Human systemic fungal infections are increasing, and causing high morbidity and mortality. Treatment is challenging because fungi share many metabolic pathways with mammals. Current antifungals are losing effectiveness due to drug resistance. In immunocompromised patients Aspergillus fumigatus causes systemic aspergillosis, the most important airborne fungal disease. Mortality from aspergillosis exceeds 50% even with aggressive treatment. We need novel antifungal drug targets. Fungal cell wall components are promising targets for antifungal therapy as they are essential for fungi and absent from humans. The sugar galactofuranose (Galf) is a 5-memberd ring form of galactose that is found in the cell walls of many fungi, but not in mammals. I used molecular biology and microscopy techniques to characterize Galf biosynthesis enzymes in the model species A. nidulans. I studied three enzymes that catalyze sequential steps in Galf biosynthesis: UgmA, UgtA and UgeA. UDP-galactopyranose mutase (UgmA) creates UDP-galactofuranose (UDP-Galf) from UDP galactopyranose (UDP-Galp) in the cytoplasm. The UDP-Galf transporter (UgtA) moves UDP Galf into membrane bound organelles for incorporation into cell wall compartments. Upstream of UgmA, UDP-glucose/galactose epimerase (UgeA) interconverts UDP-glucose into UDP-Galp, the UgmA substrate. Neither UgmA nor UgtA has a human counterpart; UgeA is in the Leloir galactose metabolism pathway that found in many organisms from bacteria to humans. None of UgeA, UgmA and UgtA is essential for viability of A. nidulans, but deleting any one of them substantially reduces colony growth and sporulation (Figure i). Wild type and Galf defective strains (ugeA∆, ugmA∆ and ugtA∆) were quantified for colony growth, cell morphometry, spore formation and germination, as well as wall architecture. The abundance of these proteins was regulated using the alcA promoter. Galf content was assessed by immunolocalization in the Galf defective strains, showing that those strains lacked immunodetectable Galf. Gene products were localized with fluorescent protein tags; both UgmA and UgeA were cytoplasmic, whereas UgtA was Golgi localized. Wall surfaces were imaged and force-probed using transmission electron microscopy and atomic force microscopy. Overall, Galf deletion strains had aberrant wall maturation, and poorly consolidated surfaces. Our results indicate that Galf is necessary for abundant sporulation, wild type growth and full maturation of Aspergillus cell wall. Galf deletion strains were assessed for sensitivity to antifungal agents in clinical use. They were significantly more sensitive to caspofungin and amphotericin B that target cell wall synthesis and cell membrane chemistry, respectively. Thus, anti-Galf drugs (once created) may be useful in combination with existing antifungal drugs. In summary, Galf biosynthesis pathway appears to be promising as an antifungal drug development target.

Human systemic fungal infections are increasing, and causing high morbidity and mortality. Treatment is challenging because fungi share many metabolic pathways with mammals. Current antifungals are losing effectiveness due to drug resistance. In immunocompromised patients Aspergillus fumigatus causes systemic aspergillosis, the most important airborne fungal disease. Mortality from aspergillosis exceeds 50% even with aggressive treatment. We need novel antifungal drug targets. Fungal cell wall components are promising targets for antifungal therapy as they are essential for fungi and absent from humans. The sugar galactofuranose (Galf) is a 5-memberd ring form of galactose that is found in the cell walls of many fungi, but not in mammals. I used molecular biology and microscopy techniques to characterize Galf biosynthesis enzymes in the model species A. nidulans. I studied three enzymes that catalyze sequential steps in Galf biosynthesis: UgmA, UgtA and UgeA. UDP-galactopyranose mutase (UgmA) creates UDP-galactofuranose (UDP-Galf) from UDP galactopyranose (UDP-Galp) in the cytoplasm. The UDP-Galf transporter (UgtA) moves UDP Galf into membrane bound organelles for incorporation into cell wall compartments. Upstream of UgmA, UDP-glucose/galactose epimerase (UgeA) interconverts UDP-glucose into UDP-Galp, the UgmA substrate. Neither UgmA nor UgtA has a human counterpart; UgeA is in the Leloir galactose metabolism pathway that found in many organisms from bacteria to humans. None of UgeA, UgmA and UgtA is essential for viability of A. nidulans, but deleting any one of them substantially reduces colony growth and sporulation (Figure i). Wild type and Galf defective strains (ugeA∆, ugmA∆ and ugtA∆) were quantified for colony growth, cell morphometry, spore formation and germination, as well as wall architecture. The abundance of these proteins was regulated using the alcA promoter. Galf content was assessed by immunolocalization in the Galf defective strains, showing that those strains lacked immunodetectable Galf. Gene products were localized with fluorescent protein tags; both UgmA and UgeA were cytoplasmic, whereas UgtA was Golgi localized. Wall surfaces were imaged and force-probed using transmission electron microscopy and atomic force microscopy. Overall, Galf deletion strains had aberrant wall maturation, and poorly consolidated surfaces. Our results indicate that Galf is necessary for abundant sporulation, wild type growth and full maturation of Aspergillus cell wall. Galf deletion strains were assessed for sensitivity to antifungal agents in clinical use. They were significantly more sensitive to caspofungin and amphotericin B that target cell wall synthesis and cell membrane chemistry, respectively. Thus, anti-Galf drugs (once created) may be useful in combination with existing antifungal drugs. In summary, Galf biosynthesis pathway appears to be promising as an antifungal drug development target.

Made available in DSpace on 2014-06-11T19:32:09Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-08-26Bitstream added on 2014-06-13T18:43:05Z : No. of bitstreams: 1 silva_hr_dr_arafcf.pdf: 2348065 bytes, checksum: c63f75a77b4cb78f5b87a6170be20a8f (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Universidade Estadual Paulista (UNESP) / Nas últimas décadas, tem ocorrido um aumento expressivo na incidência de infecções fúngicas. Por outro lado, o tratamento das micoses nem sempre é efetivo, pois os fármacos antifúngicos disponíveis apresentam espectro de atividade e perfil farmacocinético inadequados, em especial no tratamento das lesões cutâneas. Portanto, o objetivo do presente trabalho foi desenvolver e caracterizar sistemas nanoestruturados estabilizados com álcool cetílico etoxilado 20 OE e propoxilado 5 OP (PROC) contendo fluconazol (FLU), empregando ácido oléico (AO) e óleo de copaíba como fases oleosas. A caracterização química, seguida de ensaios biológicos, dos óleos de copaíba de diferentes fontes, foi determinante para a escolha do óleo a ser usado no desenvolvimento das formulações. A construção de diagramas de fases com ambos os óleos mostrou que diferentes sistemas como microemulsões (ME) e cristais líquidos (CL) podem ser formados. A caracterização físico-química (MLP, SAXS e Reologia) mostrou que na região de 40% de PROC, o aumento da quantidade de água favorece a formação de sistemas mais estruturados como CL de fase lamelar e hexagonal quando se utiliza AO e óleo de copaíba... / In the last decades, there has been an expressive increase in incidence of fungal infections. On the other hand, the treatment of mycoses is not always effective, because available antifungal drugs show inappropriate activity spectrum and pharmacokinetic profile. The aim of this work was to develop and characterize nanostructured systems stabilized by propoxyl (5OP) ethoxyl (20 OE) cethyl alcohol (PROC) containing fluconazole, using oleic acid and copaiba oil from different origins as oily phases. Chemical and biological characterization of copaiba oils from different origins was decisive for the choice of oil to be used in the development of the formulations. The construction of phase diagrams with studied copaiba oils showed that different systems such as microemulsions (ME) and liquid crystals (CL) can be formed. The characterization by polarized light microscopy, rheological behavior and SAXS confirmed the results obtained in phase diagrams, showing that in the region of 40% of PROC, the increase in the quantity of water favors the formation of more structured systems as CL of lamellar and hexagonal phase... (Complete abstract click electronic access below)

Resumo: Nas últimas décadas, tem ocorrido um aumento expressivo na incidência de infecções fúngicas. Por outro lado, o tratamento das micoses nem sempre é efetivo, pois os fármacos antifúngicos disponíveis apresentam espectro de atividade e perfil farmacocinético inadequados, em especial no tratamento das lesões cutâneas. Portanto, o objetivo do presente trabalho foi desenvolver e caracterizar sistemas nanoestruturados estabilizados com álcool cetílico etoxilado 20 OE e propoxilado 5 OP (PROC) contendo fluconazol (FLU), empregando ácido oléico (AO) e óleo de copaíba como fases oleosas. A caracterização química, seguida de ensaios biológicos, dos óleos de copaíba de diferentes fontes, foi determinante para a escolha do óleo a ser usado no desenvolvimento das formulações. A construção de diagramas de fases com ambos os óleos mostrou que diferentes sistemas como microemulsões (ME) e cristais líquidos (CL) podem ser formados. A caracterização físico-química (MLP, SAXS e Reologia) mostrou que na região de 40% de PROC, o aumento da quantidade de água favorece a formação de sistemas mais estruturados como CL de fase lamelar e hexagonal quando se utiliza AO e óleo de copaíba... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: In the last decades, there has been an expressive increase in incidence of fungal infections. On the other hand, the treatment of mycoses is not always effective, because available antifungal drugs show inappropriate activity spectrum and pharmacokinetic profile. The aim of this work was to develop and characterize nanostructured systems stabilized by propoxyl (5OP) ethoxyl (20 OE) cethyl alcohol (PROC) containing fluconazole, using oleic acid and copaiba oil from different origins as oily phases. Chemical and biological characterization of copaiba oils from different origins was decisive for the choice of oil to be used in the development of the formulations. The construction of phase diagrams with studied copaiba oils showed that different systems such as microemulsions (ME) and liquid crystals (CL) can be formed. The characterization by polarized light microscopy, rheological behavior and SAXS confirmed the results obtained in phase diagrams, showing that in the region of 40% of PROC, the increase in the quantity of water favors the formation of more structured systems as CL of lamellar and hexagonal phase... (Complete abstract click electronic access below) / Orientador: Maria Palmira Daflon Gremião / Coorientador: Georgino Honorato de Oliveira / Banca: Nereide Stela Santos Magalhães / Banca: Marlus Chorilli / Banca: Silvia Stanisçuaski Guterres / Banca: Renata Fonseca Vianna Lopez / Doutor

Ticks are blood feeding ectoparasites that ingest large volumes of vertebrate blood. They are the most important arthropods that are capable of transmitting pathogens which cause disease in humans and domestic animals. Ticks are exposed to various microorganisms during feeding as well as in their habitat. They therefore must have a very good immune system to recognize and destroy these microorganisms. In the present study a micro-broth dilution assay was used to determine whether antifungal activity was present in different tick tissue extracts with or without challenge. The midguts gave the highest inhibition of yeast growth, followed by the salivary glands and then the hemolymph. This was seen with unchallenged tick tissue extracts, as well as tissue extracts collected after yeast challenge (2 hours). Thus all of the tick tissue extracts that was analyzed in this study had antifungal activity. Proteomics was used to determine whether proteins were differentially expressed in the hemolymph plasma, after a fungal challenge. 2DE was used since proteins are not only separated by molecular mass, but also by their charge. The proteins that were separated on the 2D-gels ranged between 17.5-76 kDa and not all proteins present on the 1D-gels (14-97 kDa) could be seen on the 2D-gels. Ticks were challenged for 2 hours to define the proteins that play a role in the short term innate immune response during a fungal infection. Various proteins were differentially expressed in the hemolymph samples that were collected 2 hours after ticks were injected with saline, â-1,3-glucan or yeast (or 72 hours). Injury and fungal challenge play a role in producing proteins that might play a role in the fungal response of the tick. Five spots that were statistically significant in the hemolymph collected 2 hours after ticks were injected with yeast cells were analyzed with MS/MS. No matches were found with MASCOT database searching or with EST searching. This can be due to the limited information that is available on the soft ticks, as only hard tick ESTs heve been published. It was also attempted to identify hemolymph proteins that might play a role in the recognition of fungi. Hemolymph was incubated with live Candida albicans cells and eluted with buffer. Three protein bands (97, 88 and 26 kDa) were found to be present whether ticks were challenged or unchallenged. These proteins were subjected to MS/MS analysis and database searching was performed revealing no matches to other known proteins. The antifungal response was found to be present in the soft tick O. savignyi and might play a vital function in the innate immune response during a fungal infection. These proteins may serve as lead molecules that could be used in the development of novel antifungal drugs, as well as in vaccine development. Copyright / Dissertation (MSc)--University of Pretoria, 2010. / Biochemistry / unrestricted

Candida albicans représente la première cause d’infection fongique chez l’Homme. Chez les patients immunodéficients, ce pathogène est extrêmement virulent et le nombre de décès suite à une infection systémique par Candida atteint 200 000 chaque année dans le monde. Quatre classes de médicaments antifongiques existent mais les traitements ont un coût élevé et des problèmes récurrents de résistance. Il y a donc un besoin urgent de trouver de nouvelles options thérapeutiques.Notre projet explore une nouvelle cible potentielle de la famille des protéines BET (Bromo and extra-terminal) pour traiter les infections fongiques. Nous étudions la protéine BET de levure, bromodomain factor 1 (Bdf1), impliquée dans la régulation de la transcription. Afin de caractériser son rôle fonctionnel, j’ai combiné différentes approches en biochimie, protéomique et transcriptomique. J’ai démontré que Bdf1 et ses deux bromodomaines, Bd1 et Bd2, sont essentiels pour la croissance et la survie de C. albicans.La seconde partie de ma thèse s'inscrit dans un projet de recherche d'inhibiteurs des bromodomaines de Bdf1 chez C. albicans, inspiré par la découverte de composés anti-cancéreux ciblant les bromodomaines mammifères. Grâce à un criblage haut débit, nous avons identifié des inhibiteurs sélectifs des bromodomaines de Bdf1. Ils agissent comme des molécules antifongiques et inhibent la croissance de C. albicans.Ces découvertes indiquent que les bromodomaines de Bdf1 sont une nouvelle cible pour le développement de nouveaux traitements antifongiques. Leurs inhibitions pourraient représenter une stratégie thérapeutique innovante pour traiter les patients infectés par C. albicans. / C. albicans is the most prevalent human fungal pathogen. In immunocompromised patients, this pathogen is highly virulent and the number of deaths because of systemic infections by C. albicans reaches 200.000 per year worldwide. The limited number, high cost and toxicity of currently available antifungal drugs indicate that new therapeutic agents against C. albicans are urgently needed.We propose to investigate a novel target of BET (Bromo and extra-terminal) proteins family to treat fungal infections. We are interested in the yeast BET protein named bromodomain factor 1 (Bdf1), involved in transcription regulation. To characterize its functional role, I combined several approaches in biochemistry, proteomic and transcriptomic. I discovered that Bdf1 and its two bromodomains Bd1 and Bd2 are essentials for the growth of C. albicans.The second part of my thesis is involved in a research project that aims to identify Bdf1 bromodomains inhibitors in C. albicans, inspired by recently discovered anti-cancer compounds that target mammal bromodomains. High-throughput chemical screens have identified selective Bdf1 bromodomain inhibitors. They act as antifungal compounds and inhibit the growth of C. albicans.Altogether, these discoveries indicate that Bdf1 bromodomains are a valid antifungal target. Hopefully, their inhibition represents a new and innovative therapeutic strategy to treat patients infected with C. albicans

Incidences of fungal infections are on the rise in immunosuppressed people. Predominant causative agents for these mycoses are species of the genus Candida, including Candida albicans, Candida glabrata and Candida dublieniensis. Despite a wide range of emerging pathogens, C. albicans remains the leading cause. According to recent epidemiological studies, blood stream infections with C. albicans cause annually ~55% mortality in approximately 300,000 patients from intensive care units worldwide. Furthermore, the percentage of morbidity linked to oral, esophageal and vulvovaginal mycoses cause by C. albicans reach up to 90%. Reasons for these medical concerns are the lack of efficient diagnostics and antifungal therapy. Here, we therefore sought to find novel antifungal strategies inspired by innate immune cells, such as neutrophils. These phagocytes are able to block the fungal pathogenicity. Neutrophils are bloodstream leukocytes serving as the first line of defense against pathogenic microbes. It has been shown that neutrophils have a strong antifungal activity by impairing the conversion of the dimorphic C. albicans from yeast to hyphal form (Y-H). Consequently, we raised the question whether other immune cells, such as mast cells, with less phagocytic cabapilities may have similar activity to neutrophils. Mast cells are tissue-dwelling cells. Mucosal tissue is rich in mast cells and usually constitutes the entry ports for fungal pathogens into the human body. A contribution of mast cells in antifungal defense is, thus, very likely. We human explored mast cell functions upon encounter with fungal pathogens. Interestingly, human mast cells show a transient potential to impair fungal viability. To understand the mechanism behind this impairment we analyzed the human mast cell functions in more detail. We found that human mast cells challenged with C. albicans, immediately degranulate and secrete distinct cytokines and chemokines in an orchestrated manner. The chemokines secreted attract neutrophils. Mast cells moreover are able to internalize fungal cells and to ‘commit suicide’ by releasing extracellular DNA traps that ensnare the pathogen.   The effectiveness of future antifungals is depended on targeting the pathogen virulence with more efficiency. The dimorphism of C. albicans is proven to be essential its virulence. Blockage of this switching ability could render the pathogen avirulent. Consequently, we screened for compounds that mimic the neutrophils anti-dimorphic activity by screening small chemical molecule libraries that block Y-H transition. The screening of big chemical libraries requires a reliable, reproducible and rapid high-throughput screening assay (HTS). We developed an HTS assay based on automated microscopy and image analysis, thereby allowing to distinguish between yeast and filamentous forms. In order to find the ideal Y-H blocker, we also evaluated the cell viability via the count of ATP levels when challenged with the respective small chemical molecules.   Drug development is an elaborate and expensive process. We therefore applied our screening setup to identify antidimorphic/antifungal activity in compounds from two different chemical libraries including FDA-approved drugs. The study disclosed 7 off-patent antifungal drugs that have potent antimycotic activity, including 4 neoplastic agents, 2 antipsychotic drugs and 1 antianemic medication. In a nutshell, we aimed to mimic the anti-dimorphic/antifungal activity of neutrophils with small chemical molecules. Furthermore, we elucidated how immune cells contribute to antifungal defense to exploit these mechanisms for the development of novel antifungal therapies. Thus, this thesis provides novel tools for the discovery of more efficient compounds, identifies previously unknown antifungal aspect of off-patent FDA-approved drugs and highlights the interplay of mast cells with pathogenic fungi with the aim to define new screening strategies.

No description available.

O aumento da resistência aos antifúngicos convencionais e os possíveis efeitos colaterais destes fármacos têm estimulado pesquisas sobre produtos naturais com potencial antimicrobiano e baixa toxicidade. Assim, o objetivo desta pesquisa foi realizar uma avaliação clínica e laboratorial do tratamento da estomatite protética (EP) através de produtos naturais, por meio de cultura micológica quantitativa, de microscopia confocal e de análise das propriedades superficiais de uma resina acrílica. Em todas as avaliações, os grupos experimentais foram divididos de acordo com as seguintes substâncias: G1 - água destilada estéril; G2 - nistatina; G3 - extrato alcoólico de própolis a 20%; G4 - gel de Punica granatum Linné; G5 - gel de Uncaria tomentosa (Imuno-Max Gel). Para a cultura micológica quantitativa, 30 pacientes diagnosticados com EP utilizaram os seus respectivos medicamentos três vezes por dia, durante 14 dias, associados à escovação das próteses com dentifrício. Nas avaliações, foram coletados materiais das áreas eritematosas da mucosa palatina e das áreas correspondentes na prótese total superior. Este procedimento foi realizado antes do tratamento (T0), após 14 dias do início do tratamento (T1) e 30 dias após a suspensão do uso dos medicamentos (T2). Os dados obtidos foram submetidos ao teste não-paramétrico de Friedman para comparações intragrupos e ao teste de Kruskal-Wallis para comparações intergrupos. Para análise através de microscopia confocal, 30 espécimes de uma resina acrílica termopolimerizável foram inoculados com C. albicans para a formação do biofilme e, em seguida, imersos em sua respectiva droga. Os biofilmes remanescentes sobre os espécimes foram corados através de fluorocromos indicadores de viabilidade celular. Os dados obtidos foram analisados através do teste não paramétrico de Kruskal-Wallis e do pós-teste de comparação múltipla de Dunn. Para análise das propriedades superficiais, 50 espécimes de uma resina acrílica termopolimerizável foram fabricados, polidos e testados para a verificação inicial da rugosidade e da microdureza (T0). A seguir, cada espécime foi imerso na sua correspondente substância por 24 horas. Após 14 dias de imersão (T1), as propriedades superficiais dos espécimes foram novamente mensuradas. A variação intragrupos na rugosidade e na microdureza foi avaliada através do teste t pareado. A avaliação intergrupos, quanto ao efeito dos produtos testados na rugosidade e na microdureza, foi realizada através da análise de variância (ANOVA), seguida de teste de Tukey. Para todos os testes deste estudo foi considerado um nível de significância de 5% (p<0,05). De acordo com os resultados, foi possível concluir que o gel de P. granatum Linné exibiu propriedades superiores em relação aos produtos naturais testados. Esta substância apresentou um efeito mais completo, uma vez que, associada à escovação manual, proporcionou a maior redução da contaminação fúngica da mucosa palatina de pacientes com EP em longo prazo, além de promover, in vitro, a perda total da viabilidade celular e maior remoção das células fúngicas em biofilmes. Por fim, este produto não alterou significantemente, in vitro, a rugosidade e a microdureza da resina acrílica testada. / The increased resistance to conventional antifungal drugs and their possible side effects have stimulated research on natural products with antimicrobial activity and low toxicity. This study comprised a clinical and laboratory evaluation of the treatment of denture stomatitis (DS) using natural products by quantitative mycological culture, confocal microscopy and analysis of surface properties of an acrylic resin. In all evaluations, the experimental groups were divided according to the following substances: G1 - sterile distilled water; G2 - nystatin (Micostatin); G3 - 20% propolis alcoholic extract; G4 - P. granatum Linné gel; G5 - Uncaria tomentosa gel (Imuno-Max Gel). For quantitative mycological culture, 30 patients diagnosed with DS used their respective medicines three times a day for 14 days, associated with denture brushing with dentifrice. For the analysis, material was collected from erythematous areas of the palatal mucosa and from corresponding areas on the maxillary denture. This procedure was performed before treatment (T0), at 14 days after treatment onset (T1) and 30 days after interrupting the use of drugs (T2). Data were analyzed by the non-parametric Friedman test for intragroup comparisons and Kruskal-Wallis test for intergroup comparisons. For analysis by confocal microscopy, 30 specimens of a polymerized acrylic resin were inoculated with C. albicans for biofilm development and then immersed in the respective drugs. The remaining biofilms on the specimens were stained using fluorochrome indicators of cell viability. Data were analyzed by non-parametric Kruskal-Wallis test and Dunn\'s multiple comparison post-hoc test. For the analysis of surface properties, 50 specimens of polymerized acrylic resin were fabricated, polished and tested for initial verification of roughness and microhardness (T0). Then, the specimens were individually immersed in the respective drugs for 24 hours. After 14 days of immersion (T1), the surface properties of the specimens were measured again. The intragroup variation in roughness and microhardness was evaluated by the paired t-test. The intergroup evaluation as to the effect of tested products on roughness and microhardness was performed by analysis of variance (ANOVA) followed by Tukey test. All tests in this study considered a significance level of 5% (p<0.05). According to the results, it was concluded that P. granatum Linné gel exhibited superior properties compared to the natural products tested. This substance showed a more thorough effect, since it provided the greatest long-term reduction of fungal contamination of the palatal mucosa of patients with DS when associated with manual brushing, besides promoting total loss of cell viability and increased removal of fungal cells in biofilms in vitro. Finally, in vitro, this drug did not significantly change the roughness and hardness of the acrylic resin tested.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The prevalence of Candida spp. as commensal of the oral cavity can reach 70%. However, oral cavity colonization not always culminates in oral candidiasis, however it can be considered a preliminary condition for the development of it. Oral candidiasis is the most common fungal infection among individuals with HIV, due the result of immune deficiency. Considering the importance of this type of infection in HIV-positive, we proposed to carry out this work with the following objectives: determine the frequency of HIV positive individuals colonized by Candida spp., Candida species isolated; determine the main predisposing factors for oral colonization by Candida spp., to relate the microbial load of colonization with the count of lymphocytes TCD4+, viral load and antiretroviral therapy used at the time of collection; determine the sensitivity of isolates of Candida spp. antifungal fluconazole, itraconazole, voriconazole, amphotericin B and nystatin, by the methodology of disk diffusion and search for the exoenzymes proteinases, phospholipases, hemolysin and DNase in isolates of Candida spp. From May to October 2012 saliva samples from HIV patients attended at Clinical Hospital - Federal University of Uberlândia and HIV negative individuals were collected, which were seeded onto plates containing Sabouraud Dextrose Agar and CHROMagar Candida plates and incubated in a bacteriological incubator at 30ºC for 72 hours. The identification of the isolates was done by classical methodology, using chromogenic agar and assimilation of carbon sources and nitrogen, the differentiation between C. dubliniensis and C. albicans was made by PCR. Candida spp. were isolated from 89 of the 147 patients studied, a total of 111 isolates, C. albicans the most common species among the isolates (67.6%). The average colony count was 8.8x10³ CFU/mL. In the control group 51 of the 150 saliva samples were positive for Candida, obtained 57 isolates, of which 77.2% were C. albicans. The average of CFU/mL was 9.8x10². The predisposing factors for oral colonization were use of antibiotics and oral prosthesis and a low CD4 + cells count and high viral load. The combined use of antiretroviral class of reverse transcriptase inhibitors had a greater protective effect on the colonization than the use of these drugs associated with protease inhibitors. The nystatin antifungal, voriconazole and amphotericin B showed the highest number of samples of Candida spp. sensitive in both groups followed by fluconazole and itraconazole. The phospholipase production was observed in 69.3% and 72.6% of the isolates from the group of patients and HIV negative, respectively. The production of haemolysin by isolates of HIV positive and non-positive patients, respectively, was to 98.2% and 96.5%, DNAse was produced by 27% and 21% of the isolates from patients and non-patients of HIV. Finally, with the exception of DNAse, there was no statistically significant difference between isolates from the two study groups in the characters studied. / A prevalência de Candida spp. como comensal da cavidade oral pode chegar a 70%. Entretanto, a colonização da cavidade oral nem sempre culmina na candidíase bucal, porém pode ser considerada uma condição preliminar para o desenvolvimento da mesma. A candidiase bucal é a infecção fúngica mais comum entre os indivíduos portadores do HIV, resultado do comprometimento imunológico dos mesmos. Considerando a importância desse tipo de infecção em HIV positivos, propusemos a realização do presente trabalho com os seguintes objetivos: determinar a frequência de indivíduos HIV positivos colonizados por Candida spp., bem como as espécies de Candida isoladas; determinar os principais fatores predisponentes para a colonização oral por Candida spp., relacionar a carga microbiana de colonização com a contagem de linfócitos T CD4+, carga viral e terapia antirretroviral utilizada no momento da coleta; determinar a sensibilidade dos isolados de Candida spp. aos antifúngicos fluconazol, itraconazol, voriconazol, anfotericina B e nistatina, pela metodologia de difusão de disco e pesquisar as exoenzimas proteinases, fosfolipases, DNAse e hemolisina nos isolados de Candida spp. No período de maio a outubro de 2012 foram coletadas amostras de saliva de portadores do HIV atendidos no HC-UFU e de indivíduos HIV negativos, as quais foram semeadas em placas contendo Ágar Sabouraud Dextrose e em placas com CHROMágar Candida e incubadas em estufa bacteriológica à 30ºC por 72 horas. A identificação dos isolados foi feita pela metodologia clássica, utilização de ágar cromogênico e assimilação de fontes de carbono e nitrogênio, sendo a diferenciação de C. albicans e C. dubliniensis feita através de PCR. Os testes de sensibilidade e pesquisa de fatores de virulência foram feitos conforme descrito no documento da CLSI (2009) e na literatura. Candida spp. foram isoladas de 89 dos 147 pacientes estudados, totalizando 111 isolados, sendo C. albicans a espécie mais freqüente entre os isolados (67,6%). A contagem média de colônias foi de 8,8x103 UFC/mL. Já no grupo controle 51 das 150 amostras de saliva foram positivas para gênero Candida, obtendo 57 isolados, dos quais 77,2% eram C. albicans. A média de UFC/mL foi de 9,8x10². Os fatores predisponentes para colonização bucal foram uso de antibióticos e prótese oral, bem como uma baixa contagem de CD4+ e alta carga viral. O uso combinado de antirretrovirais da classe dos inibidores de trancriptase reversa apresentou um maior efeito protetor para a colonização do que o uso desses medicamentos associados com inibidores de protease. Os antifúngicos nistatina, voriconazol e anfotericina B apresentaram o maior número de amostras de Candida spp. sensíveis em ambos os grupos, seguidos pelo fluconazol e itraconazol. A produção de fosfolipase foi observada em 69,3% e 72,6% dos isolados provenientes do grupo de pacientes e de HIV negativos, respectivamente. Proteinase foi produzida por 77,5% e 90,7% das espécies de Candida obtidas do grupo de pacientes e de HIV negativos, respectivamente. A produção de hemolisina pelos isolados do grupo de HIV positivos e não portadores, respectivamente, foi igual a 98,2% e 96,5%. DNAse foi produzida por 27% e 21% dos isolados proveniente dos pacientes e dos não HIV. Por fim, com exceção da DNAse, não houve diferença estatisticamente significativa entre os isolados dos dois grupos de estudo em relação às características estudadas. / Mestre em Ciências da Saúde