Chapter 3. Pathogenesis of Oral Candidiasis: A Virulence Insight into Drug Discovery and New Treatments

Priscilla Guimarães Silva Vasconcelos1, Diego Romário-Silva2, Ernani Canuto Figueirêdo Júnior1, Jozinete Vieira Pereiraand Edja Maria Melo de Brito Costa1
1Department of Dentistry, State University of Paraíba (UEPB), Campina Gande, PB, Brazil
2Research Program in Integrated Dental Sciences, University of Cuiabá (UNIC), Cuiabá, MT, Brazil

Part of the book: The Book of Fungal Pathogens


Oral candidiasis is one of the most prevalent infections in humans, an opportunistic infection characterized by the overgrowth of Candida spp. in the superficial epithelium of the oral mucosa. Candida infection may be facilitated by different factors including alterations in systemic, hereditary, local, and environmental conditions. Once installed this clinicopathological condition can present itself in distinct clinical presentations, such as pseudomembranous, acute erythematous, chronic erythematous, angular cheilitis, median rhomboid glossitis, chronic hyperplastic, and linear gingival erythema. The pathogenesis of these distinct oral diseases as well as their severity is related to the microorganismal virulence factors and an infected individual’s immune conditions. The predominant species associated with oral candidiasis is Candida albicans (C. albicans), however other species have also been identified in several studies related to different clinical conditions, including Candida glabrata, Candida krusei, Candida guillermondii, Candida lusitaniae, Candida parapsilosis, Candida dubliniensis, Candida pseudotropicalis, Candida stellatoidea, and Candida tropicalis. Virulence factors of Candida species are related to the establishment of the pathogen in the body and subsequent tissue invasion. The main virulence factors involve the transition from yeast form into hyphae, expression of adhesion and invasion molecules, thigmotropism, secretion of hydrolytic enzymes, and biofilm formation. These factors are potential therapeutic targets in drug development for candidiasis treatment. Nowadays, oral candidiasis treatment relies on a limited arsenal of antifungal agents, utilized topically or systemically. The antifungal medications are divided into three classes according to mode of action and target: polyenes which involve the disruption of fungal cell membranes, azoles which cause inhibition of ergosterol synthesis, and echinocandins which inhibit the synthesis of specific enzymes. However, the paucity of available antifungal classes coupled with the suboptimal selectivity, increased toxicity, and high likelihood of developing drug resistant yeasts has prompted the study and development of alternative therapies such as the use of probiotics, photodynamic therapies, nanoparticles and nanocomposites, and phytotherapy research. Therefore, this chapter aims to discuss the prevalence and pathogenesis of oral candidiasis as well as the available therapeutic options, highlighting the current challenges and future directions for the development of new treatments and the control of this infection.

Keywords: oral candidiasis, Candida spp., virulence factors, antifungal agents, antifungal drug resistance, drug discovery


Ahmad N, Jafri Z, Khan ZH. Evaluation of nanomaterials to prevent oral Candidiasis in PMMA based denture
wearing patients. A systematic analysis. J Oral Biol Craniofac Res. 2020;10(2):189-193.
DOI: 10.1016/j.jobcr.2020.04.012.
Alberdi E, Gómez C. Efficiency of methylene blue-mediated photodynamic therapy vs intense pulsed light in
the treatment of onychomycosis in the toenails. Photodermatol Photoimmunol Photomed.
2019;35(2):69-77. DOI: 10.1111/phpp.12420.
Al-Shayyab MH, Abu-Hammad OA, Al-Omiri MK, Dar-Odeh NS. Antifungal prescribing pattern and attitude
towards the treatment of oral candidiasis among dentists in Jordan. Int Dent J. 2015;65(4):216-226.
DOI: 10.1111/idj.12173.
Andrusiów S, Pawlak Z, Zendran I, Pajączkowska M, Janczura A, Inglot M. Oral cavity fungal flora among
HIV-positive people. Przegl Epidemiol. 2020;74(1):33-42. DOI: 10.32394/pe.74.04.
Antinori S, Milazzo L, Sollima S, Galli M, Corbellino M. Candidemia and invasive candidiasis in adults:
A narrative review. Eur J Intern Med. 2016;34:21-28. DOI: 10.1016/j.ejim.2016.06.029.
Aslani, N, Abastabar, M, Hedayati, MT, Shokohi, T, Aghili, SR, Diba, K, Hosseini, T, Bahrami, B,
Ebrahimpour, A, Salehi, M, Taheri Sarvtin, M, Haghani, I, & Vafaei Moghaddam, M. Molecular
identification and antifungal susceptibility testing of Candida species isolated from dental plaques.
J Mycol Med. 2018;28(3):433-436. DOI: 10.1016/j.mycmed.2018.05.006.
Atiencia-Carrera MB, Cabezas-Mera FS, Tejera E, Machado A. Prevalence of biofilms in Candida spp.
bloodstream infections: A meta-analysis. PLoS One. 2022;17(2):e0263522. DOI: 10.1371/journal.pone.0263522.
Bassetti M, Giacobbe DR, Vena A, Wolff M. Diagnosis and Treatment of Candidemia in the Intensive Care
Unit. Semin Respir Crit Care Med. 2019;40(4):524-539. DOI: 10.1055/s-0039-1693704.
Bhattacharya S, Sae-Tia S, Fries BC. Candidiasis and Mechanisms of Antifungal Resistance. Antibiotics
(Basel). 2020;9(6):312. DOI: 10.3390/antibiotics9060312.
Blankenship JR, Mitchell AP. How to build a biofilm: a fungal perspective. Curr Opin Microbiol.
2006;9(6):588-594. DOI: 10.1016/j.mib.2006.10.003.
Borghi, E, Morace, G, Borgo, F, Rajendran, R, Sherry, L, Nile, C, & Ramage, G. New strategic insights into
managing fungal biofilms. Front Microbiol. 2015;6:1077. DOI: 10.3389/fmicb.2015.01077.
Cannon RD, Holmes AR. Learning the ABC of oral fungal drug resistance. Mol Oral Microbiol.
2015;30(6):425-437. DOI: 10.1111/omi.12109.
Carmello, JC, Alves, F, Basso, FG, de Souza Costa, CA, Tedesco, AC, Lucas Primo, F, Mima, EG de O., &
Pavarina, AC. Antimicrobial photodynamic therapy reduces adhesion capacity and biofilm formation of
Candida albicans from induced oral candidiasis in mice. Photodiagnosis Photodyn Ther. 2019;27:402-407.
DOI: 10.1016/j.pdpdt.2019.06.010.
Cássia Orlandi Sardi J, Silva DR, Soares Mendes-Giannini MJ, Rosalen PL. Candida auris: Epidemiology,
risk factors, virulence, resistance, and therapeutic options. Microb Pathog. 2018;125:116-121.
DOI: 10.1016/j.micpath.2018.09.014.
Chaffin WL, López-Ribot JL, Casanova M, Gozalbo D, Martínez JP. Cell wall and secreted proteins of Candida
albicans: identification, function, and expression. Microbiol Mol Biol Rev. 1998;62(1):130-180.
DOI: 10.1128/MMBR.62.1.130-180.1998.
Chanda W, Joseph TP, Wang W, Padhiar AA, Zhong M. The potential management of oral candidiasis using
anti-biofilm therapies. Med Hypotheses. 2017;106:15-18. DOI: 10.1016/j.mehy.2017.06.029.
Chandrasekar PH, Sobel JD. Micafungin: a new echinocandin. Clin Infect Dis. 2006;42(8):1171-1178.
DOI: 10.1086/501020.
Chaudhari MB, Desai PP, Patel PA, Patravale VB. Solid lipid nanoparticles of amphotericin B (AmbiOnp): in
vitro and in vivo assessment towards safe and effective oral treatment module. Drug Deliv Transl Res.
2016;6(4):354-364. DOI: 10.1007/s13346-015-0267-6.
Chew SY, Cheah YK, Seow HF, Sandai D, Than LT. In vitro modulation of probiotic bacteria on the biofilm
of Candida glabrata. Anaerobe. 2015;34:132-138. DOI: 10.1016/j.anaerobe.2015.05.009.
Chin VK, Lee TY, Rusliza B, Chong PP. Dissecting Candida albicans Infection from the Perspective of C.
albicans Virulence and Omics Approaches on Host-Pathogen Interaction: A Review. Int J Mol Sci.
2016;17(10):1643. DOI: 10.3390/ijms17101643.
Chinna Reddy P, Chaitanya KS, Madhusudan Rao Y. A review on bioadhesive buccal drug delivery systems:
current status of formulation and evaluation methods. Daru. 2011;19(6):385-403.
Chouhan S, Kallianpur S, Prabhu KT, Tijare M, Kasetty S, Gupta S. Candidal Prevalence in Diabetics and its
Species Identification. Int J Appl Basic Med Res. 2019;9(1):49-54. DOI: 10.4103/ijabmr.IJABMR_259_18.
Cota E, Hoyer LL. The Candida albicans agglutinin-like sequence family of adhesins: functional insights
gained from structural analysis. Future Microbiol. 2015;10(10): DOI: 10.2217/fmb.15.79.
Cowen LE, Anderson JB, Kohn LM. Evolution of drug resistance in Candida albicans. Annu Rev Microbiol.
2002;56:139-165. DOI: 10.1146/annurev.micro.56.012302.160907.
D’agostino M, Tesse N, Frippiat JP, Machouart M, Debourgogne A. Essential Oils and Their Natural Active
Compounds Presenting Antifungal Properties. Molecules. 2019;24(20):3713. DOI: 10.3390/molecules24203713.
Dangi, YS, Murari LS, Kamta PN. Oral Candidiasis: A Review. Int J Pharm. Pharm. Sci. 2012;2 (4): 36–41
Donlan RM. Biofilms: microbial life on surfaces. Emerg Infect Dis. 2002;8(9):881-890. DOI: 10.3201/eid0809.020063.
Doppalapudi R, Vundavalli S, Prabhat MP. Effect of probiotic bacteria on oral Candida in head- and neck radiotherapy patients:
A randomized clinical trial. J Cancer Res Ther. 2020;16(3):470-477. DOI: 10.4103/jcrt.JCRT_334_18.
Du, M, Xuan, W, Zhen, X, He, L, Lan, L, Yang, S, Wu, N, Qin, J, zhao, R, Qin, J, Lan, J, Lu, H, Liang, C, Li,
YR Hamblin, M, & Huang, L. Antimicrobial photodynamic therapy for oral Candida infection in adult
AIDS patients: A pilot clinical trial. Photodiagnosis Photodyn Ther. 2021;34:102310. DOI: 10.1016/j.pdpdt.2021.102310.
Ene IV, Bennett RJ. Hwp1 and related adhesins contribute to both mating and biofilm formation in Candida
albicans. Eukaryot Cell. 2009;8(12):1909-1913. DOI: 10.1128/EC.00245-09.
Fang J, Huang B, Ding Z. Efficacy of antifungal drugs in the treatment of oral candidiasis: A Bayesian network
meta-analysis. J Prosthet Dent. 2021;125(2):257-265. DOI: 10.1016/j.prosdent.2019.12.025.
Farah CS, Lynch N, McCullough MJ. Oral fungal infections: an update for the general practitioner.
Aust Dent J. 2010;55 Suppl 1:48-54. DOI: 10.1111/j.1834-7819.2010.01198.x.
Fernández-Campos F, Clares Naveros B, López Serrano O, Alonso Merino C, Calpena Campmany AC.
Evaluation of novel nystatin nanoemulsion for skin candidosis infections. Mycoses. 2013;56(1):70-81.
DOI: 10.1111/j.1439-0507.2012.02202.x.
Ferreira, E dos S, Rosalen, PL, Benso, B, de Cássia Orlandi Sardi, J, Denny, C, Alves de Sousa, S, Queiroga
Sarmento Guerra, F, de Oliveira Lima, E, Almeida Freires, I, & Dias de Castro, R. The Use of Essential
Oils and Their Isolated Compounds for the Treatment of Oral Candidiasis: A Literature Review. Evid
Based Complement Alternat Med. 2021;2021:1059274. DOI: 10.1155/2021/1059274.
Fouda SM, Gad MM, Ellakany P, Ahmad M Al-Thobity, Fahad A Al-Harbi, Jorma I Virtanen, Aune Raustia.
The effect of nanodiamonds on Candida albicans adhesion and surface characteristics of PMMA denture
base material – an in vitro study. J Appl Oral Sci. 2019;27:e20180779. DOI:10.1590/1678-7757-2018-0779.
Garcia-Diaz M, Huang YY, Hamblin MR. Use of fluorescent probes for ROS to tease apart Type I and Type
II photochemical pathways in photodynamic therapy. Methods. 2016;109:158-166. DOI: 10.1016/j.ymeth.2016.06.025.
Gøtzsche PC, Johansen HK. Nystatin prophylaxis and treatment in severely immunodepressed patients.
Cochrane Database Syst Rev. 2014;2014(9):CD002033. DOI: 10.1002/14651858.CD002033.
Guarner F, Khan AG, Garisch J, Eliakim, R, Gangl, A, Thomson A, Krabshuis J, Lemair T, Kaufmann P, De
Paula JA, Fedorak R, Shanahan F, Sanders ME, Szajewska H, Ramakrishna BS, Karakan T, Kim N. World
Gastroenterology Organisation Global Guidelines: probiotics and prebiotics October 2011. J Clin
Gastroenterol. 2012;46(6):468-481. DOI: 10.1097/MCG.0b013e3182549092.
Gulati M, Nobile CJ. Candida albicans biofilms: development, regulation, and molecular mechanisms.
Microbes Infect. 2016;18(5):310-321. DOI: 10.1016/j.micinf.2016.01.002.
Gupta B, Gupta S, Chaudhary M, Raj AT, Awan KH, Patil S. Oral Candida prevalence and species specificity
in leprosy. Dis Mon. 2020;66(7):100920. DOI: 10.1016/j.disamonth.2019.100920.
Hamill RJ. Amphotericin B formulations: a comparative review of efficacy and toxicity. Drugs.
2013;73(9):919-934. DOI: 10.1007/s40265-013-0069-4.
Harish NM, Prabhu P, Charyulu RN, Gulzar MA, Subrahmanyam EV. Formulation and evaluation of in situ
gels containing clotrimazole for oral candidiasis. Indian J Pharm Sci. 2009;71(4):421-427.
Hay RJ. Risk/benefit ratio of modern antifungal therapy: focus on hepatic reactions. J Am Acad Dermatol.
1993;29(1):S50-S54. DOI: 10.1016/S0190-9622(08)81838-5.
Hellfritzsch M, Pottegård A, Pedersen AJT, Burghle A, Mouaanaki F, Hallas J, Grove EL, & Damkier P.
Topical antimycotics for oral candidiasis in warfarin users. Basic Clin Pharmacol Toxicol.
2017;120(4):368-372. DOI: 10.1111/bcpt.12722.
Hellstein JW, Marek CL. Candidiasis: Red and White Manifestations in the Oral Cavity. Head Neck Pathol.
2019;13(1):25-32. DOI: 10.1007/s12105-019-01004-6.
Hill C, Guarner F, Reid G, Gibson GR, Merenstein DJ, Pot B, Morelli L, Canani RB, Flint HJ, Salminen S,
Calder PC & Sanders ME. Expert consensus document. The International Scientific Association for
Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic.
Nat Rev Gastroenterol Hepatol. 2014;11(8):506-514.
Hosain Pour A, Salari S, Ghasemi Nejad Almani P. Oropharyngeal candidiasis in HIV/AIDS patients and non HIV subjects in the Southeast of Iran. Curr Med Mycol. 2018;4(4):1-6. DOI: 10.18502/cmm.4.4.379.
Hossain F, Follett P, Salmieri S, Vu KD, Fraschini C, Lacroix M. Antifungal activities of combined treatments
of irradiation and essential oils (EOs) encapsulated chitosan nanocomposite films in in vitro and in situ
conditions. Int J Food Microbiol. 2019;295:33-40. DOI: 10.1016/j.ijfoodmicro.2019.02.009.
Hu L, Mao Q, Zhou P, Lv X, Hua H, Yan Z. Effects of Streptococcus salivarius K12 with nystatin on oral
candidiasis-RCT. Oral Dis. 2019;25(6):1573-1580. DOI:10.1111/odi.13142.
Inturri R, Trovato L, Volti GL, Oliveri S, Blandino G. In vitro inhibitory activity of Bifidobacterium longum
BB536 and Lactobacillus rhamnosus HN001 alone or in combination against bacterial and Candida
reference strains and clinical isolates. Heliyon. 2019;5(11):e02891. DOI: 10.1016/j.heliyon.2019.e02891.
Iqbal Z, Zafar MS. Role of antifungal medicaments added to tissue conditioners: A systematic review. J
Prosthodont Res. 2016;60(4):231-239. DOI: 10.1016/j.jpor.2016.03.006.
Ishikawa KH, Mayer MPA, Miyazima TY, Matsubara VH, Silva EG, Paula CR, Campos TT, & Nakamae AE.
M.A multispecies probiotic reduces oral Candida colonization in denture wearers. J Prosthodont.
2015;24(3):194-199. DOI: 10.1111/jopr.12198.
Jacobsen ID, Wilson D, Wächtler B, Brunke S, Naglik JR, Hube B. Candida albicans dimorphism as a
therapeutic target. Expert Rev Anti Infect Ther. 2012;10(1):85-93. Doi: 10.1586/eri.11.152.
Jørgensen MR, Kragelund C, Jensen PØ, Keller MK, Twetman S. Probiotic Lactobacillus reuteri has antifungal
effects on oral Candida species in vitro. J Oral Microbiol. 2017;9(1):1274582.
DOI: 10.1080/20002297.2016.1274582.
Kaur IP, Kakkar S. Topical delivery of antifungal agents. Expert Opin Drug Deliv. 2010;7(11):1303-1327.
DOI: 10.1517/17425247.2010.525230.
Keating G, Figgitt D. Caspofungin: a review of its use in oesophageal candidiasis, invasive candidiasis and
invasive aspergillosis. Drugs. 2003;63(20):2235-2263. DOI: 10.2165/00003495-200363200-00008.
Kinoshita H, Yoshioka M, Ihara F, Nihira T. Cryptic antifungal compounds active by synergism with polyene
antibiotics. J Biosci Bioeng. 2016;121(4):394-398. DOI: 10.1016/j.jbiosc.2015.08.003.
Kumar KSP, Samlin SS, Siva B, Sudharshan R, Vignesswary A, Divya K. Punica granatum as a salutiferous
superfruit in the treatment of oral candidiasis – An in-vitro study. J Oral Maxillofac Pathol.
2020;24(1):188-189. DOI: 10.4103/jomfp.JOMFP_268_19.
Kurt A, Erkose-Genc G, Uzun M, Sarı T, Isik-Ozkol G. The Effect of Cleaning Solutions on a Denture Base
Material: Elimination of Candida albicans and Alteration of Physical Properties. J Prosthodont.
2018;27(6):577-583. DOI: 10.1111/jopr.12539.
Laffleur F, Keckeis V. Advances in drug delivery systems: Work in progress still needed?
Int J Pharm. 2020;590:119912. DOI: 10.1016/j.ijpharm.2020.119912.
Lee X, Vergara C, Lozano CP. Severity of Candida-associated denture stomatitis is improved in
institutionalized elders who consume Lactobacillus rhamnosus SP1. Aust Dent J. 2019;64(3):229-236.
DOI: 10.1111/adj.12692.
Lewis MAO, Williams DW. Diagnosis and management of oral candidosis. Br Dent J. 2017;223(9):675-681.
DOI: 10.1038/sj.bdj.2017.886.
Li Z, Sun J, Lan J, Qi Q. Effect of a denture base acrylic resin containing silver nanoparticles on Candida
albicans adhesion and biofilm formation. Gerodontology. 2016;33(2):209-216. DOI: 10.1111/ger.12142.
Liu Y, Filler SG. Candida albicans Als3, a multifunctional adhesin and invasin. Eukaryot Cell.
2011;10(2):168-173. DOI: 10.1128/EC.00279-10.
Lohse MB, Gulati M, Johnson AD, Nobile CJ. Development and regulation of single- and multi-species
Candida albicans biofilms. Nat Rev Microbiol. 2018;16(1):19-31. DOI: 10.1038/nrmicro.2017.107.
Lombardi A, Ouanounou A. Fungal infections in dentistry: Clinical presentations, diagnosis, and treatment
alternatives. Oral Surg Oral Med Oral Pathol Oral Radiol. 2020;130(5):533-546.
DOI: 10.1016/j.oooo.2020.08.011.
Łukaszuk C, Krajewska-Kułak E, Kułak W. Retrospective observation of drug susceptibility of Candida strains
in the years 1999, 2004, and 2015. PeerJ. 2017;5:e3038. Published 2017 Feb 23. DOI: 10.7717/peerj.3038.
Lyu X, Zhao C, Yan ZM, Hua H. Efficacy of nystatin for the treatment of oral candidiasis: a systematic review
and meta-analysis. Drug Des Devel Ther. 2016;10:1161-1171. Published 2016 Mar 16.
DOI: 10.2147/DDDT.S100795.
Maia CMA, Pasetto S, Nonaka CFW, Costa EMMB, Murata RM. Yeast-Host Interactions: Anadenanthera
colubrina Modulates Virulence Factors of C. albicans and Inflammatory Response In Vitro.
Front Pharmacol. 2021;12:629778. Published 2021 Jun 8. DOI: 10.3389/fphar.2021.629778.
Matsubara VH, Bandara HM, Mayer MP, Samaranayake LP. Probiotics as Antifungals in Mucosal Candidiasis.
Clin Infect Dis. 2016;62(9):1143-1153. DOI: 10.1093/cid/ciw038.
De Matteis V, Cascione M, Toma, CC, Albanese G, De Giorgi, ML, Corsalini M, & Rinaldi R. Silver
Nanoparticles Addition in Poly(Methyl Methacrylate) Dental Matrix: Topographic and Antimycotic
Studies. Int J Mol Sci. 2019;20(19):4691. Published 2019 Sep 21. DOI: 10.3390/ijms20194691.
Mayer FL, Wilson D, Hube B. Candida albicans pathogenicity mechanisms. Virulence. 2013;4(2):119-128.
DOI: 10.4161/viru.22913.
Medeiros MAP de Melo, APV de Bento A de O, Souza LBFC de, Neto, F de AB, Garcia JBL, Zuza-Alves DL,
Francisco E., Melo AS de A, & Chaves GM. Epidemiology and prognostic factors of nosocomial
candidemia in Northeast Brazil: A six-year retrospective study. PLoS One. 2019;14(8):e0221033.
Published 2019 Aug 22. DOI: 10.1371/journal.pone.0221033.
Millsop JW, Fazel N. Oral candidiasis. Clin Dermatol. 2016;34(4):487-494.
DOI: 10.1016/j.clindermatol.2016.02.022.
Miranda-Cadena K, Marcos-Arias C, Mateo E, Aguirre JM, Quindós G, Eraso E. Prevalence and antifungal
susceptibility profiles of Candida glabrata, Candida parapsilosis and their close-related species in oral
candidiasis. Arch Oral Biol. 2018;95:100-107. DOI: 10.1016/j.archoralbio.2018.07.017.
Miyazima TY, Ishikawa KH, Mayer M, Saad S, Nakamae A. Cheese supplemented with probiotics reduced
the Candida levels in denture wearers-RCT. Oral Dis. 2017;23(7):919-925. DOI: 10.1111/odi.12669.
Monteiro DR, Gorup LF, Takamiya AS, Ruvollo-Filho AC, de Camargo ER, Barbosa DB. The growing
importance of materials that prevent microbial adhesion: antimicrobial effect of medical devices
containing silver. Int J Antimicrob Agents. 2009;34(2):103-110. DOI: 10.1016/j.ijantimicag.2009.01.017.
Mukherjee S, Ray S, Thakur RS. Solid lipid nanoparticles: a modern formulation approach in drug delivery
system. Indian J Pharm Sci. 2009;71(4):349-358. DOI: 10.4103/0250-474X.57282.
Mundula T, Ricci F, Barbetta B, Baccini M, Amedei A. Effect of Probiotics on Oral Candidiasis: A Systematic
Review and Meta-Analysis. Nutrients. 2019;11(10):2449. Published 2019 Oct 14. DOI: 10.3390/nu11102449.
Naglik JR, Challacombe SJ, Hube B. Candida albicans secreted aspartyl proteinases in virulence and
pathogenesis. Microbiol Mol Biol Rev. 2003;67(3):400-428. DOI: 10.1128/MMBR.67.3.400-428.2003.
Nett JE, Andes DR. Antifungal Agents: Spectrum of Activity, Pharmacology, and Clinical Indications.
Infect Dis Clin North Am. 2016;30(1):51-83. DOI: 10.1016/j.idc.2015.10.012.
Newman DJ, Cragg GM. Natural Products as Sources of New Drugs from 1981 to 2014. J Nat Prod.
2016;79(3):629-661. DOI: 10.1021/acs.jnatprod.5b01055.
Niimi M, Firth NA, Cannon RD. Antifungal drug resistance of oral fungi. Odontology. 2010;98(1):15-25.
DOI: 10.1007/s10266-009-0118-3.
Nivoix Y, Ledoux MP, Herbrecht R. Antifungal Therapy: New and Evolving Therapies. Semin Respir Crit
Care Med. 2020;41(1):158-174. DOI: 10.1055/s-0039-3400291.
Nobile CJ, Johnson AD. Candida albicans Biofilms and Human Disease. Annu Rev Microbiol. 2015;69:71-92.
DOI: 10.1146/annurev-micro-091014-104330.
Ntow-Boahene W, Cook D, Good L. Antifungal Polymeric Materials and Nanocomposites. Front Bioeng
Biotechnol. 2021;9:780328. Published 2021 Dec 24. DOI: 10.3389/fbioe.2021.780328.
Ostrosky-Zeichner L, Casadevall A, Galgiani JN, Odds FC, Rex JH. An insight into the antifungal pipeline:
selected new molecules and beyond. Nat Rev Drug Discov. 2010;9(9):719-727. DOI: 10.1038/nrd3074.
Papadiochou S, Polyzois G. Hygiene practices in removable prosthodontics: A systematic review. Int J Dent
Hyg. 2018;16(2):179-201. DOI: 10.1111/idh.12323.
Pappas PG, Kauffman CA, Andes DR, Clancy CJ, Marr KA, Ostrosky-Zeichner L, Reboli AC, Schuster MG,
Vazquez JA, Walsh TJ, Zaoutis TE, & Sobel JD. Clinical Practice Guideline for the Management of
Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2016;62(4):e1-
e50. DOI: 10.1093/cid/civ933.
Patel SK, Shah DR, Tiwari S. Bioadhesive films containing fluconazole for mucocutaneous candidiasis. Indian
J Pharm Sci. 2015;77(1):55-61. DOI: 10.4103/0250-474X.151601.
Paz ESL, Abreu MA, Mandú ALC, Lira CRS, Guaraná CFR, Paz Júnior FB, Alves J, Santana KR, Barbosa
LM, Cavalcanti MTMO. Prevalence of Candida in dental prostheses of patients from the College of
Dentistry of Pernambuco. 2020;9(9):e970998011.
Pemberton M, Oliver R, Theaker E. Miconazole Oral Gel and Drug Interactions. Br Dent J. 2004,196 (9):
529–31. DOI: 10.1038/sj.bdj.4811224.
Pereira Gonzales F, Maisch T. Photodynamic inactivation for controlling Candida albicans infections. Fungal
Biol. 2012;116(1):1-10.
Perlin DS. Echinocandin Resistance in Candida. Clin Infect Dis. 2015;61 Suppl 6(Suppl 6):S612-S617.
DOI: 10.1093/cid/civ791.
Peters BA, Wu J, Hayes RB, Ahn J. The oral fungal mycobiome: characteristics and relation to periodontitis
in a pilot study. BMC Microbiol. 2017;17(1):157. DOI: 10.1186/s12866-017-1064-9.
Pierce CG, Srinivasan A, Uppuluri P, Ramasubramanian AK, López-Ribot JL. Antifungal therapy with an
emphasis on biofilms. Curr Opin Pharmacol. 2013;13(5):726-730. DOI: 10.1016/j.coph.2013.08.008.
Pinto Reis C, Vasques Roque L, Baptista M, Rijo P. Innovative formulation of nystatin particulate systems in
toothpaste for candidiasis treatment. Pharm Dev Technol. 2016;21(3):282-287.
DOI: 10.3109/10837450.2014.999783.
Procópio ALF da Silva, RA Maciel, JG, Sugio CYC, Soares S, Urban VM, & Neppelenbroek KH.
Antimicrobial and cytotoxic effects of denture base acrylic resin impregnated with cleaning agents after
long-term immersion. Toxicol In Vitro. 2018;52:8-13. DOI: 10.1016/j.tiv.2018.05.012.
Quindos G, Gil-Alonso S, Marcos-Arias C, Sevillano E, Mateo E, Jauregizar N, & Eraso E. Therapeutic tools
for oral candidiasis: Current and new antifungal drugs. Med Oral Patol Oral Cir Bucal. 2019;24(2):e172-
e180. Published 2019 Mar 1. DOI: 10.4317/medoral.22978.
Rajendran R, Sherry L, Nile CJ, Sherriff A, Johnson EM, Hanson MF, Williams C, Munro CA, Jones BJ, &
Ramage G. Biofilm formation is a risk factor for mortality in patients with Candida albicans bloodstream
infection-Scotland, 2012-2013. Clin Microbiol Infect. 2016;22(1):87-93. DOI: 10.1016/j.cmi.2015.09.018.
Rajkowska K, Nowak A, Kunicka-Styczyńska A, Siadura A. Biological effects of various chemically
characterized essential oils: investigation of the mode of action against Candida albicans and HeLa cells.
RSC Advances. 2016;6: 97199-97207.
Ramage G, López-Ribot JL. Techniques for antifungal susceptibility testing of Candida albicans biofilms.
Methods Mol Med. 2005;118:71-79. DOI: 10.1385/1-59259-943-5:071.
Rautemaa R, Ramage G. Oral candidosis–clinical challenges of a biofilm disease. Crit Rev Microbiol.
2011;37(4):328-336. DOI: 10.3109/1040841X.2011.585606.
Richardson, MD, BL Jones, and R Rautemaa. Therapeutic Guidelines in Systemic Fungal Infection. 4th ed.
London: Remedica Medical Education & Publishing Ltd. 2007.
Robbins N, Uppuluri, P, Nett J, Rajendran R, Ramage G, Lopez-Ribot, JL, Andes D, & Cowen, LE. Hsp90
governs dispersion and drug resistance of fungal biofilms. PLoS Pathog. 2011;7(9):e1002257.
Rojz JCC, Cotomacio CC, Caran EMM, Chen MJ, Figueiredo MLS. Photodynamic therapy to control oral
candidiasis in a pediatric patient undergoing head and neck radiotherapy. Photodiagnosis Photodyn Ther.
Samaranayake LP, Keung Leung W, Jin L. Oral mucosal fungal infections. Periodontol 2000. 2009;49:39-59.
DOI: 10.1111/j.1600-0757.2008.00291.x.
Sardi JCO, Scorzoni L, Bernardi T, Fusco-Almeida AM, Mendes Giannini MJS. Candida species: current
epidemiology, pathogenicity, biofilm formation, natural antifungal products and new therapeutic options.
J Med Microbiol. 2013;62:10-24. DOI: 10.1099/jmm.0.045054-0.
Sawant B, Khan T. Recent advances in delivery of antifungal agentsfor therapeutic management of candidiasis.
Biomed Pharmacother. 2017;96:1478-1490. DOI: 10.1016/j.biopha.2017.11.127.
Shen Loo Y, Yee Wong T, Veettil SK, Se Wong P, Gopinath D, Mooi Ching S, & Kunnath Menon R.
Antifungal agents in preventing oral candidiasis in clinical oncology: A network meta-analysis. Oral Dis.
2021;27(7):1631-1643. DOI: 10.1111/odi.13588.
Shreaz S, Wani WA, Behbehani JM, Raja V, Irshad M, Karched M, Ali I, Siddiqi WA, & Hun LT.
Cinnamaldehyde and its derivatives, a novel class of antifungal agents. Fitoterapia. 2016;112:116-131.
DOI: 10.1016/j.fitote.2016.05.016.
Singh A, Verma R, Murari A, Agrawal A. Oral candidiasis: An overview. J Oral Maxillofac Pathol.
2014;18:S81-S85. DOI: 10.4103/0973-029X.141325.
Betzler de Oliveira de Siqueira, L, Matos AP dos S, Cardoso V da S, Villanova JCO, Guimarães B da CLR,
dos Santos EP, Beatriz Vermelho A, Santos-Oliveira R, & Ricci Junior E. Clove oil nanoemulsion showed
potent inhibitory effect against Candida spp. Nanotechnology. 2019;30(42):425101.
DOI: 10.1088/1361-6528/ab30c1.
Sookkhee S, Chulasiri M, Prachyabrued W. Lactic acid bacteria from healthy oral cavity of Thai volunteers:
inhibition of oral pathogens. J Appl Microbiol. 2001;90(2):172-179. DOI: 10.1046/j.1365-2672.2001.01229.x.
Souza RC, Junqueira JC, Rossoni RD, Pereira CA, Munin E, Jorge AO. Comparison of the photodynamic
fungicidal efficacy of methylene blue, toluidine blue, malachite green and low-power laser irradiation
alone against Candida albicans. Lasers Med Sci. 2010;25(3):385-389. DOI: 10.1007/s10103-009-0706-z.
Staab JF, Bradway SD, Fidel PL, Sundstrom P. Adhesive and mammalian transglutaminase substrate properties
of Candida albicans Hwp1. Science. 1999;283(5407):1535-1538. DOI: 10.1126/science.283.5407.1535.
Staniszewska M. Virulence Factors in Candida species. Curr Protein Pept Sci. 2020;21(3):313-323.
DOI: 10.2174/1389203720666190722152415.
Stoimenov PK, Klinger RL, Marchin GL, Klabunde KJ. Metal Oxide Nanoparticles as Bactericidal Agents.
Langmuir. 2002;18(17): 6679–86. DOI: 10.1021/la0202374.
Strickland AB, Shi M. Mechanisms of fungal dissemination. Cell Mol Life Sci. 2021;78(7):3219-3238.
DOI: 10.1007/s00018-020-03736-z.
Sun JN, Solis NV, Phan QT, Bajwa JS, Kashleva H, Thompson A, Liu Y, Dongari-Bagtzoglou A, Edgerton
M, & Filler SG. Host cell invasion and virulence mediated by Candida albicans Ssa1. PLoS Pathog.
2010;6(11):e1001181. DOI: 10.1371/journal.ppat.1001181.
Talapko J, Juzbašić M, Matijević T, Pustijanac E, Bekić S, Kotris I, & Škrlec I. Candida albicans-The
Virulence Factors and Clinical Manifestations of Infection. J Fungi (Basel). 2021;7(2):79.
DOi: 10.3390/jof7020079.
Tatapudi R, Abdul Samad SK, Manyam R, Dasari D, Lakshmi RV. Efficacy of curcumin in the treatment of
denture stomatitis: A randomized double-blind study. J Oral Maxillofac Pathol. 2021;25(2):286-291.
DOI: 10.4103/0973-029X.325128.
Uppuluri P, Pierce CG, López-Ribot JL. Candida albicans biofilm formation and its clinical consequences.
Future Microbiol. 2009;4(10):1235-1237. DOI: 10.2217/fmb.09.85.
Vazquez JA, Sobel JD. Miconazole mucoadhesive tablets: a novel delivery system. Clin Infect Dis.
2012;54(10):1480-1484. DOI: 10.1093/cid/cis205.
Verhaeghe TV, Wyatt CC, Mostafa NZ. The effect of overnight storage conditions on complete denture
colonization by Candida albicans and dimensional stability: A systematic review. J Prosthet Dent.
2020;124(2):176-182. DOI: 10.1016/j.prosdent.2019.07.014.
Vila T, Sultan AS, Montelongo-Jauregui D, Jabra-Rizk MA. Oral Candidiasis: A Disease of Opportunity. J
Fungi (Basel). 2020;6(1):15. Published 2020 Jan 16. DOI: 10.3390/jof6010015.
Vilela SF, Barbosa JO, Rossoni RD, Santos JD, Prata MCA, Anbinder AL, Jorge AOC, Junqueira CJ.
Lactobacillus acidophilus ATCC 4356 inhibits biofilm formation by C. albicans and attenuates the
experimental candidiasis in Galleria mellonella. Virulence. 2015;6(1):29-39. DOI: 10.4161/21505594.2014.981486.
Wächtler B, Wilson D, Haedicke K, Dalle F, Hube B. From attachment to damage: defined genes of Candida
albicans mediate adhesion, invasion and damage during interaction with oral epithelial cells. PLoS One.
2011;6(2):e17046. Published 2011 Feb 23. DOI: 10.1371/journal.pone.0017046.
Wagner RD, Pierson C, Warner T, Dohnalek M, Farmer J, Roberts L, Hilty M, & Balish E. Biotherapeutic
effects of probiotic bacteria on candidiasis in immunodeficient mice. Infect Immun. 1997;65(10):4165-4172.
DOI: 10.1128/IAI.65.10.4165-4172.1997.
Wiench R, Skaba D, Matys J, Grzech-Leśniak K. Efficacy of Toluidine Blue-Mediated Antimicrobial
Photodynamic Therapy on Candida spp. A Systematic Review. Antibiotics (Basel). 2021;10(4):349.
Published 2021 Mar 25. DOI: 10.3390/antibiotics10040349.
Yamada R, Nozaki K, Horiuchi N, Yamashita K, Nemoto R, Miura H, & Nagai A. Ag nanoparticle-coated
zirconia for antibacterial prosthesis. Mater Sci Eng C Mater Biol Appl. 2017;78:1054-1060.
DOI: 10.1016/j.msec.2017.04.149.
Zhang LW, Fu JY, Hua H, Yan ZM. Efficacy and safety of miconazole for oral candidiasis: a systematic review
and meta-analysis. Oral Dis. 2016;22(3):185-195. DOI: 10.1111/odi.12380.
Zhang Y, Chen YY, Huang L, Chai ZG, Shen LJ, Xiao YH. The antifungal effects and mechanical properties
of silver bromide/cationic polymer nano-composite-modified Poly-methyl methacrylate-based dental
resin. Sci Rep. 2017;7(1):1547. Published 2017 May 8. DOI: 10.1038/s41598-017-01686-4.
Zhao X, Oh SH, Cheng G, Green CB, Nuessen JA, Yeater K, Leng RP, Brown AJP, & Hoyer LL. ALS3 and
ALS8 represent a single locus that encodes a Candida albicans adhesin; functional comparisons between
Als3p and Als1p. Microbiology (Reading). 2004;150(Pt 7):2415-2428. DOI: 10.1099/mic.0.26943-0.
Zhou Y, Liao M, Zhu C, Hu Y, Tong T, Peng X, Li M, Feng M, Cheng L, Ren B, & Zhou X. ERG3 and ERG11
genes are critical for the pathogenesis of Candida albicans during the oral mucosal infection. Int J Oral
Sci. 2018;10(2):9. Published 2018 Mar 16. DOI: 10.1038/s41368-018-0013-2.
Zida A, Bamba S, Yacouba A, Ouedraogo-Traore R, Guiguemdé RT. Anti-Candida albicans natural products,
sources of new antifungal drugs: A review. J Mycol Med. 2017;27(1):1-19. DOI: 10.1016/j.mycmed.2016.10.002.


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