Thrush Research Today is a free monthly online journal that collates and summarizes the latest research about Thrush, including details on oral, vaginal, symptoms, prevention, treatment, infection.

Effect of amine fluoride-stannous fluoride preparations on oral yeasts in the elderly: a randomised placebo-controlled trial.

Meurman JH, Pärnänen P, Kari K, Samaranayake L

Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki, Finland. jukka.meurman@helsinki.fi

OBJECTIVES: Oral yeast infections are an emerging problem among medically compromised and frail elderly. Antifungal drug resistance is also increasing because of an increase in non-albicans Candida strains in these populations. We therefore set out to study, in the randomised-controlled trial setting if the use of a topical amine fluoride-stannous fluoride combination (AmF-SnF2) could control oral Candida growth in the elderly. The hypothesis was based on earlier findings showing that in vitro this combination had antifungal efficacy. METHODS: A total of 194 nursing home residents were randomised to receive either the test mouth rinse and toothpaste or a placebo twice daily for 8 months. Of these, 136 completed the trial. Saliva samples were taken using the oral rinse method, cultivated and the strain level identified with routine microbial methods. Compliance and use of preparations was assessed by a nurse. RESULTS: Significantly at the end of the trial, less mucosal lesions were observed in the test group in comparison to controls. Total bacterial count decreased in both the groups during the trial. Candida albicans was the most prevalent strain detected both at baseline and 8 months later. Only a few subjects carried non-albicans strains. The AmF-SnF2 did not significantly affect mean oral Candida counts, but median Candida counts were reduced in the AmF-SnF2 group while an increase was seen in the placebo group. However, the differences observed were not statistically significant. Compliance among the regular elderly users slightly increased during the trial for both the groups. CONCLUSION: The number of subjects with high Candida counts decreased in the AmF-SnF2 group. Hence, the fluoride combination might be useful as a support therapy for oral candidiasis. Prevalence of non-albicans Candida strains was low in this population.

Published 25 August 2009 in Gerodontology, 26(3): 202-9.
Full-text of this article is available online (may require subscription).

Articles on Thrush published 10 June 2009:

Chronic tongue ulceration resolved by sulpiride: a report of two cases.   Clin Exp Dermatol, 34(5): e40-2.

We report two patients with chronic tongue ulceration who were successfully treated using sulpiride. The clinical diagnosis was oral candidiasis related to long-term steroid treatment. The results of the culture test and cytological examination supported this diagnosis, but antifungal treatment was ineffective and the tongue pain in these patients became more severe. Furthermore, the pain could not be relieved by nonsteroidal anti-inflammatory drugs (NSAIDs). We therefore prescribed sulpiride ... [Abstract] [Full-text]

Articles on Thrush published 19 February 2009:

Carriage rate and virulence attributes of oral Candida albicans isolates from patients with oral lichen planus: a study in an ethnic Chinese cohort.   Mycoses, 52(2): 161-5.

The objectives of this study are to investigate the carriage rate of Candida albicans from the patients with oral lichen planus (OLP, erosive and non-erosive subtypes) and the healthy control individuals in a Chinese cohort and then to compare the virulence attributes of these isolates. Oral C. albicans isolates from 300 patients with OLP as well as 128 healthy controls were isolated and a total of 112 isolates from patients with erosive OLP (62), non-erosive OLP (24) and healthy control (26) ... [Abstract] [Full-text]

Articles on Thrush published 17 February 2009:

Th17 cells and IL-17 receptor signaling are essential for mucosal host defense against oral candidiasis.   J Exp Med, 206(2): 299-311.

The commensal fungus Candida albicans causes oropharyngeal candidiasis (OPC; thrush) in settings of immunodeficiency. Although disseminated, vaginal, and oral candidiasis are all caused by C. albicans species, host defense against C. albicans varies by anatomical location. T helper 1 (Th1) cells have long been implicated in defense against candidiasis, whereas the role of Th17 cells remains controversial. IL-17 mediates inflammatory pathology in a gastric model of mucosal candidiasis, but is ... [Abstract] [Full-text]

Rethinking T cell immunity in oropharyngeal candidiasis.   J Exp Med, 206(2): 269-73.

The disproportionate increase in oropharyngeal candidiasis (OPC) compared with systemic and vaginal candidiasis in female patients with AIDS has been a paradox for almost three decades. New data now show that severe OPC develops in Th17-deficient mice, but not Th1-deficient mice, implicating Th17-induced effector molecules in resistance to oral disease. These findings clarify and extend our current thinking about how CD4 T cell deficiency influences susceptibility to OPC. [Abstract] [Full-text]

Articles on Thrush published 17 December 2008:

Oral mucosal cell response to Candida albicans in transgenic mice expressing HIV-1.   Methods Mol Biol, 470: 359-68.

Controlled studies on the immunopathogenesis of mucosal candidiasis in HIV infection have been hampered by the lack of a relevant animal model. We have previously reported that oral Candida infection in CD4C/HIV transgenic mice expressing gene products of HIV-1 in immune cells and developing an AIDS-like disease closely mimics oropharyngeal candidiasis in human HIV infection. The role of defective dendritic cells and CD4+ T cells in impaired induction of protective immunity and in the phenotype ... [Abstract] [Full-text]

Articles on Thrush published 3 November 2008:

Laryngeal candidiasis mimicking malignancy.   Laryngoscope, 118(11): 1957-9.

Isolated laryngeal candidiasis in immunocompetent individuals is a rare entity with fewer than 40 cases reported in the literature. Laryngeal candidiasis secondary to inhaled steroid therapy is usually mild and has been reported in 10% to 15% of patients complaining of dysphonia during treatment. We present a case of laryngeal candidiasis mimicking laryngeal carcinoma in an immunocompetent patient being treated with inhaled fluticasone for chronic obstructive pulmonary disease. Biopsy of the ... [Abstract] [Full-text]

Articles on Thrush published 22 October 2008:

Treatment-related risk factors for hospital mortality in Candida bloodstream infections.   Crit Care Med, 36(11): 2967-72.

OBJECTIVE: To examine the relationship between treatment-related variables for Candida bloodstream infection and hospital mortality. DESIGN: Retrospective cohort analysis. SETTING: Thousand two hundred-bed academic medical center. PATIENTS: A total of 245 consecutive patients with Candida bloodstream infections who received antifungal therapy. INTERVENTIONS: Identification of treatment-related risk factors: central vein catheter retention, inadequate initial fluconazole dosing, and delayed ... [Abstract] [Full-text]

Articles on Thrush published 17 October 2008:

Patients with chronic mucocutaneous candidiasis exhibit reduced production of Th17-associated cytokines IL-17 and IL-22.   J Invest Dermatol, 128(11): 2640-5.

Chronic mucocutaneous candidiasis (CMC) constitutes a selective inability to clear infection with the yeast Candida, resulting in persistent debilitating inflammation of skin, nails, and mucous membranes. The underlying defect is unknown. Only recently, IL-17-producing T cells have been reported to be involved in clearing Candida infections. In order to characterize T cellular immune response to Candida, we analyzed T-cell cytokine secretion to Candida antigen and mitogenic stimuli in CMC ... [Abstract] [Full-text]

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