The in vitro activity of selected mouthrinses on Candida strains isolated from the oral cavity.

The purpose of this in vitro study was to determine the effects of 13 mouth rinses on one hundred Candida strains isolated from the oral cavity of patients. Five of the rinses had no antifungal activity. Chlorhexidine, Colgate and Dentosept acted on all isolated strains; Corsodyl did not act on C. glabrata (2 strains), Octenidol on C. glabrata and C. guilliermondii (1 each), Sylveco on C. tropicalis (2), Oral B on C. parapsilosis, Curasept did not affect 17 strains, including on C. albicans (5), C. guilliermondii (4), C. dubliniensis (3), C. humicola and C. parapsilosis (2 each) and C. glabrata (1). The lowest MIC (the strongest potential activity), was observed for chlorhexidine, followed by Sylveco, Corsodryl and Colgate; in contrast, the highest MIC (the lowest activity) was calculated for Octenidol and Curasept. Eight of the mouthrinses inhibited the in vitro growth of potentially pathogenic fungal strains isolated from the oral cavity at varying dilutions of up to 1:16, depending on the rinse. Chlorhexidine demonstrated strong antifungal efficiency. The antifungal effect of a mouthrinse depends on its composition and the species of fungus. Mouthrinse use is an important complement to procedures ensuring proper oral hygiene and preventing certain oral diseases.

The in vitro activity of selected mouthrinses on the reference strains of Trichomonas tenax and Entamoeba gingivalis

Protozoa, such as Trichomonas tenax, Entamoeba gingivalis and Leishmania braziliensis, may be present in the mouth but their role in the pathophysiology of oral diseases is not clear yet. The use of various types of mouthrinses plays an important role in maintaining proper oral hygiene and in removing some of the microbial components from the oral cavity. The purpose of this study was to investigate the effects of selected mouthrinses on the reference strains of Trichomonas tenax and Entamoeba gingivalis which can be a part of the oral cavity microbiota. Two standard strains Trichomonas tenax (ATCC 30207) and Entamoeba gingivalis (ATCC 30927) were used and metronidazole as a drug used in the treatment of infections caused by protozoa as well as fourteen agents used as mouthwashes were tested, with two pure compounds acting as mouthrinse ingredients, i.e. 20% benzocaine and 0.2% chlorhexidine, as well as 12 commercially-available formulas: Azulan, Colgate Plax Complete Care Sensitive, Corsodyl 0.2%, Curasept ADS 205, Dentosept, Dentosept A, Eludril Classic, Listerine Total Care, Octenidol, Oral-B Pro-Expert Clinic Line, Sylveco and Tinctura salviae. The protozoonicidal activity of the preparations was evaluated on the basis of the ratio of dead to living ratios after incubation in an incubator (37°C) for 1, 10 and 30 min. Protozoa were counted in the Bürker chamber in each case up to 100 cells in an optical microscope (over 400×). The criterion for the death of protozoa was the lack of movement and changes in the shape and characteristics of cell disintegration. The curves of activity were obtained after experiments conducted for 5­7 different solutions of each preparation. On the basis of the curves, the solution killing 50% of the population (CL50) was calculated. All mouthrinses tested in this work in their undiluted form acted lethally on both protozoa. Benzocaine, used as a local anesthetic, has etiotropic properties which can be useful for supporting antiprotozoal treatment. Chlorhexidine confirmed its high efficiency in the eradication of potentially pathogenic protozoa. The use of mouthrinses is an important complement for other procedures intended to maintain correct oral hygiene.

Drug susceptibility of fungi isolated from ICU patients

Candida species can be a reason of infections associated with high morbidity and mortality. The risk of invasive candidosis for patients admitted to intensive care units (ICUs) is increased due to immunosuppressive states, prolonged length of stay, broad-spectrum antibiotics and Candida colonization. The aim of the study was to determine selected properties of fungi isolated from patients treated in the ICUs of hospitals in Lodz. The materials were collected from the oral cavity, the tracheostomy or endotracheal tube and urine from 16 children and 35 adult. In total, 127 samples were examined to differentiate the fungal strains with used morphological and biochemical methods. Candida species were isolated from adult patients (82.9%), but were not isolated from any of the children; C. albicans was the predominant fungus (61.7%), much less frequent were C. glabrata (12.8%), C. tropicalis (6.4%) and C. kefyr, C. dubliniensis (4.3% each).The susceptibility of fungi to antimycotic drugs revealed that almost all of the strains were susceptible to nystatin (97.9%) and to amphotericin B (72.3%), and resistant to fluconazole (72.3%) and ketoconazole (57.5%). No isolation of fungi from children remaining in ICU may be an evidence of high sanitary regime at these wards; fungi from the genus Candida are the etiological factors for ICU infections; 3/5 of them are caused by C. albicans, mostly of the code 2 576 174, characteristic for strains isolated from hospitalized patients; it is necessary to determine the species of the fungus and its susceptibility to drugs, which allows to conduct effective therapy; prophylactic administration of fluconazole leads to an increase in the number of strains resistant to this chemotherapeutic agent; in the antifungal local treatment, nystatin should be a drug of choice as the drug to which most fungi are susceptible.

Prevalence of fungi in cases of geographical and fissured tongue.

One of the most common malformations of the tongue is fissured tongue, very often, is accompanied by geographic tongue; the etiopathogenesis of them is not known. The aim of study was to evaluate the prevalence of fungi in cases of fissured and geographic tongue, and to determine their species and susceptibility to selected antifungal drugs. The study included 104 patients with fissured and/or geographical tongue. To determine fungi present in the tongue, the material was collected with a sterile swab for mycological examination. The procedure was conducted according to that used at our Department. The in vitro susceptibility of the strains to nystatin and miconazole was evaluated. In 45 (43%) cases fissured tongue, in 28 (27%) geographic tongue, and in 31 (30%) both conditions were diagnosed. Mycological examination revealed fungi on the tongue in 73 (70%) patients, including 31 patients (69%) with fissured tongue, 19 (68%) with geographic tongue, and 23 (74%) with concomitant changes. The most frequently detected was Candida albicans (detected in 48-66% of cases); in individual cases, other species of Candida species were found. The strains demonstrated greater sensitivity to nystatin than to miconazole. An analysis of reported symptoms based on the presence or absence of fungi on the tongue revealed that idiopathic pain and burning were significantly more frequently reported by patients with fungi on the tongue (p = 0.034174). Statistically significant differences exist between the presence and absence of fungi with regard to the signs, symptoms of changes on the tongue (p = 0.026015). Also, statistically significant differences (p = 0.00000) exist regarding the presence of fungi with regard to brushing a fissured tongue, or a fissured and geographic tongue; fungi are frequently present when brushing is absent. The prevalence of fungi is greatest in patients with geographic tongue, especially those who do not brush the surface of the tongue.

Expression of Th1/Th2/Th3/Th17-related genes in recurrent aphthous ulcers.

The pathogenesis of recurrent aphthous ulceration (RAU) is unknown, although an abnormal immune reaction appears to be involved. RAU may result from oral epithelium damage caused by T cell-mediated immune response. To improve understanding of the role of T cells in RAU, the present study analyzed. the expression of T cell-related genes in oral ulcers from patients with RAU, as well as in healthy non-keratinized oral mucosa from aphthae-free volunteers. Biopsies from RAU patients and healthy individuals were analyzed using Human Th1-Th2-Th3 RT(2) Profiler PCR Array and qRT-PCR that allowed to quantify the transcript levels of 86 genes related to T cell activation. We found that cells present in aphthous ulcers express a characteristic Th1-like gene profile. The majority of genes up-regulated in aphthous lesions such as IFN-γ, TNF, IL-15, IRF1, STAT-1 and STAT-4 were Th1-associated. Th2-realated genes were not overexpressed in RAU tissues, with the exception for CCR3. Th3- and Th17-related gene expression patterns were not demonstrated in RAU. These findings clearly reveal that aphthous ulcer formation is predominantly dependent on the activation of the Th1-type immune response.

Knowledge on Lyme disease among foresters.

OBJECTIVES: The first aim was an attempt to evaluate the level of knowledge on Lyme disease among people whose profession involves working in the forest; the second--recognition of the health problems that should be included in health education programmes concerning Lyme disease in this group of professionals. MATERIALS AND METHODS: The study was performed on 159 subjects. RESULTS: Only 15% know the etiological factor of disease, 98%--the main cause of infection, and route of pathogen transmission. CONCLUSION: Propagation of knowledge on Lyme disease, particularly among risk group people, is not satisfactory. Little knowledge on tick risk among secondary school students indicate the necessity for cooperation between teachers, epidemiologists, and health service providers in order to propagate the knowledge on parasites, symptoms, spread and methods of prevention.

Cigarette smoking induces overexpression of c-Met receptor in microvessels of oral lichen planus.

INTRODUCTION: Cigarette smoking is related to many pathological conditions; however, chemical substances affect the oral cavity first, so it is important to consider its influence on oral mucosa and oral potentially pre-malignant lesions. The aim of this study was to investigate the effect of smoking on microvessel density in oral lichen planus. Special emphasis was placed on examining the relationship between the expression of c-Met receptor in blood vessels and smoking habits. MATERIAL AND METHODS: This study included 34 patients with oral lichen planus diagnosed clinically and verified by histopathological examination and 12 healthy individuals as controls. Biopsy of oral mucosa was performed and specimens were examined for immunohistochemical CD34 and c-Met receptor expression. The microvessel density was established by evaluation of the five most vascular areas within a section. RESULTS: Compared to normal oral mucosa, in lichen planus patients, significantly higher blood vessel density and c-Met expression were noted. Irregular distribution of microvessels was typical for oral lichen planus. Also, microvessel density was higher in cigarette smoking patients' tissues than in non-smoker specimens. Furthermore, the association of c-Met expression with smoking habit was statistically significant. CONCLUSIONS: Cigarette smoking habit has a direct impact on the oral lichen planus course; therefore, close follow-up of these patients is mandatory.

[The immune response to fungal infections]. / Odpowiedz immunologiczna na zarazenie grzybami.

In mycoses congenital--nonspecific innate as well as acquired immunity (involving neutrophiles, monocytes, macrophages, dendritic cells and lymphocytes) both play important roles in host defence. Th1 lymphocytes release cytokines (IL-2, IL-12, IFN gamma) and stimulate cytotoxic cells and neutrophiles to destroy fungal cells. Th2 lymphocytes, on the other hand, suppress cellular immunity by releasing the cytokines IL-4, IL-6 and IL-10 which counter regulate the secretion of IL-2, IL-12, IFN gamma and depress the activity of macrophages. Cellular mechanisms play essential roles in host responses to fungal infections. Dysfunction of T lymphocytes and a reduction in their number are typically observed in patients with mycotic diseases. There occurs a reduction of both T lymphocyte populations and the T-helper to T-suppressor cell number ratio, and these are of critical importance in explaining the diminished IgA production and enhanced adhesion of fungal cells to the surface of host cells as well as in facilitating the intrusion of fungi throughout the skin and mucous membranes. The specific immunological reaction, associated with the synthesis of antibodies against fungal cell wall or cytoplasmic antigens, is of little significance in protective immunity, but nevertheless has a rather important role to play in diagnosis as well as in supporting phagocytosis by inhibition of fungal cell adherence. In patients with mycoses, typically low blood serum level of the immunoglobulin class G and A and low sIgA in saliva are observed. A detailed understanding the nature and function of the immune system in mycoses is necessary to enable improvements in pharmacotherapy with antifungal antibiotics and chemotherapeutics, as well as to treatments based on immunotherapy and vaccination.

Dysfunction of CD4+CD25high T regulatory cells in patients with recurrent aphthous stomatitis.

BACKGROUND: Recurrent aphthous stomatitis (RAS) is a chronic inflammatory disease of unknown etiology characterized by recurring formation of painful oral ulcers. RAS may result from oral epithelium damage caused by T-cell-mediated immune response. CD4(+)CD25(+) T regulatory (Treg) cells suppress proliferation and effector functions of other immune cells, and therefore are crucial in regulating the immune response. METHODS: We tested the function of peripheral CD4(+)CD25(high) Treg cells in active RAS through their ability to inhibit proliferation and cytokine production of conventional CD4(+) T cells. We also attempted to detect the presence of FOXP3 and indoleamine 2,3-dioxygenase (IDO) mRNA in the lesional and non-lesional oral mucosa of RAS patients and healthy individuals using real-time PCR assay. RESULTS: Treg cells derived from RAS patients were less efficient in the suppression of cytokine production of CD4(+) T effector cells than Treg cells from healthy individuals. Moreover, in RAS, Treg cells were nearly twice less potent in the inhibition of CD4(+)CD25(-) T cell proliferation than in healthy donors. Furthermore, we have demonstrated the decreased proportion of CD4(+)CD25(+)FOXP3(+) Treg cells in peripheral blood of RAS patients compared with controls. We failed to detect FOXP3 mRNA, while IDO mRNA expression was decreased in non-lesional mucosa biopsies from RAS patients compared with ulcer biopsies or normal mucosa from healthy donors. CONCLUSIONS: These findings suggest that CD4(+)CD25(high) Treg cells are both functionally and quantitatively compromised in RAS and that decreased constitutive expression of IDO in oral mucosa in RAS may lead to the loss of local immune tolerance.

[Occurence of fungi in oral cavity of patients with periodontitis]. / Wystepowanie grzybów w jamie ustnej osób z zapaleniem przyzebia.

The role of fungi in the etiology and pathogenesis of periodontal diseases is unclear. What more, there exist only few studies concerning occurrence of fungi in the oral cavity of patients with periodontitis. The aim of the study was to assess the frequency of fungi occurrence and to search relationship between its presence and the state of paradontium, indices of oral hygiene as well as to evaluate periodontal treatment needs. The study involved a group of 189 patients of both sexes aged 20 to 87 years, never treated because of periodontitis. On the basis of clinical examination Oral Hygiene Index-Simplified and CPITN were calculated for every patient. Material from the oral cavity was taken in a form of rising for fungi cultures. Among the examined patients fungi were found in 114 cases (61.3%). The study did not find any significant dependence between age and sex of examined infected or not-infected patients but revealed dependence between the frequency of the occurrence of fungi and the type of periodontal disease and smoking.

[Clinical evaluation of periodontium in pregnant women with risk of preterm birth]. / Ocena kliniczna przyzebia kobiet w przebiegu ciazy zagrozonej.

OBJECTIVES: The aim of the study was to evaluate condition of the periodontium in pregnant women with pathological progress of the pregnancy, clinically and to compare it to periodontium in pregnant women in good health. DESIGN: Over the last years, the studies have described that periodontitis caused by dental plaque, could be the risk factor for preterm birth and low birth weight. MATERIALS AND METHODS: This study was performed in 80 pregnant women, 40 with pathologic pregnancy and 40 with normal pregnancy in it. Periodontal Indexes were used to evaluate periodontium. RESULTS: In the searching group gingivitis gravidarum haemorrhagica diffusa and hyperplastica generalisata were dominating. In the control group gingivitis gravidatum simplex and hyperplastica localisata were observed. CONCLUSIONS: More severe manifestation of gingivitis gravidarum was noticed in pregnant women with risk of preterm low birth. We did not prove correlation between amount of bacterial dental plaque in pregnant women and risk of preterm low birth weight.

[Biological action and clinical application of shark liver oil]. / Mechanizm dzialania i zastosowanie kliniczne oleju z watroby rekina.

Fish oils contain several active compounds that modify cell activity and influence various functions of the body. Shark liver oils are rich in alkylglycerols and squalene, but contain relatively low amounts of n-3 polyunsaturated fatty acids. Alkylglycerols may control immune response possibly throw modification of platelet activating factor (PAF) and diacylglycerol (DAG) production. Squalene enhances antigen presentation and induction of inflammatory response. Moreover, alkylglycerols and squalene have antitumour activity, that is possibly based on different mechanisms, ie., induction of apoptosis of neoplastic cells, suppression of signal transduction, inhibition of angiogenesis and promoting of transmembrane transport of cytotoxic agents. Shark liver oil has been found to be useful in treatment of conditions resulted from inadequate immune response, and in adjunctive treatment of several types of cancer.

Predominance of Type 1 cytokines and decreased number of CD4(+)CD25(+high) T regulatory cells in peripheral blood of patients with recurrent aphthous ulcerations.

Recurrent aphthous ulcerations (RAU) are a chronic inflammatory disease with evidence of inappropriate immune response. Previous studies have suggested cell-mediated activation of immune response towards common micro-organisms of oral cavity in RAU. In this investigation, we explored cytokine production by peripheral blood mononuclear cells (PBMC) and T regulatory cell population in blood of active and remission RAU patients as crucial factors for maintenance of peripheral tolerance. Ten patients with minor RAU and 12 healthy individuals were selected for the study. Cytokine levels were analysed in supernatants using Cytometric Bead Array Kit for flow cytometry and ELISA. We have demonstrated increased production of Type 1 cytokines IL-2, IFN-gamma and TNF-alpha as well as IL-5, IL-6 and IL-8 by peripheral blood mononuclear cells in RAU. In contrast, IL-10 and TGF-beta anti-inflammatory cytokine production was decreased in RAU patients compared to healthy individuals. Moreover, we have found that CD4(+)CD25(+high) T regulatory cell proportion was decreased in RAU and represented 3.58+/-0.654% of CD4(+) T cells in active RAU, 4.66+/-0.561% of CD4(+) T cells in remission RAU, whereas in healthy controls CD4(+)CD25(+high) T cells represented 7.30+/-1.238% of CD4(+) T cells (p<0.001). Thus, the obtained results indicate that disproportion in cytokine production may be contributing factor in the pathogenesis of RAU. Alteration in the number of CD4(+)CD25(+high) T regulatory cells in RAU may additionally influence the development of the disease. We propose that imbalance in pro- and anti-inflammatory cytokine network may lead to the breakdown of peripheral tolerance in RAU and the excessive immune response towards harmless micro-organisms colonized oral mucosa or self-antigens.

[Familial infections with Trichomonas tenax (O.F. Müller, 1773), Dobel, 1939]. / Rodzinne zarazenia Trichomonas tenax (O.F. Müller, 1773) Dobel, 1939.

Aim of the study was to research familial occurrence of Trichomonas tenax and relationship between infection with the protozoan and both a state of parodontium and hygiene of oral cavity. The study involved 10 families (22 individuals). Trichomonas tenax was found in 16 patients. Simultaneously isolates of protozoans were examined with the methods of molecular biology. The study showed the dependence of infection with Trichomonas tenax on both bad hygiene of oral cavity and occurrence of pathological lesions in the paradontium.

[Invasion of Trichomonas tenax in patients with periodontal diseases]. / Inwazja Trichomonas tenax u pacjentów z chorobami przyzebia.

The aim of the study was to analyze the frequency of occurrence of Trichomonas tenax in patients with periodontitis and also to check the relationship between the occurrence of the protozoan and the indices of oral hygiene, and to evaluate periodontal treatment needs. The study involved 91 individuals aged 23-79 years (52 women and 39 men). 34 of them were infected with Trichomonas tenax. The study revealed dependence between the frequency of occurrence of Trichomonas tenax and the state of periodontium and the hygiene of the oral cavity.

Innate immune system is implicated in recurrent aphthous ulcer pathogenesis.

BACKGROUND: Recurrent aphthous ulcers (RAU) is a chronic inflammatory disease with evidence of inappropriate immune response. This study presents the status of innate immune system in RAU. METHODS: Twenty RAU patients and 19 healthy individuals were selected. The status of peripheral blood neutrophils (reactive oxygen intermediates (ROI) production, CD11b, TNF-RI and TNF-RII expression), concentration of antioxidants, sTNF-R, C3c, C4 and haemolytic activity of the complement system, as well as mannose-binding lectin (MBL), in the serum of RAU patients in active stage and in remission of the disease were determined. RESULTS: Peripheral blood neutrophils were primed in RAU, which resulted in increased ROI production by resting and fMLP-stimulated neutrophils and diminished ROI production after in vitro priming. The increased expression of CD11b on resting and fMLP-stimulated neutrophils in RAU may also point to their previous in vivo stimulation. The decreased total antioxidant status of serum observed in RAU may be a result of increased ROI production by peripheral blood neutrophils. The levels of C3c, C4 and haemolytic activity of the complement system were higher in RAU than in healthy people. No significant differences between active and remission RAU were noted. CONCLUSION: Presented observations confirm that the innate immune system is involved in RAU pathogenesis.