We all live with a perfectly balanced mix of microbes in our mouths. Bacteria and fungi are both capable of causing disease as well as promoting health.
When a person’s immune system is compromised, such as with those affected by HIV, these microorganisms are more likely to cause disease. This is the case with Candida albicans, a fungi that will overgrow and lead to candidiasis, or oral thrush.
A new study from the Case Western Reserve School of Medicine and University Hospitals (UH) Case Medical Center compared the bacteria and fungi present in the mouths of healthy individuals with patients infected with HIV. The results point to new treatment options in the future for those affected by thrush.
What is Thrush?
Thrush can develop suddenly but it can persist, becoming a chronic infection over time. It appears as creamy white, slightly raised lesions in your mouth. They appear most often on your tongue and inner cheeks but can also appear on the roof of your mouth, gums, tonsils or the back of your throat.
These painful lesions bleed and can spread to the lungs, liver and skin. It is estimated that up to 45% of people with systemic candidiasis will die.
Thrush appears more often in those with weakened immune systems such as those with cancer, liver disease, kidney disease, multiple sclerosis and HIV. Additionally, many medicines also weaken the immune system including steroids, cancer chemotherapy and drugs to treat rheumatoid arthritis or psoriasis.
Rice University estimates that 70% of all people are affected by candida. This is why the results of the research over at UH is so important.
New Study Leads to New Treatment Option for Thrush
“Our aim was to try to understand what microorganisms live in our mouths. A disturbed equilibrium of these microorganisms can lead to disease,” says Mahmoud A. Ghannoum, PhD, EMBA, professor of dermatology and pathology at the School of Medicine and director of the Center for Medical Mycology at UH Case Medical Center.
Ghannoum and his team studied 24 patients from UH Case Medical Center. 12 of those patients were infected with HIV and 12 were a control set of healthy individuals. The results intrigued the researchers.
“When we looked at the data, we found to our surprise that bacteria did not change much between HIV-infected patients and those who were not,” Ghannoum said. “However, what changed significantly between the two groups was the composition of the fungal community. We found that when Candida is present, Pichia is not, and when Pichia is present, Candida is not — indicating Pichia plays an important role in treating thrush.”
Suspecting that Pichia was producing a chemical that killed the Candida, they mixed cultures of both microbes and filtered out the Pichia. What was left was a powerful antifungal, promising to one day become a treatment option for not only thrush, but other life-threatening systemic fungal infections as well.
“One day, not only could this lead to topical treatment for thrush, but it could also lead to a formulation of therapeutics for systemic fungal infections in all immunocompromised patients,” Ghannoum said. “In addition to patients with HIV, this would also include very young patients and patients with cancer or diabetes.
“Our findings have wide implications regarding the discovery of novel antifungal agents and will open the way to new therapeutic approaches for the management of fungal infections. Detailed investigations are warranted to purify and characterize the specific Pichia factor(s) that can inhibit Candida and other disease-causing fungi.”
If you think you may be suffering from thrush make an appointment with Dr. Matthews as soon as possible. He will be able to diagnose this illness and answer any other questions you may have.