Objectives: The aim of this study was to investigate Candida numbers and local cytokine expression in patients with or without denture stomatitis thereby indicating the different host immune response in these two groups.
Methods: Complete denture wearers with (n=42) and without (n=51) clinical signs of denture stomatitis were identified for inclusion in the study. Palatal inflammation was assessed using multiple clinical indices. Candida colonisation was assessed as CFU/cm2 from imprint cultures of the palate, fit surface of the denture and tongue. Levels of cytokines (IFNγ, IL-2, TNFα, IL-4, IL-5, IL-6, IL-10, IL-17a, IL-22 and TGF-beta1) were detected in palatal fluid samples. Cytokines were measured using a BDTM Cytometric Bead Array (CBA) human Th1/2/17 kit and single plex flex kits, and an Enzyme-linked immunosorbent assay (ELISA).
Results: Candida colonisation was significantly higher in the denture stomatitis group at all sites (palate, P=0.0301, denture, P=0.0113, tongue, P=0.0043) compared to the non-stomatitis group. Th1 (IFNγ, P=0.0004, TNFα, P=0.0009) and Th17 cytokines (IL-17a, P=0.0026, IL-22, P=0.0004) were also significantly increased in the stomatitis group. There was no significant increase in the Th2 cytokines (IL-4 and IL-5). A significant (P=0.0001) increase in TGF-beta1 was also evident which is a critical cytokine for Th17 cell differentiation.
Conclusions: In denture stomatitis subjects, increased Candida colonisation is associated with Th1 and Th17 responses by the host. This type of T cell response may protect the host from subsequent systemic infection.