuppressed mice reduces both symptoms and Candida counts (266).

Human studies support the mentioned in vitro and animal studies, with positive reported effects for probiotic intake with regards to the risk of developing oral candidiasis. Salivary levels of yeast in elderly subjects have been shown to decrease compared to basal levels after probiotic intake (267–269), together with a significant increase in anti-Candida IgA levels (269). In patients diagnosed with oral candidiasis, the local administration of a mixture of Bifidobacterium longum, Lactobacillus bulgaricus, and Streptococcus thermophilus was shown to improve oral pain and reduce the prevalence of Candida spp. compared with conventional antifungal therapies (270). Moreover, in asymptomatic denture wearers harboring oral Candida spp., yeast detection was reduced in the probiotic group compared to the placebo group (271).

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