Oral human β‐defensin 2 in HIV‐infected subjects with long‐term use of antiretroviral therapy

Abstract

BACKGROUND The objectives of this study were to determine 1) oral hBD2 expression in HIV-infected subjects compared to non-HIV controls, 2) the expression of oral hBD2 in HIV-infected subjects with ART compared with those without ART, and 3) factors associated with the expression of oral hBD2. METHODS Oral examination and punched biopsy on buccal mucosa were performed in HIV-infected subjects with and without ART, and non-HIV individuals. The expression of hBD2 mRNA was determined by quantitative real-time PCR. Saliva samples of both un-stimulated and stimulated saliva were collected and analyzed for hBD2 levels using ELISA. Student’s t-test and nonparametric multi-way ANOVA test were used for comparison of measurements between or among groups. RESULTS One hundred and fifty-seven HIV-infected subjects were enrolled; 99 on ART (age range 23–57 yr, mean 39 yr), 58 not on ART (age range 20–59 yr, mean 34 yr), and 50 non-HIV controls (age range 19–59 yr, mean 36 yr). The most common ART regimen was 2 NRTIs+1 NNRTI. Salivary levels of hBD2 were significantly increased in HIV infection (p< 0.001). The levels of hBD2 in stimulated saliva were also found to be significantly different between HIV-infected subjects who were and were not on ART (p< 0.001). No significant difference was observed with the expression of hBD2 mRNA. CONCLUSION Oral innate immunity is affected by HIV infection and use of ART. Salivary hBD2 levels may be the useful biomarkers to monitor those on long-term ART who are at risk of developing oral infections and malignant transformation.

Subgingival bacterial community profiles in HIV‐infected Brazilian adults with chronic periodontitis

“…Nittayananta et al . demonstrated that the levels of human β‐defensin‐2 protein in saliva of HIV‐infected individuals was increased with short‐term use of HAART but decreased with long‐term use of the medication. This change in oral mucosal immunity may result in significant alterations in the composition of oral bacteria, putting HIV‐infected patients at risk of developing oral infections .…”

Oral innate immunity in HIV infection in HAART era

“…The infection may directly affect the oral epithelium, resulting in the alterations in the cell structure and function that impair the innate immunity and promote colonization and infection by commensal and pathogenic organisms (6, 14, 15). Thus, oral lesions in HIV- infected individuals have been firstly documented since 1981 in a cohort of young homosexual males presenting with Pneumocystis carinii pneumonia (PCP) and concurrent mucosal candidiasis (16).…”

“…Many factors may contribution to the differences between the studies such as sample size and cohort effects, as well as types of saliva studied (whole saliva vs. glandular saliva). The levels of hBD-2 proteins in stimulated saliva were also found to be significantly different between HIV-infected patients who received HAART compared to those who were not on the medication (6). These findings suggest that HAART may impair oral epithelial cells functions in innate immunity leading to the alterations of the oral hBD-2 expression (6).…”

“…The levels of hBD-2 proteins in stimulated saliva were also found to be significantly different between HIV-infected patients who received HAART compared to those who were not on the medication (6). These findings suggest that HAART may impair oral epithelial cells functions in innate immunity leading to the alterations of the oral hBD-2 expression (6). Although previous studies suggested that oral innate immunity is affected by the use of HAART (6, 43, 115), knowledge about the mechanisms involved is still lacking and needs further investigations.…”

“…In addition, the levels of SLPI proteins in stimulated saliva were decreased with the use of HAART (43). These finding suggests that oral innate immunity may be enhanced by short-term use of HAART, but it may be adversely affected by long-term use of the medication (6). However, no significant association between types of HAART and the levels of salivary hBD-2 proteins was observed in the study because most patients received the same regimen of 2 NRTIs + 1 NNRTI.…”