| Autor: |
Lomeli-Martinez SM; 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., Valentin-Goméz E; GMCA Research Unit, Department of Microbiology and Ecology, University of Valencia, Valencia, Spain.; Severe Infection Group, Health Research Institute 'La Fe,', Valencia, Spain., Varela-Hernández JJ; Department of Medical and Life Sciences, Centro Universitario de la Ciénega, University of Guadalajara, Ocotlán, Mexico., Alvarez-Zavala M; HIV and Immunodeficiencies Research Institute, Clinical Medicine Department, Centro Universitario de Ciencias de la Salud-University of Guadalajara, Guadalajara, Mexico., Sanchez-Reyes K; HIV and Immunodeficiencies Research Institute, Clinical Medicine Department, Centro Universitario de Ciencias de la Salud-University of Guadalajara, Guadalajara, Mexico., Ramos-Solano M; HIV and Immunodeficiencies Research Institute, Clinical Medicine Department, Centro Universitario de Ciencias de la Salud-University of Guadalajara, Guadalajara, Mexico., Cabrera-Silva RI; HIV and Immunodeficiencies Research Institute, Clinical Medicine Department, Centro Universitario de Ciencias de la Salud-University of Guadalajara, Guadalajara, Mexico., Ramirez-Anguiano VM; Department of Integrated Dentistry Clinics, Centro Universitario de Ciencias de la Salud, University of Guadalajara, Guadalajara, Mexico., Lomeli-Martinez MA; Department of Wellbeing and Sustainable Development, Centro Universitario del Norte, University of Guadalajara, Colotlán, Mexico., Martinez-Salazar SY; Department of Medical and Life Sciences, Centro Universitario de la Ciénega, University of Guadalajara, Ocotlán, Mexico., González-Hernández LA; 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., Andrade-Villanueva JF; 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. |
| Abstrakt: |
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. |
