Candida albicans promotes tooth decay by inducing oral microbial dysbiosis

Abstract

Candida albicans has been detected in root carious lesions. The current study aimed to explore the action of this fungal species on the microbial ecology and the pathogenesis of root caries. Here, by analyzing C. albicans in supragingival dental plaque collected from root carious lesions and sound root surfaces of root-caries subjects as well as caries-free individuals, we observed significantly increased colonization of C. albicans in root carious lesions. Further in vitro and animal studies showed that C. albicans colonization increased the cariogenicity of oral biofilm by altering its microbial ecology, leading to a polymicrobial biofilm with enhanced acidogenicity, and consequently exacerbated tooth demineralization and carious lesion severity. More importantly, we demonstrated that the cariogenicity-promoting activity of C. albicans was dependent on PHR2. Deletion of PHR2 restored microbial equilibrium and led to a less cariogenic biofilm as demonstrated by in vitro artificial caries model or in vivo root-caries rat model. Our data indicate the critical role of C. albicans infection in the occurrence of root caries. PHR2 is the major factor that determines the ecological impact and caries-promoting activity of C. albicans in a mixed microbial consortium.

Immune Sensing of Candida albicans

“…These infections are commonly associated with biofilm for-mation, especially in patients with dentures, voice protheses and xerostomia (reduced or absent saliva flow). Biofilm formation makes these infections difficult to treat because they are generally polymicrobial in nature, and the production of extracellular matrix increases the resistance to antimicrobial therapy [5,6,84]. Oral candidiasis is prevalent in immunosuppressed individuals such as HIV patients, mouth and throat cancer patients, and patients taking oral steroids making them highly susceptible to infection.…”

“…C. albicans is armed with a plethora of virulence factors including adhesins (i.e., Hwp1, Als3, and Als5), secreted hydrolytic enzymes (i.e., SAPs and phospholipases) and the recently identified cytolytic toxin candidalysin [3,4]. C. albicans can also form biofilms in nail infections; on teeth exacerbating, tooth decay; on mucosal surfaces; and on the surfaces of medical devices, including catheters, long lines and voice prostheses [5,6]. This capacity to form biofilms has made C. albicans one of the leading causes of nosocomial infections, which are difficult to treat due to increasing antifungal resistance.…”

Selective Antifungal Activity and Fungal Biofilm Inhibition of Tryptophan Center Symmetrical Short Peptide

“…Hence, C. albicans cgmcc 2.2086 compromises fecal microbiota transplantation (FMT), which is effective in treating recurrent Clostridioides difficile infection (CDI) [ 2 ]. Furthermore, C. albicans was also confirmed to promote tooth decay by altering microbial ecology [ 3 ]. However, antifungal resistance generates less public attention than viral and bacterial infections [ 4 , 5 ].…”

The Antibacterial Activity of Nanosilver Coupled Edible Plant Extracts Against Streptococcus mutans, the Cause of Dental Caries

“…Our results showed that two Yeast species Candida albicans (45.4%) and Candida glabrata (9.0%) were identified in the DC samples collected in the current study, which Candida albicans was the predominant species. In vitro studies showed that C. albicans colonization increased the cariogenicity of oral biofilm by altering its microbial ecology, leading to a polymicrobial biofilm with enhanced acidogenicity, and consequently exacerbated tooth demineralization and carious lesion severity [46]. As stated, the origin of dental caries is multifactorial with acidogenic bacterial biofilm an absolute requirement for bacterial acid generation.…”

“…Although Candida's role in dental caries has been studied extensively, limited homogenous studies have been conducted and none have been found, that associate Candida with dental caries [45]. A recent study reported that Candida albicans promotes tooth decay by inducing oral microbial dysbiosis [46]. Our results showed that two Yeast species Candida albicans (45.4%) and Candida glabrata (9.0%) were identified in the DC samples collected in the current study, which Candida albicans was the predominant species.…”