Salivary IgA and oral candidiasis in asthmatic patients treated with inhaled corticosteroid.
BACKGROUND
Inhaled corticosteroids are used for the treatment of bronchial asthma. Systemic side effects are rare, but local problems, such as oral candidiasis, can occur. Only a proportion of patients encounter this problem, and the mechanism of oral candidiasis induced by inhaled corticosteroids remains obscure. According to reports in immunodeficient patients, oral candidiasis is related to deficiencies in topical immunity, such as salivary IgA.


OBJECTIVE
We evaluated differences in salivary IgA between asthmatics in whom Candida was detected or not detected from the pharynges, respectively.


METHODS
Saliva was collected from 18 healthy controls and 37 asthmatic patients treated with inhaled corticosteroids. The amounts of total IgA and the Candida-specific IgA of the saliva were measured. Fungal culture of the pharyngeal wall was also performed.


RESULTS
There were no differences in salivary total IgA and Candida-specific IgA between healthy controls and culture-negative asthmatic patients. Salivary total IgA of Candida-positive asthmatic patients was significantly lower than that of Candida-negative patients. However, there was no difference in Candida-specific IgA levels between these two groups.


CONCLUSIONS
Our results suggest that inhaled corticosteroids can potentially decrease salivary total IgA but that host factors are also important in the development of oral candidiasis.
Fukushima
Chizu
C
Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan.
Matsuse
Hiroto
H
Saeki
Sachiko
S
Kawano
Tetsuya
T
Machida
Ikuko
I
Kondo
Yuki
Y
Kohno
Shigeru
S
D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D000730:Androstadienes / Q000008:administration & dosage / Q000009:adverse effects; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D000918:Antibody Specificity / Q000276:immunology; D001249:Asthma / Q000188:drug therapy* / Q000276:immunology*; D001507:Beclomethasone / Q000008:administration & dosage / Q000009:adverse effects; D002176:Candida albicans / Q000276:immunology; D002180:Candidiasis, Oral / Q000276:immunology*; D005260:Female; D000068298:Fluticasone; D006801:Humans; D007071:Immunoglobulin A, Secretory / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D009894:Opportunistic Infections / Q000276:immunology*; D010614:Pharynx / Q000187:drug effects* / Q000276:immunology; D012306:Risk; D012463:Saliva / Q000276:immunology*
D000305:Adrenal Cortex Hormones; D000730:Androstadienes; D018927:Anti-Asthmatic Agents; D007071:Immunoglobulin A, Secretory; D000068298:Fluticasone; D001507:Beclomethasone