1
|
Golob Deeb J, Elnakka L, Deeb GR. Systemic management and periodontal treatment of HIV-necrotizing periodontitis: A case report. Clin Adv Periodontics 2024; 14:127-133. [PMID: 37313786 DOI: 10.1002/cap.10252] [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: 03/14/2023] [Revised: 05/26/2023] [Accepted: 06/06/2023] [Indexed: 06/15/2023]
Abstract
BACKGROUND Necrotizing periodontitis (NP) is a rare form of periodontal disease. It can manifest in immunocompromised patients and present as painful and rapidly progressing destruction with necrotic and ulcerated periodontal tissues. This case report describes a rare case of severe NP in human immunodeficiency virus (HIV)-positive patient including medical management and periodontal treatment. METHODS A 28-year-old male presented to the periodontal clinic with chief complaint of severe oral pain leading to loss of chewing ability, spontaneous gingival bleeding, generalized gingival recession, tooth mobility, and dentinal hypersensitivity. Clinical and radiographic examination revealed generalized tissue necrosis with severe periodontal destruction, extensive bleeding, spontaneous suppuration, and heavy biofilm. RESULTS Medical history was positive for perinatal HIV infection, which was treated and patient was asymptomatic until he discontinued antiviral medications nine years ago. Following initial examination, patient was referred to the Infectious disease clinic and multidisciplinary management was initiated with comprehensive management of primary disease including systemic antiviral, antibiotic, and antifungal therapy to establish immunocompetence compatible with providing mechanical nonsurgical periodontal treatment. CONCLUSIONS This case report highlights a severe and generalized form of NP in an HIV patient due to the cessation of antiviral therapy. Favorable course of interdisciplinary medical and periodontal therapy resulted in significant improvement in patient's systemic, oral, and periodontal health.
Collapse
Affiliation(s)
- Janina Golob Deeb
- Department of Periodontics, Virginia Commonwealth University, Richmond, Virginia
| | - Lina Elnakka
- Department of Periodontics, Virginia Commonwealth University, Richmond, Virginia
| | - George R Deeb
- Department of Oral and Maxillofacial Surgery, Virginia Commonwealth University, Richmond, Virginia
| |
Collapse
|
2
|
Li S, Yang X, Moog C, Wu H, Su B, Zhang T. Neglected mycobiome in HIV infection: Alterations, common fungal diseases and antifungal immunity. Front Immunol 2022; 13:1015775. [PMID: 36439143 PMCID: PMC9684632 DOI: 10.3389/fimmu.2022.1015775] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 10/26/2022] [Indexed: 09/16/2023] Open
Abstract
Human immunodeficiency virus (HIV) infection might have effects on both the human bacteriome and mycobiome. Although many studies have focused on alteration of the bacteriome in HIV infection, only a handful of studies have also characterized the composition of the mycobiome in HIV-infected individuals. Studies have shown that compromised immunity in HIV infection might contribute to the development of opportunistic fungal infections. Despite effective antiretroviral therapy (ART), opportunistic fungal infections continue to be a major cause of HIV-related mortality. Human immune responses are known to play a critical role in controlling fungal infections. However, the effect of HIV infection on innate and adaptive antifungal immunity remains unclear. Here, we review recent advances in understanding of the fungal microbiota composition and common fungal diseases in the setting of HIV. Moreover, we discuss innate and adaptive antifungal immunity in HIV infection.
Collapse
Affiliation(s)
- Shuang Li
- Beijing Key Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
- Sino-French Joint Laboratory for Research on Humoral Immune Response to HIV Infection, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Xiaodong Yang
- Beijing Key Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
- Sino-French Joint Laboratory for Research on Humoral Immune Response to HIV Infection, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Christiane Moog
- Laboratoire d’ImmunoRhumatologie Moléculaire, Institut national de la santé et de la recherche médicale (INSERM) UMR_S 1109, Institut thématique interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Faculté de Médecine, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
- Vaccine Research Institute (VRI), Créteil, France
| | - Hao Wu
- Beijing Key Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
- Sino-French Joint Laboratory for Research on Humoral Immune Response to HIV Infection, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Bin Su
- Beijing Key Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
- Sino-French Joint Laboratory for Research on Humoral Immune Response to HIV Infection, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Tong Zhang
- Beijing Key Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
- Sino-French Joint Laboratory for Research on Humoral Immune Response to HIV Infection, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
3
|
Li S, Su B, He QS, Wu H, Zhang T. Alterations in the oral microbiome in HIV infection: causes, effects and potential interventions. Chin Med J (Engl) 2021; 134:2788-2798. [PMID: 34670249 PMCID: PMC8667981 DOI: 10.1097/cm9.0000000000001825] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Indexed: 12/02/2022] Open
Abstract
ABSTRACT A massive depletion of CD4+ T lymphocytes has been described in early and acute human immunodeficiency virus (HIV) infection, leading to an imbalance between the human microbiome and immune responses. In recent years, a growing interest in the alterations in gut microbiota in HIV infection has led to many studies; however, only few studies have been conducted to explore the importance of oral microbiome in HIV-infected individuals. Evidence has indicated the dysbiosis of oral microbiota in people living with HIV (PLWH). Potential mechanisms might be related to the immunodeficiency in the oral cavity of HIV-infected individuals, including changes in secretory components such as reduced levels of enzymes and proteins in saliva and altered cellular components involved in the reduction and dysfunction of innate and adaptive immune cells. As a result, disrupted oral immunity in HIV-infected individuals leads to an imbalance between the oral microbiome and local immune responses, which may contribute to the development of HIV-related diseases and HIV-associated non-acquired immunodeficiency syndrome comorbidities. Although the introduction of antiretroviral therapy (ART) has led to a significant decrease in occurrence of the opportunistic oral infections in HIV-infected individuals, the dysbiosis in oral microbiome persists. Furthermore, several studies with the aim to investigate the ability of probiotics to regulate the dysbiosis of oral microbiota in HIV-infected individuals are ongoing. However, the effects of ART and probiotics on oral microbiome in HIV-infected individuals remain unclear. In this article, we review the composition of the oral microbiome in healthy and HIV-infected individuals and the possible effect of oral microbiome on HIV-associated oral diseases. We also discuss how ART and probiotics influence the oral microbiome in HIV infection. We believe that a deeper understanding of composition and function of the oral microbiome is critical for the development of effective preventive and therapeutic strategies for HIV infection.
Collapse
Affiliation(s)
- Shuang Li
- Beijing Key Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Bin Su
- Beijing Key Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Qiu-Shui He
- Institute of Biomedicine, Research Center for Infections and Immunity, University of Turku, Turku 20520, Finland
| | - Hao Wu
- Beijing Key Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Tong Zhang
- Beijing Key Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| |
Collapse
|
4
|
Oral lymphangioma-like Kaposi sarcoma: a Brazilian case report in a scenario of a still high number of HIV infections. Oral Maxillofac Surg 2021; 26:171-176. [PMID: 34089420 DOI: 10.1007/s10006-021-00974-8] [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: 03/04/2021] [Accepted: 05/17/2021] [Indexed: 10/21/2022]
Abstract
We present a challenging case of HIV-related lymphangioma-like Kaposi sarcoma (LLKS) affecting the oral cavity. A 54-year-old Brazilian male patient was referred to our center complaining of bleeding lesions affecting the oral cavity for 2 months. Interestingly, these oral lesions were the first clinical manifestation of HIV infection. Clinically, multiple erythematous nodular and patch lesions were observed. An incisional biopsy was performed, revealing numerous microscopic angled and irregular vascular channels lined with flattened endothelial cells. More cellularized and solid areas consisting of more fusiform cells with little pleomorphism and with slit-like vascular channels were noted. Based on immunoreactivity for CD31, CD34, D2-40, and HHV-8, the final diagnosis was oral LLKS. Highly active antiretroviral therapy (HAART) was initiated with dolutegravir, tenofovir, and lamivudine. During follow-up, the patient showed KS metastases to other sites and a chemotherapeutic protocol was initiated. Regression of the oral lesion was clearly noted by the clinicians 1 year after the KS diagnosis. Dentists should be able to recognize systemic diseases that affect the oral cavity such as KS in order to make an early diagnosis of its oral manifestations and to implement effective therapeutic measures to ensure a better prognosis.
Collapse
|
5
|
Mounika R, Nalabolu GK, Pallavi N, Birajdar SS. Association of oral candidal species with human immunodeficiency virus patients of West Godavari district, Andhra Pradesh - An in vitro study. J Oral Maxillofac Pathol 2021; 25:147-153. [PMID: 34349426 PMCID: PMC8272515 DOI: 10.4103/jomfp.jomfp_504_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/18/2021] [Accepted: 02/20/2021] [Indexed: 11/04/2022] Open
Abstract
Introduction: Human immunodeficiency virus (HIV) infection is a major worldwide health problem characterized by progressive immunosuppression. The morbidity of HIV patients is due to its association with opportunistic infections among which oral candidiasis is common. Regardless of HIV status, candidiasis can prevail when their immune system is depressed. Oral candidiasis can thus serve as a useful marker for both restoration of immune functions and HIV disease progression. Routine identification of Candida species is laborious and time-consuming. HICHROM agar stains different species into different colors facilitating rapid reliable identification of candida species as they differ in their virulence and sensitivity to antifungal drugs. Materials and Methods: This cross-sectional study includes a total of 200 HIV seropositive patients from Anti-Retroviral Therapy Centre, West Godavari District. Unstimulated saliva samples were collected in a screw-capped universal container. Five microliters of each sample using a sterile inoculating loop is streaked on the chromogenic agar culture media. The colonies formed are counted using a magnifying glass and LAPIZ colony counter. Candidal colony-forming units per milliliter were analyzed, compared and correlated among different study groups. Different candida species were also identified in the study. Results: Nonalbicans Candida was the most common species isolated in our study accounting for 53% and Candida albicans accounting for 47%. Considering initial and final CD4 counts, there is improvement in patients on retroviral therapy. Conclusion: Identification of the species is important for epidemiological reasons and for treatment purposes to ensure a better prognosis since some species present reduced susceptibility to azoles.
Collapse
Affiliation(s)
- R Mounika
- Department of Oral Pathology, Vishnu Dental College, Rajarajeswari Multispeciality Dental Clinic, Bhimavaram, Andhra Pradesh, India
| | - Govindraj K Nalabolu
- Department of Oral Pathology and Microbiology, GSL Dental College, Rajahmundry, Andhra Pradesh, India
| | - N Pallavi
- Department of Oral Pathology and Microbiology, Anil Neerukonda Institute of Dental Sciences, Vishakapatnam, Andhra Pradesh, India
| | - Smita S Birajdar
- Department of Oral Pathology and Microbiology, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| |
Collapse
|
6
|
Alves MDS, Fugisaki LRDO, Dos Santos JD, Scorzoni L, Medina RP, Silva DHS, Junqueira JC. Antifungal effects of Streptococcus mutans extract on Candida strains susceptible and resistant to fluconazole: An in vivo study. Med Mycol 2021; 59:744-747. [PMID: 33594432 DOI: 10.1093/mmy/myab008] [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: 10/01/2020] [Revised: 01/11/2021] [Accepted: 01/26/2021] [Indexed: 11/12/2022] Open
Abstract
Previous studies showed that the crude extract obtained from Streptococcus mutans inhibited the growth of Candida albicans reference strains. In this study, we evaluated whether the antifungal effects of S. mutans extract can be extended to clinical Candida isolates, including C. albicans and non-abicans strains with different susceptibilities to fluconazole. We verified that S. mutans extract increased the survival of Galleria mellonella larvae infected with C. albicans and C. glabrata and inhibited the fungal cells in hemolymph. These antifungal effects occurred for both fluconazole-susceptible and fluconazole-resistant strains. However, larvae infected by C. krusei were not affected by S. mutans extract. LAY SUMMARY Streptococcus mutans crude extract shows antifungal effects on clinical Candida strains susceptible and resistant to fluconazole in Galleria mellonella model.
Collapse
Affiliation(s)
- Mariana de Sá Alves
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, 12245-000, SP, Brazil
| | - Luciana Ruano de Oliveira Fugisaki
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, 12245-000, SP, Brazil
| | - Jéssica Diane Dos Santos
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, 12245-000, SP, Brazil
| | - Liliana Scorzoni
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, 12245-000, SP, Brazil
| | - Rebeca Previate Medina
- Department of Organic Chemistry, Institute of Chemistry, São Paulo State University (UNESP), Araraquara, 14800-900, SP, Brazil
| | - Dulce Helena Siqueira Silva
- Department of Organic Chemistry, Institute of Chemistry, São Paulo State University (UNESP), Araraquara, 14800-900, SP, Brazil
| | - Juliana Campos Junqueira
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, 12245-000, SP, Brazil
| |
Collapse
|
7
|
Reis INR, do Amaral GCLS, Mendoza AAH, das Graças YT, Mendes-Correa MC, Romito GA, Pannuti CM. Can preprocedural mouthrinses reduce SARS-CoV-2 load in dental aerosols? Med Hypotheses 2021; 146:110436. [PMID: 33288313 PMCID: PMC7691843 DOI: 10.1016/j.mehy.2020.110436] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 12/17/2022]
Abstract
Dental professionals work closely with patients and present an increased risk of person-to-person transmission of SARS-CoV-2. Moreover, the use of ultrasonic scalers, air-water syringes, and slow and high-speed handpieces, which are common in the dental office, generate spatter and aerosol. The use of preprocedural mouthrinses has been proposed to reduce the viral load in saliva and oropharyngeal tissues, thus decreasing viral load in dental aerosol. Although some mouthrinses demonstrates an antiviral effect, there is limited evidence about the clinical efficacy of any mouthrinse in the reduction of SARS-CoV-2 in the dental aerosol. We hypothesized that mouthrinses may reduce SARS-CoV-2 viral load in the oropharynx and its fluids reducing viral load in dental aerosol. The potential use of mouthrinses is discussed, along with proposal of in vitro and clinical studies, in order to evaluate this hypothesis. If this hypothesis holds true, dental professionals and patients may benefit from the routine use of preprocedural mouthrinses.
Collapse
Affiliation(s)
- Isabella Neme Ribeiro Reis
- Department of Estomatology, Division of Periodontology, School of Dentistry, University of São Paulo, Brazil; Institute of Tropical Medicine of São Paulo, Faculty of Medicine, University of São Paulo, Brazil.
| | - Guilherme Castro Lima Silva do Amaral
- Department of Estomatology, Division of Periodontology, School of Dentistry, University of São Paulo, Brazil; Institute of Tropical Medicine of São Paulo, Faculty of Medicine, University of São Paulo, Brazil.
| | - Aldrin André Huamán Mendoza
- Department of Estomatology, Division of Periodontology, School of Dentistry, University of São Paulo, Brazil; Institute of Tropical Medicine of São Paulo, Faculty of Medicine, University of São Paulo, Brazil.
| | - Yasmin Teixeira das Graças
- Department of Estomatology, Division of Periodontology, School of Dentistry, University of São Paulo, Brazil; Institute of Tropical Medicine of São Paulo, Faculty of Medicine, University of São Paulo, Brazil.
| | - Maria Cássia Mendes-Correa
- Department of Estomatology, Division of Periodontology, School of Dentistry, University of São Paulo, Brazil; Institute of Tropical Medicine of São Paulo, Faculty of Medicine, University of São Paulo, Brazil.
| | - Giuseppe Alexandre Romito
- Department of Estomatology, Division of Periodontology, School of Dentistry, University of São Paulo, Brazil; Institute of Tropical Medicine of São Paulo, Faculty of Medicine, University of São Paulo, Brazil.
| | - Claudio Mendes Pannuti
- Department of Estomatology, Division of Periodontology, School of Dentistry, University of São Paulo, Brazil; Institute of Tropical Medicine of São Paulo, Faculty of Medicine, University of São Paulo, Brazil.
| |
Collapse
|
8
|
Indrastiti RK, Wardhany II, Soegyanto AI. Oral manifestations of HIV: Can they be an indicator of disease severity? (A systematic review). Oral Dis 2020; 26 Suppl 1:133-136. [PMID: 32862546 DOI: 10.1111/odi.13394] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To review the existing research literature on the paradigm that the oral lesions could be an indicator of the disease severity with the objective of documenting the current status of research, highlighting its major findings. MATERIAL AND METHODS Publications were identified through a careful search, of which a majority focused on oral lesions as an indicator for HIV progression. A PubMed journal search of 10 years OF period publication (2009-2019) for "oral lesion, oral manifestation, indicator, HIV and HIV-associated" was performed and analysed. Various research methods were included within the study criteria including clinical study, clinical trial, comparative study and randomised control trial. RESULTS A total 33 studies were obtained and analysed, including cohort study, cross-sectional study, case-control study, clinical trial, retrospective observational analysis study, prospective observational study and randomised control trial. The most common oral lesions found in the studies were Kaposi sarcoma (KS), followed by oral candidiasis, periodontitis, necrotising ulcerative gingivitis (NUG), necrotising ulcerative periodontitis (NUP) and oral hairy leucoplakia (OHL). The early diagnosis and accurate treatment plan were very important to indicate the disease severity related to HIV infection. CONCLUSION Oral lesions reported in 39% articles and could be an indicator of HIV disease severity due to its effects on decreased cluster-differentiated (CD4+) T-cell count and increased viral load.
Collapse
Affiliation(s)
- Ratna Kumala Indrastiti
- Department of Oral Medicine, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Indriasti I Wardhany
- Department of Oral Medicine, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Anandina I Soegyanto
- Department of Oral Medicine, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| |
Collapse
|
9
|
Ramírez-Amador V, Patton LL, Naglik JR, Nittayananta W. Innovations for prevention and care of oral candidiasis in HIV-infected individuals: Are they available?-A workshop report. Oral Dis 2020; 26 Suppl 1:91-102. [PMID: 32862535 DOI: 10.1111/odi.13391] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Oral candidiasis (OC) is the most prevalent HIV-related oral lesion in patients on combined anti-retroviral therapy (cART) or without cART. Management is challenged in some patients by development of resistance to azole drugs, such as fluconazole. Recent scientific knowledge about OC pathogenesis, the role of OC in the immune reconstitution inflammatory syndrome (IRIS), the relationship of OC with the microbiome, and novelties in OC treatment was discussed in an international workshop format. Literature searches were conducted to address five questions: (a) Considering the pathogenesis of Candida spp. infection, are there any potential therapeutic targets that could be considered, mainly in HIV-infected individuals resistant to fluconazole? (b) Is oral candidiasis part of IRIS in HIV patients who receive cART? (c) Can management of the oral microbiome reduce occurrence of OC in patients with HIV infection? (d) What are the recent advances (since 2015) regarding plant-based and alternative medicines in management of OC? and (e) Is there a role for photodynamic therapy in management of OC in HIV-infected patients? A number of the key areas where further research is necessary were identified to allow a deeper insight into this oral condition that could help to understand its nature and recommend alternatives for care.
Collapse
Affiliation(s)
- Velia Ramírez-Amador
- Department of Health Care, Master´s Course in Oral Pathology and Oral Medicine, Universidad Autónoma Metropolitana-Xochimilco, México City, Mexico
| | - Lauren L Patton
- Division of Craniofacial and Surgical Care, Adams School of Dentistry University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Julian R Naglik
- Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | | |
Collapse
|
10
|
Dos Santos JD, Fugisaki LRDO, Medina RP, Scorzoni L, Alves MDS, de Barros PP, Ribeiro FC, Fuchs BB, Mylonakis E, Silva DHS, Junqueira JC. Streptococcus mutans Secreted Products Inhibit Candida albicans Induced Oral Candidiasis. Front Microbiol 2020; 11:1605. [PMID: 32760375 PMCID: PMC7374982 DOI: 10.3389/fmicb.2020.01605] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 06/19/2020] [Indexed: 12/24/2022] Open
Abstract
In the oral cavity, Candida species form mixed biofilms with Streptococcus mutans, a pathogenic bacterium that can secrete quorum sensing molecules with antifungal activity. In this study, we extracted and fractioned culture filtrate of S. mutans, seeking antifungal agents capable of inhibiting the biofilms, filamentation, and candidiasis by Candida albicans. Active S. mutans UA159 supernatant filtrate components were extracted via liquid-liquid partition and fractionated on a C-18 silica column to resolve S. mutans fraction 1 (SM-F1) and fraction 2 (SM-F2). We found anti-biofilm activity for both SM-F1 and SM-F2 in a dose dependent manner and fungal growth was reduced by 2.59 and 5.98 log for SM-F1 and SM-F2, respectively. The SM-F1 and SM-F2 fractions were also capable of reducing C. albicans filamentation, however statistically significant differences were only observed for the SM-F2 (p = 0.004). SM-F2 efficacy to inhibit C. albicans was confirmed by its capacity to downregulate filamentation genes CPH1, EFG1, HWP1, and UME6. Using Galleria mellonella as an invertebrate infection model, therapeutic treatment with SM-F2 prolonged larvae survival. Examination of the antifungal capacity was extended to a murine model of oral candidiasis that exhibited a reduction in C. albicans colonization (CFU/mL) in the oral cavity when treated with SM-F1 (2.46 log) and SM-F2 (2.34 log) compared to the control (3.25 log). Although both SM-F1 and SM-F2 fractions decreased candidiasis in mice, only SM-F2 exhibited significant quantitative differences compared to the non-treated group for macroscopic lesions, hyphae invasion, tissue lesions, and inflammatory infiltrate. Taken together, these results indicate that the SM-F2 fraction contains antifungal components, providing a promising resource in the discovery of new inhibitors for oral candidiasis.
Collapse
Affiliation(s)
- Jéssica Diane Dos Santos
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, Brazil
| | - Luciana Ruano de Oliveira Fugisaki
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, Brazil
| | - Rebeca Previate Medina
- Department of Organic Chemistry, Institute of Chemistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - Liliana Scorzoni
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, Brazil
| | - Mariana de Sá Alves
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, Brazil
| | - Patrícia Pimentel de Barros
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, Brazil
| | - Felipe Camargo Ribeiro
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, Brazil
| | - Beth Burgwyn Fuchs
- Division of Infectious Diseases, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Eleftherios Mylonakis
- Division of Infectious Diseases, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Dulce Helena Siqueira Silva
- Department of Organic Chemistry, Institute of Chemistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - Juliana Campos Junqueira
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, Brazil
| |
Collapse
|
11
|
Development of Probiotic Formulations for Oral Candidiasis Prevention: Gellan Gum as a Carrier To Deliver Lactobacillus paracasei 28.4. Antimicrob Agents Chemother 2020; 64:AAC.02323-19. [PMID: 32253208 DOI: 10.1128/aac.02323-19] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 03/29/2020] [Indexed: 01/12/2023] Open
Abstract
Probiotics might provide an alternative approach for the control of oral candidiasis. However, studies on the antifungal activity of probiotics in the oral cavity are based on the consumption of yogurt or other dietary products, and it is necessary to use appropriate biomaterials and specific strains to obtain probiotic formulations targeted for local oral administration. In this study, we impregnated gellan gum, a natural biopolymer used as a food additive, with a probiotic and investigated its antifungal activity against Candida albicans Lactobacillus paracasei 28.4, a strain recently isolated from the oral cavity of a caries-free individual, was incorporated in several concentrations of gellan gum (0.6% to 1% [wt/vol]). All tested concentrations could incorporate L. paracasei cells while maintaining bacterial viability. Probiotic-gellan gum formulations were stable for 7 days when stored at room temperature or 4°C. Long-term storage of bacterium-impregnated gellan gum was achieved when L. paracasei 28.4 was lyophilized. The probiotic-gellan gum formulations provided a release of L. paracasei cells over 24 h that was sufficient to inhibit the growth of C. albicans, with effects dependent on the cell concentrations incorporated into gellan gum. The probiotic-gellan gum formulations also had inhibitory activity against Candida sp. biofilms by reducing the number of Candida sp. cells (P < 0.0001), decreasing the total biomass (P = 0.0003), and impairing hyphae formation (P = 0.0002), compared to the control group which received no treatment. Interestingly, a probiotic formulation of 1% (wt/vol) gellan gum provided an oral colonization of L. paracasei in mice with approximately 6 log CFU/ml after 10 days. This formulation inhibited C. albicans growth (P < 0.0001), prevented the development of candidiasis lesions (P = 0.0013), and suppressed inflammation (P = 0.0006) compared to the mice not treated in the microscopic analysis of the tongue dorsum. These results indicate that gellan gum is a promising biomaterial and can be used as a carrier system to promote oral colonization for probiotics that prevent oral candidiasis.
Collapse
|
12
|
Fonseca RRS, Carvalho CA, Rodrigues TMS, Cavaleiro RMS, Menezes SAF, Machado LFA. Severe Necrotizing Periodontitis in an HIV-Infected Patient: Case Report and Non-Surgical Treatment. Clin Adv Periodontics 2020; 11:59-63. [PMID: 32277739 DOI: 10.1002/cap.10105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 03/27/2020] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Necrotizing periodontitis (NP) is an atypical and painful form of periodontal disease, it is described by a promptly progress of ulceration and destruction of periodontal tissues; the NP is commonly linked to HIV-positive patients. The aim of this report is to present a rare case of severe necrotizing ulcerative periodontitis treated non-surgically. CASE PRESENTATION A 28-year-old dark skin female patient was referred to a dentistry college with the main complaint of spontaneous gingival bleeding and enlargement, oral pain during deglutition and dental hypersensitivity. Clinical and radiographic examination revealed generalized severe periodontal destruction, extensive bleeding, increased biofilm presence and spontaneous suppuration. Medical exams were requested, red and white blood cells were evaluated and among those exams an enzyme-linked immunosorbent assay for HIV-1 antibodies, the result reveled reagent to HIV-1. The diagnosis of NP was assigned based on periodontal parameters such as necrosis and ulceration of the coronal portion of interdental papillae and gingival margin. Treatment established was scaling and root planning plus antibiotics. At 3 months of treatment the clinical and periodontal condition were stable. CONCLUSION This case report highlights a severe and generalized form of NP, where periodontal non-surgical associated with antimicrobials resulted in elimination of the gingival enlargement, necrosis and ulceration of the coronal portion of interdental papillae and significant improvement of periodontal parameters.
Collapse
Affiliation(s)
- Ricardo R S Fonseca
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, PA, Brazil
| | - Carlos A Carvalho
- Department of Periodontology, University Center of State of Pará, Belém, PA, Brazil
| | - Tânia M S Rodrigues
- Department of Periodontology, University Center of State of Pará, Belém, PA, Brazil
| | - Rosely M S Cavaleiro
- Department of Special Needs Care, University Center of State of Pará, Belém, PA, Brazil
| | - Silvio A F Menezes
- Department of Periodontology, University Center of State of Pará, Belém, PA, Brazil
| | - Luiz F A Machado
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, PA, Brazil
| |
Collapse
|
13
|
Ranganathan K, Umadevi KMR. Common oral opportunistic infections in Human Immunodeficiency Virus infection/Acquired Immunodeficiency Syndrome: Changing epidemiology; diagnostic criteria and methods; management protocols. Periodontol 2000 2019; 80:177-188. [PMID: 31090147 DOI: 10.1111/prd.12274] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
There were 36.9 million in the world living with human immunodeficiency virus (HIV) infection/acquired immunodeficiency syndrome (AIDS) as of 2017, and new infections have seen a reduction by 18% since 2010. But this rate of decline is not sufficient for the goal of eradication of AIDS by 2030. Only 21.7 million people infected with HIV have accesses to antiretroviral therapy, with the rest at risk of the potential complications of HIV infection. It has been shown that oral lesions are diagnostic and prognostic of HIV infection, and many oral opportunistic infections continue to be a major problem, particularly in developing countries. It is therefore important that dental surgeons be aware and updated to recognize and manage the oral effects of HIV infection/AIDS. This chapter describes the classification, diagnosis, and management of oral lesions in these patients, based on our current understanding of the infection. This review also discusses the standardization of diagnosis of oral lesions in HIV infection/AIDS patients, immune reconstitution inflammatory syndrome case definition, and the research priorities formulated at the 7th World Workshop on Oral Health and Disease in AIDS.
Collapse
Affiliation(s)
- Kannan Ranganathan
- Department of Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, Chennai, India
| | | |
Collapse
|
14
|
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.
Collapse
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
| |
Collapse
|
15
|
Robbins MR. Recent Recommendations for Management of Human Immunodeficiency Virus-Positive Patients. Dent Clin North Am 2018; 61:365-387. [PMID: 28317571 DOI: 10.1016/j.cden.2016.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Human immunodeficiency virus (HIV) infection has become a chronic condition. HIV is not a valid reason to deny, delay, or withhold dental treatment. There are no absolute contraindications and few complications associated with comprehensive oral health care treatment delivered in an outpatient setting for asymptomatic HIV-infected patients and clinically stable patients with AIDS. Consultation with the patient's medical provider and modifications in the delivery of dental treatment may be necessary when treating patients with advanced HIV disease or other comorbid conditions. Oral health care is an integral and important part of comprehensive health care for all patients with HIV/AIDS.
Collapse
Affiliation(s)
- Miriam R Robbins
- Department of Dental Medicine, Winthrop University Hospital, 200 Old Country Road, Suite 460, Mineola, NY 11501, USA; Department of Oral and Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry, 345 E. 24th Street, New York, NY 10010, USA.
| |
Collapse
|
16
|
Abstract
An opportunistic infection (OI) is a disease of microbial cause or pathogenesis generally thought to occur in hosts with weakened immunity. Oral OIs are associated with many risk factors and pathogens. Causative organisms for oral OIs have unique modes of transmission. The clinical presentation of oral OIs is heterogeneous and diagnosis can be challenging. Therefore, laboratory identification of causative pathogens is useful for definitive diagnosis and targeted therapeutics, and can be achieved by biological, serologic, histologic, and/or molecular methods. Clinical risk assessment and history with review of systems, and accurate diagnosis, treatment, and follow-up, are essential.
Collapse
|
17
|
Abstract
Survival with human immunodeficiency virus (HIV) infection has greatly improved due to effective antiretroviral therapy (ART). As infectious complications have declined, malignancy now accounts for over one-third of deaths among people living with HIV (PLWH). Based on practices in the general population, cancer screening of PLWH can decrease both morbidity and mortality. In this article, we review and consider directed approaches for colorectal, breast, cervical and lung cancer screening. Furthermore, routine physical examinations may detect lymphomas and skin, anal and oral cancers. Comprehensive cancer prevention in PLWH should also include ART adherence, vaccination against oncogenic viruses, treatment of hepatitis viruses and smoking cessation. Cancer screening for PLWH warrants further research on safety and efficacy as well as targeted efforts to increase adherence.
Collapse
|
18
|
Lamster IB, Myers-Wright N. Oral Health Care in the Future: Expansion of the Scope of Dental Practice to Improve Health. J Dent Educ 2017; 81:eS83-eS90. [PMID: 28864808 DOI: 10.21815/jde.017.038] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 02/06/2017] [Indexed: 12/30/2022]
Abstract
The health care environment in the U.S. is changing. The population is aging, the prevalence of non-communicable diseases (NCDs) is increasing, edentulism is decreasing, and periodontal infection/inflammation has been identified as a risk factor for NCDs. These trends offer an opportunity for oral health care providers to broaden the scope of traditional dental practice, specifically becoming more involved in the management of the general health of patients. This new practice paradigm will promote a closer integration with the larger health care system. This change is based on the realization that a healthy mouth is essential for a healthy life, including proper mastication, communication, esthetics, and comfort. Two types of primary care are proposed: screenings for medical conditions that are directly affected by oral disease (and may modify the provision of dental care), and a broader emphasis on prevention that focuses on lifestyle behaviors. Included in the former category are screenings for NCDs (e.g., the risk of cardiovascular disease and identification of patients with undiagnosed dysglycemia or poorly managed diabetes mellitus), as well as identification of infectious diseases, such as HIV or hepatitis C. Reducing the risk of disease can be accomplished by an emphasis on smoking cessation and dietary intake and the prevention of obesity. These activities will promote interprofessional health care education and practice. While change is always challenging, this new practice paradigm could improve both oral health and health outcomes of patients seen in the dental office. This article was written as part of the project "Advancing Dental Education in the 21st Century."
Collapse
Affiliation(s)
- Ira B Lamster
- Dr. Lamster is Professor, Department of Health Policy and Management, Mailman School of Public Health, Columbia University; Dr. Myers-Wright is Professor, Department of Health Policy and Management, Mailman School of Public Health, Columbia University.
| | - Noreen Myers-Wright
- Dr. Lamster is Professor, Department of Health Policy and Management, Mailman School of Public Health, Columbia University; Dr. Myers-Wright is Professor, Department of Health Policy and Management, Mailman School of Public Health, Columbia University
| |
Collapse
|
19
|
Preparation, characterization and toxicity evaluation of amphotericin B loaded MPEG-PCL micelles and its application for buccal tablets. Appl Microbiol Biotechnol 2017; 101:7357-7370. [DOI: 10.1007/s00253-017-8463-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 07/21/2017] [Accepted: 07/30/2017] [Indexed: 12/19/2022]
|