Department of Wellbeing and Sustainable Development, Centro Universitario del Norte, University of Guadalajara, Colotlán, Mexico.
Biological and Agricultural Sciences Ph.D. Program, Centro Universitario de la Ciénega, University of Guadalajara, Ocotlán, Mexico.
Front Immunol. 2019 Jun 27;10:1465. doi: 10.3389/fimmu.2019.01465. eCollection 2019.
Chronic periodontitis (CP), caused by bacteria and fungi, appears in up to 66% of HIV-patients. The impact and association of HIV-treatment (HAART) and itself has not been properly evaluated in the development and progression of CP. The immunopathogenesis is characterized by CD4 T-cells activation and the balance between the T-helper 1 (Th1) and T-helper 2 (Th2) or a mixed cytokine profile. Currently, the associated causes of an immune response in HIV-patients with CP is controversial. Our aims were the determination of spp. and cytokine profile in oral samples from HIV-positive patients with CP, considering the CD4 T cells levels and HAART use. From 500 HIV-positive patients evaluated, 228 patients were enrolled. Patients were separated in groups: (A) = 53 (≤200 CD4 T-cells on HAART); (B) = 57 (≤200 CD4 T-cells without HAART); (C) = 50 (>200 CD4 T-cells without HAART); (D) = 68 (>200 CD4 T-cells on HAART). spp. were isolated from the oral biofilm and crevicular fluid in CHROMagar and confirmed by endpoint PCR. Cytokine levels were measured by beads-based immunoassay in saliva by flow cytometry. 147 patients (64.5%) were positive to . and 204 strains were isolated; 138 (67.6%) were and the remaining species (>>>. In this study, CHROMagar showed good sensitivity (95%) but poor specificity (68%); since of the 152 samples identified as , only 131 were confirmed by PCR; from the 10 samples identified as , only six were confirmed. Finally, of the 42 samples detected as , only five were confirmed. When evaluating spp. presence, group A and D had higher isolation, while group B had the highest species diversity. Whereas, group C had a significant reduction of spp. Despite the presence of and HAART, we found a Th1/Th2 hybrid profile in the saliva of patients with low CD4 T-cell count (group A). Abundance and diversity of the spp. detected in HIV-patients with CP could be related to HAART and low CD4 T-cells levels. Also, the immunosuppression might promote a local Th1/Th2 hybrid cytokine profile.
慢性牙周炎（CP）由细菌和真菌引起，在多达 66%的 HIV 患者中出现。HIV 治疗（HAART）本身及其对 CP 发展和进展的影响和关联尚未得到适当评估。免疫发病机制的特征是 CD4 T 细胞的激活以及 Th1（Th1）和 Th2（Th2）辅助性 T 细胞之间的平衡或混合细胞因子谱。目前，CP 合并 HIV 患者的免疫反应的相关原因存在争议。我们的目的是确定口腔样本中 spp. 和细胞因子谱，同时考虑 CD4 T 细胞水平和 HAART 的使用。从评估的 500 名 HIV 阳性患者中，有 228 名患者入组。患者分为以下几组：（A）=53 名（HAART 时 CD4 T 细胞≤200）；（B）=57 名（无 HAART 时 CD4 T 细胞≤200）；（C）=50 名（无 HAART 时 CD4 T 细胞＞200）；（D）=68 名（HAART 时 CD4 T 细胞＞200）。从 CHROMagar 中的口腔生物膜和龈沟液中分离出 spp.，并用终点 PCR 进行确认。通过流式细胞术，用基于珠的免疫测定法测量唾液中的细胞因子水平。147 名患者（64.5%）对 呈阳性，共分离出 204 株；138 株（67.6%）为 ，其余种（＞＞＞。在本研究中，CHROMagar 显示出良好的灵敏度（95%）但较差的特异性（68%）；因为在 152 个被鉴定为 的样本中，只有 131 个被 PCR 证实；在 10 个被鉴定为 的样本中，只有 6 个被证实。最后，在检测到的 42 个样本中，只有 5 个被证实。在评估 spp. 存在时，A 组和 D 组的分离率较高，而 B 组的物种多样性最高。然而，C 组的 spp. 显著减少。尽管存在 和 HAART，但我们在低 CD4 T 细胞计数（A 组）的患者唾液中发现了 Th1/Th2 混合表型。在 CP 合并 HIV 患者中检测到的 spp. 的丰度和多样性可能与 HAART 和低 CD4 T 细胞水平有关。此外，免疫抑制可能会促进局部 Th1/Th2 混合细胞因子谱。
