Candida Albicans Adherence Control by Alginate / Xylitol Containing Toothpaste
Objectives: In Candida albicans (CA) high risk groups (impaired salivary gland function, diabetes mellitus, etc.), antifungal prophylaxis reduces incidence and severity of infections by preventing colonization and cytotoxicity of CA.
The study aimed to evaluate the antiadhesive properties of toothpaste containing xylitol / potassium alginate (AXT) compared to placebo (PT) relative to CA on the human musculoskeletal fibroblasts (HMF) model
Methods: AXT or PT toothpastes containing identical basic ingredients were used as 10% solution in Eagle medium. The tested sample additionally included Potassium alginate and Xylitol.
HMF were cultivated in Leighton tubes in Eagle medium for 24 hours at 37°C, until a confluent monolayer was formed. 1.8 ml of toothpaste solutions and 0.2 ml of CA 108 CFU/ml were added to incubate for 2 hours at 37°C.
HMF were washed, fixed with 96% ethanol, stained and studied microscopically.
Adhesion index was measured by calculating the average number of CA cells attached to one eukaryotic cell (EC); percentage of monolayer cells affected was calculated.
Results: Incubation of CA with HMF for 2 hours resulted in complete destruction of the monolayer. Adhesion index was 12-14 CFU per 1 EC.
Incubation of fibroblasts with 0.04% toothpastes did not lead to any destruction after a 2-hour exposure.
When PT was used, fibroblast monolayer degraded 90% due to CA cytotoxicity. The remaining fibroblasts (10%) were infected with the test strain. Adhesion index was 12-14 CFU per 1 EC.
When AXT was used, CA cytotoxic effect on HMF was no more than 10%. Adhesion index was 1-2 CFU per 1 EC. The percentage of affected cells was 2%.
Conclusions: AXT lowers the intensity of HMF destruction in presence of CA by 90%, and helps significantly lower microbial adhesion (7-10 times) compared to placebo.
Alginate and xylitol in toothpastes is promising in clinical practice when increased risk of candidiasis is detected.