{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:10:16Z","timestamp":1785496216281,"version":"3.56.0"},"reference-count":68,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2019,6,13]],"date-time":"2019-06-13T00:00:00Z","timestamp":1560384000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000072","name":"National Institute of Dental and Craniofacial Research","doi-asserted-by":"publisher","award":["R01DE021578"],"award-info":[{"award-number":["R01DE021578"]}],"id":[{"id":"10.13039\/100000072","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000009","name":"Foundation for the National Institutes of Health","doi-asserted-by":"publisher","award":["RO1DE013986"],"award-info":[{"award-number":["RO1DE013986"]}],"id":[{"id":"10.13039\/100000009","id-type":"DOI","asserted-by":"publisher"}]},{"name":"UConn Health General Clinical Research Center","award":["M01RR006192"],"award-info":[{"award-number":["M01RR006192"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>Oral candidiasis is a common side effect of cancer chemotherapy. To better understand predisposing factors, we followed forty-five subjects who received 5-fluorouracil- or doxorubicin-based treatment, during one chemotherapy cycle. Subjects were evaluated at baseline, prior to the first infusion, and at three additional visits within a two-week window. We assessed the demographic, medical and oral health parameters, neutrophil surveillance, and characterized the salivary bacteriome and mycobiome communities through amplicon high throughput sequencing. Twenty percent of all subjects developed oral candidiasis. Using multivariate statistics, we identified smoking, amount of dental plaque, low bacteriome and mycobiome alpha-diversity, and the proportions of specific bacterial and fungal taxa as baseline predictors of oral candidiasis development during the treatment cycle. All subjects who developed oral candidiasis had baseline microbiome communities dominated by Candida and enriched in aciduric bacteria. Longitudinally, oral candidiasis was associated with a decrease in salivary flow prior to lesion development, and occurred simultaneously or before oral mucositis. Candidiasis was also longitudinally associated with a decrease in peripheral neutrophils but increased the neutrophil killing capacity of Candida albicans. Oral candidiasis was not found to be associated with mycobiome structure shifts during the cycle but was the result of an increase in Candida load, with C. albicans and Candida dubliniensis being the most abundant species comprising the salivary mycobiome of the affected subjects. In conclusion, we identified a set of clinical and microbiome baseline factors associated with susceptibility to oral candidiasis, which might be useful tools in identifying at risk individuals, prior to chemotherapy.<\/jats:p>","DOI":"10.3390\/jof5020049","type":"journal-article","created":{"date-parts":[[2019,6,13]],"date-time":"2019-06-13T11:15:58Z","timestamp":1560424558000},"page":"49","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Integrated Analysis of Clinical and Microbiome Risk Factors Associated with the Development of Oral Candidiasis during Cancer Chemotherapy"],"prefix":"10.3390","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9501-1145","authenticated-orcid":false,"given":"Patricia","family":"Diaz","sequence":"first","affiliation":[{"name":"Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, UConn Health, Farmington, CT 06030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo-Young","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, UConn Health, Farmington, CT 06030, USA"},{"name":"The Jackson Laboratory for Genomic Medicine, Farmington, CT 06032, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Dupuy","sequence":"additional","affiliation":[{"name":"Department of Molecular and Cell Biology, University of Connecticut, Storrs, CT 06269, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6015-5704","authenticated-orcid":false,"given":"Linda","family":"Choquette","sequence":"additional","affiliation":[{"name":"Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, UConn Health, Farmington, CT 06030, USA"},{"name":"The Jackson Laboratory for Genomic Medicine, Farmington, CT 06032, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, UConn Health, Farmington, CT 06030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Salner","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Hartford Healthcare, Hartford, CT 06106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Schauer","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Hartford Healthcare, Hartford, CT 06106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Upendra","family":"Hegde","sequence":"additional","affiliation":[{"name":"Department of Medicine, UConn Health, Farmington, CT 06030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Burleson","sequence":"additional","affiliation":[{"name":"Department of Community Medicine and Health Care, UConn Health, Farmington, CT 06032, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Strausbaugh","sequence":"additional","affiliation":[{"name":"Department of Molecular and Cell Biology, University of Connecticut, Storrs, CT 06269, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Peterson","sequence":"additional","affiliation":[{"name":"Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, UConn Health, Farmington, CT 06030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Dongari-Bagtzoglou","sequence":"additional","affiliation":[{"name":"Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, UConn Health, Farmington, CT 06030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,6,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1038\/nrc1318","article-title":"The pathobiology of mucositis","volume":"4","author":"Sonis","year":"2004","journal-title":"Nat. Rev. Cancer"},{"key":"ref_2","first-page":"263","article-title":"Oral candidiasis: Pathogenesis, clinical presentation, diagnosis and treatment strategies","volume":"41","author":"Lalla","year":"2013","journal-title":"J. Calif. Dent. Assoc."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1007\/s00520-010-0892-z","article-title":"A systematic review of oral fungal infections in patients receiving cancer therapy","volume":"18","author":"Lalla","year":"2010","journal-title":"Support Care Cancer"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1016\/j.oooo.2012.10.012","article-title":"Microbiology and epidemiology of oral yeast colonization in hemopoietic progenitor cell transplant recipients","volume":"115","author":"Westbrook","year":"2013","journal-title":"Oral Surg. Oral Med. Oral Pathol Oral Radiol. Endod."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1080\/13693780410001731574","article-title":"Candida glabrata sepsis secondary to oral colonization in bone marrow transplantation","volume":"42","author":"Redding","year":"2004","journal-title":"Med. Mycol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1080\/13693780601164306","article-title":"Candida krusei sepsis secondary to oral colonization in a hemopoietic stem cell transplant recipient","volume":"45","author":"Westbrook","year":"2007","journal-title":"Med. Mycol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2780","DOI":"10.1002\/1097-0142(19821215)50:12<2780::AID-CNCR2820501215>3.0.CO;2-P","article-title":"Candida infections in patients with acute leukemia: Ineffectiveness of nystatin prophylaxis and relationship between oropharyngeal and systemic candidiasis","volume":"50","author":"DeGregorio","year":"1982","journal-title":"Cancer"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/j.ijantimicag.2014.05.015","article-title":"Breakthrough candidaemia caused by phenotypically susceptible Candida spp. in patients with haematological malignancies does not correlate with established interpretive breakpoints","volume":"44","author":"Gamaletsou","year":"2014","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1080\/14787210.2018.1536546","article-title":"Candidemia in the cancer patient: Diagnosis, treatment, and future directions","volume":"16","author":"McCarthy","year":"2018","journal-title":"Expert Rev. Anti Infect. Ther."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"5002","DOI":"10.1128\/JB.00542-10","article-title":"The human oral microbiome","volume":"192","author":"Dewhirst","year":"2010","journal-title":"J. Bacteriol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Ghannoum, M.A., Jurevic, R.J., Mukherjee, P.K., Cui, F., Sikaroodi, M., Naqvi, A., and Gillevet, P.M. (2010). Characterization of the oral fungal microbiome (mycobiome) in healthy individuals. PLoS Pathog., 6.","DOI":"10.1371\/journal.ppat.1000713"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Dupuy, A.K., David, M.S., Li, L., Heider, T.N., Peterson, J.D., Montano, E.A., Dongari-Bagtzoglou, A., Diaz, P.I., and Strausbaugh, L.D. (2014). Redefining the human oral mycobiome with improved practices in amplicon-based taxonomy: Discovery of Malassezia as a prominent commensal. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0090899"},{"key":"ref_13","unstructured":"Moutsopoulos, N.M., and Konkel, J.E. (2017). Tissue-Specific Immunity at the Oral Mucosal Barrier. Trends Immunol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1111\/cmi.12127","article-title":"Commensal bacteria-dependent select expression of CXCL2 contributes to periodontal tissue homeostasis","volume":"15","author":"Zenobia","year":"2013","journal-title":"Cell Microbiol"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1111\/jre.12000","article-title":"The distribution and expression of S100A8 and S100A9 in gingival epithelium of mice","volume":"48","author":"Nishii","year":"2013","journal-title":"J. Periodontal Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1517\/14656566.2011.541155","article-title":"Prophylactic and therapeutic strategies in chemotherapy-induced neutropenia","volume":"12","author":"Saloustros","year":"2011","journal-title":"Expert Opin Pharmacother"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1007\/s00280-005-0086-4","article-title":"Failure of neutrophil chemotactic function in breast cancer patients treated with chemotherapy","volume":"57","author":"Mendonca","year":"2006","journal-title":"Cancer Chemother Pharmacol"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1111\/j.1365-2141.1993.tb03071.x","article-title":"Effect of cytotoxic drugs on mature neutrophil function in the presence and absence of granulocyte-macrophage colony-stimulating factor","volume":"84","author":"Humphreys","year":"1993","journal-title":"Br. J. Haematol"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1745","DOI":"10.4049\/jimmunol.1302265","article-title":"Role of neutrophils in IL-17-dependent immunity to mucosal candidiasis","volume":"192","author":"Huppler","year":"2014","journal-title":"J. Immunol"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1080\/21505594.2016.1252015","article-title":"Mining the oral mycobiome: Methods, components, and meaning","volume":"8","author":"Diaz","year":"2017","journal-title":"Virulence"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.oraloncology.2007.01.015","article-title":"Adjuvant chemotherapy in breast cancer patients induces temporary salivary gland hypofunction","volume":"44","author":"Jensen","year":"2008","journal-title":"Oral Oncol"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1128\/EC.00095-14","article-title":"How does it kill?: Understanding the candidacidal mechanism of salivary histatin 5","volume":"13","author":"Puri","year":"2014","journal-title":"Eukaryotic Cell"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"905","DOI":"10.3109\/1040841X.2015.1091805","article-title":"Vulvovaginal candidiasis: Epidemiology, microbiology and risk factors","volume":"42","author":"Goncalves","year":"2016","journal-title":"Crit Rev. Microbiol"},{"key":"ref_24","unstructured":"Xu, H., Sobue, T., Thompson, A., Xie, Z., Poon, K., Ricker, A., Cervantes, J., Diaz, P.I., and Dongari-Bagtzoglou, A. (2013). Streptococcal co-infection augments Candida pathogenicity by amplifying the mucosal inflammatory response. Cell Microbiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1128\/IAI.05896-11","article-title":"Synergistic Interaction between Candida albicans and Commensal Oral Streptococci in a Novel In Vitro Mucosal Model","volume":"80","author":"Diaz","year":"2012","journal-title":"Infect. Immun"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Bertolini, M., Ranjan, A., Thompson, A., Diaz, P.I., Sobue, T., Maas, K., and Dongari-Bagtzoglou, A. (2019). Candida albicans induces mucosal bacterial dysbiosis that promotes invasive infection. PLoS Pathog, 15.","DOI":"10.1371\/journal.ppat.1007717"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1186\/s40168-019-0679-5","article-title":"Chemotherapy-induced oral mucositis is associated with detrimental bacterial dysbiosis","volume":"7","author":"Hong","year":"2019","journal-title":"Microbiome"},{"key":"ref_28","first-page":"281","article-title":"Development of the World Health Organization (WHO) community periodontal index of treatment needs (CPITN)","volume":"32","author":"Ainamo","year":"1982","journal-title":"Int Dent. J."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"121","DOI":"10.3109\/00016356408993968","article-title":"Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condition","volume":"22","author":"Silness","year":"1964","journal-title":"Acta Odontol Scand."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1038\/sj.bmt.1705025","article-title":"A noninvasive oral rinse assay to monitor engraftment, neutrophil tissue delivery and susceptibility to infection following HSCT in pediatric patients","volume":"36","author":"Cheretakis","year":"2005","journal-title":"Bone Marrow Transplant."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1936","DOI":"10.1093\/infdis\/jis607","article-title":"Candida albicans biofilms do not trigger reactive oxygen species and evade neutrophil killing","volume":"206","author":"Xie","year":"2012","journal-title":"J. Infect. Dis."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1111\/j.2041-1014.2012.00642.x","article-title":"Using high throughput sequencing to explore the biodiversity in oral bacterial communities","volume":"27","author":"Diaz","year":"2012","journal-title":"Mol. Oral Microbiol."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Sundquist, A., Bigdeli, S., Jalili, R., Druzin, M.L., Waller, S., Pullen, K.M., El-Sayed, Y.Y., Taslimi, M.M., Batzoglou, S., and Ronaghi, M. (2007). Bacterial flora-typing with targeted, chip-based Pyrosequencing. BMC Microbiol., 7.","DOI":"10.1186\/1471-2180-7-108"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1111\/j.1365-294X.1993.tb00005.x","article-title":"ITS primers with enhanced specificity for basidiomycetes - application to the identification of mycorrhizae and rusts","volume":"2","author":"Gardes","year":"1993","journal-title":"Mol. Ecol."},{"key":"ref_35","unstructured":"Innis, M.A., Gelfand, D.H., Sninksy, J.J., and White, T.J. (1990). Amplification and direct sequencing of fungal ribosomal RNA genes for phylogenetics. PCR Protocols: A Guide to Methods and Applications, Academic Press."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"7537","DOI":"10.1128\/AEM.01541-09","article-title":"Introducing mothur: Open-source, platform-independent, community-supported software for describing and comparing microbial communities","volume":"75","author":"Schloss","year":"2009","journal-title":"Appl. Environ. Microbiol."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Schloss, P.D., Gevers, D., and Westcott, S.L. (2011). Reducing the effects of PCR amplification and sequencing artifacts on 16S rRNA-based studies. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0027310"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2194","DOI":"10.1093\/bioinformatics\/btr381","article-title":"UCHIME improves sensitivity and speed of chimera detection","volume":"27","author":"Edgar","year":"2011","journal-title":"Bioinformatics"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"28934","DOI":"10.3402\/jom.v7.28934","article-title":"Robust species taxonomy assignment algorithm for 16S rRNA NGS reads: Application to oral carcinoma samples","volume":"7","author":"Nasher","year":"2015","journal-title":"J. Oral Microbiol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1038\/nature12171","article-title":"Topographic diversity of fungal and bacterial communities in human skin","volume":"498","author":"Findley","year":"2013","journal-title":"Nature"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Matsen, F.A., Kodner, R.B., and Armbrust, E.V. (2010). pplacer: Linear time maximum-likelihood and Bayesian phylogenetic placement of sequences onto a fixed reference tree. BMC Bioinformatics, 11.","DOI":"10.1186\/1471-2105-11-538"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1099\/00221287-148-1-257","article-title":"Determination of bacterial load by real-time PCR using a broad-range (universal) probe and primers set","volume":"148","author":"Nadkarni","year":"2002","journal-title":"Microbiol."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Kraneveld, E.A., Buijs, M.J., Bonder, M.J., Visser, M., Keijser, B.J., Crielaard, W., and Zaura, E. (2012). The relation between oral Candida load and bacterial microbiome profiles in Dutch older adults. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0042770"},{"key":"ref_44","unstructured":"Le Cao, K.A., Boitard, S., and Besse, P. (2011). Sparse PLS discriminant analysis: Biologically relevant feature selection and graphical displays for multiclass problems. BMC Bioinformatics, 12."},{"key":"ref_45","unstructured":"Le Cao, K.A., Costello, M.E., Lakis, V.A., Bartolo, F., Chua, X.Y., Brazeilles, R., and Rondeau, P. (2016). MixMC: A Multivariate Statistical Framework to Gain Insight into Microbial Communities. PLoS ONE, 11."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1111\/prd.12098","article-title":"Influence of saliva on the oral microbiota","volume":"70","author":"Marsh","year":"2016","journal-title":"Periodontol 2000"},{"key":"ref_47","unstructured":"Altmeier, S., Toska, A., Sparber, F., Teijeira, A., Halin, C., and LeibundGut-Landmann, S. (2016). IL-1 Coordinates the Neutrophil Response to C. albicans in the Oral Mucosa. PLoS Pathog., 12."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1111\/j.1365-2141.1977.tb00646.x","article-title":"Development of Neutrophilia by serially increasing doses of dexamethasone","volume":"36","author":"Mishler","year":"1977","journal-title":"Br. J. Haematol"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"780","DOI":"10.4049\/jimmunol.1500909","article-title":"IL-17-Mediated Immunity to the Opportunistic Fungal Pathogen Candida albicans","volume":"195","author":"Conti","year":"2015","journal-title":"J. Immunol."},{"key":"ref_50","first-page":"262471","article-title":"The Changing Epidemiology of Oropharyngeal Candidiasis in Patients with HIV\/AIDS in the Era of Antiretroviral Therapy","volume":"2012","author":"Patel","year":"2012","journal-title":"AIDS Res. Treat."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1177\/00220345950740050301","article-title":"Oral Candida: Clearance, colonization, or candidiasis?","volume":"74","author":"Cannon","year":"1995","journal-title":"J. Dent. Res."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2423","DOI":"10.1128\/JCM.38.6.2423-2426.2000","article-title":"Retrospective identification and characterization of Candida dubliniensis isolates among Candida albicans clinical laboratory isolates from human immunodeficiency virus (HIV)-infected and non-HIV-infected individuals","volume":"38","author":"Falkler","year":"2000","journal-title":"J. Clin. Microbiol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"3595","DOI":"10.1128\/JCM.38.10.3595-3607.2000","article-title":"Elevated phenotypic switching and drug resistance of Candida albicans from human immunodeficiency virus-positive individuals prior to first thrush episode","volume":"38","author":"Vargas","year":"2000","journal-title":"J. Clin. Microbiol."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Wu, G., Zhao, H., Li, C., Rajapakse, M.P., Wong, W.C., Xu, J., Saunders, C.W., Reeder, N.L., Reilman, R.A., and Scheynius, A. (2015). Genus-Wide Comparative Genomics of Malassezia Delineates Its Phylogeny, Physiology, and Niche Adaptation on Human Skin. PLoS Genet., 11.","DOI":"10.1371\/journal.pgen.1005614"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.tripleo.2008.04.003","article-title":"Oral mucosal lesions, microbial changes, and taste disturbances induced by adjuvant chemotherapy in breast cancer patients","volume":"106","author":"Jensen","year":"2008","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1602","DOI":"10.1080\/21505594.2017.1326438","article-title":"Dongari-Bagtzoglou, A.S. oralis activates the Efg1 filamentation pathway in C. albicans to promote cross-kingdom interactions and mucosal biofilms","volume":"17","author":"Xu","year":"2017","journal-title":"Virulence"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Abusleme, L., Diaz, P.I., Freeman, A.F., Greenwell-Wild, T., Brenchley, L., Desai, J.V., Ng, W.I., Holland, S.M., Lionakis, M.S., and Segre, J.A. (2018). Human defects in STAT3 promote oral mucosal fungal and bacterial dysbiosis. JCI Insight, 3.","DOI":"10.1172\/jci.insight.122061"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"4644","DOI":"10.1128\/IAI.00685-10","article-title":"Interaction of Candida albicans cell wall Als3 protein with Streptococcus gordonii SspB adhesin promotes development of mixed-species communities","volume":"78","author":"Silverman","year":"2010","journal-title":"Infect. Immun."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Morales, D.K., and Hogan, D.A. (2010). Candida albicans interactions with bacteria in the context of human health and disease. PLoS Pathog., 6.","DOI":"10.1371\/journal.ppat.1000886"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"4680","DOI":"10.1073\/pnas.1002611107","article-title":"Vaginal microbiome of reproductive-age women","volume":"108","author":"Ravel","year":"2011","journal-title":"PNAS"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/S1079-2104(03)00296-8","article-title":"Oral candidiasis in hematopoietic cell transplantation patients: An outcome-based analysis","volume":"96","author":"Epstein","year":"2003","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"3231","DOI":"10.1007\/s00520-012-1463-2","article-title":"Oral bacteria and yeasts in relationship to oral ulcerations in hematopoietic stem cell transplant recipients","volume":"20","author":"Laheij","year":"2012","journal-title":"Support. Care Cancer"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"aaf1098","DOI":"10.1126\/science.aaf1098","article-title":"Trained immunity: A program of innate immune memory in health and disease","volume":"352","author":"Netea","year":"2016","journal-title":"Science"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1111\/j.1601-0825.2009.01514.x","article-title":"Salivary secretion, mucin concentrations and Candida carriage in HIV-infected patients","volume":"15","author":"Jainkittivong","year":"2009","journal-title":"Oral Dis."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1111\/odi.12626","article-title":"Elucidating the role of hyposalivation and autoimmunity in oral candidiasis","volume":"23","author":"Billings","year":"2017","journal-title":"Oral Dis."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.tripleo.2004.06.081","article-title":"Incidence of oral candidiasis and oral hairy leukoplakia in HIV-infected adults in North Carolina","volume":"99","author":"Chattopadhyay","year":"2005","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"S38","DOI":"10.1513\/AnnalsATS.201306-154MG","article-title":"Cigarette smoke effects on innate immune mechanisms in the nasal mucosa. Potential effects on the microbiome","volume":"11","author":"Jaspers","year":"2014","journal-title":"Ann. Am. Thorac Soc."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1159\/000430112","article-title":"Cigarette Smoke Modulates NOD1 Signal Pathway and Human beta Defensins Expression in Human Oral Mucosa","volume":"36","author":"Qian","year":"2015","journal-title":"Cell Physiol. Biochem."}],"container-title":["Journal of Fungi"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2309-608X\/5\/2\/49\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T12:58:08Z","timestamp":1760187488000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2309-608X\/5\/2\/49"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,13]]},"references-count":68,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2019,6]]}},"alternative-id":["jof5020049"],"URL":"https:\/\/doi.org\/10.3390\/jof5020049","relation":{},"ISSN":["2309-608X"],"issn-type":[{"value":"2309-608X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,6,13]]}}}