The influence of antifungal drugs on virulence properties of Candida albicans in patients with diabetes mellitus

• Published in: Oral surgery, oral medicine, oral pathology, oral radiology and endodontics oral medicine, oral pathology, oral radiology and endodontics, 2001-03, Vol.91 (3), p.317-321
• Main Authors: Willis, Amanda M., Coulter, Wilson A., Fulton, Catherine R., Hayes, John R., Bell, Patrick M., Lamey, Philip-John
• Format: Article
• Language: English
• Subjects: Analysis of Variance; Antifungal Agents - pharmacology; Antifungal Agents - therapeutic use; Bacterial Adhesion - drug effects; Biological and medical sciences; Candida albicans - drug effects; Candida albicans - enzymology; Candida albicans - physiology; Candidiasis, Oral - complications; Candidiasis, Oral - drug therapy; Chi-Square Distribution; Dentistry; Diabetes Mellitus, Type 1 - complications; Ent and stomatologic mycoses; Epithelial Cells - drug effects; Female; Fluconazole - pharmacology; Fluconazole - therapeutic use; Human mycoses; Humans; Infectious diseases; Male; Medical sciences; Middle Aged; Mycoses; Nystatin - pharmacology; Nystatin - therapeutic use; Phospholipases - biosynthesis; Prospective Studies; Virulence - drug effects
• ISSN: 1079-2104; 1528-395X
• DOI: 10.1067/moe.2001.112155

Objective: This study investigated the influence of nystatin and fluconazole on virulence properties of Candida albicans . Study Design: A total of 108 diabetic patients participated in the study. Eighty-eight patients had clinical oral candidosis. Drug therapy was given at 6 hourly intervals for nystatin or daily with fluconazole for a maximum of 2 weeks. Adhesion of C albicans to buccal epithelial cells was determined by using an autologous adhesion assay prospectively over 6 months. Phospholipase production was estimated by using an agar plate method. The data analysis included a paired Student t test and calculation of correlation coefficients. Results: Unlike nystatin, treatment with fluconazole reduced the ability of C albicans to colonize the buccal mucosa for up to 8 weeks after the treatment. Patients without clinical signs of oral candidosis had significantly fewer C albicans isolates producing phospholipase than did patients with oral candidosis. Treatment with fluconazole, but not nystatin, reduced the production of phospholipase from C albicans oral isolates in patients with diabetes mellitus. Conclusions: In addition to being antifungal, fluconazole alters phospholipase production, modifies buccal epithelial cells, and reduces adhesion of C albicans to human buccal epithelial cells for up to 8 weeks posttreatment in diabetic patients with oral candidosis. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;91:317-21)