常在真菌Candidaの病原性─カンジダ症とその対応─

抄録

Candida is the most significant species among fungi, because it is not only a member of the normal microbiota of oral cavity, skin, gastrointestinal tract and vagina, but also one of the pathogens for opportunistic infections（candidiasis）. Recently incidence and prevalence of candidiasis have increased in large populations of compromised hosts.

Studies of poly-microbial Candida biofilms suggest that the hyphae of Candida provides the scaffold for oral bacteria in biofilms and show the interactions with many oral infections such as dental caries, periodontal disease, endodontic infection, and denture stomatitis.

Candida has a number of virulence factors, the most important is aspartic proteinase （Sap）. Sap plays a central role in the pathogenicity of Candida destroying human proteins and invading tissues.

The gold standard of diagnosis for candidiasis is based on clinical findings and confirmed by identification of colonies cultured on the media for Candida. However, microscopic examinations of staining smear samples are faster and simpler methods than culture methods, if the staining is sufficiently accurate. We compared staining methods of candidiasis smear samples, and suggest that Fungiflora Y staining is useful for the diagnosis of oral erythematous candidiasis.

Right now, we are doing both, basic and clinical research to reduce Candida colonization in the oral cavity. Basic research includes the development of probiotics with lactobacilli as well as biogenic products of lactobacilli for controlling Candida colonization in the oral cavity. Clinical research comprises of reducing the number of Candida in the oral cavity by gargling with a diluted antifungal drug（amphotericin B）.

The goal of our studies is to improve QOL, not restricted to the oral cavity, but for the entire body by eliminating Candida from the oral cavity.