Elderly nutritional status effection salivary anticandidal capacity against Candida albicans

• Main Authors: Ria Puspitawati, Nurtami Soedarsono, Elisabeth A Putri, Anissha D Putri, Boy M Bachtiar
• Format: Article
• Language: English
• Published: Universitas Airlangga 2011-06-01
• Series: Dental Journal: Majalah Kedokteran Gigi
• Subjects: Candida albicans; elderly; malnutrition; saliva; lansia; malnutrisi
• Online Access: http://e-journal.unair.ac.id/index.php/MKG/article/view/871
• ISSN: 1978-3728; 2442-9740

<p><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Background</strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>: Elderly often suffer malnutrition and oral candidiasis. Candida albicans (C. albicans) which is the most prominent </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>cause of oral candidiasis, is one of commensal oral micro-flora. Nutritional status affect the characteristic of saliva. Saliva is the </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>regulator in the development of C. albicans from comensal into pathogen. </em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Purpose</strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>: The purpose of this study was to determining </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>the correlation between elderly nutritional status with salivary total protein and its activity in inhibiting C. albicans growth and </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>biofilm formation. </em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Methods</strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>: Using mini nutritional assessment 30 elderly were classified into normal and malnutrition groups. </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Total protein of unstimulated saliva was measured using Bradford protein assay. The colony forming unit (CFU) of C. albicans was </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>counted on 72 hours on SDA cultures without (control) or with 2 hour saliva exposure. Biofilm formation was analyzed from the optical </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>density of 10</em><span style="font-family: TribuneItalic; font-size: 7pt; color: #231f20; font-style: normal; font-variant: normal;"><em>–5 </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>C. albicans suspension without saliva exposure (control) or with exposure of 10.000 μg/ml saliva and incubated in </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>37</em><span style="font-family: TribuneRegular; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;">° <span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>C for 2 days. The suspension was put into 96 well plates, stained with crystal-violet dye, and analyzed using microplate reader. </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Differences between groups were analyzed using independent t-test or Kruskall-Wallis. Correlation between variables was analyzed </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>using Spearman test. </em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Results</strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>: Salivary total protein of normal elderly (1.113.5 ± 1.1143.3) was higher than those of malnutrition </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>(613.6 ± 253.6) but not statistically significant (p &gt; 0.05). The CFU of C. albicans exposed to saliva of normal samples (2.060 cfu/ml) </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>was significantly lower than control (24.100 cfu/ml) and those exposed to malnutrition saliva (5.513.3 cfu/ml). C. albicans biofilm </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>formation is highest in controls (0.177), lower in those exposed to malnourished saliva (0.151) and lowest in those exposed to saliva </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>of good nourished elderly (0.133). </em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Conclusion</strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>: Although does not cause significant decrease of salivary total protein, malnutrition </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>in elderly results in lower capacity of saliva in inhibiting the growth and declining the virulence of C. albicans.</em></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 7pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneRegular; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Latar belakang</strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>: Lansia sering menderita malnutrisi dan kandidiasis oral. Candida albicans yang merupakan penyebab utama </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>terjadinya candidiasis, adalah salah satu mikroflora rongga mulut yang bersifat konvensional. Malnutrisi memengaruhi karakteristik </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>saliva. Saliva merupakan regulator utama perkembangan Candida albicans (C. albicans) dari sifat konvensional menjadi bersifat </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>patogen.</em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Tujuan: </strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Tujuan dari penelitian ini adalah untuk menentukan korelasi antara status gizi lansia dengan total protein dan </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>aktivitas saliva dalam menghambat pertumbuhan dan pembentukan biofilm C. albicans. </em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Metode</strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>: Menggunakan mini nutritional </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>assessment, 30 lansia diklasifikasikan menjadi kelompok gizi baik dan gizi buruk. Total protein unstimulated saliva diukur dengan </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>metode Bradford protein assay. Colony forming unit (CFU) dihitung pada kultur C. albicans pada saburaud dextrose agar (SDA) </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>berusia 72 jam yang sebelumnya telah dipaparkan saliva selama 2 jam. Kontrol adalah kultur C. albicans tanpa paparan saliva. </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Pembentukan biofilm adalah pengukuran optical density suspensi 10</em><span style="font-family: TribuneItalic; font-size: 7pt; color: #231f20; font-style: normal; font-variant: normal;"><em>–5 </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>C. albicans tanpa paparan saliva (kontrol) atau dengan </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>paparan saliva 10.000 μg/ml dan diinkubasi pada suhu 37° C selama 2 hari. Suspensi tersebut kemudian dimasukkan ke dalam </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>96 well plates, diberi pewarna crystal violet, dan diukur menggunakan microplate reader. Analisis data menggunakan uji beda t </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Independen atau Kruskall-Wallis, dan uji korelasi Spearman. </em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Hasil</strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>: Total protein saliva lansia gizi baik (1.113,5 ± 1.1143,3) lebih </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>tinggi dari lansia gizi buruk (613,6 ± 253,6) tetapi tidak bermakna secara statistik (p &gt; 0,05). Pembentukan koloni C. albicans </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>yang terpapar saliva lansia gizi baik (2.060 cfu/ml) secara signifikan lebih rendah dari kontrol (24.100 cfu/ml) dan daripada yang </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>terpapar saliva lansia gizi buruk (5.513,3 cfu/ml). Pembentukan biofilm C. albicans tetinggi pada kontrol (0,177), lebih rendah pada</em></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span> <span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>yang terpapar saliva gizi buruk (0,151) dan terrendah pada yang terpapar saliva gizi baik (0,133). </em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Kesimpulan</strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>: Meskipun malnutrisi </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>tidak menyebabkan penurunan total protein saliva lansia, tetapi menurunkan kapasitasnya dalam menghambat pertumbuhan dan </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>mengurangi virulensi C. albicans.</em></span></span></span></span></span><br /></em></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p>