Abstract
Purpose: There is a burgeoning recognition and interest in the potential of probiotics in the treatment and prevention of oral candidiasis associated with the use of dentures. Our aim was to investigate if commercially available over-the-counter probiotics can influence the ability of Candida albicans to form biofilms, which is considered a hallmark of the initiation and progression of oral candidiasis.
Methods: We conducted a 2×5 factorial in vitro study to culture C. albicans on denture strips and challenge with one of the following four commercially available probiotics in bacterial or cell-free supernatant form: Accuflora®, Align®, Culturelle® and Sustenex®. C. albicans biofilm formation was studied in triplicates in all factorial combinations of the study and assessed qualitatively with fluorescence microscopy and quantitatively with tetrazolium salt (XTT) reduction assay. Quality control measures included determination of coefficient of variation, Bland Altman plots and Pittman's test. Results were analyzed using two-way analysis of variance (ANOVA) with pairwise post-hoc Scheffe's tests.
Results: Our experimental conditions passed the quality control checks. Two-way ANOVA results indicated that cell-free supernatants provided a stronger and significant inhibitory effect on biofilm formation than their bacterial counterparts (2-way ANOVA p=3.8×10−6). Further, Lactobacillus-containing probiotic formulations (Accuflora® and Culturelle®) significantly reduced biofilm formation especially in supernatant form.
Conclusion: Commercially available probiotics that contain Lactobacilli species interfere with the in vitro ability of C. albicans to form biofilms on dentures. The mechanistic and clinical implications of our results need to be addressed by larger in vivo studies.
Footnotes
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Shweta Ujaoney, MDS is currently a dental student at Virginia Commonwealth University School of Dentistry. Jyotsna Chandra, PhD is a Senior Research Associate at the Center for Medical Mycology, Department of Dermatology, University Hospitals of Cleveland and Case Western Reserve University, Cleveland, OH. Fady Faddoul, DDS, MSD is Professor and Vice-Chairman of the Department of Comprehensive Care and Director of the AEGD and Faculty Practice programs at Case Western Reserve University School of Dental Medicine. Maya Chane, D.D.S, M.S. is a Senior Instructor in the Department of AEGD, Case Western Reserve University School of Dental Medicine. Jing Wang, DMD was a Resident in AEGD at the Case Western Reserve University School of Dental Medicine when this study was conducted. Louay Taifour was a resident in AEGD at the Case Western Reserve University School of Dental Medicine when this study was conducted. Manju R. Mamtani, MD is a member of Lata Medical Research Foundation, Nagpur, India and Staff Scientist I at the Texas Biomedical Research Institute in San Antonio, TX. Tushar P. Thakre, MD, PhD is a member of Lata Medical Research Foundation, Nagpur, India and Assistant Professor at the East Carolina University Brody School of Medicine. Hemant Kulkarni, MD is the President of Lata Medical Research Foundation, Nagpur, India and Staff Scientist II at the Texas Biomedical Research Institute in San Antonio, TX. Pranab Mukherjee, PhD is an Assistant Professor in the Department of Dermatology at University Hospitals of Cleveland and Case Western Reserve University, Cleveland, OH. Mahmoud A. Ghannoum, PhD is Professor in the Department of Dermatology at University Hospitals of Cleveland and Case Western Reserve University, Cleveland, OH. He is also the Director of the Center for Medical Mycology.
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This study supports the NDHRA priority area, Health Promotion/Disease Prevention: Validate and test assessment instruments/strategies/mechanisms that increase health promotion and disease prevention among diverse populations.
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