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Rajadurai SG, Maharajan MK, Veettil SK, Gopinath D. Comparative Efficacy and Safety of Antifungal Agents in the Prophylaxis of Oropharyngeal Candidiasis among HIV-Infected Adults: A Systematic Review and Network Meta-Analysis. Life (Basel) 2022; 12:life12040515. [PMID: 35455006 PMCID: PMC9025400 DOI: 10.3390/life12040515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 03/17/2022] [Accepted: 03/22/2022] [Indexed: 11/16/2022] Open
Abstract
The objective of the study was to compare the efficacy and safety of antifungal agents used in the prevention of oropharyngeal candidiasis among HIV-infected adults. A systematic search was conducted in four databases (MEDLINE, Scopus, CENTRAL, and Embase) for eligible randomized control trials (RCTs). The network meta-analyses (NMA) were performed using a random-effects model. Interventions were ranked based on the efficacy and safety using the surface under the cumulative ranking curve (SUCRA). The quality of evidence was assessed using the GRADE approach. From a total of 1574 studies screened, 7 RCTs comprising 959 participants were included in NMA. The use of fluconazole as a prophylactic agent was associated with a significant reduction in incidence of OPC compared to placebo (RR, 0.45 (95% CI: 0.27–0.77)) in HIV-infected adults. The overall quality of evidence was graded as moderate. Fluconazole was ranked the best antifungal for efficacy (SUCRA—95.6%) as well as safety (SUCRA—39.3%) in HIV-infected adults. Overall, the quality of evidence was graded as moderate. Fluconazole can be considered as an effective agent with a better safety profile for the prophylaxis of OPC in HIV-infected adults. However, similar to any other antimicrobial agent, the risk of possibility of resistance must be weighed against the benefits.
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Affiliation(s)
- Shamala Gopal Rajadurai
- School of Postgraduate Studies, International Medical University, Kuala Lumpur 57000, Malaysia;
| | - Mari Kannan Maharajan
- Department of Pharmacy Practice, School of Pharmacy, International Medical University, Kuala Lumpur 57000, Malaysia;
| | - Sajesh K. Veettil
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA;
| | - Divya Gopinath
- Clinical Oral Health Sciences, International Medical University, Kuala Lumpur 57000, Malaysia
- Correspondence:
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Oral Cavity and Candida albicans: Colonisation to the Development of Infection. Pathogens 2022; 11:pathogens11030335. [PMID: 35335659 PMCID: PMC8953496 DOI: 10.3390/pathogens11030335] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 02/01/2023] Open
Abstract
Candida colonisation of the oral cavity increases in immunocompromised individuals which leads to the development of oral candidiasis. In addition, host factors such as xerostomia, smoking, oral prostheses, dental caries, diabetes and cancer treatment accelerate the disease process. Candida albicans is the primary causative agent of this infection, owing to its ability to form biofilm and hyphae and to produce hydrolytic enzymes and candialysin. Although mucosal immunity is activated, from the time hyphae-associated toxin is formed by the colonising C. albicans cells, an increased number and virulence of this pathogenic organism collectively leads to infection. Prevention of the development of infection can be achieved by addressing the host physiological factors and habits. For maintenance of oral health, conventional oral hygiene products containing antimicrobial compounds, essential oils and phytochemicals can be considered, these products can maintain the low number of Candida in the oral cavity and reduce their virulence. Vulnerable patients should be educated in order to increase compliance.
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Shruthi DK, Channabasappa S, Mithun KM, Suresh BS, Tegginamani A, Smitha T. The role of salivary lactate levels in assessing the severity of septic shock. J Oral Maxillofac Pathol 2021; 25:437-440. [PMID: 35281171 PMCID: PMC8859604 DOI: 10.4103/jomfp.jomfp_199_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 11/15/2021] [Indexed: 11/04/2022] Open
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Sah P, Patel P, Chandrashekar C, Martena S, Ballal M, Hegde M, Guddattu V, Murdoch C, Sharma M, Radhakrishnan R. Oral candidal carriage correlates with CD4 + cell count but not with HIV and highly active antiretroviral therapy status. ACTA ACUST UNITED AC 2019; 10:e12438. [PMID: 31313889 DOI: 10.1111/jicd.12438] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 05/28/2019] [Accepted: 06/13/2019] [Indexed: 01/03/2023]
Abstract
AIM The occurrence of oropharyngeal candidiasis (OPC) may be influenced by oral candidal carriage (OCC). Although OPC is strongly associated with low CD4+ cell count (400-700 cells/mm3 ) and a lack of highly active antiretroviral therapy (HAART), the effect of these two parameters on OCC is debatable. We investigated the oral candidal carriage, species diversity, antifungal susceptibility and the association of OCC with CD4+ cell count and HAART. METHODS Oral candidal isolates from 120 HIV+ patients (60 receiving and 60 not receiving HAART) and 60 healthy controls were quantified, and their species determined using standard culture and biochemical methods, followed by antifungal susceptibility testing using the agar dilution method. RESULTS The OCC was significantly higher in HIV+ patients; Candida albicans was the most frequently isolated species in both groups, followed by Candida tropicalis. Candidal density carriage correlated significantly with CD4+ cell count, but not with HIV and HAART status. Among the isolates from HIV+ patients, 35.4% showed reduced susceptibility to fluconazole. CONCLUSION HIV status results in significantly elevated rates of OCC C albicans remains the predominant pathogen, although other species are emerging rapidly. Resistance to fluconazole is on the rise, and more efficient treatment strategies need to be implemented.
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Affiliation(s)
| | - Pratik Patel
- Clinical Oral Pathologist, Oroscan Diagnostics, Surat, Gujarat, India
| | - Chetana Chandrashekar
- Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Suganthi Martena
- Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Mamatha Ballal
- Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Manjayya Hegde
- Antiretroviral Treatment Centre, Government District Hospital, Udupi, India
| | - Vasudeva Guddattu
- Department of Statistics, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Craig Murdoch
- Unit of Oral and Maxillofacial Medicine and Surgery, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Mohit Sharma
- Department of Oral Pathology, Sudha Rustagi College of Dental Sciences and Research, Faridabad, India
| | - Raghu Radhakrishnan
- Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
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Ghazal ARA, Idris G, Hajeer MY, Alawer K, Cannon RD. Efficacy of removing Candida albicans from orthodontic acrylic bases: an in vitro study. BMC Oral Health 2019; 19:71. [PMID: 31046747 PMCID: PMC6498590 DOI: 10.1186/s12903-019-0765-x] [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: 05/09/2018] [Accepted: 04/15/2019] [Indexed: 12/23/2022] Open
Abstract
Background This study evaluated the efficacy of four methods in removing Candida albicans from the acrylic base material used to fabricate removable orthodontic appliances. Methods Heat-processed bars of orthodontic acrylic were incubated in a suspension of C. albicans for 2 h at 37 °C. Samples were allocated into five groups (five bars per group) according to the cleaning method: (1) manual brushing using a toothbrush; (2) soaking in a commercial denture cleaning solution; (3) soaking in a commercial mouthwash solution; (4) using an ultrasonic cleaner; and (5) soaking in distilled water as a negative control. Yeast remaining attached to the bars after cleaning were removed by vortexing in growth medium and plated on Sabouraud dextrose agar. The reduction in yeast colony count after cleaning was calculated and expressed as the number of colony forming units per acrylic bar (CFU/bar). The experiment was carried out three times. Results All four cleaning methods resulted in a significant decrease in viable yeast cells associated with the acrylic bars compared to the control group. The mean percentage reduction in viable yeast cells affected by the cleaning methods was: brushing 89.9%; chlorhexidine 95.8%; ultrasonic cleaning 99.9%; and denture tablet 100%. Conclusions All four methods evaluated in this study were effective, to some extent, in removing C. albicans from orthodontic acrylic samples. The most effective, and readily available, cleaning method was the use of commercial denture sterilizing tablets.
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Affiliation(s)
| | - Ghassan Idris
- Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - Mohammad Y Hajeer
- Department of Orthodontics, University of Damascus Dental School, Damascus, Syria
| | - Karam Alawer
- Research microbiology Laboratory, Hama University, Hama, Syria
| | - Richard D Cannon
- Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
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MacManus CF, Collins CB, Nguyen TT, Alfano RW, Jedlicka P, de Zoeten EF. VEN-120, a Recombinant Human Lactoferrin, Promotes a Regulatory T Cell [Treg] Phenotype and Drives Resolution of Inflammation in Distinct Murine Models of Inflammatory Bowel Disease. J Crohns Colitis 2017; 11:1101-1112. [PMID: 28472424 PMCID: PMC5881664 DOI: 10.1093/ecco-jcc/jjx056] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 04/20/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS Inflammatory bowel disease [IBD] is characterised by a disruption of immune homeostasis, which is tightly regulated to protect against harmful pathogens yet not react to commensal antigens. Animal studies indicate that regulatory T cells [Treg] modulate the immune response to prevent IBD development. Lactoferrin [LF] is an endogenous anti-inflammatory pleiotropic protein secreted at high concentrations in colostrum and at mucosal sites. However, the effect of LF on specific T lymphocyte populations has not been studied. Here, we identify a novel mechanism by which a recombinant human LF, VEN-120, regulates T cell populations in health and disease. METHODS Two murine models of intestinal inflammation, the dextran sodium sulphate colitis model and the TNFΔARE/+ model of ileitis, were used to study the anti-inflammatory and T cell modulating ability of VEN-120. Flow cytometry was used to evaluate T cell populations within the lamina propria and mesenteric lymph nodes, and to evaluate the effect of VEN-120 on CD4+ T cells in vitro. RESULTS VEN-120 reduced inflammation in both models of IBD, accompanied by increased Tregs in the intestinal lamina propria. Treatment of CD4+ T cells in vitro resulted in an upregulation of Treg genes and skewing towards a Treg population. This in vitro T cell skewing translated to an increase of Treg homing to the intestinal lamina propria and associated lymph tissue in healthy mice. CONCLUSIONS These data provide a novel immunological mechanism by which VEN-120 modulates T cells to restrict inflammatory T cell-driven disease.
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Affiliation(s)
- Christopher F MacManus
- Ventria Biosciences, Fort Collins, CO, USA,Corresponding author: Christopher MacManus, Ventria Bioscience, 320 E. Vine Dr., Fort Collins, CO 80524, USA. Tel.: 970-407-1239;
| | - Colm B Collins
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Tom T Nguyen
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | | | - Paul Jedlicka
- Department of Pathology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Edwin F de Zoeten
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
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Urbanowicz M, Jasiński A, Jasińska M, Drucis K, Ekman M, Szarmach A, Suchodolski R, Pomećko R, Bocheńska M. Simultaneous Determination of Na+, K+, Ca2+, Mg2+and Cl−in Unstimulated and Stimulated Human Saliva Using All Solid State Multisensor Platform. ELECTROANAL 2017. [DOI: 10.1002/elan.201700149] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Marcin Urbanowicz
- Department of Chemistry and Technology of Functional Materials, Chemical Faculty; Gdansk University of Technology; Narutowicza 11/12 80-233 Gdańsk Poland
| | - Artur Jasiński
- Department of Chemistry and Technology of Functional Materials, Chemical Faculty; Gdansk University of Technology; Narutowicza 11/12 80-233 Gdańsk Poland
| | - Małgorzata Jasińska
- Department of Chemistry and Technology of Functional Materials, Chemical Faculty; Gdansk University of Technology; Narutowicza 11/12 80-233 Gdańsk Poland
| | - Kamil Drucis
- Department of Surgical Oncology; Medical University of Gdansk; Debinki 7 80-952 Gdansk Poland
| | - Marcin Ekman
- Department of Surgical Oncology; Medical University of Gdansk; Debinki 7 80-952 Gdansk Poland
| | - Arkadiusz Szarmach
- Department of Surgical Oncology; Medical University of Gdansk; Debinki 7 80-952 Gdansk Poland
| | - Rafał Suchodolski
- Department of Surgical Oncology; Medical University of Gdansk; Debinki 7 80-952 Gdansk Poland
| | - Radosław Pomećko
- Department of Chemistry and Technology of Functional Materials, Chemical Faculty; Gdansk University of Technology; Narutowicza 11/12 80-233 Gdańsk Poland
| | - Maria Bocheńska
- Department of Chemistry and Technology of Functional Materials, Chemical Faculty; Gdansk University of Technology; Narutowicza 11/12 80-233 Gdańsk Poland
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Heron SE, Elahi S. HIV Infection and Compromised Mucosal Immunity: Oral Manifestations and Systemic Inflammation. Front Immunol 2017; 8:241. [PMID: 28326084 PMCID: PMC5339276 DOI: 10.3389/fimmu.2017.00241] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 02/20/2017] [Indexed: 12/26/2022] Open
Abstract
Mucosal surfaces account for the vast majority of HIV transmission. In adults, HIV transmission occurs mainly by vaginal and rectal routes but rarely via oral route. By contrast, pediatric HIV infections could be as the result of oral route by breastfeeding. As such mucosal surfaces play a crucial role in HIV acquisition, and spread of the virus depends on its ability to cross a mucosal barrier. HIV selectively infects, depletes, and/or dysregulates multiple arms of the human immune system particularly at the mucosal sites and causes substantial irreversible damage to the mucosal barriers. This leads to microbial products translocation and subsequently hyper-immune activation. Although introduction of antiretroviral therapy (ART) has led to significant reduction in morbidity and mortality of HIV-infected patients, viral replication persists. As a result, antigen presence and immune activation are linked to “inflammaging” that attributes to a pro-inflammatory environment and the accelerated aging process in HIV patients. HIV infection is also associated with the prevalence of oral mucosal infections and dysregulation of oral microbiota, both of which may compromise the oral mucosal immunity of HIV-infected individuals. In addition, impaired oral immunity in HIV infection may predispose the patients to periodontal diseases that are associated with systemic inflammation and increased risk of cardiovascular diseases. The purpose of this review is to examine existing evidence regarding the role of innate and cellular components of the oral cavity in HIV infection and how HIV infection may drive systemic hyper-immune activation in these patients. We will also discuss current knowledge on HIV oral transmission, HIV immunosenescence in relation to the oral mucosal alterations during the course of HIV infection and periodontal disease. Finally, we discuss oral manifestations associated with HIV infection and how HIV infection and ART influence the oral microbiome. Therefore, unraveling how HIV compromises the integrity of the oral mucosal tissues and innate immune components of the oral cavity and its association with induction of chronic inflammation are critical for the development of effective preventive interventions and therapeutic strategies.
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Affiliation(s)
- Samantha E Heron
- Faculty of Medicine and Dentistry, Department of Dentistry, University of Alberta , Edmonton, AB , Canada
| | - Shokrollah Elahi
- Faculty of Medicine and Dentistry, Department of Dentistry, University of Alberta, Edmonton, AB, Canada; Faculty of Medicine and Dentistry, Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, AB, Canada
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9
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Heron SE, Elahi S. HIV Infection and Compromised Mucosal Immunity: Oral Manifestations and Systemic Inflammation. Front Immunol 2017; 8:241. [PMID: 28326084 DOI: 10.3389/fimmu.2017.00241doi|] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 02/20/2017] [Indexed: 05/25/2023] Open
Abstract
Mucosal surfaces account for the vast majority of HIV transmission. In adults, HIV transmission occurs mainly by vaginal and rectal routes but rarely via oral route. By contrast, pediatric HIV infections could be as the result of oral route by breastfeeding. As such mucosal surfaces play a crucial role in HIV acquisition, and spread of the virus depends on its ability to cross a mucosal barrier. HIV selectively infects, depletes, and/or dysregulates multiple arms of the human immune system particularly at the mucosal sites and causes substantial irreversible damage to the mucosal barriers. This leads to microbial products translocation and subsequently hyper-immune activation. Although introduction of antiretroviral therapy (ART) has led to significant reduction in morbidity and mortality of HIV-infected patients, viral replication persists. As a result, antigen presence and immune activation are linked to "inflammaging" that attributes to a pro-inflammatory environment and the accelerated aging process in HIV patients. HIV infection is also associated with the prevalence of oral mucosal infections and dysregulation of oral microbiota, both of which may compromise the oral mucosal immunity of HIV-infected individuals. In addition, impaired oral immunity in HIV infection may predispose the patients to periodontal diseases that are associated with systemic inflammation and increased risk of cardiovascular diseases. The purpose of this review is to examine existing evidence regarding the role of innate and cellular components of the oral cavity in HIV infection and how HIV infection may drive systemic hyper-immune activation in these patients. We will also discuss current knowledge on HIV oral transmission, HIV immunosenescence in relation to the oral mucosal alterations during the course of HIV infection and periodontal disease. Finally, we discuss oral manifestations associated with HIV infection and how HIV infection and ART influence the oral microbiome. Therefore, unraveling how HIV compromises the integrity of the oral mucosal tissues and innate immune components of the oral cavity and its association with induction of chronic inflammation are critical for the development of effective preventive interventions and therapeutic strategies.
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Affiliation(s)
- Samantha E Heron
- Faculty of Medicine and Dentistry, Department of Dentistry, University of Alberta , Edmonton, AB , Canada
| | - Shokrollah Elahi
- Faculty of Medicine and Dentistry, Department of Dentistry, University of Alberta, Edmonton, AB, Canada; Faculty of Medicine and Dentistry, Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, AB, Canada
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Limeres Posse J, Diz Dios P, Scully C. Infection Transmission by Saliva and the Paradoxical Protective Role of Saliva. SALIVA PROTECTION AND TRANSMISSIBLE DISEASES 2017. [PMCID: PMC7173548 DOI: 10.1016/b978-0-12-813681-2.00001-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Saliva is produced by both major (parotid and submandibular and sublingual) and minor (located in the mouth) glands, with different constituents and properties between the two groups. In the mouth saliva is a colorless, odorless, tasteless, watery liquid containing 99% water and 1% organic and inorganic substances and dissolved gases, mainly oxygen and carbon dioxide. Salivary constituents can be grouped into proteins (e.g., amylase and lysozyme), organic molecules (e.g., urea, lipids, and glucose mainly), and electrolytes (e.g., sodium, calcium, chlorine, and phosphates). Cellular elements such as epithelial cells, leukocytes and various hormones, and vitamins have also been detected. The composition of saliva is modified, depending on factors such as secreted amount, circadian rhythm, duration and nature of stimuli, diet, and medication intake, among others.
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Ide M, Saruta J, To M, Yamamoto Y, Sugimoto M, Fuchida S, Yokoyama M, Kimoto S, Tsukinoki K. Relationship between salivary immunoglobulin a, lactoferrin and lysozyme flow rates and lifestyle factors in Japanese children: a cross-sectional study. Acta Odontol Scand 2016; 74:576-583. [PMID: 27565888 DOI: 10.1080/00016357.2016.1223340] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The antimicrobial substances in saliva contribute to the maintenance of both oral health and overall health of the body. Therefore, the associations among immunoglobulin A (IgA), lactoferrin and lysozyme flow rates in the saliva of children, and their relationships with the physical attributes and lifestyle factors of children, were examined. MATERIALS AND METHODS Saliva was collected from 90 children who visited the Kanagawa Dental University Hospital Pediatric Dentistry, and questionnaires were completed by guardians. IgA, lactoferrin and lysozyme concentrations were measured in the saliva samples using enzyme-linked immunosorbent assays (ELISAs). RESULTS The IgA flow rate in saliva increased as age, height and weight increased. A correlation was found between lactoferrin and lysozyme flow rates. When the antimicrobial substance flow rates in the saliva were divided into two groups of 22 children each based on the highest and lowest quartiles, children with either a low or high IgA flow rate also had a high or low lactoferrin flow rate, respectively. The same pattern was observed for lactoferrin and lysozyme flow rates. CONCLUSIONS There is a high probability that the IgA flow rate in the saliva of children reflects and corresponds to the developmental status of immune function as the child ages and increases in height and weight. The flow rates of lactoferrin and lysozyme were correlated in children. In addition, regarding lifestyle factors, the duration of sleep and lactoferrin flow rate were also related.
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Ahmad M, Piludu M, Oppenheim FG, Helmerhorst EJ, Hand AR. Immunocytochemical Localization of Histatins in Human Salivary Glands. J Histochem Cytochem 2016; 52:361-70. [PMID: 14966203 DOI: 10.1177/002215540405200307] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Histatins are a family of salivary proteins with bactericidal and fungicidal activities that contribute to the innate defense of the oral cavity. Histatins are present in the serous granules of the parotid and submandibular glands. The important role of histatins in saliva, and the limited information on their cellular and subcellular distribution, prompted us to further define the localization of histatins in the major salivary glands. Immunogold-silver staining of 1-μm sections of plastic-embedded tissue with anti-histatin antibody revealed histatin immunoreactivity in the serous acinar cells of the parotid and submandibular glands, the serous demilune cells of the submandibular and sublingual glands, and in occasional intercalated duct cells. No reactivity was seen in mucous cells or in striated or excretory duct cells. Electron microscopic observations of thin sections labeled with anti-histatin and gold-labeled secondary antibodies revealed immunoreactivity associated with the rough endoplasmic reticulum and Golgi complex and in secretory granules of serous acinar and demilune cells. The granules of parotid acinar cells exhibited relatively uniform labeling of their content, whereas the granules of serous cells in the submandibular and sublingual glands showed variable labeling of the dense and light regions of their content. A few intercalated duct cells adjacent to the acinar cells also exhibited labeled granules. These results suggest that the serous cells of the major glands are the main source of histatins in human saliva. They are also consistent with several previous studies demonstrating the variable distribution of different proteins within the granule content.
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Affiliation(s)
- Mansur Ahmad
- Department of Diagnostic and Surgical Science, University of Minnesota, School of Dentistry, Minneapolis, Minnesota, USA
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Biopolymeric Mucin and Synthetic Polymer Analogs: Their Structure, Function and Role in Biomedical Applications. Polymers (Basel) 2016; 8:polym8030071. [PMID: 30979166 PMCID: PMC6432556 DOI: 10.3390/polym8030071] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 02/23/2016] [Accepted: 02/24/2016] [Indexed: 12/17/2022] Open
Abstract
Mucin networks are viscoelastic fibrillar aggregates formed through the complex self-association of biopolymeric glycoprotein chains. The networks form a lubricious, hydrated protective shield along epithelial regions within the human body. The critical role played by mucin networks in impacting the transport properties of biofunctional molecules (e.g., biogenic molecules, probes, nanoparticles), and its effect on bioavailability are well described in the literature. An alternate perspective is provided in this paper, presenting mucin’s complex network structure, and its interdependent functional characteristics in human physiology. We highlight the recent advances that were achieved through the use of mucin in diverse areas of bioengineering applications (e.g., drug delivery, biomedical devices and tissue engineering). Mucin network formation is a highly complex process, driven by wide variety of molecular interactions, and the network possess structural and chemical variations, posing a great challenge to understand mucin’s bulk behavior. Through this review, the prospective potential of polymer based analogs to serve as mucin mimic is suggested. These analog systems, apart from functioning as an artificial model, reducing the current dependency on animal models, can aid in furthering our fundamental understanding of such complex structures.
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Lokesh K, Kannabiran J, Rao MD. Salivary Lactate Dehydrogenase (LDH)- A Novel Technique in Oral Cancer Detection and Diagnosis. J Clin Diagn Res 2016; 10:ZC34-7. [PMID: 27042582 DOI: 10.7860/jcdr/2016/16243.7223] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 11/06/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Oral squamous cell carcinoma (OSCC) is the sixth most common malignancy which is a major cause for cancer morbidity and mortality worldwide. Early diagnosis and intervention improves the overall survival rate. AIM The current study was done to evaluate the accuracy of salivary LDH as a potential biomarker for diagnosis of OSCC and to correlate the levels of salivary LDH with the histological differentiation of the tumour. MATERIALS AND METHODS Thirty patients visiting the outpatient department diagnosed clinically and histologically with OSCC were selected for the study with a control group of 20 patients. Unstimulated salivary samples collected from the selected patients were centrifuged and processed. Readings of enzyme activity in the salivary samples was established through auto analysis using International Federation of Clinical Chemistry (IFCC) method. Levels of the enzyme activity in both the control and the study group were compared and statistically analysed using student t-test. The three subgroups were also compared and statistically analysed. RESULTS The results showed a mean value of 497.00 with a SD of 51.75 among the control group and a mean value of 1225.40 with a SD of 221.79 among the cases with a p-value of 0.0001 which was statistically significant. Furthermore, when the LDH values for the various grades of OSCC were compared, the mean values were 1049.07, 1309.50 and 1586.20 respectively, for well differentiated, moderately differentiated and poorly differentiated carcinoma. CONCLUSION The p-value thus obtained revealed LDH values which were significantly higher in patients with OSCC and furthermore the levels significantly correlated with the histopathological grade of the tumour.
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Affiliation(s)
| | - Jayanthi Kannabiran
- Former Professor and Head of Department, Department of Oral Medicine and Radiology, Bangalore Institute of Dental Sciences & Hospital , Bangalore, India
| | - Mahesh Dathu Rao
- Reader, Department of Oral Medicine and Radiology, Dayanand Sagar College of Dental Sciences , Bangalore, India
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Nittayananta W, Tao R, Jiang L, Peng Y, Huang Y. Oral innate immunity in HIV infection in HAART era. J Oral Pathol Med 2015; 45:3-8. [PMID: 25639844 DOI: 10.1111/jop.12304] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2014] [Indexed: 02/05/2023]
Abstract
Oral innate immunity, an important component in host defense and immune surveillance in the oral cavity, plays a crucial role in the regulation of oral health. As part of the innate immune system, epithelial cells lining oral mucosal surfaces not only provide a physical barrier but also produce different antimicrobial peptides, including human β-defensins (hBDs), secretory leukocyte protease inhibitor (SLPI), and various cytokines. These innate immune mediators help in maintaining oral homeostasis. When they are impaired either by local or systemic causes, various oral infections and malignancies may be developed. Human immunodeficiency virus (HIV) infection and other co-infections appear to have both direct and indirect effects on systemic and local innate immunity leading to the development of oral opportunistic infections and malignancies. Highly active antiretroviral therapy (HAART), the standard treatment of HIV infection, contributed to a global reduction of HIV-associated oral lesions. However, prolonged use of HAART may lead to adverse effects on the oral innate immunity resulting in the relapse of oral lesions. This review article focused on the roles of oral innate immunity in HIV infection in HAART era. The following five key questions were addressed: (i) What are the roles of oral innate immunity in health and disease?, (ii) What are the effects of HIV infection on oral innate immunity?, (iii) What are the roles of oral innate immunity against other co-infections?, (iv) What are the effects of HAART on oral innate immunity?, and (v) Is oral innate immunity enhanced by HAART?
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Affiliation(s)
| | - Renchuan Tao
- Department of Periodontology and Oral Medicine, College of Stomatology, Guangxi Medical University, Guangxi, China.,Guangxi Key Laboratory of AIDS Prevention and Treatment, Guangxi Medical University, Guangxi, China
| | - Lanlan Jiang
- Department of Periodontology and Oral Medicine, College of Stomatology, Guangxi Medical University, Guangxi, China
| | - Yuanyuan Peng
- Department of Periodontology and Oral Medicine, College of Stomatology, Guangxi Medical University, Guangxi, China
| | - Yuxiao Huang
- Department of Periodontology and Oral Medicine, College of Stomatology, Guangxi Medical University, Guangxi, China
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Ferreira SMS, Gonçalves LS, Torres SR, Nogueira SA, Meiller TF. Lactoferrin levels in gingival crevicular fluid and saliva of HIV-infected patients with chronic periodontitis. ACTA ACUST UNITED AC 2014; 6:16-24. [PMID: 25331852 DOI: 10.1111/jicd.12017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Accepted: 09/30/2012] [Indexed: 11/28/2022]
Abstract
AIM This study compared lactoferrin (LF) levels in the gingival crevicular fluid (GCF) and saliva between HIV-infected and noninfected patients with chronic periodontitis. METHODS For each subject, LF levels were analyzed in one shallow site (SS; PD ≤3 mm), one deep site (DS; PD >5 mm) and in resting whole saliva. Two groups, 28 HIV-infected and 10 noninfected, were selected. RESULTS Although the salivary LF levels were higher in HIV-infected than in noninfected individuals, especially in AIDS patients, this was not statistically significant (P > 0.05). Subgingival LF levels for SS and DS were lower among HIV-infected individuals, although AIDS patients showed the lowest levels. Age, smoking, gender, T CD4 lymphocytes levels and viral load did not influence subgingival LF levels, neither for SS nor for DP. Positive fungal culture was observed in 24 HIV-infected patients, but only observed in one in the control group. Overall, LF concentration was significantly higher in DS than SS, both in HIV-infected and noninfected individuals (P < 0.05) and salivary LF levels were always higher than GCF levels. CONCLUSION The data indicate that LF levels in the GCF and saliva are not different between HIV-infected and noninfected patients with chronic periodontitis.
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Khan SA, Fidel PL, Thunayyan AA, Varlotta S, Meiller TF, Jabra-Rizk MA. Impaired Histatin-5 Levels and Salivary Antimicrobial Activity against C. albicans in HIV Infected Individuals. ACTA ACUST UNITED AC 2013; 4. [PMID: 23730535 DOI: 10.4172/2155-6113.1000193] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
HIV-infected individuals constitute a population highly susceptible to opportunistic infections, particularly oral candidiasis caused by the most pathogenic human fungal species Candida albicans. Host-produced salivary antimicrobial peptides are considered to be an important part of the host innate immune system involved in protection of the oral cavity against colonization and infection by microbial species. Histatin-5 (Hst-5) specifically has exhibited potent anti-candidal properties in vitro. However, its importance in protecting the oral mucosa against candidal colonization and importantly, its contribution to the observed enhanced susceptibility of HIV-infected individuals to candidiasis has not been previously investigated. To that end, a novel immunoassay was used to demonstrate significant decrease in salivary Hst-5 levels in HIV+ individuals concomitant with enhanced candidal prevalence. Further, saliva's anti-candidal potency was found to be proportional to Hst-5 concentration and significantly compromised in HIV+ subjects compared to controls. The key role for Hst-5 was further confirmed upon exposure to the Hst-5-specific antibody where saliva's initial killing activity was substantially compromised. Combined, these findings identify Hst-5 as a key anti-candidal salivary component and demonstrate its decreased levels in HIV infection providing new insights into oral Innate immune defense mechanisms and the enhanced susceptibility of HIV+ individuals to oral candidiasis.
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Affiliation(s)
- Shariq A Khan
- Department of Oncology and Diagnostic Sciences, Dental School, University of Maryland, Baltimore, USA
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Sardi JCO, Almeida AMF, Mendes Giannini MJS. New antimicrobial therapies used against fungi present in subgingival sites--a brief review. Arch Oral Biol 2011; 56:951-9. [PMID: 21676377 DOI: 10.1016/j.archoralbio.2011.03.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 03/16/2011] [Accepted: 03/17/2011] [Indexed: 01/14/2023]
Abstract
Although the main reservoir of Candida spp. is believed to be the buccal mucosa, these microorganisms can coaggregate with bacteria in subgingival biofilm and adhere to epithelial cells. The treatment of periodontal disease includes scaling and root planning (SRP) associated with proper oral hygiene. However, some patients may have negative responses to different therapeutic procedures, with a continuous loss of insertion, so the use of antimicrobials is needed as an adjuvant to SRP treatment. The use of a broad-spectrum antibiotic, such as tetracycline and metronidazole, as an aid in periodontal treatment has also been a factor for the development of superinfections by resistant bacteria and Candida species, even in patients with HIV. In the dental practice, the most commonly used antifungals are nystatin and fluconazole. However, the introduction of new drugs like the next generation of azoles is essential before the onset of emergent species in periodontal disease. Plants are good options for obtaining a wide variety of drugs. This alternative could benefit a large population that uses plants as a first treatment option. Plants have been used in medicine for a long time and are extensively used in folk medicine, because they represent an economic alternative, are easily accessible and are applicable to various diseases. Herein, we briefly review the literature pertaining the presence of Candida sp. in periodontal pockets, the conventional antifungal resistance and new therapies that include natural antifungal agents are reviewed.
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Affiliation(s)
- Janaina Cássia Orlandi Sardi
- Faculty of Pharmaceutical Sciences of Araraquara, Department of Clinical Analysis, Laboratory of Clinical Mycology, Univ Estadual Paulista, UNESP, Araraquara, SP, Brazil
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Pomarico L, de Souza IPR, Castro GFBDA, Teles RP, Luiz RR, Maia LC. Levels of salivary IgA antibodies to Candida spp. in HIV-infected adult patients: a systematic review. J Dent 2010; 38:10-5. [PMID: 19761812 DOI: 10.1016/j.jdent.2009.09.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2009] [Revised: 08/13/2009] [Accepted: 09/08/2009] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To perform a systematic review of published data with the aim of evaluating the levels of IgA antibodies to Candida albicans in HIV-infected adult patients. METHODS The search strategy was based on PubMed, Web of Science, Google Scholar, Cochrane and EMBASE databases. Also, the reference lists of included studies were searched. All abstracts found by electronic searches were independently scrutinized by two reviewers. To be eligible for review, the controlled studies had to present the following characteristics: samples of both HIV-infected adults and noninfected adults; appropriate HIV-diagnostic tests for both patient groups (case and control); IgA-diagnostic test applied to a similar population sample. RESULTS Of 144 studies found, only six met the initial eligibility criteria, but three were excluded after a thorough analysis. To assess the methodological quality of the three remaining studies, they were categorized according the risk of bias. The three selected studies revealed that the levels of C. albicans-specific IgA antibody were higher in HIV-infected individuals compared with the control group. CONCLUSION Adequate IgA antibody responses to C. albicans appear to be maintained, since the levels of these antibodies were higher in all studies selected. Although the findings of this systematic review are encouraging, the scientific evidence should be interpreted carefully because there are only a few reports in the literature, mostly because of the lack of important methodological details or the varying methodologies employed.
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Affiliation(s)
- Luciana Pomarico
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Brazil.
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Pomarico L, Cerqueira DF, de Araujo Soares RM, de Souza IPR, de Araujo Castro GFB, Socransky S, Haffajee A, Teles RP. Associations among the use of highly active antiretroviral therapy, oral candidiasis, oral Candida species and salivary immunoglobulin A in HIV-infected children. ACTA ACUST UNITED AC 2009; 108:203-10. [PMID: 19615660 DOI: 10.1016/j.tripleo.2009.05.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2009] [Revised: 04/19/2009] [Accepted: 05/05/2009] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim was to examine the impact of antiretroviral therapy on the prevalence of oral candidiasis, recovery of oral Candida spp. , and salivary levels of total secretory immunoglobulin A (SIgA) and Candida-specific SIgA in human immunodeficiency virus (HIV)-infected children. STUDY DESIGN Sixty-six HIV+ and 40 HIV- children were cross-sectionally examined for the presence of oral lesions. Whole stimulated saliva samples were collected for the identification of Candida spp. using culture and measurement of total and specific SIgA using enzyme-linked immunosorbent assay (ELISA). RESULTS The HIV+ children had a higher prevalence of oral candidiasis (P < .05), higher frequency of detection of Candida spp. (P < .05), and higher levels of total (P < .05) and Candida-specific SIgA (P < .001) than the HIV- children. Among the HIV+ subjects, antiretroviral users had lower viral loads (P < .001) and lower levels of Candida spp. (P < .05) and total SIgA (P < .05) compared with antiretroviral nonusers. CONCLUSIONS The use of antiretroviral therapy was associated with decreases in the prevalence of oral candidiasis. This diminished exposure to Candida spp. was accompanied by decreases in levels of total and Candida-specific SIgA.
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Affiliation(s)
- Luciana Pomarico
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
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Hibino K, Wong RWK, Hägg U, Samaranayake LP. The effects of orthodontic appliances on Candida in the human mouth. Int J Paediatr Dent 2009; 19:301-8. [PMID: 19486368 DOI: 10.1111/j.1365-263x.2009.00988.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Candida is an opportunistic pathogen present in about 50-60% of the healthy human population, and becomes pathogenic when the host immune defence is undermined such as in HIV infection. Adhesion and colonization of the oral cavity by Candida albicans is an initial step in candidosis, and the presence of orthodontic and other oral appliances seems to alter the oral ecological environment, hence may tip the balance to favour the candidal presence. OBJECTIVE The purpose of this paper was to review the literature with specific attention to prevalence; intra-oral density of the candidal organisms; and Candida carriage status in orthodontic patients before, during, and after treatment. CONCLUSIONS The limited amount of literature demonstrated that the density of Candida increases; the most common Candida species isolated in the orthodontic patients was C. albicans; and that there seems to be a direct relationship between the presence of a removable appliance, Candida, and low salivary pH levels. No healthy patients developed Candida infection from the orthodontic appliances. However, there seems to be a trend that some non-Candida carriers converted to Candida carriers following the insertion of the appliances by unknown mechanism. This may indicate a more cautious approach when providing orthodontic treatments to immunocompromised children concerning the possible increased risk of candidal infection.
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Affiliation(s)
- Kyoko Hibino
- Discipline of Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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22
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The role of salivary factors in persistent oral carriage of Candida in humans. Arch Oral Biol 2009; 54:678-83. [PMID: 19439266 DOI: 10.1016/j.archoralbio.2009.04.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2008] [Revised: 03/31/2009] [Accepted: 04/13/2009] [Indexed: 11/24/2022]
Abstract
BACKGROUND Candida albicans is a commensal oral yeast in approximately one-third to one-half of the healthy population. To date, there are no studies investigating the multiple anti-candidal salivary constituents of healthy individuals with either nil or, consistent oral yeast carriage. OBJECTIVE To compare the composition and anti-candidal activity in stimulated whole saliva of healthy 'consistent' oral Candida carriers with Candida-free individuals. METHODS A sub-sample of 22 consistent, Candida-free individuals and 10 consistent Candida carriers were recruited from a 12 months screening study investigating oral Candida carriage in 97 healthy patients treated by fixed orthodontic appliances. Unstimulated and stimulated saliva samples were collected. The following salivary attributes were measured using standard methodology: the flow rate, pH, lysozyme, lactoferrin and IgA concentration and, the degree of inhibition of blastoconidial growth and blastospore germination. RESULTS Saliva from the Candida-free individuals showed 20.2% higher inhibition of blastoconidial growth (p < 0.05) of a reference strain of Candida albicans. No significant differences between the other salivary attributes of the two groups were found. CONCLUSION The fact that saliva of Candida-free individuals significantly inhibited the blastoconidial growth more than Candida-carriers (p < 0.05) suggests that saliva may play a role in modulating oral candidal populations in health. Further studies, with a larger cohort are needed to confirm these findings and determine the factors that confer enhanced salivary anti-candidal activity.
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Jainkittivong A, Lin AL, Johnson DA, Langlais RP, Yeh CK. Salivary secretion, mucin concentrations and candida carriage in HIV-infected patients. Oral Dis 2009; 15:229-34. [DOI: 10.1111/j.1601-0825.2009.01514.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cerven D, DeGeorge G, Bethell D. 28-Day repeated dose oral toxicity of recombinant human holo-lactoferrin in rats. Regul Toxicol Pharmacol 2008; 52:174-9. [DOI: 10.1016/j.yrtph.2008.07.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2007] [Revised: 06/30/2008] [Accepted: 07/11/2008] [Indexed: 11/17/2022]
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Back-Brito GN, Mota AJ, Vasconcellos TC, Querido SMR, Jorge AOC, Reis ASM, Balducci I, Koga-Ito CY. Frequency of Candida spp. in the Oral Cavity of Brazilian HIV-Positive Patients and Correlation with CD4 Cell Counts and Viral Load. Mycopathologia 2008; 167:81-7. [DOI: 10.1007/s11046-008-9153-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2007] [Accepted: 08/10/2008] [Indexed: 10/21/2022]
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28-Day repeated dose oral toxicity of recombinant human apo-lactoferrin or recombinant human lysozyme in rats. Regul Toxicol Pharmacol 2008; 51:162-7. [PMID: 18457910 DOI: 10.1016/j.yrtph.2008.03.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2007] [Revised: 03/03/2008] [Accepted: 03/14/2008] [Indexed: 11/23/2022]
Abstract
Lactoferrin and lysozyme are important proteins of the human innate immune system. These proteins are found in breast milk and have been associated with improved infant health. Recombinant human apo-lactoferrin (apo-rhLF), 1800 and 180mg/kg bw/day, and recombinant human lysozyme (rhLZ), 360 and 36mg/kg bw/day, were orally administered to Wistar rats for 28 days. Apo-rhLF and rhLZ were expressed in rice grain, extracted, purified; the lactoferrin was iron desaturated. The animals were examined for evidence of toxicity; there were no deaths and in-life physical signs were normal. Transient differences in mean food consumption occurred in high dose apo-rhLF and low dose LZ females at week three. There were no biologically significant differences in hematological or clinical chemistry parameters. Necropsy results were normal and microscopic evaluation showed no treatment related changes in animals dosed with 1800mg/kg/day apo-rhLF or 360mg/kg/day rhLZ. The results of the 28-day oral administration demonstrate a lack of toxicity of apo-rhLF and rhLZ in rats. There were no treatment related, toxicologically relevant changes in clinical signs, growth, food consumption, hematology, clinical chemistry, organ weight and pathology. The no observed adverse effect level (NOAEL) is greater than 1800mg/kg/day for apo-rhLF and 360mg/kg/day for rhLZ.
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The role of released ATP in killing Candida albicans and other extracellular microbial pathogens by cationic peptides. Purinergic Signal 2007; 3:91-7. [PMID: 18404422 PMCID: PMC2096768 DOI: 10.1007/s11302-006-9040-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2006] [Accepted: 05/30/2006] [Indexed: 02/07/2023] Open
Abstract
A unifying theme common to the action of many cationic peptides that display lethal activities against microbial pathogens is their specific action at microbial membranes that results in selective loss of ions and small nucleotides chiefly ATP. One model cationic peptide that induces non-lytic release of ATP from the fungal pathogen Candida albicans is salivary histatin 5 (Hst 5). The major characteristic of Hst 5-induced ATP release is that it occurs rapidly while cells are still metabolically active and have polarized membranes, thus precluding cell lysis as the means of release of ATP. Other cationic peptides that induce selective release of ATP from target microbes are lactoferricin, human neutrophil defensins, bactenecin, and cathelicidin peptides. The role of released extracellular ATP induced by cationic peptides is not known, but localized increases in extracellular ATP concentration may serve to potentiate cell killing, facilitate further peptide uptake, or function as an additional signal to activate the host innate immune system at the site of infection.
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Lin AL, Johnson DA, Sims CA, Stephan KT, Yeh CK. Salivary gland function in HIV-infected patients treated with highly active antiretroviral therapy (HAART). ACTA ACUST UNITED AC 2006; 102:318-24. [PMID: 16920540 DOI: 10.1016/j.tripleo.2005.07.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2004] [Revised: 06/02/2005] [Accepted: 07/06/2005] [Indexed: 01/21/2023]
Abstract
OBJECTIVE This study was undertaken to determine if HAART alters salivary oral host defense in HIV(+) men. STUDY DESIGN Whole, parotid, and submandibular/sublingual saliva was collected from 39 healthy men and 147 HIV(+) patients with mild to moderate immune dysfunction (69 treated with HAART [HAART(+)]; 78 not treated [HAART(-)]). Salivary flow rates, anticandidal activities, electrolytes, and antimicrobial/antifungal proteins were determined. RESULTS While CD4(+) cell counts were not different between the HIV(+) groups, the median viral load for HAART(-) was 15 times greater than HAART(+). For both HAART groups, salivary yeast carriage rates and concentration were comparable and both showed similar reductions in salivary flow rates. Salivary anticandidal activities were not altered. Saliva composition of both HIV(+) groups was different from control, but only uric acid in parotid saliva of HAART(+) differed from HAART(-). CONCLUSIONS HAART does not adversely affect inherent salivary oral host defense in HIV(+) patients with mild to moderate immune dysfunction.
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Affiliation(s)
- Alan L Lin
- Department of Dental Diagnostic Science, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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Abstract
HIV infection affects residents of all countries of the world, but the greater majority of affected individuals reside in the developing world. In the past decade there have been substantial changes in the management of HIV disease, particularly the introduction of highly active antiretroviral therapy (HAART). Such agents have reduced significantly the morbidity and mortality associated with HIV disease, however, they are not available for most HIV-infected individuals in the developing world. There is now considerable understanding of the molecular epidemiology, transmission and therapy of the common opportunistic oral infections of HIV disease, and as a consequence of improved anti-HIV strategies, the frequency and severity of oral disease associated with HIV infection have reduced considerably, although HAART may predispose to human papilloma virus infection of the mouth and potentially increase the risk of later oral squamous cell carcinoma. Despite advances in clinical care the majority of individuals with HIV disease worldwide will continue to develop oral disease, as they are resident in the developing world and do not have ready access to even simple therapies.
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Affiliation(s)
- Cristina Frezzini
- Oral Medicine Division of Maxillofacial Diagnostic, Medical and Surgical Sciences, Eastman Dental Institute for Oral Health Care Sciences, UCL, University of London, London, UK
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Aps JKM, Martens LC. Review: The physiology of saliva and transfer of drugs into saliva. Forensic Sci Int 2005; 150:119-31. [PMID: 15944052 DOI: 10.1016/j.forsciint.2004.10.026] [Citation(s) in RCA: 307] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2004] [Revised: 10/10/2004] [Accepted: 10/10/2004] [Indexed: 11/21/2022]
Abstract
Although saliva or oral fluid "lacks the drama of blood, the sincerity of sweat and the emotional appeal of tears", quoting Mandel in 1990 [I.D. Mandel, The diagnostic uses of saliva, J. Oral Pathol. Med. 19 (1990) 119-125], it is now meeting the demand for inexpensive, non-invasive and easy-to-use diagnostic aids for oral and systemic diseases, drug monitoring and detection of illicit use of drugs of abuse, including alcohol. As the salivary secretion is a reflex response controlled by both parasympathetic and sympathetic secretomotor nerves, it can be influenced by several stimuli. Moreover, patients taking medication which influences either the central nervous system or the peripheral nervous system, or medication which mimic the latter as a side effect, will have an altered salivary composition and salivary volume. Patients suffering from certain systemic diseases may present the same salivary alterations. The circadian rhythm determines both the volume of saliva that will and can be secreted and the salivary electrolyte concentrations. Dietary influences and the patient's age also have an impact on composition and volume of saliva. The latter implies a wide variation in composition both inter- and intra-individually. Sampling must therefore be performed under standardized conditions. The greatest advantage, when compared to blood sample collection, is that saliva is readily accessible and collectible. Consequently, it can be used in clinically difficult situations, such as in children, handicapped and anxious patients, where blood sampling could be a difficult act to perform.
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Affiliation(s)
- Johan K M Aps
- UZG-P8- Department of Paediatric Dentistry and Centre for Special Care, PaeCaMed Research Unit, Ghent University, De Pintelaan 185, 9000 Gent, Belgium.
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Laibe S, Biichlé S, Clair S, Bard E, Millon L, Drobacheff C, Meillet D. Augmentation des synthèses locales de la lactoferrine et du lysozyme chez des patients infectés par le virus de l'immunodéficience humaine avec candidose oropharyngée : rôle de l'immunité muqueuse innée ? J Mycol Med 2005. [DOI: 10.1016/j.mycmed.2005.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Navazesh M, Mulligan R, Pogoda J, Greenspan D, Alves M, Phelan J, Greenspan J, Slots J. The effect of HAART on salivary microbiota in the Women's Interagency HIV Study (WIHS). ACTA ACUST UNITED AC 2005; 100:701-8. [PMID: 16301151 DOI: 10.1016/j.tripleo.2004.10.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2004] [Revised: 10/04/2004] [Accepted: 10/08/2004] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Study the prevalence of potentially pathogenic microorganisms in saliva of HIV-positive women in the Women's Interagency HIV Study. STUDY DESIGN 157 HIV-positive and 31 HIV-negative women were studied. At baseline and every 6 months over 4 years, information was collected on socioeconomic and educational status, oral and systemic health, including HIV markers and antiretroviral therapy, and frequency of professional oral care utilization. Bacterial and yeast pathogenic isolates from stimulated whole saliva were tentatively identified using standard methodologies. RESULTS The prevalence of microorganisms in stimulated saliva of HIV-positive women was not significantly different from that of HIV-negative women. In HIV-positive women, highly active antiretroviral therapy (HAART) was independently and significantly associated with the presence of a variety of salivary bacterial species. HAART increased the risk for recovering Fusobacterium species (P < .001), enteric gram-negative rods (P < .05), Peptostreptococcus micros (P < .05), Campylobacter species (P < .0001), Eubacterium species (P < .001), and Tannerella forsythia (P < .01). In contrast, HAART led to decreased recovery rate of yeasts (Candida albicans and Candida dubliniensis) (P < .0001). CONCLUSION The present findings suggest that the institution of HAART promotes an increasingly pathogenic salivary microbiota, at least temporarily. Similar findings have been reported for various nonoral microbial ecosystems.
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Affiliation(s)
- Mavash Navazesh
- Division of Diagnostic Sciences, School of Dentistry, University of Southern California, Los Angeles, California 90089-0641, USA.
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de Repentigny L, Lewandowski D, Jolicoeur P. Immunopathogenesis of oropharyngeal candidiasis in human immunodeficiency virus infection. Clin Microbiol Rev 2004; 17:729-59, table of contents. [PMID: 15489345 PMCID: PMC523562 DOI: 10.1128/cmr.17.4.729-759.2004] [Citation(s) in RCA: 144] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Oropharyngeal and esophageal candidiases remain significant causes of morbidity in human immunodeficiency virus (HIV)-infected patients, despite the dramatic ability of antiretroviral therapy to reconstitute immunity. Notable advances have been achieved in understanding, at the molecular level, the relationships between the progression of HIV infection, the acquisition, maintenance, and clonality of oral candidal populations, and the emergence of antifungal resistance. However, the critical immunological defects which are responsible for the onset and maintenance of mucosal candidiasis in patients with HIV infection have not been elucidated. The devastating impact of HIV infection on mucosal Langerhans' cell and CD4(+) cell populations is most probably central to the pathogenesis of mucosal candidiasis in HIV-infected patients. However, these defects may be partly compensated by preserved host defense mechanisms (calprotectin, keratinocytes, CD8(+) T cells, and phagocytes) which, individually or together, may limit Candida albicans proliferation to the superficial mucosa. The availability of CD4C/HIV transgenic mice expressing HIV-1 in immune cells has provided the opportunity to devise a novel model of mucosal candidiasis that closely mimics the clinical and pathological features of candidal infection in human HIV infection. These transgenic mice allow, for the first time, a precise cause-and-effect analysis of the immunopathogenesis of mucosal candidiasis in HIV infection under controlled conditions in a small laboratory animal.
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Affiliation(s)
- Louis de Repentigny
- Department of Microbiology and Immunology, Faculty of Medicine, University of Montreal, 3175 Côte Sainte-Catherine, Montreal, Quebec H3T 1C5, Canada.
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Leigh J. Saliva composition and flow rates are impacted by early HIV disease irrespective of xerostomic medications. J Evid Based Dent Pract 2004. [DOI: 10.1016/j.jebdp.2004.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
The etiology of salivary gland hypofunction in HIV(+) patients is unclear. This study was designed to determine the effect of early-stage HIV(+) infection (CD4(+) > 200 cells/ micro L; n = 139) on salivary gland function and the relationship of this dysfunction to the taking of xerostomic medications. Salivary flow rates and the content of electrolytes and antimicrobial proteins in stimulated parotid and submandibular/sublingual saliva were determined. Compared with healthy controls (n = 50), the HIV(+) group showed significant reductions in flow rates of unstimulated whole (35%), stimulated parotid (47%), unstimulated submandibular/sublingual (23%), and stimulated submandibular/sublingual (39%) saliva. The flow rates for the HIV(+) patients taking xerostomic medications did not differ from those of patients who did not. Concentrations of some salivary gland components were altered in the HIV(+) group. Analysis of these data suggests that salivary gland function is adversely affected early in HIV infection and that these changes do not appear to be compounded by the taking of xerostomic medications.
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Affiliation(s)
- A L Lin
- Departments of Dental Diagnostic Science, University of Texas Health Science Center at San Antonio, TX 78229-4404, USA
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Laibe S, Bard E, Biichlé S, Vielle J, Millon L, Drobacheff C, Seilles E, Meillet D. New sensitive method for the measurement of lysozyme and lactoferrin to explore mucosal innate immunity. Part II: time-resolved immunofluorometric assay used in HIV patients with oral candidiasis. Clin Chem Lab Med 2003; 41:134-8. [PMID: 12666997 DOI: 10.1515/cclm.2003.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of this study was to explore lysozyme and lactoferrin concentrations in human immunodeficiency virus (HIV)-infected patients with oropharyngeal candidiasis (OPC). These proteins were measured by time-resolved immunofluorometric assay, validated in Part I of this study, in paired serum and salivary secretions of 30 patients. Eleven HIV-positive patients without OPC, eight HIV-positive patients with OPC and eleven HIV-negative healthy subjects were included in the study. The relative coefficient of excretion of salivary albumin was used to establish protein origin. In serum, the low lactoferrin concentrations in HIV-infected patients with and without OPC (0.610 mg/l (p < 0.05) and 0.896 mg/l (p < 0.01) vs. 1.439 mg/l in healthy subjects) were probably due to a decrease in nonspecific immunity, particularly the polymorphonuclear cells. In HIV-infected patients with OPC, the high salivary lysozyme and lactoferrin concentrations (170.94 mg/l and 66.48 mg/l vs. 23.35 mg/l and 10.20 mg/l in healthy subjects, respectively) and their mean relative coefficient of excretion of above 1 indicated a high local production of lysozyme and lactoferrin in saliva. The development of OPC in HIV-infected patients could be a consequence of inefficient lysozyme and lactoferrin concentrations and of decreased cooperation between innate and adaptative immune systems.
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Affiliation(s)
- Sophy Laibe
- Laboratoires de Parasitologie-Mycologie (EA 482) et Immunologie (EA 3181), Faculté de Médecine-Pharmacie, Besançon, France
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