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Title: Oral yeast infection among patients with diabetes mellitus
Author: Aly, Fatima Zahra
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1993
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Patients with insulin-dependent diabetes mellitus (IDDM) (n = 231) or non-insulin dependent diabetes mellitus (NIDDM) (n &61 205) were selected as models for investigation of oral yeast infection in immunocompromised host. The general objectives were: 1. to assess the contributions of genetic and environmental factors to colonization by yeast and development of denture stomatitis; 2. to assess the effects of the differential distribution of H and Lewis blood group antigens on epithelial cells of secretors and non-secretors on attachment of C. albicans. Predisposing factors contributing to colonization and development of denture stomatitis are distinct for individuals with IDDM compared with those with NIDDM. By multivariate analyses, palatal and overall oral carriage of yeast among individuals with IDDM was associated with age (p < 0.01). The factor contributing to palatal carriage of yeasts among individuals with NIDDM was poor glycaemic control (p &60 0.05); carriage in the oral cavity as a whole was influenced additionally by non-secretion of ABH blood group antigens. Introduction of a denture altered the risk factors. For individuals with IDDM, overall oral carriage was associated with the presence of retinopathy (p < 0.05) and palatal carriage by poor glycaemic control (p < 0.05) and age (p < 0.05). For those with NIDDM palatal carriage was associated with continuous presence of the denture (p < 0.01) and overall oral carriage with raised plasma glucose levels (p < 0.05). Denture stomatitis was associated with poor glycaemic control among subjects with IDDM and for those with NIDDM with continuous wearing of dentures, large numbers of yeasts and non-secretion. Host pathogen interactions underlying the increased susceptibility of non-secretors to colonization were explored. Buccal epithelial cells (BEC) from secretor and non-secretor donors were assessed by flow cytometry for their ability to bind yeasts. C. albicans 2346 which expresses an adhesion that binds fucose, the immunodominant sugar of the H and Lewis blood group antigens, was used. There was a trend for BEC from non-secretors to bind more C. albicans 2346 compared with BEC from secretors. These results suggested that Lea antigen present at higher levels on cells from non-secretors might be one of the receptors for C. albicans 2346.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available