| Summary: | Electronic cigarette (e-cigarette) vapor comes in contact with the different constituents of the oral cavity, including such microorganisms as <i>Candida albicans</i>. We examined the impact of e-cigarettes on <i>C. albicans</i> growth and expression of different virulent genes, such as secreted aspartic proteases (<i>SAPs</i>), and the effect of e-cigarette vapor-exposed <i>C. albicans</i> on gingival epithelial cell morphology, growth, and lactate dehydrogenase (LDH) activity. An increase in <i>C. albicans</i> growth was observed with nicotine-rich e-cigarettes compared with non-exposed cultures. Following exposure to e-cigarette vapor, <i>C. albicans</i> produced high levels of chitin. E-cigarettes also increased <i>C. albicans</i> hyphal length and the expression of <i>SAP2</i>, <i>SAP3</i>, and <i>SAP9</i> genes. When in contact with gingival epithelial cells, e-cigarette-exposed <i>C. albicans</i> adhered better to epithelial cells than the control. Indirect contact between e-cigarette-exposed <i>C. albicans</i> and gingival epithelial cells led to epithelial cell differentiation, reduced cell growth, and increased LDH activity. Overall, results indicate that e-cigarettes may interact with <i>C. albicans</i> to promote their pathogenesis, which may increase the risk of oral candidiasis in e-cigarette users.
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