Periodontal disease in HIV-infected adults in the HAART era: Clinical, immunological, and microbiological aspects

Gonçalves, Lúcio Souza; Gonçalves, Barbara Mulatinho Lopo; Fontes, Tatiana Vasconcellos

doi:10.1016/j.archoralbio.2013.05.002

Cited by 42 publications

(46 citation statements)

References 99 publications

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“…characterized by a significant increase in generalized immune activation (1,2) and in mucosal inflammatory conditions such as periodontitis and gingivitis (3)(4)(5)(6). Some studies have reported an increased migration of inflammatory cells into the oral mucosa (7), whereas others have shown that levels of proinflammatory cytokines such as interleukin-6 (IL-6) (8-10) were significantly elevated during HIV infection.…”

Section: Hronic Human Immunodeficiency Virus (Hiv) Infection Ismentioning

confidence: 99%

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

George

Lewis

Renne

et al. 2015

J Virol

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C hronic human immunodeficiency virus (HIV) infection is characterized by a significant increase in generalized immune activation (1, 2) and in mucosal inflammatory conditions such as periodontitis and gingivitis (3-6). Some studies have reported an increased migration of inflammatory cells into the oral mucosa (7), whereas others have shown that levels of proinflammatory cytokines such as interleukin-6 (IL-6) (8-10) were significantly elevated during HIV infection. Interestingly, chronic immune activation and mucosal inflammation occurs in the presence of transforming growth factor ␤ (TGF␤), a highly immunosuppressive cytokine (11, 12) that has been shown to deactivate mononuclear phagocytes (13), reduce IL-2 receptor expression on T cells, and inhibit IL-2-induced T cell proliferation (14,15).Numerous studies have shown that TGF␤ levels were elevated during HIV infection and were associated with disease progression (16-18). Titers of plasma TGF␤ were shown to be sufficient to induce cellular responses in vitro (16). Likewise, simian immunodeficiency virus (SIV)-infected rhesus macaques were found to have persistently increased levels of TGF␤ in the plasma during chronic infection (19).Why immune activation and chronic inflammation persist even in the presence of high levels of immunosuppressive cytokines is not clear. Ploquin et al. (20) reported that the failure of TGF␤ to resorb virus-driven inflammation and activation during pathogenic HIV type 1 (HIV-1) and SIV infections may be due to increased unresponsiveness to TGF␤ that was associated with altered signaling. The exact mechanisms for this unresponsiveness are still not clear.TGF␤ binds to and signals through its high-affinity type I and type II serine/threonine kinase receptors TGF␤ receptor 1 (TGF␤-R1) and TGF␤-R2, which are expressed on a variety of cell types (21,22). Binding of TGF␤ to TGF␤-R2 phosphorylates and activates TGF␤-R1, which in turn recruits and phosphorylates a number of receptor-activated Smad proteins such as Smad1 to Smad5 (23). We hypothesized that the inability of TGF␤ to suppress immune activation may be associated with the dysregulated expression of its receptors in the oral mucosa. The loss of TGF␤ receptors has been shown to mediate resistance to TGF␤ in cell lines (22,24). We used the rhesus macaque model of HIV infection to address this question.Seventeen rhesus macaques (Macaca mulatta) of Indian origin (n ϭ 17) were used in this study. Ten animals were chronically infected with pathogenic SIVmac251, whereas the rest (n ϭ 7) were uninfected. The animals were housed in accordance with the guidelines of the American Association for Accreditation of Laboratory Animal and were seronegative for SIV, simian retrovirus (SRV), and simian T-cell leukemia virus (STLV) type 1 prior to SIV challenge.Peripheral blood and oropharyngeal tissue samples were collected at the time of sacrifice. Plasma and peripheral blood mononuclear cells (PBMC) were isolated and cryopreserved along with the oropharyngeal tissue samples. PBMC were isolated...

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Section: Hronic Human Immunodeficiency Virus (Hiv) Infection Ismentioning

confidence: 99%

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

George

Lewis

Renne

et al. 2015

J Virol

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“…[24] There are a few studies that concur with our results such as the one done by Greenspan et al [25] This reduction in occurrence as is due to the fact that many of the periodontal diseases in patients with HIV are caused by the opportunistic microbes, and that the increase in CD4+ counts in patients under HAART reduces the colonization of such microbes. [26]…”

Section: Discussionmentioning

confidence: 99%

Impact of highly active antiretroviral therapy on oral manifestations of patients with human immunodeficiency virus/acquired immuno deficiency syndrome in South India

Rao

Chitturi

Kattappagari

et al. 2015

Indian J Sex Transm Dis

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Background:Human immunodeficiency virus (HIV) infection remains a global health problem, although the development of highly active antiretroviral therapy (HAART) has significantly modified the course of HIV disease into a manageable disease with improved quality-of-life mainly in the developed countries. Very few studies are available regarding effect of HAART on oral lesions in developing countries like India.Aims and Objectives:The aim was to document and compare oral lesions in HIV-seropositive patients before and after HAART.Materials and Methods:Oral manifestations were recorded in 320 HIV seropositive patients attending to the Voluntary Counseling and Confidential Testing Centre at the Government General Hospital, Guntur, before and after treating with HAART and the results were statistically analyzed using Student's t-test and Chi-square test.Results:Oral Candidiasis was significantly reduced in patients under HAART after 3 months. Furthermore, there was decreased incidence of periodontal diseases, but increased hyperpigmentation in patients undergoing HAART.Conclusion:The oral manifestations of HIV infection have changed due to the advent of HAART. Many opportunistic infections have resolved as a result of an improved immune system. Though the risk of hyperpigmentation in those with HAART has increased the prevalence of oral candidiasis and periodontal diseases were less in patients who had access to HAART.

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“…Exact percentage of oral candidiasis in HIV patients is diffi cult to determine due to variations in the study designs. Generally, HAART has considerably reduced the incidence of oral candidiasis in HIV patients (Coogan et al 2005 ;Cerqueira et al 2010 ;Goncalves et al 2013 ). On the other hand, some studies report a signifi cant reduction in hyperplastic and pseudomembranous variants of the disease with a compensatory increase in erythematous candidiasis (Ceballos-Salobrena et al 2004 ).…”

Section: Hiv-associated Oral Candidiasis and Linear Gingival Erythemamentioning

confidence: 97%

“…CD88 expression of PMNL has been shown to be defective in AIDS state. These factors may contribute to the high prevalence of oral Candida lesions seen in HIV-infected patients including that of LGE (Goncalves et al 2013 ).…”

Section: Proposed Mechanismmentioning

confidence: 98%

Association of Candida with Linear Gingival Erythema in HIV-Infected Subjects

Seneviratne

Jayasinghe

2015

Oral Candidosis

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Linear gingival erythema (LGE) in HIV patients has a contentious association with Candida infection. Although now it is widely accepted that Candida contributes to the occurrence of LGE, still some controversy exists in the nature of its association as an aetiological agent. We will briefl y discuss the clinical picture of LGE. This will be followed by an update on insight of microbial association with the lesion, prevalence of LGE, diagnosis and treatment. The current hypothesis and proposed mechanism of the LGE are then discussed.

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Periodontal disease in HIV-infected adults in the HAART era: Clinical, immunological, and microbiological aspects

Cited by 42 publications

References 99 publications

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

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

Impact of highly active antiretroviral therapy on oral manifestations of patients with human immunodeficiency virus/acquired immuno deficiency syndrome in South India

Association of Candida with Linear Gingival Erythema in HIV-Infected Subjects

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