Karkowska-Kuleta Justyna, Satala Dorota, Smolarz Magdalena, Zawrotniak Marcin, Rapala-Kozik Maria
Department of Comparative Biochemistry and Bioanalytics, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University in Krakow, Kraków, Poland.
Adv Exp Med Biol. 2022;1373:113-138. doi: 10.1007/978-3-030-96881-6_6.
The human oral cavity is a diverse ecological niche favorable for colonization by hundreds of different species of microorganisms. They include not only bacteria but also numerous species of fungi, many of which are able to cause opportunistic infections when the host's immunity is impaired, predominantly by systemic and chronic diseases like diabetes, pulmonary diseases, renal disorders, or acquired immunodeficiency syndrome. Within the dental biofilm and subgingival sites, fungi of the genus Candida are often found, also in individuals affected with periodontitis. Moreover, fungal species of other genera, including Malassezia, Aspergillus, Penicillium, and Rhodotorula were identified in the oral cavity as well. The wide range of various virulence factors and mechanisms displayed by fungal pathogens allows them effectively invading host tissues during periodontal infections. These pathogenicity-related mechanisms include firstly the fungal ability to adhere successfully to the host tissues closely related to the formation of hyphae, the increase in the surface hydrophobicity, and the surface display of a wide variety of adhesins. Further mechanisms include biofilm formation and secretion of an armory of hydrolytic enzymes and toxins enabling the attack on host cells, modulation of the local inflammatory state, and evading the host immune system. In the pathogenesis of periodontitis, the significant role of fungal co-existence with key bacterial periodontopathogens has been demonstrated, and such interactions were primarily confirmed for Candida albicans and Porphyromonas gingivalis, where the presence of fungi ensured the survival of strictly anaerobic bacteria under unfavorable aerobic conditions. However, several other mechanisms, including those related to the production of quorum sensing molecules, might also be indicated as particularly important for synergistic or antagonistic interactions with a variety of bacterial species within mixed biofilms. These interactions constitute an extraordinary challenge for applying effective methods of combating biofilm-related infections in the periodontium without the risk of the development of drug resistance, the recurrence of disease symptoms, and the progress of life-threating systemic complications.
人类口腔是一个多样的生态位，有利于数百种不同微生物的定植。它们不仅包括细菌，还包括许多种真菌，其中许多真菌在宿主免疫力受损时能够引起机会性感染，主要是由糖尿病、肺部疾病、肾脏疾病或获得性免疫缺陷综合征等全身性和慢性疾病引起的。在牙菌斑和龈下部位，经常发现念珠菌属的真菌，在患有牙周炎的个体中也是如此。此外，口腔中还鉴定出了其他属的真菌，包括马拉色菌属、曲霉属、青霉属和红酵母属。真菌病原体表现出的广泛的各种毒力因子和机制使它们能够在牙周感染期间有效地侵入宿主组织。这些与致病性相关的机制首先包括真菌成功粘附到与菌丝形成密切相关的宿主组织的能力、表面疏水性的增加以及多种粘附素的表面展示。进一步的机制包括生物膜形成以及分泌一系列水解酶和毒素，从而能够攻击宿主细胞、调节局部炎症状态并逃避宿主免疫系统。在牙周炎的发病机制中，已经证明真菌与关键的牙周病原菌共存具有重要作用，这种相互作用主要在白色念珠菌和牙龈卟啉单胞菌中得到证实，其中真菌的存在确保了严格厌氧菌在不利的需氧条件下的存活。然而，其他几种机制，包括与群体感应分子产生相关的机制，也可能被认为对于与混合生物膜中多种细菌物种的协同或拮抗相互作用特别重要。这些相互作用对于应用有效的方法来对抗牙周生物膜相关感染构成了巨大挑战，同时又不会有耐药性发展、疾病症状复发以及危及生命的全身并发症进展的风险。
