ABSTRACT
Introduction: Oral candidiasis develops as a result of an opportunistic infection. In patients on hemodialysis who may be immune-compromised, candida can change from a commensal to a pathogen. Identification and classification of Candida species are crucial for the treatment of these patients. To distinguish between distinct species of candida found in hemodialysis patients with chronic renal failure's oral cavity. Materials and Methods: A total of 100 people were investigated, including 50 patients with "Chronic Renal Failure (CRF)" on hemodialysis and 50 healthy controls. Using "Sabouraud's Dextrose Agar (SDA)" and "CHROM Agar Culture Media", salivary samples were incubated for 24, 48, or 72 hours at 37°C to develop candida species. Colony forming units/milliliter, a unit of measurement for colonies, were counted and calculated (CFU). Results: On SDA and CHROM agar medium, positive candidal growth was seen in the CRF with HD and Control Groups. There was a significant variance in the growth and the subspecies distribution of the colonies among the groups. The most common species was c.albicans followed by c. cruzi and tropical. Other subspecies were negligible. The number of colonies was also greater than 400 CFU in the majority of the dialysis subjects, while it was only 200 CFU for the majority of the controls. Conclusion: Patients with chronic renal failure receiving hemodialysis showed significantly higher levels of candida isolation and differentiation than healthy individuals (P 0.05).
ABSTRACT
Invasion of the brain by non-small cell lung cancer (NSCLC) results in a shift of the blood-brain barrier (BBB) to the insufficiently characterized blood-tumor barrier (BTB). Effective drug delivery through the BTB is one of the greatest therapeutic obstacles in treating brain metastases. Using an experimental model, we defined key changes within the BTB and the BBB in the brain around the tumor (BAT) region over time. Brain-seeking NSCLC cells were delivered into the circulation of athymic-nude mice via intracardiac injection and developing brain metastases were evaluated over six-weeks. Components of the BBB and BTB were analyzed using immunofluorescence microscopy and compared using a mixed model of regression. Our results demonstrate a dynamic time-dependent BTB phenotype. Capillaries of the BAT and BTB were dilated with increased CD31 expression compared to controls. Expression of collagen IV, a pan-basement membrane component, was significantly decreased in the BTB compared to the BBB. There was also a significant increase in the desmin-positive pericyte subpopulation in the BTB compared to the BBB. The most striking changes were identified in astrocyte water channels with a 12.18-fold (p < 0.001) decrease in aquaporin-4 in the BTB; the BAT was unchanged. Analysis of NSCLC brain metastases from patient samples similarly demonstrated dilated capillaries and loss of both collagen IV and aquaporin-4. These data provide a comprehensive analysis of the BTB in NSCLC brain metastasis. Astrocytic endfeet, pericytes, and the basement membrane are potential therapeutic targets to improve efficacy of chemotherapeutic delivery into NSCLC brain metastases.
