Salivary IgA in Candida-associated Denture Stomatitis

Objectives: Denture-induced stomatitis is an inflammatory process that involves mainly the palatal mucosa covered by a complete denture. Candida albicans and related species play an important role in the pathogenesis of this condition. Salivary IgA is a major component of the protective immunological response of the oral cavity. The aim of this study was (i) to identify yeast-like fungi in the oral mucosa of patients suffering from Candida-associated denture stomatitis, (ii) to assess the occurrence of blastospores and hyphal cells of yeasts, and (iii) to evaluate the IgA concentration in whole saliva.

Materials and Methods: Seventy patients, complete denture wearers, suffering from Candida–associated denture stomatitis were examined. A group of 20 denture wearers with clinically healthy oral mucosa served as a control. The yeasts were isolated by culture method and identified by a germ-tube formation test and the ID 32C Candida identification kit (bioMerieux SA, Marcy-l'Etoile, France). Salivary IgA was quantified using ELISA assay (Immundiagnostic, Germany).

Results: A total of 90 Candida strains were identified: C. albicans (52%), C. glabrata (22.2%), C. parapsilosis (18.3%) and C. tropicalis (7.5%). Both forms of C. albicans were noted: yeast-like blastospores and hyphal cells. Blastospores were the more prevalent form, observed in 100%, and the mycelial form in 52% of C. albicans isolates. Women had lower levels of salivary IgA than men (p<0.01). A significantly higher level of salivary IgA was found in patients with Candida-associated denture stomatitis (p<0.001). In patients with the mycelial form the level of salivary IgA was higher than in the patients with yeast-like blastospores (p<0.0005).

Conclusions: Salivary IgA may play an important role in the pathogenesis of Candida-associated denture stomatitis.