DOI: https://doi.org/10.22263/2312-4156.2025.3.104
A.A. Pozharitskaya, N.A. Karpuk
The treatment method of oral mucosa leukoplakia associated with oral candidiasis
Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
Vestnik VGMU. 2025;24(3):104-114.
Abstract.
Objectives. To develop an effective method for treating leukoplakia of the oral mucosa associated with oral candidiasis (LOMOC).
Material and methods. 54 patients with LOMOC were treated using a standard method and a newly proposed method, including systemic use of vitamin B12 and the immunomodulator interleukin 2 (IL-2) «Roncoleukin», local laser therapy with violet spectrum radiation (λ=405±0.02 nm) and red spectrum (λ=650±0.02 nm) in combination with a 2% oil solution of «Сhlorophyllipt».
Results. The proposed treatment method of LOMOC allows increasing the number of cases of complete recovery (by 2.8 times), reducing the severity of the oral mucosa damage (by 2,4 times), decreasing the contamination with Candida spp. (in 96,5% of cases after 6 months) compared to the standard method (p<0.05), increasing the initially reduced level of IL-2 in the blood serum of patients after treatment by 2,2 times (from 4,6 to 10,2 pg/ml, p<0,01). The developed method for diagnosing leukoplakia of the oral mucosa, taking into account the severity of damage to the oral mucosa, will permit to evaluate the dynamics of treatment and the degree of therapeutic effect: after 1 month of treatment, a statistically significant transition from a moderate form to a mild one was observed in the main group in 97% of cases (n=28) in contrast to the comparison group (52% of cases, p<0.05). The indicator of the level of life quality (OHIP) after treatment of LOMOC by the proposed method in patients of the main group was significantly higher in all parameters (p<0.05) than in the comparison group, and objectively improved from poor to good quality of life (42.98 and 9.66, respectively).
Conclusions. The proposed method of therapy of LOMOC allows obtaining a more stable and pronounced therapeutic effect, and the result of its application is an improvement in the quality of life of patients.
Keywords: oral candidiasis, leukoplakia of the oral mucosa, treatment method, local laser therapy.
The sources of funding. The study was performed within the framework of Belarusian Republican Fund for Fundamental Research (No. GR 20221321 dated 08/01/2022) and a scientific startup grant for young scientists of the educational institution “Vitebsk State Order of Peoples’ Friendship Medical University” “Assessment of the immune status and development of methods for treating candidiasis of the oral mucosa.”
Acknowledgments. The authors declare no conflicts of interest and thank the anonymous reviewers of the article.
References
1. Novikov DK, Pozharitskaya AA, Karpuk IYu. Clinical significance of the level of intercellular adhesion molecules 1 in patients with candidal stomatitis depending on the biofilm-forming ability of fungi of the genus Candida. Immunopatologiya Allergologiya Іnfektologiya. 2020;(4):52-57. (In Russ.). doi: http://dx.doi.org/10.14427/jipai.2020.4.52
2. Pozharitskaya AA, Sakharuk NA, Kashkina TA. Oral candidiasis in patients with coronavirus infection. Stomatologiya Estetika Innovatsii. 2021;5(1):30-37.(In Russ.). doi: http://dx.doi.org/10.34883/PI.2021.5.1.003
3. Pellon A, Sadeghi Nasab SD, Moyes DL. New insights in Candida albicans innate immunity at the mucosa: toxins, epitheli um, metabolism, and beyond. Frontiers in Cellular and Infection Microbiology. 2020 Mar:10:81. doi: http://dx.doi.org/10.3389/fcimb.2020.00081
4. Odds FC. Pathogenesis of fungal disease. In: Kibbler CC, Barton R, Gow N, Howell S, MacCallum DM, Manuel RJ, ed. Oxford Textbook of Medical Mycology. 1-st ed. Great Britain, Glasgow: Bell&Bain Ltd; UK, Oxford: Oxford University Press; 2018. P. 56-61.
5. Karpuk NA, Rubnikovich SP, Ishchenko OV. Candida albicans CD4+CD25+CD45+ T-lymphocyte activation in vitro in patients with leukoplakia associated with candidal stomatitis. Immunopatologiya Allergologiya Infektologiya. 2024;(1):6-12. (In Russ.). doi: http://dx.doi.org/10.14427/jipai.2024.1.6
6. Gupta SR, Gupta N, Sharma A, Xess I, Singh G, Mani K. The association of Candida and antifungal therapy with pro-inflammatory cytokines in oral leukoplakia. Clinical Oral Investigations. 2021 Nov;25(11):6287-6296. doi: http://dx.doi.org/10.1007/s00784-021-03927-3
7. Verma AH, Richardson JP, Zhou C, Coleman BM, Moyes DL, Ho J, et al. Oral epithelial cells orchestrate innate type 17 responses to Candida albicans through the virulence factor Candidalysin. Science Immunology. 2017 Nov;2(17):eaam8834. doi: http://dx.doi.org/10.1126/sciimmunol.aam8834
8. Kaźmierczak-Siedlecka K, Dvořák A, Folwarski M, Daca A, Przewłócka K, Makarewicz W. Fungal gut microbiota dysbiosis and its role in colorectal, oral, and pancreatic carcinogenesis. Cancers (Basel). 2020 May;12(5):1326. doi: http://dx.doi.org/10.3390/cancers12051326
9. Shukla K, Vun I, Lov I, Laparidis G, McCamley C, Ariyawardana A. Role of Candida infection in the malignant transformation of oral leukoplakia: a systematic review of observational studies. Translational Research in Oral Oncology. 2019;4:2057178X19828229. doi: http://dx.doi.org/10.1177/2057178X19828229
10. Quatrin PM, Verdi CM, de Souza ME, de Godoi SN, Klein B, Gundel A, et al. Antimicrobial and antibiofilm activities of nanoemulsions containing Eucalyptus globulus oil against Pseudomonas aeruginosa and Candida spp. Microbial Pathogenesis. 2017 Nov:112:230-242. doi: http://dx.doi.org/10.1016/j.micpath.2017.09.062
11. Huang MC, Shen M, Huang YJ, Lin HC, Chen CT. Photodynamic Inactivation Potentiates the Susceptibility of Antifungal Agents against the Planktonic and Biofilm Cells of Candida albicans. International Journal of Molecular Sciences. 2018 Feb;19(2):434. doi: http://dx.doi.org/10.3390/ijms19020434
12. Dai T, Huang YY, Hamblin MR. Photodynamic therapy for localized infections-state of the art. Photodiagnosis and Photodynamic Therapy. 2009 Sep-Dec;6(3-4):170-188. doi: http://dx.doi.org/10.1016/j.pdpdt.2009.10.008
13. Wiench R, Skaba D, Matys J, Grzech-Leśniak K. Efficacy of Toluidine Blue-Mediated Antimicrobial Photodynamic Therapy on Candida spp. A Systematic Review. Antibiotics (Basel). 2021 Mar;10(4):349. doi: http://dx.doi.org/10.3390/antibiotics10040349
14. Farah N, Chin VK, Chong PP, Lim WF, Lim CW, Basir R, et al. Riboflavin as a promising antimicrobial agent? A multi-perspective review. Current Research in Microbial Sciences. 2022 Feb:3:100111. doi: http://dx.doi.org/10.1016/j.crmicr.2022.100111
15. Sekulic S, John MT, Häggman-Henrikson B, Theis-Mahon N. Dental patients' functional, pain-related, aesthetic, and psychosocial impact of oral conditions on quality of life-Project overview, data collection, quality assessment, and publication bias. Journal of Oral Rehabilitation. 2021 Mar;48(3):246-255. doi: http://dx.doi.org/10.1111/joor.13045
Submitted 20.03.2025
Accepted 13.06.2025
Information about authors:
Anastasiya A. Pozharitskaya – Chief Physician of the University Clinic “University Dental Clinic”, Vitebsk State Order of Peoples’ Friendship Medical University, https://orcid.org/0000-0002-7752-0990, e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра.;
N.A. Karpuk – Candidate of Medical Sciences, associate professor of the Chair of General Dentistry and Prosthodontic Dentistry with the course of the Faculty of Advanced Training and Retraining, Vitebsk State Order of Peoples’ Friendship Medical University, https://orcid.org/0000-0001-9991-7034
