Original scientific paper

https://doi.org/10.20471/acc.2026.65.03.08

Oral Candida albicans Colonization and Salivary Biomarkers of Stress and Sleep in Preschool Children with Autism Spectrum Disorder: A Cross-Sectional Study

Argjira Veseli ; School of Dental Medicine, University of Zagreb, Zagreb, Croatia; Department of Periodontology and Oral Medicine, Alma Mater Europaea Campus College Rezonanca, Pristina, Republic of Kosovo *
Lul Raka ; Faculty of Medicine, University of Pristina, Pristina, Republic of Kosovo; National Institute of Public Health of Kosovo, Pristina, Republic of Kosovo
Enis Veseli ; Department of Prosthodontics, Dental School, Faculty of Medicine, University of Pristina, Pristina, Republic of Kosovo
Mentor Kurshumliu ; PROLAB – Laboratory Diagnostic Center, Pristina, Republic of Kosovo; Heimerer College, Pristina, Republic of Kosovo
Ivana Čuković-Bagić ; Department of Paediatric and Preventive Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia; University Hospital Centre Zagreb, Clinic for Dental Medicine, Zagreb, Croatia

* Corresponding author.

Abstract

Autism spectrum disorder (ASD) is a neurodevelopmental condition associated
with microbial and neuroendocrine alterations. Our goal was to evaluate the
prevalence of oral Candida albicans and salivary hormone levels in preschool
children diagnosed with ASD, to explore the potential relation between fungal
load and neuroendocrine markers. This cross-sectional study included 90 children
aged 4–6 years (45 with ASD and 45 typically developing peers). In both
groups, we collected oral and saliva samples. Oral samples were collected from
the dorsal surface of the tongue and the buccal mucosa of the cheeks to detect
C. albicans colonies, while saliva samples were collected using Salivette® collection
devices and then analyzed for cortisol and melatonin levels using ELISA.
Candida albicans had significantly higher colony counts in the ASD group. It was
detected in 35.6% of children with ASD compared to 11.1% of controls (P = 0.006).
Children with ASD also exhibited elevated salivary cortisol levels (P < 0.001) and
reduced melatonin concentrations (P = 0.04). However, no significant correlations
were found between Candida load and hormone levels. Age was the only
significant predictor of cortisol in the ASD group, while logistic regression revealed
non-significant trends. Children with ASD demonstrated increased C. albicans
colonization, elevated cortisol, and decreased melatonin levels compared
to controls. Although no direct associations between hormone levels and fungal
presence were established, these findings underscore a potential neuroendocrine-
microbial imbalance in ASD, warranting further investigation with larger
sample sizes and longitudinal study designs.

Keywords

Autism spectrum disorder; Candida albicans; Salivary biomarkers; Cortisol; Melatonin; Oral microbiota

Hrčak ID:

351359

URI

https://hrcak.srce.hr/351359

Publication date:

28.9.2026.

Article data in other languages: croatian

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