Oral Candidiasis as a Local Adverse Effect of Inhaled Corticosteroids: What the Dental Practitioner Should Know

Yıl 2022, Cilt: 5 Sayı: 1, 107 - 115, 01.01.2022

Birsay Gümrü Melda Pelin Akkitap

https://doi.org/10.19127/bshealthscience.943993

Öz

Inhaled corticosteroids are increasingly recommended at all stages of asthma in all age groups as a first-line treatment for controlling symptoms and minimizing oral corticosteroid dependence in chronic asthma owing to their anti-inflammatory and immunosuppressive effects. Despite the fact that they are highly effective, their use can be accompanied by systemic and local adverse effects. Systemic adverse effects are infrequent, but oral candidiasis, the most common oral fungal infection, is a frequently observed local adverse effect of inhaled corticosteroid use. This adverse effect may lead to discomfort and cause reduced patient compliance. In this review, clinical findings of oral candidiasis, potential pathogenity mechanisms following such therapy along with the specific prophylactic measures that should be undertaken to minimize this adverse effect are discussed extensively. Understanding the factors leading to increased risk can give the opportunity of focusing on the patients who need timely intervention.

Anahtar Kelimeler

Corticosteroid, Inhaler, Local adverse effects, Oral candidiasis

Kaynakça

• Baptist AP, Reddy RC. 2009. Inhaled corticosteroids for asthma: are they all the same? J Clin Pharm Ther, 34(1): 1-12.
• Barkvoll P, Attramadal A. 1989. Effect of nystatin and chlorhexidine digluconate on Candida albicans. Oral Surg Oral Med Oral Pathol, 67(3): 279-281.
• Barnes PJ, Adcock IM. 2003. How do corticosteroids work in asthma? Ann Intern Med, 139(5 Pt 1): 359-370.
• Buhl R. 2006. Local oropharyngeal side effects of inhaled corticosteroids in patients with asthma. Allergy, 61(5): 518-526.
• Buttini F, Miozzi M, Balducci AG, Royall PG, Brambilla G, Colombo P, Bettini R, Forbes B. 2014. Differences in physical chemistry and dissolution rate of solid particle aerosols from solution pressurised inhalers. Int J Pharm, 465(1-2): 42-51.
• Cates CJ, Bestall J, Adams N. 2006. Holding chambers versus nebulisers for inhaled steroids in chronic asthma. Cochrane Database Syst Rev, 1: CD001491.
• Cheng T, Yong L, Zhang H, Chen L, Tu J, Hui X, Cheng Q, Wan H. 2017. Incidence of oral candidiasis is associated with inhaled corticosteroids in Chinese patients: a systematic review and meta-analysis. Int J Clin Exp Med, 10(3): 5546-5560.
• Dahl R. 2006. Systemic side effects of inhaled corticosteroids in patients with asthma. Respir Med, 100(8): 1307-1317.
• Dekhuijzen PNR, Batsiou M, Bjermer L, Bosnic-Anticevich S, Chrystyn H, Papi A, Rodríguez-Roisin R, Fletcher M, Wood L, Cifra A, Soriano JB, Price DB. 2016. Incidence of oral thrush in patients with COPD prescribed inhaled corticosteroids: effect of drug, dose, and device. Respir Med, 120: 54-63.
• Dennis M, Itkin IH. 1964. Effectiveness and complications of aerosol dexamethasone phosphate in severe asthma. J Allergy, 35: 70-76.
• Derendorf H, Nave R, Drollmann A, Cerasoli F, Wurst W. 2006. Relevance of pharmacokinetics and pharmacodynamics of inhaled corticosteroids to asthma. Eur Respir J, 28(5): 1042-1050.
• Derendorf H. 1997. Pharmacokinetic and pharmacodynamic properties of inhaled corticosteroids in relation to efficacy and safety. Respir Med, 91(Suppl A): 22-28.
• Ellepola AN, Samaranayake LP. 2001. Inhalational and topical steroids, and oral candidosis: a mini review. Oral Dis, 7(4): 211-216.
• Epstein JB, Komiyama K, Duncan D. 1986. Oral topical steroids and secondary oral candidiasis. J Oral Med, 41(4): 223-227, 273.
• Erdoğan T, Karakaya G, Kalyoncu AF. 2019. The frequency and risk factors for oropharyngeal candidiasis in adult asthma patients using inhaled corticosteroids. Turk Thorac J, 20(2): 136-139.
• Fukushima C, Matsuse H, Tomari S, Obase Y, Miyazaki Y, Shimoda T, Kohno S. 2003. Oral candidiasis associated with inhaled corticosteroid use: comparison of fluticasone and beclomethasone. Ann Allergy Asthma Immunol, 90(6): 646-651.
• Fukushima C, Shimoda T, Kawano T, Tomari S, Mitsuta K, Obase Y, Matsuo N, Matsuse H, Kohno S. 2001. Effects of amphotericin B gargles on oral colonization of Candida albicans in asthmatic patients on steroid inhalation therapy. Respiration, 68(5): 465-470.
• Godara N, Godara R, Khullar M. 2011. Impact of inhalation therapy on oral health. Lung India, 28(4): 272-275.
• Gumru Tarcin B. 2011. Oral candidosis: aetiology, clinical manifestations, diagnosis and management. MÜSBED, 1(2): 140-148.
• Hanania NA, Chapman KR, Kesten S. 1995. Adverse effects of inhaled corticosteroids. Am J Med, 98(5 Pt 1): 196-208.
• Hejazi ME, Shafiifar A, Mashayekhi S, Sattari M. 2016. Evaluation of proper usage of glucocorticosteroid inhalers and their adverse effects in asthmatic patients. Tanaffos, 15(1): 9-16.
• Helmerhorst EJ, Troxler RF, Oppenheim FG. 2001. The human salivary peptide histatin 5 exerts its antifungal activity through the formation of reactive oxygen species. Proc Natl Acad Sci U S A, 98(25): 14637-14642.
• Holmes MS, Seheult JN, O’Connell P, D’Arcy S, Ehrhardt C, Healy AM, Costello RW, Reilly RB. 2015. An acoustic-based method to detect and quantify the effect of exhalation into a dry powder inhaler. J Aerosol Med Pulm Drug Deliv, 28(4): 247-253.
• Hossny E, Rosario N, Lee BW, Singh M, El-Ghoneimy D, Soh JY, Le Souef P. 2016. The use of inhaled corticosteroids in pediatric asthma: update. World Allergy Organ J, 9: 26.
• Irwin RS, Richardson ND. 2006. Side effects with inhaled corticosteroids: the physician’s perception. Chest, 130(1 Suppl): 41S-53S.
• Ishikawa KH, Mayer MP, Miyazima TY, Matsubara VH, Silva EG, Paula CR, Campos TT, Nakamae AE. 2015. A multispecies probiotic reduces oral Candida colonization in denture wearers. J Prosthodont, 24(3): 194-199.
• Kargul B, Tanboga I, Ergeneli S, Karakoc F, Dagli E. 1998. Inhaler medicament effects on saliva and plaque pH in asthmatic children. J Clin Pediatr Dent, 22(2): 137-140.
• Kennedy WA, Laurier C, Gautrin D, Ghezzo H, Paré M, Malo JL, Contandriopoulos AP. 2000, Occurrence and risk factors of oral candidiasis treated with oral antifungals in seniors using inhaled steroids. J Clin Epidemiol, 53(7): 696-701.
• Komiyama EY, Ribeiro PM, Junqueira JC, Koga-Ito CY, Jorge AO. 2004. Prevalence of yeasts in the oral cavity of children treated with inhaled corticosteroids. Braz Oral Res, 18(3): 197-201.
• Kwah JH, Peters AT. 2019. Asthma in adults: Principles of treatment. Allergy Asthma Proc, 40(6): 396-402.
• Lenander-Lumikari M, Soderling E, Loimaranta V, Ampula L. 2000. Effect of inhaled corticosteroids on plaque pH. Caries Res, 34: 348.
• Levy ML, Dekhuijzen PN, Barnes PJ, Broeders M, Corrigan CJ, Chawes BL, Corbetta L, Dubus JC, Hausen T, Lavorini F, Roche N, Sanchis J, Usmani OS, Viejo J, Vincken W, Voshaar T, Crompton GK, Pedersen S. 2016. Inhaler technique: facts and fantasies. A view from the Aerosol Drug Management Improvement Team (ADMIT). NPJ Prim Care Respir Med, 26: 16017.
• Li D, Li Q, Liu C, Lin M, Li X, Xiao X, Zhu Z, Gong Q, Zhou H. 2014. Efficacy and safety of probiotics in the treatment of Candida-associated stomatitis. Mycoses, 57(3): 141-146.
• Lima SL, Colombo AL, de Almeida Junior JN. 2019. Fungal cell wall: Emerging antifungals and drug resistance. Front Microbiol, 10: 2573.
• Lipworth BJ. 1995. New perspectives on inhaled drug delivery and systemic bioactivity. Thorax, 50(2): 105-110.
• Lombardi A, Ouanounou A. 2020. Fungal infections in dentistry: Clinical presentations, diagnosis, and treatment alternatives. Oral Surg Oral Med Oral Pathol Oral Radiol, 130(5): 533-546.
• Martin MV, Dinsdale RC. 1982. Nystatin-resistance of candida albicans isolates from two cases of oral candidiasis. Br J Oral Surg, 20(4): 294-298.
• Matsubara VH, Bandara HM, Mayer MP, Samaranayake LP. 2016. Probiotics as antifungals in mucosal candidiasis. Clin Infect Dis, 62(9): 1143-1153.
• Maxwell DL. 1990. Adverse effects of inhaled corticosteroids. Biomed Pharmacother, 44(8): 421-427.
• Ming SWY, Haughney J, Ryan D, Patel S, Ochel M, d'Alcontres MS, Thornhill S, Kocks JWH, Price D. 2019. Comparison of adverse events associated with different spacers used with non-extrafine beclometasone dipropionate for asthma. NPJ Prim Care Respir Med, 29(1): 3.
• Newman SP, Weisz AW, Talaee N, Clarke SW. 1991. Improvement of drug delivery with a breath actuated pressurised aerosol for patients with poor inhaler technique. Thorax, 46(10): 712-716.
• Nivoix Y, Ledoux MP, Herbrecht R. 2020. Antifungal therapy: New and evolving therapies. Semin Respir Crit Care Med, 41(1): 158-174.
• Patil A, Susmitha HR, Basappa S, Mahesh MS. 2016. Drug-induced oral candidiasis: a case report. IJSS Case Rep Rev, 2(12): 1-4.
• Pedersen S, O’Byrne P. 1997. A comparison of the efficacy and safety of inhaled corticosteroids in asthma. Allergy, 52(39 Suppl): 1-34.
• Prentice AG. 1989. Oral and gastrointestinal candidosis: prophylaxis during immunosuppressive therapy. Mycoses, 32(Suppl 2): 42-46.
• Rachelefsky GS, Liao Y, Faruqi R. 2007. Impact of inhaled corticosteroid-induced oropharyngeal adverse events: results from a meta-analysis. Ann Allergy Asthma Immunol, 98(3): 225-238.
• Regezi JA, Sciubba JJ, Jordan RCK. 2016. Oral Pathology, Clinical Pathologic Correlations. Elsevier, St. Louis, Missoouri, USA, 7th ed., pp 108.
• Roland NJ, Bhalla RK, Earis J. 2004. The local side effects of inhaled corticosteroids: current understanding and review of the literature. Chest, 126(1): 213-219.
• Samaranayake YH, Samaranayake LP, Pow EH, Beena VT, Yeung KW. 2001. Antifungal effects of lysozyme and lactoferrin against genetically similar, sequential Candida albicans isolates from a human immunodeficiency virus-infected southern Chinese cohort. J Clin Microbiol, 39(9): 3296-3302.
• Samaranayake YH, Samaranayake LP. 2001. Experimental oral candidiasis in animal models. Clin Microbiol Rev, 14(2): 398-429.
• Sawaki K, Mizukawa N, Yamaai T, Fukunaga J, Sugahara T. 2002. Immunohistochemical study on expression of alpha-defensin and beta-defensin-2 in human buccal epithelia with candidiasis. Oral Dis, 8(1): 37-41.
• Selroos O, Backman R, Forsén KO, Löfroos AB, Niemistö M, Pietinalho A, Aikäs C, Riska H. 1994. Local side-effects during 4-year treatment with inhaled corticosteroids - a comparison between pressurized metered-dose inhalers and Turbuhaler. Allergy, 49(10): 888-890.
• Sharma S, Gaur P, Gupta S, Kant S. 2018. Impact of asthma on oral health: a review. Int J Recent Sci Res, 9(5): 26512-26514.
• Spector SL, Wangaard C, Bardana EJ Jr. 1982. The use of cultures and immunologic procedures to predict oropharyngeal candidiasis in patients on steroid aerosols. Clin Allergy, 12(3): 269-278.
• Thomas MS, Parolia A, Kundabala M, Vikram M. 2010. Asthma and oral health: a review. Aust Dent J, 55(2): 128-133.
• Thompson PJ, Wingfield HJ, Cosgrove RF, Hughes BO, Turner-Warwick ME. 1986. Assessment of oral candidiasis in patients with respiratory disease and efficacy of a new nystatin formulation. Br Med J (Clin Res Ed), 292(6537): 1699-700.
• Thorsson L, Kenyon C, Newman SP, Borgström, L. 1998. Lung deposition of budesonide in asthmatics: a comparison of different formulations. Int J Pharm, 168: 119-127.
• Toogood JH, Jennings B, Greenway RW, Chuang L. 1980. Candidiasis and dysphonia complicating beclomethasone treatment of asthma. J Allergy Clin Immunol, 65(2): 145-153.
• Toogood JH. 1990. Complications of topical steroid therapy for asthma. Am Rev Respir Dis, 141(2 Pt 2): S89-S96.
• Ullah Z, Iqbal Z, Anwar K. 2016. Frequency of oral candidiasis in ashtma patients using inhaled corticosteroids by different inhaler devices. Pak J Chest Med, 22(1): 8-11.
• van Boven JF, de Jong-van den Berg LT, Vegter S. 2013. Inhaled corticosteroids and the occurrence of oral candidiasis: a prescription sequence symmetry analysis. Drug Saf, 36(4): 231-236.
• Wu T, Samaranayake LP. 1999. The expression of secreted aspartyl proteinases of Candida species in human whole saliva. J Med Microbiol, 48(8): 711-720.
• Yokoyama H, Nakajima Y, Yamamura Y, Iga T, Yamada Y. 2005. Investigation of mouth washing by patients after inhaling corticosteroids. Yakugaku Zasshi, 125(5): 455-461.
• Yokoyama H, Yamamura Y, Ozeki T, Iga T, Yamada Y. 2006. Influence of mouth washing procedures on the removal of drug residues following inhalation of corticosteroids. Biol Pharm Bull, 29(9): 1923-1925.
• Yudt MR, Cidlowski JA. 2002. The glucocorticoid receptor: coding a diversity of proteins and responses through a single gene. Mol Endocrinol, 16(8): 1719-1726.