Characterisation of Candida albicans populations associated with chronic hyperplastic candidosis (Candida leukoplakia) and non-Candida leukoplakia lesions in patients presenting with oral leukoplakic lesions in Ireland

Abstract

Oral squamous cell carcinoma is a significant global health problem, affecting about a half of a million people worldwide annually. Oral leukoplakic lesions have been reported to have significantly increased potential for malignant change. Leukoplakias infected with Candida (chronic hyperplastic candidosis, CHC) are regarded as a high-risk lesions compared to uninfected, non-candidal leukoplakia (NCL). Whether Candida is the cause of the hyperkeratosis and dysplasia seen in these lesions, or only a superimposed infection of a pre-existent leukoplakic lesion has been open to debate. The main objectives of the present study were to investigate the role of Candida species in the aetiopathogenesis of biopsy-proven CHC, to characterise oral Candida species and their relative abundance isolated from CHC lesions compared to NCL, to investigate the cellular adhesion properties of these isolates and their genetic population structure compared to commensal isolates from healthy carriers. Seventy eight patients (designated the OL group) were enrolled in the study, 31 with biopsy-proven CHC and 47 with NCL. Clinical and histopathological data were gathered on the patients along with oral rinse and lesional swab samples to correlate clinical findings with Candida culture findings.