In Vitro Exposure to Vaped Tetrahydrocannabinol Increases Candida albicans (SC5314) Growth, Metabolic Activity, Biofilm Formation, and the Expression of Virulence Genes

Vaping tetrahydrocannabinol (THC), a cannabis derivative, using electronic cigarettes (e-cigarettes) could deregulate oral health and lead to oral candidiasis. This study aimed to investigate the effects of vaped THC on Candida albicans growth, metabolic activity, biofilm formation, and the expression of virulence genes. Exposure to e-cigarette aerosol with or without nicotine and with or without 10% or 15% THC increased C. albicans growth and metabolic activity; the effects were more pronounced when THC was present in the e-cigarette aerosol. Biofilm analyses showed that e-cigarette aerosol with THC significantly promoted C. albicans biofilm formation, with the higher THC concentration (15%) having the greater effect. Consistently, e-cigarette aerosol with THC increased the expression of the virulence genes EAP1, SAP2, SAP4, and SAP9. These findings suggested that exposure to vaped THC could contribute to the pathogenesis of oral candidiasis, which may lead to oral health problems.