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Teixeira LR, Ramos Peña DE, de Castro LR, dos Santos M, Saraiva MDCP, Chahud F, Pozzetto B, Lourenço AG, Motta ACF. HIV-Infected Individuals Do Not Present Significant Differences regarding Periodontal Status: A Systematic Review and Meta-Analysis. Int J Dent 2024; 2024:5559610. [PMID: 39224190 PMCID: PMC11368558 DOI: 10.1155/2024/5559610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 07/18/2024] [Accepted: 07/25/2024] [Indexed: 09/04/2024] Open
Abstract
Objective To evaluate, through a systematic literature review, whether periodontal status in HIV-infected individuals is different from those non-HIV-infected. Materials and Methods A systematic search for published observational studies within six electronic databases and grey literature was conducted, PROSPERO database number CRD42020160062. Results from studies reporting clinical periodontal parameters: probing pocket depth, bleeding on probing, clinical attachment level, plaque index, and gingival index, in HIV- and non-HIV-infected individuals were reviewed. The quality of the assessment was evaluated according to the Joanna Briggs Institute Appraise Checklist. Results Twenty-three observational studies met the eligibility criteria and were included for analysis. The qualitative analysis indicated similarities in periodontal parameters within both groups, with no significant mean difference (MD) within both groups regarding clinical periodontal parameters; severe heterogeneity was also detected. Conclusions No significant differences were found in the periodontal profile of HIV-infected and non-HIV-infected individuals. However, the high heterogeneity among the studies calls for caution in interpreting these findings. Further investigations using standardized methods for periodontal evaluation are needed to clarify the association between HIV infection and periodontal conditions.
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Affiliation(s)
- Lucas Ribeiro Teixeira
- Department of Pathology and Forensic MedicineRibeirão Preto Medical SchoolUniversity of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | | | - Márcia dos Santos
- Central Library of Ribeirão PretoUniversity of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Fernando Chahud
- Department of Pathology and Forensic MedicineRibeirão Preto Medical SchoolUniversity of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Bruno Pozzetto
- Team Mucosal Immunity and Pathogen AgentsInternational Center for Infectiology Research (CIRI)INSERM U1111University of LyonUniversity of Saint-Etienne, Saint-Etienne, France
| | - Alan Grupioni Lourenço
- Department of Basic and Oral BiologyRibeirão Preto School of DentistryUniversity of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Ana Carolina Fragoso Motta
- Department of StomatologyPublic Health and Forensic DentistryRibeirão Preto School of DentistryUniversity of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Tebcherany H, Rogers T, Khocht A. Alveolar bone loss is a significant contributor to tooth loss in dentate HIV+ patients: A retrospective study. SPECIAL CARE IN DENTISTRY 2024. [PMID: 39167009 DOI: 10.1111/scd.13054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 07/25/2024] [Accepted: 08/06/2024] [Indexed: 08/23/2024]
Abstract
BACKGROUND The study objectives were to determine tooth loss prevalence and to investigate the relationship between tooth loss and potential risk factors among adult dentate HIV+ patients on newer antiretroviral therapy (ART) regimens. METHODS Health records of 450 human immunodeficiency virus (HIV)-infected individuals were surveyed. Eighty-eight records of dentate HIV+ individuals with full-mouth periodontal charting and intra-oral periapical radiographs were identified. We collected data on demographics, systemic risk factors, oral health, and HIV disease measures. Caries exposure and alveolar bone loss (ABL) were radiographically assessed. RESULTS Eighty-eight percent of patients showed tooth loss. Patients with ABL ≥15% had a higher number of missing teeth (p < .01). Stepwise regression analyses indicated that tooth loss was positively associated with age (β = 0.45, p < .01) and ABL (β = 0.39, p < .01). By contrast number of years on ART was negatively associated with tooth loss (β = -0.28, p < .05). CONCLUSIONS Tooth loss remains prevalent among HIV+ patients, and periodontal disease is a significant contributor. The number of years on ART seem to improve oral health behavior and reduce tooth loss.
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Affiliation(s)
- Houda Tebcherany
- Department of General Dentistry, School of Dentistry, Loma Linda University, Loma Linda, California, USA
| | - Tom Rogers
- Center for Dental Research, School of Dentistry, Loma Linda University, Loma Linda, California, USA
| | - Ahmed Khocht
- Department of Periodontics, School of Dentistry, Loma Linda University, Loma Linda, California, USA
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Bashor L, Rawlinson JE, Kozakiewicz CP, Behzadi E, Miller C, Kim J, Conry M, Nehring M, Carver S, Abdo Z, VandeWoude S. Impacts of Antiretroviral Therapy on the Oral Microbiome and Periodontal Health of Feline Immunodeficiency Virus Positive Cats. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.07.10.602918. [PMID: 39026780 PMCID: PMC11257590 DOI: 10.1101/2024.07.10.602918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2024]
Abstract
Feline immunodeficiency virus (FIV) is the domestic cat analogue of HIV infection in humans. Both viruses induce oral disease in untreated individuals, with clinical signs that include gingivitis and periodontal lesions. Oral disease manifestations in HIV patients are abated by highly effective combination antiretroviral therapy (cART), though certain oral manifestations persist despite therapy. Microorganisms associated with oral cavity opportunistic infections in patients with HIV cause similar pathologies in cats. To further develop this model, we evaluated characteristics of feline oral health and oral microbiome during experimental FIV infection over an 8-month period following cART. Using 16S metagenomics sequencing, we evaluated gingival bacterial communities at four timepoints in uninfected and FIV-infected cats treated with cART or placebo. Comprehensive oral examinations were also conducted by a veterinary dental specialist over the experimental period. Gingival inflammation was higher in FIV-infected cats treated with placebo compared to cART-treated cats and controls at study endpoint. Oral microbiome alpha diversity increased in all groups, while beta diversity differed among treatment groups, documenting a significant effect of cART therapy on microbiome community composition. This finding has not previously been reported and indicates cART ameliorates immunodeficiency virus-associated oral disease via preservation of oral mucosal microbiota. Further, this study illustrates the value of the FIV animal model for investigations of mechanistic associations and therapeutic interventions for HIV oral manifestations.
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Affiliation(s)
- Laura Bashor
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO, USA
| | - Jennifer E Rawlinson
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Christopher P Kozakiewicz
- W.K. Kellogg Biological Station, Michigan State University, Hickory Corners, MI, USA
- Department of Integrative Biology, Michigan State University, East Lansing, MI, USA
- Ecology, Evolution, and Behavior Program, Michigan State University, East Lansing, MI, USA
| | - Elisa Behzadi
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO, USA
| | - Craig Miller
- Department of Veterinary Pathobiology, College of Veterinary Medicine, Oklahoma State University, Stillwater, OK, USA
| | - Jeffrey Kim
- Comparative Medicine Research Unit, School of Medicine, University of Louisville, Louisville, KY, USA
| | - Megan Conry
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Mary Nehring
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO, USA
| | - Scott Carver
- Odum School of Ecology, University of Georgia, Athens, GA
- Center for the Ecology of Infectious Diseases, University of Georgia, Athens, GA
- Department of Biological Sciences, University of Tasmania, Tasmania, Australia
| | - Zaid Abdo
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO, USA
| | - Sue VandeWoude
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO, USA
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Pinet V, Lambert C, Goncalves É, Jacomet C, Devoize L. Access to dental care is still complex in 2022 for patients living with HIV despite the need for careful monitoring of pathologies of the oral mucosa. Results of a monocentric cross-sectional study in the Infectious Diseases Department of Clermont-Ferrand University Hospital. Clin Oral Investig 2023; 28:57. [PMID: 38157049 DOI: 10.1007/s00784-023-05456-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/18/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVES Describe the dental care pathway of people living with HIV (PLHIV) and their oral pathologies. MATERIALS AND METHODS A monocentric cross-sectional study involving adult PLHIVs followed (October 2021/April 2022) in our department. Socio-demographic and medical data, course of dental care, and presence of pathologies of the oral mucosa were recorded. RESULTS 112 PLHIV (71% men, 54 ± 14 years) were included. Of the 112, 96% had already consulted a dentist, and 78% had a referring dentist; 73% had disclosed their seropositivity; for 84%, the visit proceeded normally, 7% refused treatment; for 8%, the dentist was not comfortable, and for 4% the dentist's attitude became negative; 21% of the PLHIV had already encountered difficulties in finding a dentist including 37% because of their viral status. Among the oral pathologies listed, 23 lesions were identified: 15 (65%) were unrelated to HIV, 4 (17%) were classified stages B/C (1 Kaposi's sarcoma, 1 oral villous leukoplakia, 2 chronic candidiasis), and 4 (17%) were lesions with evolution specifically due to HIV (2 inhomogeneous leukoplakias, 1 cancer, 1 verrucous papilloma). CONCLUSION Although 78% of the PLHIV included had a referring dentist, discrimination by dentists toward PLHIV still persists (16% of the PLHIV concerned). CLINICAL RELEVANCE 27% of participants did not feel ready to disclose their infection. The resulting lack of follow-up is also a loss of opportunity because while most of the small number of oral lesions diagnosed in this population are related to age or comorbidities, some are serious and need to be identified.
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Affiliation(s)
- Victoire Pinet
- Service d'Odontologie, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Céline Lambert
- Unité de Biostatistiques, DRCI, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Émilie Goncalves
- Service Des Maladies Infectieuses Et Tropicales, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Christine Jacomet
- Service Des Maladies Infectieuses Et Tropicales, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Laurent Devoize
- Service d'Odontologie, CHU de Clermont-Ferrand, Clermont-Ferrand, France.
- Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM, Neuro-Dol, 63000, Clermont-Ferrand, France.
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Savoia P, Azzimonti B, Rolla R, Zavattaro E. Role of the Microbiota in Skin Neoplasms: New Therapeutic Horizons. Microorganisms 2023; 11:2386. [PMID: 37894044 PMCID: PMC10608979 DOI: 10.3390/microorganisms11102386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 10/29/2023] Open
Abstract
The skin and the gut are regularly colonized by a variety of microorganisms capable of interacting with the immune system through their metabolites and influencing the balance between immune tolerance and inflammation. Alterations in the composition and diversity of the skin microbiota have been described in various cutaneous diseases, including skin cancer, and the actual function of the human microbiota in skin carcinogenesis, such as in progression and metastasis, is currently an active area of research. The role of Human Papilloma Virus (HPV) in the pathogenesis of squamous cell carcinoma is well consolidated, especially in chronically immunosuppressed patients. Furthermore, an imbalance between Staphylococcus spp., such as Staphylococcus epidermidis and aureus, has been found to be strongly related to the progression from actinic keratosis to squamous cell carcinoma and differently associated with various stages of the diseases in cutaneous T-cell lymphoma patients. Also, in melanoma patients, differences in microbiota have been related to dissimilar disease course and prognosis and may affect the effectiveness and tolerability of immune checkpoint inhibitors, which currently represent one of the best chances of a cure. From this point of view, acting on microbiota can be considered a possible therapeutic option for patients with advanced skin cancers, even if several issues are still open.
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Affiliation(s)
- Paola Savoia
- Department of Health Science, University of Eastern Piedmont, via Solaroli 17, 28100 Novara, Italy; (B.A.); (R.R.); (E.Z.)
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Ntolou P, Pani P, Panis V, Madianos P, Vassilopoulos S. The effect of antiretroviral therapyon the periodontal conditions of patients with HIV infection: A systematic review and meta-analysis. J Clin Periodontol 2023; 50:170-182. [PMID: 36261851 DOI: 10.1111/jcpe.13735] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 10/08/2022] [Accepted: 10/11/2022] [Indexed: 01/18/2023]
Abstract
AIM To assess any differences (1) in the prevalence of periodontitis and necrotizing periodontal diseases, specifically necrotizing gingivitis (NG) and necrotizing periodontitis (NP) between HIV patients receiving antiretroviral therapy (HAART) and those not receiving the therapy and (2) in the severity of periodontitis based on probing depths (PDs) and clinical attachment loss (CAL) between the two groups. MATERIALS AND METHODS Systematic electronic search on five databases (PubMed, Google Scholar, Scopus, Web of Science and Scielo) was conducted to identify cross-sectional and longitudinal studies reporting on prevalence of NG, NP and periodontitis among HIV patients who either receive or do not receive HAART treatment. The differences in clinical parameters of PDs and CAL among these patients were assessed. RESULTS Eighteen articles were considered. The meta-analysis for NG showed that the overall assessment for the relative frequency ratio in the two groups was 0.45 (n = 7; 95% confidence interval [CI]: [0.21, 0.97]; p < .042). Regarding NP, the overall assessment for the relative frequency ratio in both groups was 0.60 (n = 5; 95% CI [0.22, 1.64]; p = .321). With regard to periodontitis, the overall assessment for the relative frequency ratio in the two groups was 1.17 (n = 9; 95% CI [0.90, 1.52]; p = .248). No significant differences in PD and CAL were found between the two groups 0.00 (n = 3; 95% CI [-0.52, -0.53]; p = .985) and 0.32 (n = 3; 95% CI [-0.19, 0.82]; p = .22), respectively. CONCLUSIONS The prevalence of NG appeared to be significantly reduced in patients receiving antiretroviral therapy. No statistical significant difference was found in the prevalence of NP or periodontitis between the two groups.
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Affiliation(s)
- Panagiota Ntolou
- Department of Periodontology, National and Kapodistrian University of Athens, School of Dentistry, Athens, Greece
| | - Pinelopi Pani
- Department of Periodontology, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, USA
| | - Vassileios Panis
- Department of Periodontology, National and Kapodistrian University of Athens, School of Dentistry, Athens, Greece
| | - Phoebus Madianos
- Department of Periodontology, National and Kapodistrian University of Athens, School of Dentistry, Athens, Greece
| | - Spyridon Vassilopoulos
- Department of Periodontology, National and Kapodistrian University of Athens, School of Dentistry, Athens, Greece
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7
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Pereira LL, Veiga Siqueira Amorim D, Brito Sampaio W, Almeida Cruz Azevêdo T, Bispo Pereira Cardoso V, Barreto Lemos F, Silva Chang A, Machado F, Pereira Lima F, Sampaio Neves F, Leal Figueiredo AC. Factors Associated with Periodontitis in Patients with and without HIV. Int J Dent 2023; 2023:9929835. [PMID: 37159593 PMCID: PMC10163962 DOI: 10.1155/2023/9929835] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 03/27/2023] [Accepted: 04/05/2023] [Indexed: 05/11/2023] Open
Abstract
Purpose The aim of this study was to compare clinical periodontal conditions in HIV-positive people on HAART with an HIV-negative group, in addition to investigating factors associated with periodontitis in the entire sample. Methods This was a cross-sectional study. Data were collected by oral clinical examination for the diagnosis of periodontitis, review of medical records, and application of a questionnaire containing personal data, deleterious habits, and oral hygiene habits for the other variables. The results were analyzed by Pearson's χ 2 test and Student's t-test. A logistic regression model was constructed for the multivariate analysis and periodontitis was defined as a dependent variable. The analysis was performed on the entire sample (HIV+ and HIV-) and also on the group consisting of only people living with HIV. Results Individuals older than 43 years old and with HIV were more likely to develop moderate and severe periodontitis (47.80 and 4.84 times, respectively). When analyzing only HIV+, in addition to age (OR = 2.795; CI = 1.080-7.233), the use of nonnucleoside reverse transcriptase inhibitors (NNRTIs) (OR = 2.841; CI = 1.135-7.112) was also associated with moderate and severe periodontitis. Conclusion It was possible to observe a higher prevalence of periodontitis among individuals with HIV, showing an association between the virus, advanced age, and moderate or severe periodontitis.
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Affiliation(s)
- Luanderson Lopes Pereira
- Postgraduate Program in Dentistry and Health, Federal University of Bahia (UFBA), Salvador, Brazil
| | | | - Willian Brito Sampaio
- Postgraduate Program in Dentistry and Health, Federal University of Bahia (UFBA), Salvador, Brazil
| | | | | | - Felipe Barreto Lemos
- Postgraduate Program in Dentistry and Health, Federal University of Bahia (UFBA), Salvador, Brazil
| | - Andressa Silva Chang
- Postgraduate Program in Dentistry and Health, Federal University of Bahia (UFBA), Salvador, Brazil
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Abstract
Periodontitis, being a multifactorial disorder is found to be the most common oral disease denoted by the inflammation of gingiva and resorption of tooth supporting alveolar bone. The disease being closely linked with fast life style and determined by unhygienic behavioural factors, the internal milieu of oral cavity and formation of plaque biofilm on the dental and gingival surfaces. Porphyromonas gingivalis, being the major keystone pathogen of the periodontal biofilm evokes host immune responses that causes damage of gingival tissues and resorption of bones. The biofilm associated microbial community progressively aggravates the condition resulting in chronic inflammation and finally tooth loss. The disease often maintains bidirectional relationship with different systemic, genetic, autoimmune, immunodeficiency diseases and even psychological disorders. The disease can be diagnosed and predicted by various genetic, radiographic and computer-aided design (CAD) & computer-aided engineering (CAE) and artificial neural network (ANN). The elucidation of genetic background explains the inheritance of the disease. The therapeutic approaches commonly followed include mechanical removal of dental plaque with the use of systemic antibiotics. Awareness generation amongst local people, adoption of good practice of timely tooth brushing preferably with fluoride paste or with nanoconjugate pastes will reduce the chance of periodontal plaque formation. Modern tissue engineering technology like 3D bioprinting of periodontal tissue may help in patient specific flawless regeneration of tooth structures and associated bones.
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Affiliation(s)
- Rina Rani Ray
- Department of Biotechnology, Maulana Abul Kalam Azad University of Technology, West Bengal, Haringhata, Nadia, India.
- Department of Biotechnology and Bioinformatics, Sambalpur University, FVHM+9QP, Jyoti Vihar, Burla, Odisha, 768019, India.
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Lomelí-Martínez SM, González-Hernández LA, Ruiz-Anaya ADJ, Lomelí-Martínez MA, Martínez-Salazar SY, Mercado González AE, Andrade-Villanueva JF, Varela-Hernández JJ. Oral Manifestations Associated with HIV/AIDS Patients. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:1214. [PMID: 36143891 PMCID: PMC9504409 DOI: 10.3390/medicina58091214] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/01/2022] [Accepted: 08/30/2022] [Indexed: 11/17/2022]
Abstract
Oral manifestations are early and important clinical indicators of Human Immunodeficiency Virus (HIV) infection since they can occur in up to 50% of HIV-infected patients and in up to 80% of patients at the AIDS stage (<200 CD4+ T lymphocytes). Oral health is related to physical and mental well-being because the presence of some lesions can compromise dental aesthetics, and alter speech, chewing, and swallowing, thus impacting the quality of life of patients. For this reason, it is necessary to integrate, as part of the medical treatment of HIV-positive patients, the prevention, diagnosis, and control of oral health. It is essential that health professionals have the power to identify, diagnose, and treat oral pathologies through clinical characteristics, etiological agents, and risk factors, both local and systemic. A diagnosis at an early stage of injury allows optimizing and prioritizing oral treatments, especially in acute pathologies, such as gingivitis and necrotizing periodontitis. In this group of patients, the development of strategies for the prevention, control, and reduction of these pathologies must be prioritized in order to reduce morbidity and mortality in this group of patients.
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Affiliation(s)
- Sarah Monserrat Lomelí-Martínez
- Department of Medical and Life Sciences, Centro Universitario de la Ciénega, Universidad de Guadalajara, Ocotlán 47810, Mexico
- Master of Public Health, Department of Wellbeing and Sustainable Development, Centro Universitario del Norte, Universidad de Guadalajara, Colotlán 46200, Mexico
- Periodontics Program, Department of Integrated Dentistry Clinics, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
- Prostodontics Program, Department of Integrated Dentistry Clinics, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Luz Alicia González-Hernández
- HIV and Immunodeficiencies Research Institute, Department of Medical Clinic, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
- HIV Unit Department, Antiguo Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Universidad de Guadalajara, Guadalajara 44280, Mexico
| | - Antonio de Jesús Ruiz-Anaya
- Prostodontics Program, Department of Integrated Dentistry Clinics, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Manuel Arturo Lomelí-Martínez
- Department of Plastic and Reconstructive Surgery, Hospital Regional de la Zona No. 89, Instituto Mexicano del Seguro Social, Guadalajara 44190, Mexico
| | - Silvia Yolanda Martínez-Salazar
- Department of Medical and Life Sciences, Centro Universitario de la Ciénega, Universidad de Guadalajara, Ocotlán 47810, Mexico
| | - Ana Esther Mercado González
- HIV Unit Department, Antiguo Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Universidad de Guadalajara, Guadalajara 44280, Mexico
- Pediatric Dentistry Program, Department of Integrated Dentistry Clinics, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Jaime Federico Andrade-Villanueva
- HIV and Immunodeficiencies Research Institute, Department of Medical Clinic, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
- HIV Unit Department, Antiguo Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Universidad de Guadalajara, Guadalajara 44280, Mexico
| | - Juan José Varela-Hernández
- Department of Medical and Life Sciences, Centro Universitario de la Ciénega, Universidad de Guadalajara, Ocotlán 47810, Mexico
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Wetherill MS, Bakhsh C, Caywood L, Williams MB, Hartwell ML, Wheeler DL, Hubach RD, Teague TK, Köhler G, Hebert JR, Weiser SD. Unpacking determinants and consequences of food insecurity for insulin resistance among people living with HIV: Conceptual framework and protocol for the NOURISH-OK study. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 3. [PMID: 36225538 PMCID: PMC9552993 DOI: 10.3389/fcdhc.2022.947552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background: Over the past four decades, advances in HIV treatment have contributed to a longer life expectancy for people living with HIV (PLWH). With these gains, the prevention and management of chronic co-morbidities, such as diabetes, are now central medical care goals for this population. In the United States, food insecurity disproportionately impacts PLWH and may play a role in the development of insulin resistance through direct and indirect pathways. The Nutrition to Optimize, Understand, and Restore Insulin Sensitivity in HIV for Oklahoma (NOURISH-OK) will use a novel, multi-level, integrated framework to explore how food insecurity contributes to insulin resistance among PLWH. Specifically, it will explore how food insecurity may operate as an intermediary risk factor for insulin resistance, including potential linkages between upstream determinants of health and downstream consequences of poor diet, other behavioral risk factors, and chronic inflammation. Methods/design: This paper summarizes the protocol for the first aim of the NOURISH-OK study, which involves purposeful cross-sectional sampling of PLWH (n=500) across four levels of food insecurity to test our conceptual framework. Developed in collaboration with community stakeholders, this initial phase involves the collection of anthropometrics, fasting blood samples, non-blood biomarkers, 24-hour food recall to estimate the Dietary Inflammatory Index (DII®) score, and survey data. A 1-month, prospective observational sub-study (total n=100; n=25 for each food security group) involves weekly 24-hour food recalls and stool samples to identify temporal associations between food insecurity, diet, and gut microbiome composition. Using structural equation modeling, we will explore how upstream risk factors, including early life events, current discrimination, and community food access, may influence food insecurity and its potential downstream impacts, including diet, other lifestyle risk behaviors, and chronic inflammation, with insulin resistance as the ultimate outcome variable. Findings from these analyses of observational data will inform the subsequent study aims, which involve qualitative exploration of significant pathways, followed by development and testing of a low-DII® food as medicine intervention to reverse insulin resistance among PLWH (ClinicalTrials.gov Identifier: NCT05208671). Discussion: The NOURISH-OK study will address important research gaps to inform the development of food as medicine interventions to support healthy aging for PLWH.
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Affiliation(s)
- Marianna S. Wetherill
- Department of Health Promotion Sciences, Hudson College of Public Health, University of Oklahoma Tulsa Schusterman Center, Tulsa, OK, United States
- Department of Family and Community Medicine, University of Oklahoma School of Community Medicine, Tulsa, OK, United States
- *Correspondence: Marianna S. Wetherill,
| | | | - Lacey Caywood
- Department of Health Promotion Sciences, Hudson College of Public Health, University of Oklahoma Tulsa Schusterman Center, Tulsa, OK, United States
| | - Mary B. Williams
- Department of Family and Community Medicine, University of Oklahoma School of Community Medicine, Tulsa, OK, United States
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Tulsa Schusterman Center, Tulsa, OK, United States
| | - Micah L. Hartwell
- Department of Psychiatry, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Denna L. Wheeler
- Center for Rural Health, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Randolph D. Hubach
- Department of Public Health, Purdue University, West Lafayette, IN, United States
| | - T. Kent Teague
- Department of Surgery, University of Oklahoma School of Community Medicine, Tulsa, OK, United States
- Department of Psychiatry, University of Oklahoma School of Community Medicine, Tulsa, OK, United States
- Department of Biochemistry and Microbiology, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Gerwald Köhler
- Department of Biochemistry and Microbiology, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - James R. Hebert
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, United States
| | - Sheri D. Weiser
- Division of HIV, Infectious Disease and Global Medicine, Department of Medicine, University of California, San Francisco (UCSF), San Francisco, CA, United States
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Dai L, Lu YC, Chen J, Plaisance-Bonstaff K, Mu S, Forrest JC, Whitby D, Post SR, Qin Z. Oral Shedding of an Oncogenic Virus Alters the Oral Microbiome in HIV+ Patients. Front Microbiol 2022; 13:882520. [PMID: 35516440 PMCID: PMC9063630 DOI: 10.3389/fmicb.2022.882520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 03/31/2022] [Indexed: 11/16/2022] Open
Abstract
Kaposi's Sarcoma (KS) caused by Kaposi's sarcoma-associated herpesvirus (KSHV) continues to be the most common AIDS-associated tumor. Involvement of the oral cavity represents one of the most common clinical manifestations of this tumor. Numerous types of cancer are associated with the alterations of in components of the microbiome. However, little is known about how KSHV coinfection affects the oral microbiome in HIV+ patients, especially in a "pre-cancer" niche. Using 16S rRNA pyrosequencing, we found that oral shedding of KSHV correlated with altered oral microbiome signatures in HIV+ patients, including a reduction in the microbiota diversity, changing the relative composition of specific phyla and species, and regulating microbial functions. Furthermore, we found that Streptococcus sp., one of the most increased species in the oral cavity of HIV+/KSHV+ patients, induced KSHV lytic reactivation in primary oral cells. Together, these data indicate that oral shedding of KSHV may manipulate the oral microbiome to promote viral pathogenesis and tumorigenesis especially in immunocompromised patients.
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Affiliation(s)
- Lu Dai
- Department of Pathology, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Yong-Chen Lu
- Department of Pathology, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Jungang Chen
- Department of Pathology, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Karlie Plaisance-Bonstaff
- Department of Medicine, Louisiana State University Health Sciences Center, Louisiana Cancer Research Center, New Orleans, LA, United States
| | - Shengyu Mu
- Department of Pharmacology and Toxicology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - J. Craig Forrest
- Department of Microbiology and Immunology, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick, MD, United States
| | - Steven R. Post
- Department of Pathology, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Zhiqiang Qin
- Department of Pathology, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, United States
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12
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Peña DER, Santos EDS, Bezerra RDS, Nobre ÁVV, Pólvora TLS, da Fonseca BAL, Pozzetto B, Lourenço AG, do Nascimento C, Motta ACF. Nonsurgical periodontal debridement affects subgingival bacterial diversity in human immunodeficiency virus (HIV)-1 infected patients with periodontitis. J Periodontol 2022; 93:1455-1467. [PMID: 34986272 DOI: 10.1002/jper.21-0466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 10/18/2021] [Accepted: 11/03/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND Following HIV-1 infection and antiretroviral therapy, the development of periodontal disease was shown to be favored. However, the influence of HIV-1 infection on the periodontal microbiota after nonsurgical periodontal debridement (NSPD) needs a broad comprehension. This work aimed to compare the subgingival microbiological content of HIV-infected and control patients with periodontitis undergoing NSPD. METHODS The bacterial profile of subgingival biofilm samples of HIV-1-infected (n = 18) and control (n = 14) patients with periodontitis was assessed using 16S rRNA gene sequencing. The samples were collected at baseline, 30 and 90 days after NSPD. The taxonomic analysis of gingival microbiota was performed using a ribosomal RNA database. The microbiota content was evaluated in the light of CD4 cell count and viral load. RESULTS Both HIV and control groups showed similar stages and grades of periodontitis. At baseline, the HIV group showed higher alpha diversity for both healthy (HS) and periodontal sites (PS). Streptococcus, Fusobacterium, Veillonella and Prevotella were the predominant bacterial genera. A low abundance of periodontopathogenic bacteria was observed, and the NSPD induced shifts in the subgingival biofilm of HIV-infected patients, leading to a microbiota similar to that of control patients. CONCLUSION Different subgingival microbiota profiles were identified - a less diverse microbiota was found in HIV-1-infected patients, in contrast to a more diverse microbiota in control patients. NSPD caused changes in the microbiota of both groups, with a greater impact on the HIV group, leading to a decrease in alpha diversity, and produced a positive impact on the serological immune markers in HIV-1-infected patients. Control of periodontitis should be included as part of an oral primary care, providing the oral health benefits and better control of HIV-1 infection. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Diana Estefania Ramos Peña
- Department of Oral & Maxillofacial Surgery, and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Emerson de Souza Santos
- Department of Clinical Analyses, Toxicology and Food Science of the School of Pharmaceutical Sciences of Ribeirão Preto
| | - Rafael Dos Santos Bezerra
- Blood Center of Ribeirao Preto, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
| | - Átila V V Nobre
- Department of Oral & Maxillofacial Surgery, and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Tábata L S Pólvora
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Benedito A L da Fonseca
- Department of Medical Clinic of Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Bruno Pozzetto
- Team Mucosal Immunity and Pathogen Agents, University of Lyon, University of Saint-Etienne, Saint-Etienne, France
| | - Alan G Lourenço
- Department of Basic and Oral Biology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Cássio do Nascimento
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Ana Carolina F Motta
- Department of Stomatology, Public Health and Forensic Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
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13
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Kiran S, Karnam Y, Niharika B. Epidemiological evaluation of maternal periodontal status in human immunodeficiency virus seropositive pregnant women in India. JOURNAL OF INDIAN ASSOCIATION OF PUBLIC HEALTH DENTISTRY 2022. [DOI: 10.4103/jiaphd.jiaphd_97_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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14
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Coker MO, Cairo C, Garzino-Demo A. HIV-Associated Interactions Between Oral Microbiota and Mucosal Immune Cells: Knowledge Gaps and Future Directions. Front Immunol 2021; 12:676669. [PMID: 34616391 PMCID: PMC8488204 DOI: 10.3389/fimmu.2021.676669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 08/06/2021] [Indexed: 02/02/2023] Open
Abstract
Even with sustained use of antiretroviral therapy (ART), HIV-infected individuals have an increased risk of systemic comorbid conditions and oral pathologies, including opportunistic infections, oral mucosal inflammation, and gingival and periodontal diseases. The immune-mediated mechanisms that drive this increased risk, in the context of sustained viral suppression, are unclear. HIV infection, even when controlled, alters microbial communities contributing to a chronic low-grade inflammatory state that underlies these non-HIV co-morbidities. The higher prevalence of dental caries, and mucosal and periodontal inflammation reported in HIV-infected individuals on ART is often associated with differentially abundant oral microbial communities, possibly leading to a heightened susceptibility to inflammation. This mini-review highlights current gaps in knowledge regarding the microbe-mediated oral mucosal immunity with HIV infection while discussing opportunities for future research investigations and implementation of novel approaches to elucidate these gaps. Interventions targeting both inflammation and microbial diversity are needed to mitigate oral inflammation-related comorbidities, particularly in HIV-infected individuals. More broadly, additional research is needed to bolster general models of microbiome-mediated chronic immune activation and aid the development of precise microbiota-targeted interventions to reverse or mitigate adverse outcomes.
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Affiliation(s)
- Modupe O Coker
- Department of Oral Biology, School of Dental Medicine at Rutgers, Newark, NJ, United States.,Department of Epidemiology, School of Public Health at Rutgers, Newark, NJ, United States
| | - Cristiana Cairo
- Institute of Human Virology, School of Medicine, University of Maryland, Baltimore, MD, United States.,Department of Medicine, School of Medicine, University of Maryland, Baltimore, MD, United States
| | - Alfredo Garzino-Demo
- Institute of Human Virology, School of Medicine, University of Maryland, Baltimore, MD, United States.,Department of Microbiology and Immunology, School of Medicine, University of Maryland, Baltimore, MD, United States.,Department of Molecular Medicine, University of Padova, Padova, Italy
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15
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Stage II and stage III periodontitis clinical burdens of HIV-1 undergoing antiretroviral therapy. Clin Oral Investig 2021; 26:2187-2195. [PMID: 34601633 PMCID: PMC8487450 DOI: 10.1007/s00784-021-04201-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 09/22/2021] [Indexed: 12/01/2022]
Abstract
Objectives The aim of this retrospective cross-sectional study was to estimate the association of HIV-1 infection under highly active antiretroviral treatment (HAART) on the clinical parameters of periodontitis. Materials and methods A total of 205 patients were divided in two groups: 74 HIV + and 131 HIV − . Periodontal probing depth (PPD), clinical attachment loss (CAL), bleeding on probing (BOP), and visible supragingival biofilm (VSB) were recorded. The association of HIV-1 infection with the presence of at least 3 sites with PPD ≥ 5 mm and/or CAL ≥ 4 mm in non-adjacent teeth was estimated using binary logistic regression models. Results The variables HIV-1 infection (OR = 5.53, p < 0.0001, 95% CI: 2.45–13.64), age [range 35–50 years old (OR = 5.73, p < 0.0001, 95% CI: 2.49–13.20); > 50 years old (OR = 6.29, p = 0.002, 95% CI: 1.94–20.42)], and VSB (OR = 23.68, p < 0.0001, 95% CI: 8.07–69.53) showed a significant direct association with BOP outcome. Conclusions HIV-1 infection under HAART did not have association with the presence of at least 3 sites with PPD ≥ 5 mm and/or CAL ≥ 4 mm. However, HIV patients on HAART had direct association of HIV-1 infection with BOP and an inverse association with PPD. Clinical relevance These results support that monitoring gingival bleeding associated with oral prophylaxis would be beneficial in the prevention and management of periodontitis in HIV-1 patients on HAART.
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16
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Bhaskaran N, Schneider E, Faddoul F, Paes da Silva A, Asaad R, Talla A, Greenspan N, Levine AD, McDonald D, Karn J, Lederman MM, Pandiyan P. Oral immune dysfunction is associated with the expansion of FOXP3 +PD-1 +Amphiregulin + T cells during HIV infection. Nat Commun 2021; 12:5143. [PMID: 34446704 PMCID: PMC8390677 DOI: 10.1038/s41467-021-25340-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 08/03/2021] [Indexed: 02/07/2023] Open
Abstract
Residual systemic inflammation and mucosal immune dysfunction persist in people living with HIV, despite treatment with combined anti-retroviral therapy, but the underlying immune mechanisms are poorly understood. Here we report that the altered immune landscape of the oral mucosa of HIV-positive patients on therapy involves increased TLR and inflammasome signaling, localized CD4+ T cell hyperactivation, and, counterintuitively, enrichment of FOXP3+ T cells. HIV infection of oral tonsil cultures in vitro causes an increase in FOXP3+ T cells expressing PD-1, IFN-γ, Amphiregulin and IL-10. These cells persist even in the presence of anti-retroviral drugs, and further expand when stimulated by TLR2 ligands and IL-1β. Mechanistically, IL-1β upregulates PD-1 expression via AKT signaling, and PD-1 stabilizes FOXP3 and Amphiregulin through a mechanism involving asparaginyl endopeptidase, resulting in FOXP3+ cells that are incapable of suppressing CD4+ T cells in vitro. The FOXP3+ T cells that are abundant in HIV-positive patients are phenotypically similar to the in vitro cultured, HIV-responsive FOXP3+ T cells, and their presence strongly correlates with CD4+ T cell hyper-activation. This suggests that FOXP3+ T cell dysregulation might play a role in the mucosal immune dysfunction of HIV patients on therapy.
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Affiliation(s)
- N Bhaskaran
- Department of Biological Sciences, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - E Schneider
- Department of Biological Sciences, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - F Faddoul
- Advanced Education in General Dentistry, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - A Paes da Silva
- Department of Periodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - R Asaad
- University Hospitals Cleveland Medical Center AIDS Clinical Trials Unit, Division of Infectious Diseases & HIV Medicine, Cleveland, OH, USA
| | - A Talla
- Department of Pathology, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - N Greenspan
- Department of Pathology, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - A D Levine
- Department of Microbiology and Molecular Biology, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - D McDonald
- Division of AIDS, NIAID, NIH, Bethesda, MD, USA
| | - J Karn
- Department of Microbiology and Molecular Biology, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
- Center for AIDS Research, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - M M Lederman
- University Hospitals Cleveland Medical Center AIDS Clinical Trials Unit, Division of Infectious Diseases & HIV Medicine, Cleveland, OH, USA
- Department of Pathology, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - P Pandiyan
- Department of Biological Sciences, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA.
- Department of Pathology, School of Medicine, Case Western Reserve University, Cleveland, OH, USA.
- Center for AIDS Research, School of Medicine, Case Western Reserve University, Cleveland, OH, USA.
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17
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Oro-facial opportunistic infections and related pathologies in HIV patients: A comprehensive review. Dis Mon 2021; 67:101170. [PMID: 33618831 DOI: 10.1016/j.disamonth.2021.101170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Among all the viral infections, acquired immunodeficiency syndrome (AIDS) is considered as one of the most morbid infections caused by the human immunodeficiency virus (HIV). The prime reason for the pathogenesis is the profound immunosuppression that leads to lethal opportunistic infections (OI), neurological disorders, unexpected malignancies and pathologies of the orofacial region. Patients with OI whose HIV status is unknown have shown a mortality rate higher than those with known HIV status. Among HIV-associated infections, orofacial lesions contribute a major proportion of the OI attributed to the plethora of micro-organisms present in the oral cavity. Apart from serious clinical manifestations, opportunistic infections also lead to significant impairment of quality of life. These lesions not only indicate the HIV infection but also among the clinical manifestations, which often occur early in the course of disease. World Health Organization has also provided policies for treatment/prevention of oral lesions, strengthening the promotion and care of oral health in HIV/AIDS patients. The present review provides comprehensive information about orofacial OI in HIV/AIDS patients and emphasis was also given to the malignancies associated with EB and HTLV virus.
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18
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Dai L, Barrett L, Plaisance-Bonstaff K, Post SR, Qin Z. Porphyromonas gingivalis coinfects with KSHV in oral cavities of HIV+ patients and induces viral lytic reactivation. J Med Virol 2020; 92:3862-3867. [PMID: 32436999 PMCID: PMC7679274 DOI: 10.1002/jmv.26028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 05/14/2020] [Accepted: 05/15/2020] [Indexed: 11/06/2022]
Abstract
Kaposi's sarcoma-associated herpesvirus (KSHV) infection causes several human cancers, including Kaposi's sarcoma (KS), one of the most common AIDS-associated tumors. The involvement of the oral cavity represents one common clinical manifestation of AIDS-KS individuals with periodontal diseases and an oral carriage of a variety of pathogenic bacteria, including Porphyromonas gingivalis. In the current study, we report the clinical relevance of P. gingivalis and KSHV coinfection in the oral cavity of a cohort of HIV+ patients. Furthermore, we found that P. gingivalis conditioned medium or derived lipopolysaccharide effectively induced KSHV lytic reactivation from infected oral cells. This reactivation requires TLR4 as well as the activities of p38 and Jun N-terminal kinase- mitogen-activated protein kinase signaling pathways. Our findings reveal the mechanisms through which coinfected periodontal pathogens potentially promote oncogenic virus pathogenesis in the unique niche of immunocompromised patients.
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Affiliation(s)
- Lu Dai
- Department of Pathology, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR 72205, USA
| | - Lindsey Barrett
- Department of Pathology, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR 72205, USA
| | - Karlie Plaisance-Bonstaff
- Departments of Medicine, Louisiana State University Health Sciences Center, Louisiana Cancer Research Center, 1700 Tulane Ave., New Orleans, LA 70112, USA
| | - Steven R. Post
- Department of Pathology, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR 72205, USA
| | - Zhiqiang Qin
- Department of Pathology, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR 72205, USA
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19
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Abstract
Abstract
We present a case of a necrotising disease of the orofacial tissues, the so-called noma, in a female patient with AIDS in a stage of severe immune deficiency. To our knowledge, this is the first time a case like that has been reported in Bulgaria. The patient received an antibiotic course of treatment with a triple combination to good effect on the inflammatory process, and began also HAART. Within 3 weeks, the patient’s general condition improved. However, despite the treatment, a demarcation line was formed, and a defect on the lower lip occurred. Noma is a manifestation of severe immune deficiency with lasting adverse consequences for the patient: severe deformation of the maxilo-facial region and functional impairment (i.e. difficulties eating and speaking, and salivary leak).
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20
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Abbamonte JM, Sawhney M, Alcaide ML, Weiss SM, Kumar M, Asfar T, Jones DL. The association of HIV and cocaine use to cigarette smoking in the context of depression and perceived stress. AIDS Care 2020; 32:1229-1237. [PMID: 32539456 PMCID: PMC7529880 DOI: 10.1080/09540121.2020.1778627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 06/02/2020] [Indexed: 10/24/2022]
Abstract
Mental well-being can contribute to cigarette smoking and negatively impact disease progression among people living with HIV (PLWH). This study examined potential associations between cocaine use (COC), depression, and HIV status in predicting cigarette smoking; hypothesizing that depression would be highest in cocaine users and predict cigarette smoking. An exploratory analysis including stress was also examined as a potential predictor of cigarette use. More than half of the sample (65%) endorsed smoking at some point in the past, and 52% endorsed being current smokers at the time of the study. Smokers were most likely to be cocaine users (87.1%), cocaine using PLWH (74.3%), or PLWH (36.6%). Neither HIV status (χ2(1) = 1.5, p = .221), perceived stress (χ2(1) = 0.75 p = .386), nor depressive symptomatology (χ2(1) = 1.2, p = .274) were related to smoking. Non-cocaine users were approximately 95.4% less likely to smoke than cocaine users, controlling for all other variables. Overall, cocaine use was the greatest predictor of cigarette smoking and quantity of cigarettes smoked. Perceived stress and depression were not associated with cigarette smoking in the sample. Future interventions targeting cigarette use should include a cocaine-related component to encourage smoking cessation among this high-risk group.
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Affiliation(s)
- J M Abbamonte
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - M Sawhney
- Liffrig Family School of Education & Behavioral Sciences, University of Mary, Bismarck, ND, USA
| | - M L Alcaide
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - S M Weiss
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - M Kumar
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - T Asfar
- Department of Public Health, University of Miami Miller School of Medicine, Miami, FL, USA
| | - D L Jones
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
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21
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Ryder MI, Shiboski C, Yao TJ, Moscicki AB. Current trends and new developments in HIV research and periodontal diseases. Periodontol 2000 2020; 82:65-77. [PMID: 31850628 DOI: 10.1111/prd.12321] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
With the advent of combined antiretroviral therapies, the face of HIV infection has changed dramatically from a disease with almost certain mortality from serious comorbidities, to a manageable chronic condition with an extended lifespan. In this paper we present the more recent investigations into the epidemiology, microbiology, and pathogenesis of periodontal diseases in patients with HIV, and the effects of combined antiretroviral therapies on the incidence and progression of these diseases both in adults and perinatally infected children. In addition, comparisons and potential interactions between the HIV-associated microbiome, host responses, and pathogenesis in the oral cavity with the gastrointestinal tract and other areas of the body are presented. Also, the effects of HIV and combined antiretroviral therapies on comorbidities such as hyposalivation, dementia, and osteoporosis on periodontal disease progression are discussed.
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Affiliation(s)
- Mark I Ryder
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, California, USA
| | - Caroline Shiboski
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, California, USA
| | - Tzy-Jyun Yao
- Center for Biostatistics in AIDS Research (CBAR), Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Anna-Barbara Moscicki
- Division of Adolescent Medicine, Department of Pediatrics, University of California, Los Angeles, California, USA
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22
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Dai L, Qiao J, Yin J, Goldstein A, Lin HY, Post SR, Qin Z. Kaposi Sarcoma-Associated Herpesvirus and Staphylococcus aureus Coinfection in Oral Cavities of HIV-Positive Patients: A Unique Niche for Oncogenic Virus Lytic Reactivation. J Infect Dis 2020; 221:1331-1341. [PMID: 31111897 PMCID: PMC7325796 DOI: 10.1093/infdis/jiz249] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 05/09/2019] [Indexed: 01/22/2023] Open
Abstract
Collectively, viruses are the principal cause of cancers arising in patients with immune dysfunction, including human immunodeficiency virus (HIV)-positive patients. Kaposi sarcoma (KS) etiologically linked to Kaposi sarcoma-associated herpesvirus (KSHV) continues to be the most common AIDS-associated tumor. The involvement of the oral cavity represents one of the most common clinical manifestations of this tumor. HIV infection incurs an increased risk among individuals with periodontal diseases and oral carriage of a variety of pathogenic bacteria. However, whether interactions involving periodontal bacteria and oncogenic viruses in the local environment facilitate replication or maintenance of these viruses in the oral cavity of HIV-positive patients remain largely unknown. We previously showed that pathogen-associated molecular patterns (PAMPs) from specific periodontal bacteria promoted KSHV entry into oral cells and subsequent establishment of latency. In the current study, we demonstrate that Staphylococcus aureus, one of common pathogens causing infection in HIV-positive patients, and its PAMPs can effectively induce KSHV lytic reactivation from infected oral cells, through the Toll-like receptor reactive oxygen species and cyclin D1-Dicer-viral microRNA axis. This investigation provides further clinical evidence about the relevance of coinfection due to these 2 pathogens in the oral cavities of a cohort HIV-positive patients and reveals novel mechanisms through which these coinfecting pathogens potentially promote virus-associated cancer development in the unique niche of immunocompromised patients.
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Affiliation(s)
- Lu Dai
- Department of Pathology, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock
| | - Jing Qiao
- Department of Pediatrics, Research Center for Translational Medicine and Key Laboratory of Arrhythmias, East Hospital, Tongji University School of Medicine, Shanghai China
| | - Jun Yin
- Department of Pediatrics, Research Center for Translational Medicine and Key Laboratory of Arrhythmias, East Hospital, Tongji University School of Medicine, Shanghai China
| | - Alana Goldstein
- Departments of Diagnostic Sciences, School of Dentistry, New Orleans
| | - Hui-Yi Lin
- Biostatistics Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans
| | - Steven R Post
- Department of Pathology, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock
| | - Zhiqiang Qin
- Department of Pathology, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock
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23
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Gruffaz M, Zhang T, Marshall V, Gonçalves P, Ramaswami R, Labo N, Whitby D, Uldrick TS, Yarchoan R, Huang Y, Gao SJ. Signatures of oral microbiome in HIV-infected individuals with oral Kaposi's sarcoma and cell-associated KSHV DNA. PLoS Pathog 2020; 16:e1008114. [PMID: 31951641 PMCID: PMC6992226 DOI: 10.1371/journal.ppat.1008114] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 01/30/2020] [Accepted: 09/27/2019] [Indexed: 01/01/2023] Open
Abstract
Infection by Kaposi's sarcoma-associated herpesvirus (KSHV) is necessary for the development of Kaposi's sarcoma (KS), which most often develops in HIV-infected individuals. KS frequently has oral manifestations and KSHV DNA can be detected in oral cells. Numerous types of cancer are associated with the alteration of microbiome including bacteria and virus. We hypothesize that oral bacterial microbiota affects or is affected by oral KS and the presence of oral cell-associated KSHV DNA. In this study, oral and blood specimens were collected from a cohort of HIV/KSHV-coinfected individuals all previously diagnosed with KS, and were classified as having oral KS with any oral cell-associated KSHV DNA status (O-KS, n = 9), no oral KS but with oral cell-associated KSHV DNA (O-KSHV, n = 10), or with neither oral KS nor oral cell-associated KSHV DNA (No KSHV, n = 10). We sequenced the hypervariable V1-V2 region of the 16S rRNA gene present in oral cell-associated DNA by next generation sequencing. The diversity, richness, relative abundance of operational taxonomic units (OTUs) and taxonomic composition of oral microbiota were analyzed and compared across the 3 studied groups. We found impoverishment of oral microbial diversity and enrichment of specific microbiota in O-KS individuals compared to O-KSHV or No KSHV individuals. These results suggest that HIV/KSHV coinfection and oral microbiota might impact one another and influence the development of oral KS.
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Affiliation(s)
- Marion Gruffaz
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, United States of America
| | - Tinghe Zhang
- Department of Electrical and Computer Engineering, University of Texas at San Antonio, San Antonio, Texas, United States of America
| | - Vickie Marshall
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Priscila Gonçalves
- HIV and AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Ramya Ramaswami
- HIV and AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Nazzarena Labo
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Thomas S. Uldrick
- HIV and AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, United States of America
- Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Robert Yarchoan
- HIV and AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Yufei Huang
- Department of Electrical and Computer Engineering, University of Texas at San Antonio, San Antonio, Texas, United States of America
- Department of Epidemiology and Biostatistics, The University of Texas Health San Antonio, San Antonio, Texas, United States of America
| | - Shou-Jiang Gao
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, United States of America
- UPMC Hillman Cancer Center, Department of Microbiology and Molecular Genetics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
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Jampani ND, Sunkavilli RK, Songa VM, Buggapati L, Pathagunti SR. Periodontal health status among HIV-seropositive pregnant women. Indian J Dent Res 2019; 30:521-526. [PMID: 31745046 DOI: 10.4103/ijdr.ijdr_144_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Aims and Objective Routine oral health care is essential for those living with HIV (human immunodeficiency virus) infection, especially in pregnant women. Hormonal changes during pregnancy, immunosupression in HIV along with bacterial load in periodontal infections strongly influence the pregnancy outcomes. The aim of this study was to evaluate the periodontal health status in HIV seropositive pregnant women in Andhra Pradesh, India. Materials and Methods This study includes a sample of 90 divided into three groups; HIV seropositive pregnant women (group PH; n = 30), HIV seropositive nonpregnant women (group H; n = 30), and healthy pregnant women without HIV infection (group P; n = 30). Clinical examination includes the recording of probing depths (PD), clinical attachment level (CAL), plaque index (PI), gingival index (GI), and periodontal screening and recording index (PSR) were assessed in three groups. Statistical analysis was done by Mann-Whitney U-test and Wilcoxon paired test using the software SPSS version 17. Results Clinical parameters do not show any significant variation between the three groups. But slightly higher mean PD and CAL levels was observed in HIV seropositive pregnant and nonpregnant women compared with healthy pregnant women without HIV infection. About 13% of severe gingivitis cases were observed in HIV seropositive pregnant group compared with 6% in HIV seropositive and 3% in healthy pregnant group. Conclusions Presence of slightly higher percentage of severe gingivitis in HIV seropositive pregnant women strengthens the fact of extra need for preventive oral health services during the prenatal period and provides recommendations for promoting maternal oral health in regional antiretroviral therapy centers in India.
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Affiliation(s)
- Narendra Dev Jampani
- Department of Periodontics, Dr. NTR University of Health Sciences, Government Dental College and Hospital, Vijayawada, Andhra Pradesh, India
| | - Ravi Kiran Sunkavilli
- Department of Periodontics, Dr. NTR University of Health Sciences, Government Dental College and Hospital, Vijayawada, Andhra Pradesh, India
| | - Vajra Madhuri Songa
- Department of Periodontics, Dr. NTR University of Health Sciences, Government Dental College and Hospital, Vijayawada, Andhra Pradesh, India
| | - Lahari Buggapati
- Department of Periodontics, Dr. NTR University of Health Sciences, Government Dental College and Hospital, Vijayawada, Andhra Pradesh, India
| | - Srinivasa Reddy Pathagunti
- Department of Periodontics, Dr. NTR University of Health Sciences, Government Dental College and Hospital, Vijayawada, Andhra Pradesh, India
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Lomeli-Martinez SM, Valentin-Goméz E, Varela-Hernández JJ, Alvarez-Zavala M, Sanchez-Reyes K, Ramos-Solano M, Cabrera-Silva RI, Ramirez-Anguiano VM, Lomeli-Martinez MA, Martinez-Salazar SY, González-Hernández LA, Andrade-Villanueva JF. Candida spp. Determination and Th1/Th2 Mixed Cytokine Profile in Oral Samples From HIV+ Patients With Chronic Periodontitis. Front Immunol 2019; 10:1465. [PMID: 31316513 PMCID: PMC6610488 DOI: 10.3389/fimmu.2019.01465] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 06/11/2019] [Indexed: 12/14/2022] Open
Abstract
Background: 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 Candida 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 Candida spp. and cytokine profile in oral samples from HIV-positive patients with CP, considering the CD4+ T cells levels and HAART use. Methods: From 500 HIV-positive patients evaluated, 228 patients were enrolled. Patients were separated in groups: (A) n = 53 (≤200 CD4+ T-cells on HAART); (B) n = 57 (≤200 CD4+ T-cells without HAART); (C) n = 50 (>200 CD4+ T-cells without HAART); (D) n = 68 (>200 CD4+ T-cells on HAART). Candida 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. Results: 147 patients (64.5%) were positive to Candida spp. and 204 strains were isolated; 138 (67.6%) were C. albicans and the remaining C. non-albicans species (C. glabrata>C. tropicalis>C. krusei>C. dubliniensis). In this study, CHROMagar showed good sensitivity (95%) but poor specificity (68%); since of the 152 samples identified as C. albicans, only 131 were confirmed by PCR; from the 10 samples identified as C. glabrata, only six were confirmed. Finally, of the 42 samples detected as C. tropicalis, only five were confirmed. When evaluating Candida 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 Candida spp. Despite the presence of Candida and HAART, we found a Th1/Th2 hybrid profile in the saliva of patients with low CD4+ T-cell count (group A). Conclusion: Abundance and diversity of the Candida 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.
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Affiliation(s)
- Sarah M Lomeli-Martinez
- 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
| | - Eulogio Valentin-Goméz
- GMCA Research Unit, Department of Microbiology and Ecology, University of Valencia, Valencia, Spain.,Severe Infection Group, Health Research Institute "La Fe,", Valencia, Spain
| | - Juan J Varela-Hernández
- Department of Medical and Life Sciences, Centro Universitario de la Ciénega, University of Guadalajara, Ocotlán, Mexico
| | - Monserrat Alvarez-Zavala
- HIV and Immunodeficiencies Research Institute, Clinical Medicine Department, Centro Universitario de Ciencias de la Salud-University of Guadalajara, Guadalajara, Mexico
| | - Karina Sanchez-Reyes
- HIV and Immunodeficiencies Research Institute, Clinical Medicine Department, Centro Universitario de Ciencias de la Salud-University of Guadalajara, Guadalajara, Mexico
| | - Moises Ramos-Solano
- HIV and Immunodeficiencies Research Institute, Clinical Medicine Department, Centro Universitario de Ciencias de la Salud-University of Guadalajara, Guadalajara, Mexico
| | - Rodolfo I Cabrera-Silva
- HIV and Immunodeficiencies Research Institute, Clinical Medicine Department, Centro Universitario de Ciencias de la Salud-University of Guadalajara, Guadalajara, Mexico
| | - Victor M Ramirez-Anguiano
- Department of Integrated Dentistry Clinics, Centro Universitario de Ciencias de la Salud, University of Guadalajara, Guadalajara, Mexico
| | - Manuel A Lomeli-Martinez
- Department of Wellbeing and Sustainable Development, Centro Universitario del Norte, University of Guadalajara, Colotlán, Mexico
| | - Silvia Y Martinez-Salazar
- Department of Medical and Life Sciences, Centro Universitario de la Ciénega, University of Guadalajara, Ocotlán, Mexico
| | - Luz A González-Hernández
- HIV and Immunodeficiencies Research Institute, Clinical Medicine Department, Centro Universitario de Ciencias de la Salud-University of Guadalajara, Guadalajara, Mexico.,HIV Unit Department, University Hospital "Fray Antonio Alcalde," University of Guadalajara, Guadalajara, Mexico
| | - Jaime F Andrade-Villanueva
- HIV and Immunodeficiencies Research Institute, Clinical Medicine Department, Centro Universitario de Ciencias de la Salud-University of Guadalajara, Guadalajara, Mexico.,HIV Unit Department, University Hospital "Fray Antonio Alcalde," University of Guadalajara, Guadalajara, Mexico
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Groenewegen H, Bierman WFW, Delli K, Dijkstra PU, Nesse W, Vissink A, Spijkervet FKL. Severe periodontitis is more common in HIV- infected patients. J Infect 2018; 78:171-177. [PMID: 30528870 DOI: 10.1016/j.jinf.2018.11.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 11/27/2018] [Accepted: 11/28/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To assess periodontitis prevalence and severity in HIV infected patients as compared to controls. Furthermore, to assess whether HIV infection characteristics are associated with periodontitis. DESIGN cross-sectional controlled study. METHODS We assessed prevalence and severity of periodontitis in 258 HIV-infected patients and 539 historical controls with the Dutch Periodontal Screening Index (DPSI). HIV characteristics were collected from medical charts. Age-related diseases and oral care were assessed with questionnaires. RESULTS Severe periodontitis (DPSI 4) was more prevalent in HIV-infected patients than in controls (66% vs. 36%, p = 0.002). HIV-infection, increasing age and male sex were significant risk factors for severe periodontitis. In particular, older male HIV patients have a higher risk of severe periodontitis. Clinical, immunological and virologic characteristics, and antiretroviral therapy were not associated with periodontitis prevalence or severity. HIV-infected patients rate the importance of their oral health as high, although many do not disclose their HIV infection to their dentists. CONCLUSIONS Prevalence and severity of periodontitis are higher in HIV-infected patients compared to controls, particularly in older males. Awareness of the increased prevalence of periodontitis associated with HIV-infection among patients and health-care professionals could significantly improve oral health and quality of life of HIV-infected patients.
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Affiliation(s)
- Hester Groenewegen
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
| | - Wouter F W Bierman
- Department of Internal Medicine, Division of Infectious Diseases, University of Groningen and University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
| | - Konstantina Delli
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
| | - Pieter U Dijkstra
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands; Department of Oral and Maxillofacial Surgery and Department Rehabilitation, Center of Rehabilitation, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
| | - Willem Nesse
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands; Department of Oral and Maxillofacial Surgery, Wilhelmina Hospital Assen, Postbus 30001, 9400 RA Assen, The Netherlands.
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
| | - Frederik K L Spijkervet
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
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Nobre ÁVV, Pólvora TLS, Silva LRM, Teles VDO, Villafuerte KV, da Motta RJG, Fortes JHP, Silva GA, Ranieri ALP, de Macedo LD, Morejon KML, da Fonseca BAL, Tirapelli C, Saraiva MCP, Taba M, Lourenço AG, Motta ACF. Effects of non-surgical periodontal therapy on clinical and immunological profile and oral colonization of Candida spp in HIV-infected patients with chronic periodontitis. J Periodontol 2018; 90:167-176. [PMID: 30118537 DOI: 10.1002/jper.18-0197] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 07/07/2018] [Accepted: 07/08/2018] [Indexed: 11/06/2022]
Abstract
BACKGROUND After the introduction of antiretroviral therapy (ART), human immunodeficiency virus (HIV) infection has become a chronic controllable disease. For this reason, chronic conditions related to both HIV infection and senescence, such as chronic periodontitis (CP) need to be studied. This study investigated the impact of non-surgical periodontal therapy (NSPT) on clinical and immunological features of CP, and on oral colonization by Candida spp. in HIV-infected and non-HIV-infected individuals. METHODS HIV-infected (test group) and non-HIV-infected (control group) adults patients with CP were selected. Gingival bleeding index (GI), probing depth (PD), clinical attachment level (CAL), number of teeth, CD4+ T lymphocytes and viral load (only for HIV-infected individuals), salivary cytokines (interleukin, [IL]-6, IL-8, and tumoral necrosis factor-alpha [TNF-α]), and oral Candida infection (colony forming units and species) were assessed at baseline, and 30 and 90 days after NSPT. RESULTS Twenty-two HIV-infected patients and 20 non-HIV-infected patients were evaluated. Candida counts and salivary IL-6, IL-8, and TNF-a levels were higher in the test group than in the control group. Both groups showed a decrease in oral Candida counts, GI, PD, IL-6, and IL-8 as well as gain in CAL at 30 and 90 days after NSPT. In addition, patients in the test group showed an increase of CD4+ T lymphocytes and a decrease of viral load. CONCLUSION NSPT had a beneficial impact on clinical and immunological parameters of CP, reduction of oral Candida counts, and improvement of HIV-infection status.
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Affiliation(s)
- Átila V V Nobre
- Department of Oral & Maxillofacial Surgery, and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Tábata L S Pólvora
- Department of Stomatology, School of Dentistry, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Letícia R M Silva
- Department of Stomatology, Public Health and Forensic Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Vanessa de O Teles
- Department of Stomatology, Public Health and Forensic Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Kelly Vargas Villafuerte
- Department of Oral & Maxillofacial Surgery, and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Raphael J G da Motta
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - João H P Fortes
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Gilberto A Silva
- Department of Morphology, Physiology and Basic Pathology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Ana Laura P Ranieri
- Divison of Dentistry and Stomatology of the Clinical Hospital of Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Leandro D de Macedo
- Divison of Dentistry and Stomatology of the Clinical Hospital of Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Karen M L Morejon
- Department of Medical Clinic of Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Benedito A L da Fonseca
- Department of Medical Clinic of Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Camila Tirapelli
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Maria C P Saraiva
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Mário Taba
- Department of Oral & Maxillofacial Surgery, and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Alan G Lourenço
- Department of Morphology, Physiology and Basic Pathology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Ana Carolina F Motta
- Department of Stomatology, Public Health and Forensic Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
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Schuettfort G, de Leuw P, Haberl A, Herrmann E, Park KH, Wolf T, Stephan C. HLA-B57.01 shields people living with HIV for significantly better periodontal health. J Periodontol 2018; 89:966-972. [PMID: 29742276 DOI: 10.1002/jper.17-0532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 01/04/2018] [Accepted: 01/25/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND To assess the association between HLA-B57.01 (Human leukocyte antigen) and clinical parameters of chronic periodontitis in people living with HIV (PLWHIV). METHODS All patients were recruited from the HIVCENTER at the University Hospital Frankfurt during April 2014 and July 2015. Periodontal examination included Periodontal Screening Index (PSI), Gingivalindex (GI), Bleeding on Probing Index (BOP), Periodontal Probing Depth (PD), Clinical Attachment Level (CAL) and DMF-T Score (decayed, missing, filled teeth). Associations among periodontitis, HLA-system and additional risk factors in PLWHIV were evaluated in multivariate analyses. RESULTS One hundred PLWHIV were enrolled. Forty-five patients were naive, meaning that these patients never took antiretroviral (ARV) drugs before, 55 patients treated with combined antiretroviral therapy (cART). Nineteen patients presented a positive HLA-B 57.01 status. PLWHIV who were carriers of HLA-B 57.01 had significantly lower PSI-scores (Grade 3 or higher; 0/19 [0%] versus 16/41 [39%] versus 17/40 [42%]; p = < 0.001), GI-scores (Grade 2 or higher; 0/19 [0%] versus 19/41 [46%] versus 28/40 [70%]; p = < 0.001) and BOP-Scores (2/19 [1%] versus 38/41 [92%] versus 40/40 [100%]; p = < 0.001) in comparison to naive PLWHIV and PLWHIV receiving cART, who were both not carriers of HLA-B 57.01. A lower value of PSI-, GI- and BOP-Score is associated with improved periodontal health. The adjusted odds ratio (OR) of periodontitis was decreased in patients who were carriers of HLA-B 57.01 by measurement of PSI-Score (OR = 0.006, 95% confidence interval (CI) = 0.001 to 0.026), GI-Score (OR = 0.018, 95% confidence interval (CI) = 0.003 to 0.104) and BOP-Score (OR = 0.003, 95% confidence interval (CI) = < 0.001 to 0.011). CONCLUSIONS HLA-B 57.01 is an independent resistance indicator for generalized periodontitis in PLWHIV with respect to established cofactors.
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Affiliation(s)
- Gundolf Schuettfort
- University Hospital Frankfurt, J.W. Goethe-University, Department for Infectious Diseases, Internal Medicine II, Frankfurt, Germany
| | - Philipp de Leuw
- University Hospital Frankfurt, J.W. Goethe-University, Department for Infectious Diseases, Internal Medicine II, Frankfurt, Germany
| | - Annette Haberl
- University Hospital Frankfurt, J.W. Goethe-University, Department for Infectious Diseases, Internal Medicine II, Frankfurt, Germany
| | - Eva Herrmann
- University Hospital Frankfurt, J.W. Goethe-University, Department for Biostatistics and Mathematical Modelling, Frankfurt, Germany
| | | | - Timo Wolf
- University Hospital Frankfurt, J.W. Goethe-University, Department for Infectious Diseases, Internal Medicine II, Frankfurt, Germany
| | - Christoph Stephan
- University Hospital Frankfurt, J.W. Goethe-University, Department for Infectious Diseases, Internal Medicine II, Frankfurt, Germany
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Alterations in the oral microbiome in HIV-infected participants after antiretroviral therapy administration are influenced by immune status. AIDS 2018; 32:1279-1287. [PMID: 29851662 DOI: 10.1097/qad.0000000000001811] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To characterize the oral bacterial microbiome in HIV-infected participants at baseline and after 24 weeks of EFV/FTC/TDF. DESIGN Thirty-five participants co-enrolled in two AIDS Clinical Trials Group (ACTG) studies, A5272 and A5280, with paired saliva samples and complete data sets were assessed. METHODS Paired saliva samples were evaluated for bacterial microbiome using 16S rDNA PCR followed by Illumina sequencing. Diversity and differential abundance was compared between groups. A random forest classification scheme was used to determine the contribution of parameters in classifying participants' CD4+ T-cell count. RESULTS Bacterial communities demonstrated considerable variability both within participants and between timepoints, although they became more similar after 24 weeks of ART. At baseline, both the number of taxa detected and the average alpha diversity were variable between participants, but did not differ significantly based on CD4+ cell count, viral load or other factors. After 24 weeks of ART samples obtained from participants with persistently low CD4+ T-cell counts had significantly higher bacterial richness and diversity. Several differentially abundant taxa, including Porphyromonas species associated with periodontal disease, were identified, which discriminated between baseline and posttreatment samples. Analysis demonstrated that although inflammatory markers are important in untreated disease, the salivary microbiome may play an important role in CD4+ T-cell count recovery after ART. CONCLUSION Shifts in the oral microbiome after ART initiation are complex, and may play an important role in immune function and inflammatory disease.
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Applications of the FIV Model to Study HIV Pathogenesis. Viruses 2018; 10:v10040206. [PMID: 29677122 PMCID: PMC5923500 DOI: 10.3390/v10040206] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 04/17/2018] [Accepted: 04/17/2018] [Indexed: 12/15/2022] Open
Abstract
Feline immunodeficiency virus (FIV) is a naturally-occurring retrovirus that infects domestic and non-domestic feline species, producing progressive immune depletion that results in an acquired immunodeficiency syndrome (AIDS). Much has been learned about FIV since it was first described in 1987, particularly in regard to its application as a model to study the closely related lentivirus, human immunodeficiency virus (HIV). In particular, FIV and HIV share remarkable structure and sequence organization, utilize parallel modes of receptor-mediated entry, and result in a similar spectrum of immunodeficiency-related diseases due to analogous modes of immune dysfunction. This review summarizes current knowledge of FIV infection kinetics and the mechanisms of immune dysfunction in relation to opportunistic disease, specifically in regard to studying HIV pathogenesis. Furthermore, we present data that highlight changes in the oral microbiota and oral immune system during FIV infection, and outline the potential for the feline model of oral AIDS manifestations to elucidate pathogenic mechanisms of HIV-induced oral disease. Finally, we discuss advances in molecular biology, vaccine development, neurologic dysfunction, and the ability to apply pharmacologic interventions and sophisticated imaging technologies to study experimental and naturally occurring FIV, which provide an excellent, but often overlooked, resource for advancing therapies and the management of HIV/AIDS.
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Pólvora TLS, Nobre ÁVV, Tirapelli C, Taba M, Macedo LDD, Santana RC, Pozzetto B, Lourenço AG, Motta ACF. Relationship between human immunodeficiency virus (HIV-1) infection and chronic periodontitis. Expert Rev Clin Immunol 2018; 14:315-327. [PMID: 29595347 DOI: 10.1080/1744666x.2018.1459571] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Current studies show that, even in the era of antiretroviral therapies, HIV-1 infection is associated with more severe and frequent refractory chronic periodontitis. Areas covered: This review, based on a systematic analysis of the literature, intends to provide an update on factors that may be involved in the pathogenesis of periodontal disease in HIV-1-infected patients, including local immunosuppression, oral microbial factors, systemic inflammation, salivary markers, and the role of gingival tissue as a possible reservoir of HIV-1. Expert commentary: The therapeutic revolution of ART made HIV-1 infection a chronic controllable disease, reduced HIV-1 mortality rate, restored at least partially the immune response and dramatically increased life expectancy of HIV-1-infected patients. Despite all these positive aspects, chronic periodontitis assumes an important role in the HIV-1 infection status for activating systemic inflammation favoring viral replication and influencing HIV-1 status, and also acting as a possible reservoir of HIV-1. All these issues still need to be clarified and validated, but have important clinical implications that certainly will benefit the diagnosis and management of chronic periodontitis in HIV-1-infected patients, and also contributes to HIV-1 eradication.
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Affiliation(s)
| | - Átila Vinícius V Nobre
- b Department of Oral & Maxillofacial Surgery, and Periodontology, School of Dentistry of Ribeirão Preto , University of São Paulo , Ribeirão Preto , Brazil
| | - Camila Tirapelli
- c Department of Dental Material and Prosthesis, School of Dentistry of Ribeirão Preto , USP - University of São Paulo , Ribeirão Preto , Brazil
| | - Mário Taba
- b Department of Oral & Maxillofacial Surgery, and Periodontology, School of Dentistry of Ribeirão Preto , University of São Paulo , Ribeirão Preto , Brazil
| | - Leandro Dorigan de Macedo
- d Division of Dentistry and Stomatology, Clinical Hospital, Ribeirão Preto Medical School , University of São Paulo , Ribeirão Preto , Brazil
| | - Rodrigo Carvalho Santana
- e Department of Internal Medicine, Ribeirão Preto Medical School , USP - University of São Paulo , Ribeirão Preto , Brazil
| | - Bruno Pozzetto
- f GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes) , University of Lyon , Saint-Etienne , France
| | - Alan Grupioni Lourenço
- g Department of Stomatology, Public Oral Health and Forensic Dentistry, School of Dentistry of Ribeirão Preto , University of São Paulo , Ribeirão Preto , Brazil
| | - Ana Carolina F Motta
- g Department of Stomatology, Public Oral Health and Forensic Dentistry, School of Dentistry of Ribeirão Preto , University of São Paulo , Ribeirão Preto , Brazil
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Effectiveness of Systematic Periodontal Treatment in Male HIV-Infected Patients after 9 Years: A Case Series. Adv Med 2018; 2018:4135607. [PMID: 30186883 PMCID: PMC6109988 DOI: 10.1155/2018/4135607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 06/07/2018] [Accepted: 07/07/2018] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To investigate effectiveness of systematic periodontal treatment in the long term in HIV-infected patients undergoing highly active antiretroviral treatment. METHODS Longitudinal, prospective, open-label case series over a period of nine years. Periodontal treatment was performed by scaling and root planing and supportive periodontal care (SPC) at regular intervals. To measure effectiveness, reductions of pocket probing depths were defined as primary study endpoint. RESULTS During the study period, there was a proportional increase in periodontal pockets ≥4 mm of +53% and in pockets ≥ 6 mm of +100%. Mean pocket depth reductions on patient's level were, however, 0.4 mm nine years after scaling and root planing and supportive periodontal care (p=0.180). No teeth were lost during the observation period. CONCLUSIONS In terms of best evidence available, it is concluded that systematic periodontal treatment including SPC is effective in virologically controlled HIV infection and can be performed in dental practice safely.
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Peacock ME, Arce RM, Cutler CW. Periodontal and other oral manifestations of immunodeficiency diseases. Oral Dis 2017; 23:866-888. [PMID: 27630012 PMCID: PMC5352551 DOI: 10.1111/odi.12584] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 08/31/2016] [Accepted: 09/08/2016] [Indexed: 12/14/2022]
Abstract
The list of immunodeficiency diseases grows each year as novel disorders are discovered, classified, and sometimes reclassified due to our ever-increasing knowledge of immune system function. Although the number of patients with secondary immunodeficiencies (SIDs) greatly exceeds those with primary immunodeficiencies (PIDs), the prevalence of both appears to be on the rise probably because of scientific breakthroughs that facilitate earlier and more accurate diagnosis. Primary immunodeficiencies in adults are not as rare as once thought. Globally, the main causes of secondary immunodeficiency are HIV infection and nutritional insufficiencies. Persons with acquired immune disorders such as AIDS caused by the human immunodeficiency virus (HIV) are now living long and fulfilling lives as a result of highly active antiretroviral therapy (HAART). Irrespective of whether the patient's immune-deficient state is a consequence of a genetic defect or is secondary in nature, dental and medical practitioners must be aware of the constant potential for infections and/or expressions of autoimmunity in these individuals. The purpose of this review was to study the most common conditions resulting from primary and secondary immunodeficiency states, how they are classified, and the detrimental manifestations of these disorders on the periodontal and oral tissues.
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Affiliation(s)
- Mark E Peacock
- Associate Professor, Departments of Periodontics, Oral Biology
| | - Roger M. Arce
- Assistant Professor, Departments of Periodontics, Oral Biology
| | - Christopher W Cutler
- Professor, Departments of Periodontics, Oral Biology; Chair, Department of Periodontics, Associate Dean for Research, The Dental College of Georgia at Augusta University
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Miller C, Boegler K, Carver S, MacMillan M, Bielefeldt-Ohmann H, VandeWoude S. Pathogenesis of oral FIV infection. PLoS One 2017; 12:e0185138. [PMID: 28934316 PMCID: PMC5608358 DOI: 10.1371/journal.pone.0185138] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 09/05/2017] [Indexed: 01/09/2023] Open
Abstract
Feline immunodeficiency virus (FIV) is the feline analogue of human immunodeficiency virus (HIV) and features many hallmarks of HIV infection and pathogenesis, including the development of concurrent oral lesions. While HIV is typically transmitted via parenteral transmucosal contact, recent studies prove that oral transmission can occur, and that saliva from infected individuals contains significant amounts of HIV RNA and DNA. While it is accepted that FIV is primarily transmitted by biting, few studies have evaluated FIV oral infection kinetics and transmission mechanisms over the last 20 years. Modern quantitative analyses applied to natural FIV oral infection could significantly further our understanding of lentiviral oral disease and transmission. We therefore characterized FIV salivary viral kinetics and antibody secretions to more fully document oral viral pathogenesis. Our results demonstrate that: (i) saliva of FIV-infected cats contains infectious virus particles, FIV viral RNA at levels equivalent to circulation, and lower but significant amounts of FIV proviral DNA; (ii) the ratio of FIV RNA to DNA is significantly higher in saliva than in circulation; (iii) FIV viral load in oral lymphoid tissues (tonsil, lymph nodes) is significantly higher than mucosal tissues (buccal mucosa, salivary gland, tongue); (iv) salivary IgG antibodies increase significantly over time in FIV-infected cats, while salivary IgA levels remain static; and, (v) saliva from naïve Specific Pathogen Free cats inhibits FIV growth in vitro. Collectively, these results suggest that oral lymphoid tissues serve as a site for enhanced FIV replication, resulting in accumulation of FIV particles and FIV-infected cells in saliva. Failure to induce a virus-specific oral mucosal antibody response, and/or viral capability to overcome inhibitory components in saliva may perpetuate chronic oral cavity infection. Based upon these findings, we propose a model of oral FIV pathogenesis and suggest alternative diagnostic modalities and translational approaches to study oral HIV infection.
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Affiliation(s)
- Craig Miller
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado
| | - Karen Boegler
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado
| | - Scott Carver
- School of Zoology, University of Tasmania, Hobart, Tasmania, Australia
| | - Martha MacMillan
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado
| | - Helle Bielefeldt-Ohmann
- Australian Infectious Diseases Research Centre, University of Queensland, St. Lucia, Queensland, Australia
| | - Sue VandeWoude
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado
- * E-mail:
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Elizondo JE, Rocha-Pizaña MDR, Treviño AC, Violant D, Álvarez MM, Rivas-Estilla AM. Potential gingival crevicular fluid and serum biomarkers by stage of HIV infection. Cytokine 2016; 91:96-103. [PMID: 28043030 DOI: 10.1016/j.cyto.2016.12.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Revised: 12/20/2016] [Accepted: 12/22/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This study evaluates the potential of gingival crevicular fluid and serum cytokines as HIV stage biomarkers. METHODS Gingival crevicular fluid (GCF) and serum samples from 78 HIV-positive adult male subjects (cases) and 39 HIV-negative male subjects (controls) from Mexico were examined for 17 cytokines using multiplex ELISA. Participants were divided into five subgroups by HIV stage of infection on age-specific CD4+ T-lymphocyte count and antiretroviral therapy (ART), and further correlated to the cytokine levels. RESULTS GCF concentrations of IL-6, IL-7, IL-10, IL-12, G-CSF and MCP-1, as well as serum concentrations of IL-1β, IL-2 and IL-6 showed a statistically significant difference among subgroups. We found a significant effect size correlation on cytokines expression levels. Subjects who were not in ART showed significantly higher levels of some of the analyzed cytokines compared to the rest. We found that GCF IL-8 was a significant predictor for the Non-ART HIV status (p<0.05). We observed the same result for GCF G-CSF in the ART Short-term group and serum GM-CSF in the ART Long-term subgroup. CONCLUSION Results indicate a high variability of GCF and serum cytokines concentrations and low frequency of their detection in different HIV/ART stages. However, within the limits of the present study, some GCF and serum cytokine concentrations correlate positively. Oral and periodontal innate immunity is affected by HIV viremia and ART. GCF IL-8, G-CSF, as well as serum IL-8, MCP-1 and GM-CSF may be useful biomarkers for the detection of disease presence and/or its severity due to HIV infection and ART use.
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Affiliation(s)
- Jesús Eduardo Elizondo
- Postgraduate Program in Biotechnology, Department of Biopharmaceuticals and Biopharmaceutical Engineering, FEMSA Biotechnology Center, National Graduate School of Science, Engineering and Technology, Tecnológico de Monterrey, Nuevo León, Mexico; Postgraduate Program in Dentistry, Doctorate School, Universitat Internacional de Catalunya, Barcelona, Spain; Medical and Health Sciences Program, Department of Basic Sciences, National School of Medicine, Tecnológico de Monterrey, Nuevo León, Mexico.
| | - María Del Refugio Rocha-Pizaña
- Postgraduate Program in Biotechnology, Department of Biopharmaceuticals and Biopharmaceutical Engineering, FEMSA Biotechnology Center, National Graduate School of Science, Engineering and Technology, Tecnológico de Monterrey, Nuevo León, Mexico
| | - Ana Cecilia Treviño
- Medical and Surgical Dentist Program, Tecnológico de Monterrey, Nuevo León, Mexico
| | - Deborah Violant
- Postgraduate Program in Dentistry, Doctorate School, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Mario Moisés Álvarez
- Postgraduate Program in Biotechnology, Department of Biopharmaceuticals and Biopharmaceutical Engineering, FEMSA Biotechnology Center, National Graduate School of Science, Engineering and Technology, Tecnológico de Monterrey, Nuevo León, Mexico; Biomaterials Innovation Research Center, Division of Biomedical Engineering, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston 02139, MA, USA
| | - Ana María Rivas-Estilla
- Postgraduate Program in Molecular Biology and Genetic Engineering, Department of Virology, Laboratory of Molecular Infectology, Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Universidad Autónoma de Nuevo León, Mexico
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Knight ET, Liu J, Seymour GJ, Faggion CM, Cullinan MP. Risk factors that may modify the innate and adaptive immune responses in periodontal diseases. Periodontol 2000 2016; 71:22-51. [DOI: 10.1111/prd.12110] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2015] [Indexed: 12/31/2022]
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Herrera D, Alonso B, de Arriba L, Santa Cruz I, Serrano C, Sanz M. Acute periodontal lesions. Periodontol 2000 2015; 65:149-77. [PMID: 24738591 DOI: 10.1111/prd.12022] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2012] [Indexed: 11/30/2022]
Abstract
This review provides updates on acute conditions affecting the periodontal tissues, including abscesses in the periodontium, necrotizing periodontal diseases and other acute conditions that cause gingival lesions with acute presentation, such as infectious processes not associated with oral bacterial biofilms, mucocutaneous disorders and traumatic and allergic lesions. A periodontal abscess is clinically important because it is a relatively frequent dental emergency, it can compromise the periodontal prognosis of the affected tooth and bacteria within the abscess can spread and cause infections in other body sites. Different types of abscesses have been identified, mainly classified by their etiology, and there are clear differences between those affecting a pre-existing periodontal pocket and those affecting healthy sites. Therapy for this acute condition consists of drainage and tissue debridement, while an evaluation of the need for systemic antimicrobial therapy will be made for each case, based on local and systemic factors. The definitive treatment of the pre-existing condition should be accomplished after the acute phase is controlled. Necrotizing periodontal diseases present three typical clinical features: papilla necrosis, gingival bleeding and pain. Although the prevalence of these diseases is not high, their importance is clear because they represent the most severe conditions associated with the dental biofilm, with very rapid tissue destruction. In addition to bacteria, the etiology of necrotizing periodontal disease includes numerous factors that alter the host response and predispose to these diseases, namely HIV infection, malnutrition, stress or tobacco smoking. The treatment consists of superficial debridement, careful mechanical oral hygiene, rinsing with chlorhexidine and daily re-evaluation. Systemic antimicrobials may be used adjunctively in severe cases or in nonresponding conditions, being the first option metronidazole. Once the acute disease is under control, definitive treatment should be provided, including appropriate therapy for the pre-existing gingivitis or periodontitis. Among other acute conditions affecting the periodontal tissues, but not caused by the microorganisms present in oral biofilms, infectious diseases, mucocutaneous diseases and traumatic or allergic lesions can be listed. In most cases, the gingival involvement is not severe; however, these conditions are common and may prompt an emergency dental visit. These conditions may have the appearance of an erythematous lesion, which is sometimes erosive. Erosive lesions may be the direct result of trauma or a consequence of the breaking of vesicles and bullae. A proper differential diagnosis is important for adequate management of the case.
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Kistler JO, Arirachakaran P, Poovorawan Y, Dahlén G, Wade WG. The oral microbiome in human immunodeficiency virus (HIV)-positive individuals. J Med Microbiol 2015; 64:1094-1101. [PMID: 26297584 DOI: 10.1099/jmm.0.000128] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Human immunodeficiency virus (HIV) infection is associated with a range of oral conditions, and increased numbers of disease-associated microbial species have previously been found in HIV-positive subjects. The aim of this study was to use next-generation sequencing to compare the composition of the oral microbiome in HIV-positive and -negative individuals. Plaque and saliva were collected from 37 HIV-positive individuals and 37 HIV-negative individuals, and their bacterial composition determined by pyrosequencing of partial 16S rRNA genes. A total of 855,222 sequences were analysed. The number of species-level operational taxonomic units (OTUs) detected was significantly lower in the saliva of HIV-positive individuals (mean = 303.3) than in that of HIV-negative individuals (mean = 365.5) (P < 0.0003). Principal coordinates analysis (PCoA) based on community membership (Jaccard index) and structure (Yue and Clayton measure of dissimilarity) showed significant separation of plaque and saliva samples [analysis of molecular variance (AMOVA), P < 0.001]. PCoA plots did not show any clear separation based on HIV status. However, AMOVA indicated that there was a significant difference in the community membership of saliva between HIV-positive and -negative groups (P = 0.001). Linear discriminant analysis effect size revealed an OTU identified as Haemophilus parainfluenzae to be significantly associated with HIV-positive individuals, whilst Streptococcus mitis/HOT473 was most significantly associated with HIV-negative individuals. In conclusion, this study has confirmed that the microbial composition of saliva and plaque is different. The oral microbiomes of HIV-positive and -negative individuals were found to be similar overall, although there were minor but significant differences in the composition of the salivary microbiota of the two groups.
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Affiliation(s)
- James O Kistler
- Centre for Immunobiology, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Pratanporn Arirachakaran
- Infectious Diseases Clinic, Dental Hospital, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Yong Poovorawan
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Gunnar Dahlén
- Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - William G Wade
- Centre for Immunobiology, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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George J, Lewis MG, Renne R, Mattapallil JJ. Suppression of transforming growth factor β receptor 2 and Smad5 is associated with high levels of microRNA miR-155 in the oral mucosa during chronic simian immunodeficiency virus infection. J Virol 2015; 89:2972-8. [PMID: 25540365 PMCID: PMC4325739 DOI: 10.1128/jvi.03248-14] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 12/15/2014] [Indexed: 12/12/2022] Open
Abstract
Chronic human immunodeficiency virus and simian immunodeficiency virus (HIV and SIV) infections are characterized by mucosal inflammation in the presence of anti-inflammatory cytokines such as transforming growth factor β (TGFβ). The mechanisms for refractiveness to TGFβ are not clear. Here we show that the expression of microRNA miR-155 was significantly upregulated in the oropharyngeal mucosa during chronic SIV infection and was coincident with downregulation of TGFβ receptor 2 (TGFβ-R2) and SMAD5, key TGFβ signaling genes that harbor putative target sites for miR-155. Ectopic expression of miR-155 in vitro was found to significantly downregulate TGFβ-R2 and Smad5 expression, suggesting a role for miR-155 in the suppression of TGFβ-R2 and SMAD5 genes in vivo. The downregulation of TGFβ signaling genes by miR-155 likely contributes to the nonresponsiveness to TGFβ during SIV infection and may inadvertently aid in increased immune activation during HIV and SIV infections.
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Affiliation(s)
- Jeffy George
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | | | - Rolf Renne
- University of Florida, Gainesville, Florida, USA
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López LM, Guerra ME. Caries Experience and Periodontal Status during Pregnancy in a Group of Pregnant Women with HIV+ Infections from Puerto Rico. ACTA ACUST UNITED AC 2015; 6. [PMID: 27695639 PMCID: PMC5042149 DOI: 10.4172/2155-6113.1000434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES The aim of this study was to determine the caries rate and periodontal status in a sample of pregnant women with HIV+ infections from Puerto Rico. METHODS A pilot study was conducted on a cross sectional convenience sample of 25 pregnant women with HIV+ infections from Puerto Rico who visit the CEMI clinic (Centro de Estudios Materno Infantil) at the University of Puerto Rico. The women subjects were evaluated for caries, DMFT (D: Decay tooth; M: Missing tooth due to caries; F: Filled tooth) index, oral lesions associated with HIV+/AIDS and periodontal disease parameters, with a Florida probe by a calibrated dentist on periodontal indexes such as as bleeding on probing, CEJ (cemento-enamel junction) and pocket depth. Periodontal disease was classified as having 4 sites with pocket depth greater than 4 mm and caries were identified following the Radike criteria. Data was statistically analyzed using the SSPS Program (Statistical Software Program for Social Sciences) and descriptive statistics were calculated. RESULTS Mean DT (decayed teeth), MT (missing teeth due to caries), FT (filled teeth) and DMFT (decay, missing and filled teeth) were 4.8, 1.86, 5.3 and 12, respectively; mean sites of bleeding on probing=12.06; mean sites with pocket depth>4 mm=6.95 and mean sites with loss of attachment greater than 4 mm=7.66. [Almost 50% of the patients had generalized chronic periodontitis. A 72% prevalence of periodontal disease was found. No oral lesions related to HIV+/AIDS were reported. CD4 and viral load was statistically associated with bleeding on probing and severe signs of periodontal disease. CONCLUSIONS High levels of dental disease were found in pregnant women with HIV+/AIDS infections from Puerto Rico, and these women were in need of substantial dental services.
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Affiliation(s)
- Lydia M López
- Surgical Sciences Department, University of Puerto Rico School of Dental Medicine, San Juan, Puerto Rico, USA
| | - María Elena Guerra
- Pediatric Dentist and Professor, Central University of Venezuela, School of Dentistry, CAPEI (Centro de Atención a Pacientes con Enfermedades Infectocontagiosas) Dental Clinic, Caracas, Venezuela, USA
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Arirachakaran P, Poovorawan Y, Dahlén G. Highly-active antiretroviral therapy and oral opportunistic microorganisms in HIV-positive individuals of Thailand. ACTA ACUST UNITED AC 2014; 7:158-67. [PMID: 25537925 DOI: 10.1111/jicd.12142] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 10/25/2014] [Indexed: 12/01/2022]
Abstract
AIM Oral mucosal lesions and opportunistic microorganisms in HIV-positive Thais treated with highly-active antiretroviral therapy (HAART) for more than 5 years were investigated. METHODS A total of 221 HIV-infected patients, comprising 148 HIV patients undergoing HAART for more than 5 years, 20 non-HAART HIV patients, 53 vertically-transmitted (VT) HAART HIV patients, and 30 HIV-negative controls, were examined for CD4+ counts, viral load, saliva secretion rate, and oral mucosal lesions. Samples from the tongue, gingival crevices, and mucosal lesions when present were cultured for the amounts of Candida, staphylococci, enterococci, and aerobic Gram-negative bacilli. RESULTS HAART (including HIV-VT) maintained oral microbial homeostasis predominated by alpha-hemolytic streptococci similar to the non-HIV controls and with a low prevalence of mucosal lesions. The HAART group had a reduced saliva secretion rate. The frequency and load of opportunistic microorganisms in the HAART group were similar to the non-HAART group, which was significantly higher than the HIV-negative controls. Candida spp. was found significantly more frequently on the tongue in HIV-infected individuals with CD4+ counts <500 cells/mm(3). CONCLUSION Although we did not find lower levels of mucosal lesions among HAART compared to non-HAART individuals, HAART therapy could prolong the time before opportunistic oral pathogens overwhelm the commensal members of oral microbiota.
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Affiliation(s)
- Pratanporn Arirachakaran
- Department of Oral Medicine, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.,Infectious Diseases Clinic and Dental Hospital, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Yong Poovorawan
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Gunnar Dahlén
- Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Das B, Dobrowolski C, Shahir AM, Feng Z, Yu X, Sha J, Bissada NF, Weinberg A, Karn J, Ye F. Short chain fatty acids potently induce latent HIV-1 in T-cells by activating P-TEFb and multiple histone modifications. Virology 2014; 474:65-81. [PMID: 25463605 DOI: 10.1016/j.virol.2014.10.033] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 10/25/2014] [Accepted: 10/27/2014] [Indexed: 12/14/2022]
Abstract
HIV patients with severe periodontitis have high levels of residual virus in their saliva and plasma despite effective therapy (HAART). Multiple short chain fatty acids (SCFAs) from periodontal pathogens reactivate HIV-1 in both Jurkat and primary T-cell models of latency. SCFAs not only activate positive transcription elongation factor b (P-TEFb), which is an essential cellular cofactor for Tat, but can also reverse chromatin blocks by inducing histone modifications. SCFAs simultaneously increase histone acetylation by inhibiting class-1/2 histone deacetylases (HDACs) and decrease repressive histone tri-methylation at the proviral LTR by downregulating expression of the class-3 HDAC sirtuin-1 (SIRT1), and the histone methyltransferases enhancer of Zeste homolog 2 (EZH2) and suppressor of variegation 3-9 homolog 1 (SUV39H1). Our findings provide a mechanistic link between periodontal disease and enhanced HIV-1 replication, and suggest that treatment of periodontal disease, or blocking the activities of SCFAs, will have a therapeutic benefit for HIV patients.
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Affiliation(s)
- Biswajit Das
- Department of Molecular Biology and Microbiology, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, United States
| | - Curtis Dobrowolski
- Department of Molecular Biology and Microbiology, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, United States
| | - Abdel-Malek Shahir
- Department of Periodontics, School of Dental Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, United States
| | - Zhimin Feng
- Department of Biological Sciences, School of Dental Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, United States
| | - Xiaolan Yu
- Department of Biological Sciences, School of Dental Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, United States
| | - Jinfeng Sha
- Department of Biological Sciences, School of Dental Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, United States
| | - Nabil F Bissada
- Department of Periodontics, School of Dental Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, United States
| | - Aaron Weinberg
- Department of Biological Sciences, School of Dental Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, United States
| | - Jonathan Karn
- Department of Molecular Biology and Microbiology, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, United States.
| | - Fengchun Ye
- Department of Biological Sciences, School of Dental Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, United States.
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Jordan RA, Lucaciu A, Zimmer S. Influence of highly-active antiretroviral therapy on the subgingival biofilm in HIV-infected patients. ACTA ACUST UNITED AC 2014; 7:65-71. [PMID: 25283543 DOI: 10.1111/jicd.12124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 07/27/2013] [Indexed: 11/29/2022]
Abstract
AIM Highly-active antiretroviral therapy (HAART) has been associated with alterations in subgingival biofilm and periodontal disease. The purpose of the present study was to investigate the association between different HAART regimens and the prevalence of periodontal pathogens in HIV-infected patients with chronic periodontitis. METHODS Subgingival periodontal pathogens were determined by a DNA chip microarray in a case series in 14 HIV-infected patients receiving HAART with different drug combinations: protease inhibitor (PI)-based HAART versus non-nucleoside reverse transcriptase inhibitor (NNRTI)-based HAART. A statistical analysis was conducted to determine whether specific HAART regimens were associated with 10 periodontal pathogens using odds ratios (OR). RESULTS At baseline and after treatment, the patients did not show significant clinical and immunological differences. In general, the highest OR for the prevalence of periodontal pathogens were found in the PI HAART group for Actinomyces viscosus (A. viscosus) (OR: 303), Campylobacter rectus (OR: 90), and Treponema denticola (OR: 25). In the NNRTI HAART group, higher OR were documented for Fusobacterium nucleatum (OR: 56) and Eikenella corrodens (OR: 25). The association between A. viscosus and PI HAART was statistically significant (P = 0.03). CONCLUSIONS The results demonstrated statistical associations between subgingival bacteria and antiretroviral drug therapies. Further investigation on the clinical significance and underlying mechanisms are needed to support these findings.
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Affiliation(s)
- Rainer A Jordan
- Department of Operative and Preventive Dentistry, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | | | - Stefan Zimmer
- Department of Operative and Preventive Dentistry, Faculty of Health, Witten/Herdecke University, Witten, Germany
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Abstract
Human immunodeficiency virus (HIV) primary infection occurs at mucosa tissues, suggesting an intricate interplay between the microbiome and HIV infection. Recent advanced technologies of high-throughput sequencing and bioinformatics allow researchers to explore nonculturable microbes, including bacteria, virus, and fungi, and their association with diseases. HIV/simian immunodeficiency virus infection is associated with microbiome shifts and immune activation that may affect the outcome of disease progression. In this review, the authors focus on microbiome in HIV infection at various mucosal compartments. Understanding the relationship between microbiome and HIV may offer insights into development of better strategies for HIV prevention and treatment.
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Affiliation(s)
- January T Salas
- Department of Microbiology and Molecular Genetics, Public Health Research Institute, Rutgers-New Jersey Medical School, 225 Warren Street, Newark, NJ 07103, USA
| | - Theresa L Chang
- Department of Microbiology and Molecular Genetics, Public Health Research Institute, Rutgers-New Jersey Medical School, 225 Warren Street, Newark, NJ 07103, USA.
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Dai L, DeFee MR, Cao Y, Wen J, Wen X, Noverr MC, Qin Z. Lipoteichoic acid (LTA) and lipopolysaccharides (LPS) from periodontal pathogenic bacteria facilitate oncogenic herpesvirus infection within primary oral cells. PLoS One 2014; 9:e101326. [PMID: 24971655 PMCID: PMC4074159 DOI: 10.1371/journal.pone.0101326] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 06/05/2014] [Indexed: 02/03/2023] Open
Abstract
Kaposi's sarcoma (KS) remains the most common tumor arising in patients with HIV/AIDS, and involvement of the oral cavity represents one of the most common clinical manifestations of this tumor. HIV infection incurs an increased risk for periodontal diseases and oral carriage of a variety of bacteria. Whether interactions involving pathogenic bacteria and oncogenic viruses in the local environment facilitate replication or maintenance of these viruses in the oral cavity remains unknown. In the current study, our data indicate that pretreatment of primary human oral fibroblasts with two prototypical pathogen-associated molecular patterns (PAMPs) produced by oral pathogenic bacteria-lipoteichoic acid (LTA) and lipopolysaccharide (LPS), increase KSHV entry and subsequent viral latent gene expression during de novo infection. Further experiments demonstrate that the underlying mechanisms induced by LTA and/or LPS include upregulation of cellular receptor, increasing production of reactive oxygen species (ROS), and activating intracellular signaling pathways such as MAPK and NF-κB, and all of which are closely associated with KSHV entry or gene expression within oral cells. Based on these findings, we hope to provide the framework of developing novel targeted approaches for treatment and prevention of oral KSHV infection and KS development in high-risk HIV-positive patients.
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Affiliation(s)
- Lu Dai
- Research Center for Translational Medicine and Key Laboratory of Arrhythmias. East Hospital, Tongji University School of Medicine, Shanghai, China
- Department of Medicine, Louisiana State University Health Sciences Center, Louisiana Cancer Research Center, New Orleans, Louisiana, United States of America
| | - Michael R. DeFee
- Department of Oral Health Sciences, Medical University of South Carolina, Charleston, South Carolina, United States of America
| | - Yueyu Cao
- Research Center for Translational Medicine and Key Laboratory of Arrhythmias. East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jiling Wen
- Department of Urology, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiaofei Wen
- Department of Urology, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Mairi C. Noverr
- Department of Oral and Craniofacial Biology, Louisiana State University Health Sciences Center, Louisiana Cancer Research Center, New Orleans, Louisiana, United States of America
| | - Zhiqiang Qin
- Research Center for Translational Medicine and Key Laboratory of Arrhythmias. East Hospital, Tongji University School of Medicine, Shanghai, China
- Department of Microbiology/Immunology/Parasitology, Louisiana State University Health Sciences Center, Louisiana Cancer Research Center, New Orleans, Louisiana, United States of America
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Short-chain fatty acids from periodontal pathogens suppress histone deacetylases, EZH2, and SUV39H1 to promote Kaposi's sarcoma-associated herpesvirus replication. J Virol 2014; 88:4466-79. [PMID: 24501407 DOI: 10.1128/jvi.03326-13] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
UNLABELLED Periodontal pathogens such as Porphyromonas gingivalis and Fusobacterium nucleatum produce five different short-chain fatty acids (SCFAs) as metabolic by-products. We detect significantly higher levels of SCFAs in the saliva of patients with severe periodontal disease. The different SCFAs stimulate lytic gene expression of Kaposi's sarcoma-associated herpesvirus (KSHV) dose dependently and synergistically. SCFAs inhibit class-1/2 histone deacetylases (HDACs) and downregulate expression of silent information regulator-1 (SIRT1). SCFAs also downregulate expression of enhancer of zeste homolog2 (EZH2) and suppressor of variegation 3-9 homolog1 (SUV39H1), which are two histone N-lysine methyltransferases (HLMTs). By suppressing the different components of host epigenetic regulatory machinery, SCFAs increase histone acetylation and decrease repressive histone trimethylations to transactivate the viral chromatin. These new findings provide mechanistic support that SCFAs from periodontal pathogens stimulate KSHV replication and infection in the oral cavity and are potential risk factors for development of oral Kaposi's sarcoma (KS). IMPORTANCE About 20% of KS patients develop KS lesions first in the oral cavity, while other patients never develop oral KS. It is not known if the oral microenvironment plays a role in oral KS tumor development. In this work, we demonstrate that a group of metabolic by-products, namely, short-chain fatty acids, from bacteria that cause periodontal disease promote lytic replication of KSHV, the etiological agent associated with KS. These new findings provide mechanistic support that periodontal pathogens create a unique microenvironment in the oral cavity that contributes to KSHV replication and development of oral KS.
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John CN, Stephen LX, Joyce Africa CW. Is human immunodeficiency virus (HIV) stage an independent risk factor for altering the periodontal status of HIV-positive patients? A South African study. BMC Oral Health 2013; 13:69. [PMID: 24295071 PMCID: PMC4219621 DOI: 10.1186/1472-6831-13-69] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 11/26/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The immunosuppresion in HIV patients makes them highly susceptible to microbial infections. The aim of the study was to establish whether HIV stage (as depicted by CD4+ T lymphocyte counts) could independently be associated with periodontal status (as revealed by the measurement of clinical indices). METHODS One hundred and twenty HIV-infected patients attending an infectious diseases clinic in the Western Cape, South Africa were included in the study. The periodontal clinical indices such as plaque index, gingival index, pocket probing depth and clinical attachment levels were measured on the mesial aspect of the six Ramfjord teeth. The CD4 + T cell counts were taken from the patients' medical records and patients' HIV stage determined and grouped according to their CD4+ T cell counts into A (<200 cells /mm3), B (200-500 cells /mm3) and C (>500 cells /mm3). RESULTS The mean age of 120 HIV-positive patients was 33.25 years and the mean CD4 + T cell count was 293.43 cells/mm3. The probing depth and clinical attachment loss were found to be significantly associated with the total CD4 + T cell counts but not with HIV stage. Significant correlations were found between age and all clinical indices except for clinical attachment loss. No correlation was found between age and HIV stage of the patients. The use of antiretroviral therapy was significantly associated with probing depth and clinical attachment loss, but not with plaque nor gingival index. Significant associations were observed between smoking and all of the clinical indices except for the gingival index. A significant association was observed between the use of interdental aids and all the clinical indices except for probing depth, while brushing was significantly associated with plaque index only. CD4 + T cell counts were significantly associated with brushing frequency (p = 0.0190) and the use of interdental aids (p = 0.0170). CONCLUSION The findings of this study conclude that HIV stage, ART and age are not independent risk factors for changes in the periodontal status of HIV-positive subjects but rather that smoking and oral hygiene habits determine their susceptibility to disease.
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Affiliation(s)
- Cathy Nisha John
- Department of Periodontics and Oral Medicine, University of the Western Cape, Western Cape, South Africa
| | - Lawrence Xavier Stephen
- Department of Periodontics and Oral Medicine, University of the Western Cape, Western Cape, South Africa
| | - Charlene Wilma Joyce Africa
- Anaerobe group, Department of Medical Biosciences, University of the Western Cape, Western Cape, South Africa
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Abstract
Human immunodeficiency virus (HIV)-associated oral disease among people living with HIV infection includes oral candidiasis, oral hairy leukoplakia, Kaposi sarcoma, oral warts, herpes simplex virus ulcers, major aphthous ulcers or ulcers not otherwise specified, HIV salivary gland disease, and atypical gingival and periodontal diseases. Diagnosis of some oral lesions is based on clinical appearance and behavior, whereas others require biopsy, culture, or imaging for definitive diagnosis. Management strategies including pharmacologic and nonpharmacologic approaches are discussed in this article. Dentists also need to be cognizant of the potential oral side effects of HIV antiretroviral medications.
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MESH Headings
- AIDS-Related Opportunistic Infections/diagnosis
- AIDS-Related Opportunistic Infections/therapy
- Antiretroviral Therapy, Highly Active/adverse effects
- Candidiasis, Oral/diagnosis
- Candidiasis, Oral/etiology
- Candidiasis, Oral/therapy
- HIV Infections/complications
- Humans
- Leukoplakia, Hairy/diagnosis
- Leukoplakia, Hairy/etiology
- Leukoplakia, Hairy/therapy
- Mouth Mucosa/pathology
- Mouth Neoplasms/diagnosis
- Mouth Neoplasms/etiology
- Sarcoma, Kaposi/diagnosis
- Sarcoma, Kaposi/etiology
- Sarcoma, Kaposi/therapy
- Sialadenitis/diagnosis
- Sialadenitis/etiology
- Sialadenitis/therapy
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Affiliation(s)
- Lauren L Patton
- Department of Dental Ecology, School of Dentistry, University of North Carolina, Room 467A, Brauer Hall, Chapel Hill, NC 27599-7450, USA.
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Pereira VT, Pavan P, Souza RC, Souto R, Vettore MV, Torres SR, Colombo APV, de Uzeda M, Sansone C, Gonçalves LS. The association between detectable plasmatic human immunodeficiency virus (HIV) viral load and different subgingival microorganisms in Brazilian adults with HIV: a multilevel analysis. J Periodontol 2013; 85:697-705. [PMID: 23952074 DOI: 10.1902/jop.2013.130273] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND This study investigates the association between detectable plasmatic human immunodeficiency virus (HIV) viral load (HVL) and high levels of periodontal- and non-periodontal-related microorganisms in the subgingival microbiota of individuals with HIV. METHODS Thirty-seven individuals with HIV were divided into two groups: 1) detectable HVL (n = 15); and 2) undetectable HVL (n = 22). Subgingival biofilm samples were obtained, and the levels of 35 microbial species were determined by the checkerboard DNA-DNA hybridization method. Periodontal clinical measures and laboratory and sociodemographic data were also registered. χ(2) test, Fisher exact test, and Mann-Whitney U test were used to compare groups. Multilevel ordinal regression models were used to test the association between HVL and the levels of 35 microbial species in subgingival biofilm, adjusted for confounders. RESULTS Of the 35 species studied, 11 (31.4%) showed higher mean levels in the detectable HVL group than undetectable HVL group (P <0.001). These species included Actinomyces naeslundii II, Actinomyces israelii, Actinomyces odontolyticus, Veillonella parvula, Capnocytophaga gingivalis, Eikenella corrodens, Campylobacter concisus, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Candida albicans. Significant associations between detectable HVL and high levels of microorganisms, adjusted for confounders, were observed for A. naeslundii I, Actinomyces gerencseriae, C. gingivalis, E. corrodens, C. concisus, Prevotella nigrescens, T. forsythia, and Dialister pneumosintes. CONCLUSION Detectable plasmatic HVL in individuals with HIV was associated with elevated levels of known periodontal pathogens, such as P. nigrescens, T. forsythia, and E. corrodens, as well as C. concisus, C. gingivalis, and D. pneumosintes in the subgingival biofilm.
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Affiliation(s)
- Viviane Tiago Pereira
- Department of Dental Clinics, Division of Graduate Periodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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50
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Noro Filho GA, Salgado DMRDA, Casarin RCV, Casati MZ, Costa C, Giovani EM. Anti-infective periodontal therapy promoting improvement in systemic markers of HIV infection. AIDS Res Hum Retroviruses 2013; 29:1040-4. [PMID: 23530962 DOI: 10.1089/aid.2012.0359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Research supports the theory that the chronic infectious response occurring in periodontal disease may have a role as a risk modifier of systemic diseases. This study assessed the impact of HIV-associated chronic periodontitis treatment on systemic HIV-related markers (CD4 T lymphocytes cell counts and HIV viral load). Fifteen HIV patients presenting chronic periodontitis [at least eight sites presenting a probing depth (PD) >4 mm and bleeding] were included in this study. Patients received full mouth periodontal treatment with an ultrasonic device and supragingival plaque control. Medical (CD4 cell counts and HIV load) as well as periodontal clinical parameters [probing pocket depth (PPD), clinical attachment level (CAL)] were assessed at baseline and 3 and 6 months after treatment. ANOVA/Tukey and Pearson's correlation tests were used for statistical analysis (α=5%). The results showed that PPD reduction and CAL gain were statistically significant at 3 and 6 months after periodontal therapy (p<0.05). At 6 months, CAL gain was 0.6±0.5 mm and PPD reduction was 0.7±0.5 mm. At the same time, a statistically significant increase in CD4 cell counts could be seen after the third month (p<0.05) and sixth month (p<0.05). Moreover, at 6 months, the relationship between the improvement in clinical parameters, i.e., PPD reduction, and the number of TCD4 lymphocytes could be highlighted. This was shown as the greater the PPD reduction, the greater the increase in TCD4 cells (r=0.68, p=0.02). These data suggest that periodontitis treatment could be associated with an improvement in medical conditions in HIV subjects.
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Affiliation(s)
- Gilberto Araujo Noro Filho
- Division of Special Care in Dentistry, Paulista University, São Paulo, São Paulo, Brazil
- Departament of Stomatology, University of São Paulo School of Dentistry, São Paulo, São Paulo, Brazil
| | - Daniela Miranda Richarte de Andrade Salgado
- Division of Special Care in Dentistry, Paulista University, São Paulo, São Paulo, Brazil
- Departament of Stomatology, University of São Paulo School of Dentistry, São Paulo, São Paulo, Brazil
| | | | | | - Claudio Costa
- Departament of Stomatology, University of São Paulo School of Dentistry, São Paulo, São Paulo, Brazil
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