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Fungal diseases: Oral dysbiosis in susceptible hosts

Journal

PERIODONTOLOGY 2000
Volume 87, Issue 1, Pages 166-180

Publisher

WILEY
DOI: 10.1111/prd.12378

Keywords

Candida; dysbiosis; oral candidiasis; polymicrobial infection

Funding

  1. NIH/NIDCR [RO1DE013986]

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The oral microbiota plays a key role in maintaining a healthy oral cavity, and the development of oral candidiasis is influenced by dysbiosis and disturbances in the host's immune system. Various factors, including medications, host genetics, and microbial interactions, can disrupt the oral microbiota and increase the risk of oral candidiasis.
The oral cavity is colonized by a large number of microorganisms that are referred to collectively as the oral microbiota. These indigenous microorganisms have evolved in symbiotic relationships with the oral mucosal immune system and are involved in maintaining homeostasis in the oral cavity. Although Candida species are commonly found in the healthy oral cavity without causing infection, these fungi can become pathogenic. Recents advances indicate that the development of oral candidiasis is driven both by Candida albicans overgrowth in a dysbiotic microbiome and by disturbances in the host's immune system. Perturbation of the oral microbiota triggered by host-extrinsic (ie, medications), host-intrinsic (ie, host genetics), and microbiome-intrinsic (ie, microbial interactions) factors may increase the risk of oral candidiasis. In this review, we provide an overview of the oral mycobiome, with a particular focus on the interactions of Candida albicans with some of the most common oral bacteria and the oral mucosal immune system. Also, we present a summary of our current knowledge of the host-intrinsic and host-extrinsic factors that can predispose to oral candidiasis.

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