The mouth is a first responder for the immune system: New study provides clues for how the body defends against oral invaders
12/05/2017 // Janine Acero // Views

New research has identified how the mouth acts as a trigger for the immune system's defenses to kick in once the fungus Candida albicans – which causes oral thrush –  has invaded the body.

The international team, led by the researchers at the University of Pittsburgh School of Medicine, studied how microbes inside the mouth called commensals, which are usually harmless to healthy individuals, can cause severe and painful oral infections when the immune system is compromised. One of these so-called commensals is the fungus Candida albicans, which causes oral candidiasis, more commonly known as oral thrush.

Candida becomes an infectious microbe when the immune system is weak, which makes infants highly prone to developing oral thrush, as well as people with HIV/AIDS and those on immunosuppressants such as chemotherapy.

The study aims to know how fungal immunity in the mouth operates, as seen in people with healthy immune systems, who still harbor the Candida fungus in their mouths but without its invasive form.

The researchers used mouse models infected orally with Candida and human oral epithelial cells (OECs) cultured in vitro, to study how Candidalysin (a toxin secreted by Candida) is fended off by the OECs and another immune cell called helper T cells, as the fungal toxin attacks the mucous membrane lining in the inside of the mouth.

"To use a Game of Thrones analogy: The oral epithelial cells form a protective 'wall' that keeps the marauding Candida invaders at bay. Patrolling the wall are the helper T cells, which use IL-17 as their weapon to protect the kingdom," said the paper's first author, postdoctoral fellow Akash Verma, Ph.D.


The research is further detailed in

Facts about oral thrush

Oral thrush is a yeast infection on the inside of the mouth and on the tongue, caused by the fungus Candida albicans, which harmlessly thrives in your mouth unnoticed, until it grows uncontrollably and becomes invasive, triggering an immune response. Infection from this fungus is characterized by white lesions or bumps on the inner cheeks and tongue.

Infants and toddlers, whose immune systems have not fully developed, are highly susceptible to oral thrush. It causes difficulty feeding, fussiness, and irritability. However, this infection is treatable and rarely escalates into a more complicated infection.

There are no noticeable signs at the onset of this infection, but over time the fungus continues to grow and the symptoms begin to appear, which include:

  • Creamy white lesions or bumps on the tongue, inner cheeks, gums, tonsils, or sometimes on the roof of the mouth.
  • Slight bleeding when the bumps are scraped.
  • Dry, cracked skin at the corners of the mouth.
  • Difficulty swallowing due to soreness and pain.
  • Loss of taste.

People whose immune systems are significantly weakened, such as HIV/AIDS patients and cancer patients, are also highly prone to the infection. In severe cases, the lesions may spread all the way to the esophagus. This causes pain and difficulty in swallowing.

Oral thrush treatment depends on the age and overall health of the infected individual. gives a list of do-it-yourself remedies, including:

  • Brushing your teeth with a soft toothbrush; be careful not to touch the bumps.
  • Replacing your toothbrush every day until the infection subsides.
  • Refraining from using mouthwashes or breathsprays.
  • Rinsing your mouth with a salt-water mixture.
  • Maintaining appropriate blood sugar levels if you have diabetes.
  • Eating unsweetened yogurt to help restore and maintain healthy levels of good bacteria.

Read more about natural remedies for different infections at

Sources include:

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