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Yang Y, Yu F, Fei Y, Dong G, Cao P, Liu Y. Immune indices and oral health in patients infected with the human immunodeficiency virus. BMC Oral Health 2023; 23:1009. [PMID: 38102603 PMCID: PMC10724968 DOI: 10.1186/s12903-023-03752-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/08/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND The human immunodeficiency virus (HIV) is the causative agent of acquired immunodeficiency syndrome (AIDS). During the incubation period of AIDS, oral manifestations may precede systemic symptoms; therefore, it is vitally important to explore the relationship between HIV and oral health and other indicators. This study aimed to further assess the correlation between demographic risk factors, the dental health of HIV-infected patients, and the correlation of oral health indicators with CD4+ T-cell counts (CTCCs) and HIV viral loads (HIV-VLs). METHODS Demographic data on 108 HIV-infected patients were first recorded by questionnaire from March 2016 to November 2018. Patients' dental health and oral lesions were assessed by a dental specialist; in addition, they were tested for CTCCs and HIV-VLs by flow cytometry and NucliSENS EasyQ® HIV-1 virometer. Finally, the links between CTCC, HIV-VL, and the dental health (including oral lesions) of the patients were analyzed. RESULTS We found that age, marital status, and body mass index (BMI) were relevant to the patient's dental health (P < 0.05) and that their oral hygiene was relevant to their dental health (P < 0.05). However, HIV-VL was not directly related to periodontal/dental clinical indicators (P > 0.05). We discovered that the oral lesions in HIV-infected patients were related to decreased CTCCs and increased HIV-VLs (P < 0.05). CONCLUSIONS We concluded that HIV-infected patients with severely impaired immune function tend to have poor dental health. Moreover, the prevalence of oral lesions was negatively correlated with CTCC and positively correlated with HIV-VL.
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Affiliation(s)
- Yuxiang Yang
- Department of Radiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Feixue Yu
- Department of Radiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yujie Fei
- West China School of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Guangyan Dong
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Peilin Cao
- Department of Stomatology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 32# W. Sec 2, 1st Ring Rd. Chengdu, Chengdu, 610072, Sichuan, China.
| | - Yi Liu
- Department of Stomatology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 32# W. Sec 2, 1st Ring Rd. Chengdu, Chengdu, 610072, Sichuan, China.
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Shukla RK, Gunasena M, Reinhold-Larsson N, Duncan M, Hatharasinghe A, Cray S, Weragalaarachchi K, Kasturiratna D, Demberg T, Liyanage NPM. Innate adaptive immune cell dynamics in tonsillar tissues during chronic SIV infection. Front Immunol 2023; 14:1201677. [PMID: 37671159 PMCID: PMC10475724 DOI: 10.3389/fimmu.2023.1201677] [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: 04/06/2023] [Accepted: 08/01/2023] [Indexed: 09/07/2023] Open
Abstract
HIV-infected patients are at higher risk of developing oral mucosal infection and Epstein-Barr virus (EBV)-associated B cell malignancies. However, the potential role of oral immunity in the pathogenesis of oral lesions is unknown. Tonsils are oral-pharyngeal mucosal-associated lymphoid tissues that play an important role in oral mucosal immunity. In this study, we investigated the changes of innate and adaptive immune cells in macaque tonsils during chronic SIV infection. We found significantly higher frequencies of classical monocytes, CD3+CD56+ (NKT-like) cells, CD3+CD4+CD8+ (DP), and CD161+ CD4 T cells in tonsils from chronic infected compared to naïve animals. On the contrary, intermediate monocytes and CD3+CD4-CD8- (DN) cells were lower in chronic SIV-infected macaques. We further confirmed a recently described small B-cell subset, NKB cells, were higher during chronic infection. Furthermore, both adaptive and innate cells showed significantly higher TNF-α and cytotoxic marker CD107a, while IL-22 production was significantly reduced in innate and adaptive immune cells in chronic SIV-infected animals. A dramatic reduction of IFN-γ production by innate immune cells might indicate enhanced susceptibility to EBV infection and potential transformation of B cells in the tonsils. In summary, our observation shows that the SIV-associated immune responses are distinct in the tonsils compared to other mucosal tissues. Our data extends our understanding of the oral innate immune system during SIV infection and could aid future studies in evaluating the role of tonsillar immune cells during HIV-associated oral mucosal infections.
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Affiliation(s)
- Rajni Kant Shukla
- Department of Microbial Infection and Immunity, College of Medicine, Ohio State University, Columbus, OH, United States
| | - Manuja Gunasena
- Department of Microbial Infection and Immunity, College of Medicine, Ohio State University, Columbus, OH, United States
| | - Nicole Reinhold-Larsson
- Department of Microbial Infection and Immunity, College of Medicine, Ohio State University, Columbus, OH, United States
| | - Michael Duncan
- Department of Microbial Infection and Immunity, College of Medicine, Ohio State University, Columbus, OH, United States
| | - Amila Hatharasinghe
- Department of Microbial Infection and Immunity, College of Medicine, Ohio State University, Columbus, OH, United States
| | - Samuel Cray
- Department of Microbial Infection and Immunity, College of Medicine, Ohio State University, Columbus, OH, United States
| | - Krishanthi Weragalaarachchi
- Department of Microbial Infection and Immunity, College of Medicine, Ohio State University, Columbus, OH, United States
| | - Dhanuja Kasturiratna
- Department of Mathematics and Statistics, Northern Kentucky University, KY, Highland Heights, KY, United States
| | - Thorsten Demberg
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Namal P. M. Liyanage
- Department of Microbial Infection and Immunity, College of Medicine, Ohio State University, Columbus, OH, United States
- Department of Veterinary Biosciences, College of Veterinary Medicine, Ohio State University, Columbus, OH, United States
- Infectious Diseases Institute, The Ohio State University, Columbus, OH, United States
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Roberto de Souza Fonseca R, Valois Laurentino R, Fernando Almeida Machado L, Eduardo Vieira da Silva Gomes C, Oliveira de Alencar Menezes T, Faciola Pessoa O, Branco Oliveira-Filho A, Resque Beckmann Carvalho T, Gabriela Faciola Pessoa de Oliveira P, Brito Tanaka E, Sá Elias Nogueira J, Magno Guimarães D, Newton Carneiro M, Mendes Acatauassú Carneiro P, Ferreira Celestino Junior A, de Almeida Rodrigues P, Augusto Fernandes de Menezes S. HIV Infection and Oral Manifestations: An Update. Infect Dis (Lond) 2022. [DOI: 10.5772/intechopen.105894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Human immunodeficiency virus (HIV) causes a complete depletion of the immune system; it has been a major health issue around the world since the 1980s, and due to the reduction of CD4+ T lymphocytes levels, it can trigger various opportunistic infections. Oral lesions are usually accurate indicators of immunosuppression because these oral manifestations may occur as a result of the compromised immune system caused by HIV infection; therefore, oral lesions might be initial and common clinical features in people living with HIV. So, it is necessary to evaluate and understand the mechanism, prevalence, and risk factors of oral lesions to avoid the increase morbidity among those with oral diseases.
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Wang Y, Zhou H, Wang W, Duan N, Luo Z, Chai H, Jiang L, Chen Q, Liu J, Hua H, Yan Z, Fan Y, Xu J, Guan X, Wang H, Lu H, Lun W, Fei W, Zhang T, Zhao J, Jia C, Kong H, Shen X, Liu Q, Wang W, Tang G. Efficacy and safety of miconazole muco-adhesive tablet versus itraconazole in oropharyngeal candidiasis: A randomized, multi-centered, double-blind, phase 3 trial. Med Mycol 2022; 60:myac076. [PMID: 36149321 DOI: 10.1093/mmy/myac076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 06/16/2022] [Accepted: 09/21/2022] [Indexed: 11/14/2022] Open
Abstract
Oropharyngeal candidiasis (OPC) is an opportunistic infection treated with anti-fungal agents. Herein, we evaluate the efficacy and safety of miconazole buccal tablets (MBT) and itraconazole capsules in the localized treatment of patients with OPC. In this multi-centered, double-blinded, phase III trial (CTR20130414), both males and non-pregnant females (≥18 years) with OPC were randomized (1:1) to MBT plus placebo (experimental group) or itraconazole capsules plus placebo (control group). The primary endpoint was clinical cure at the end-of-treatment period [visit 4 (V4)] while secondary endpoints were clinical remission rates, partial remission rates, mycological cure, clinical relapse, and adverse events (AEs). All endpoints were statistically analyzed in both the full analysis set (FAS) and per-protocol (PP) set. A total of 431 (experimental: 216; control: 215) subjects were included. At V4, in the FAS set, the clinical cure was achieved in 68% and 59% patients in experimental and control groups, respectively with a treatment difference of 9% [95% confidence interval (CI): -1,19; P < .001] demonstrating non-inferiority of MBT over itraconazole. At V4, mycological cure rates were 68.2% and 42.0% in the experimental group and control groups (P < .001), respectively in FAS. The relapse rates were 5.4% and 6.6%, respectively, in the experimental and control groups. A total of 210 patients experienced AEs during treatment with 47.7% in the experimental group and 49.8% in the control group with no deaths. This study demonstrated that once-daily treatment with MBT was non-inferior to itraconazole with higher mycological cure rates and was tolerable with mild AE in patients with OPC.
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Affiliation(s)
- Yufeng Wang
- Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Stomatological Center; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory, Shanghai 200011, China
| | - Haiwen Zhou
- Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Stomatological Center; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory, Shanghai 200011, China
| | - Wenmei Wang
- Department of Oral Medicine, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, Jiangsu, China
| | - Ning Duan
- Department of Oral Medicine, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, Jiangsu, China
| | - Zhixiao Luo
- Dental Department, Taihe Hospital, Affiliated Hospital of Hubei, University of Medicine, Shiyan 442099, Hubei, China
| | - Hongbo Chai
- Dental Department, Taihe Hospital, Affiliated Hospital of Hubei, University of Medicine, Shiyan 442099, Hubei, China
| | - Lu Jiang
- Department of Oral Medicine, West China School/Hospital Stomatology Sichuan University, Chengdu 610042, Sichuan, China
| | - Qianming Chen
- Department of Oral Medicine, West China School/Hospital Stomatology Sichuan University, Chengdu 610042, Sichuan, China
| | - Jinli Liu
- Department of Oral Medicine, West China School/Hospital Stomatology Sichuan University, Chengdu 610042, Sichuan, China
| | - Hong Hua
- Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Zhimin Yan
- Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Yuan Fan
- Department of Oral Medicine, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, Jiangsu, China
| | - Juanyong Xu
- Department of Oral Medicine, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, Jiangsu, China
| | - Xiaobing Guan
- Department of Oral Medicine, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China
| | - Hongjian Wang
- Department of Oral Medicine, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China
| | - Hongzhou Lu
- Department of Infectious Diseases and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Wenhui Lun
- Department of Dermatology and Venereology, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - Wei Fei
- Department of Stomatology, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan, China
| | - Tong Zhang
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Jizhi Zhao
- Department of Stomatology, Peking Union Medical College Hospital, Beijing 100730, China
| | - Chunling Jia
- Department of Oral Medicine, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
| | - Hui Kong
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral Medicine, Department of Operative Dentistry & Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Xuemin Shen
- Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Stomatological Center; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory, Shanghai 200011, China
| | - Qing Liu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral Medicine, Department of Operative Dentistry & Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Weizhi Wang
- Department of Oral Medicine, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
| | - Guoyao Tang
- Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Stomatological Center; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory, Shanghai 200011, China
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Recurrent Aphthous Stomatitis – An Overview. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2022. [DOI: 10.2478/sjecr-2021-0058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Recurrent aphthous ulcers are common painful mucosal conditions affecting the oral cavity. Despite their high prevalence and knowledge of many etiological factors, the exact mechanism of disease is still not fully understood. There are three different clinical forms of recurrent aphthous stomatitis and the therapy differs depending on it.
The aim of this article is to provide an overview of current knowledge about the possible causes and treatment of recurrent aphthous stomatitis. We discuss its pathogenesis which is currently the least explained in the literature. This review offers scientists and clinicians useful information about clinical presentation, diagnosis, predisposing aetiological factors and recent trends in the management of recurrent aphthous stomatitis.
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Shu W, Du F, Bai JS, Yin LY, Duan KW, Li CW. A Real-World Evidence-Based Management of HIV by Differential Duration HAART Treatment and its Association with Incidence of Oral Lesions. Curr HIV Res 2021; 20:91-99. [PMID: 34961450 PMCID: PMC9127730 DOI: 10.2174/1570162x20666211227154558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/06/2021] [Accepted: 11/17/2021] [Indexed: 11/22/2022]
Abstract
Background The efficacy of highly active antiretroviral therapy (HAART) can be estimated by the immunological response and the incidence of opportunistic infections. Objective This study aimed at evaluating the effectiveness of different durations of HAART in terms of immunological response markers (CD4 count and CD4/CD8 ratio) along with disease progression markers (incidence of oral lesions) in Chinese patients with HIV. Methods This single-center, retrospective, and real-world study included patients with HIV, grouped into a treatment group and treatment-naïve group, of which the former was further divided into 6, 12, and 18 months based on the treatment duration. The CD4 and CD8 cell counts were analyzed by the FACSCalibur flow cytometry. Kruskal-Wallis test was applied to determine the outcome of different duration of HAART. Oral examination was carried out according to the WHO type IV examination. Results In 246 patients with HIV, CD4 counts increased significantly post-HAART compared to pre-HAART in all three treatment groups (P<.001), while CD8 count decreased significantly (P<.05) in all three treated groups. A significant association of HAART with the CD4/CD8 ratio was observed (P<.001). A significant increase in CD4 count was observed between 12-months and 18-months treatment groups (P<.05). The occurrence of oral lesions reduced significantly in the treatment group. Conclusion We observed a better response to the HAART regimen with 18-months of duration than 12-months and 6-months therapies and reduction in oral lesions.
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Affiliation(s)
- Wen Shu
- Department of Stomatology, Kunming Medical University Yan'an Hospital, Yan'an Hospital of Kunming, East Ren Min Road 245, Kunming 650051, PR China
| | - Fei Du
- Department of Stomatology, Kunming Medical University Yan'an Hospital, Yan'an Hospital of Kunming, East Ren Min Road 245, Kunming 650051, PR China
| | - Jin- Song Bai
- Department of Infectious Disease, Kunming Third People\'s Hospital, Kunming, PR China
| | - Ling-Yun Yin
- Department of Stomatology, Kunming Medical University Yan'an Hospital, Yan'an Hospital of Kunming, East Ren Min Road 245, Kunming 650051, PR China
| | - Kai-Wen Duan
- Department of Stomatology, Kunming Medical University Yan'an Hospital, Yan'an Hospital of Kunming, East Ren Min Road 245, Kunming 650051, PR China
| | - Cheng-Wen Li
- Department of Research Management, The Third Affiliated Hospital of Kunming Medical University, Kunming, PR China
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Moosazadeh M, Shafaroudi AM, Gorji NE, Barzegari S, Nasiri P. Prevalence of oral lesions in patients with AIDS: a systematic review and meta-analysis. Evid Based Dent 2021:10.1038/s41432-021-0209-8. [PMID: 34795396 DOI: 10.1038/s41432-021-0209-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/04/2021] [Indexed: 11/10/2022]
Abstract
Background Oral lesions are considered to be early clinical signs which may predict the progression of patients with acquired immune deficiency syndrome (AIDS). Due to the lack of a comprehensive study that includes oral lesions in people with AIDS, the global prevalence of oral lesions in people with AIDS was estimated by combining preliminary studies' results using meta-analysis.Material and methods Databases including PubMed, Science Direct and Scopus were searched using keywords as 'HIV', 'AIDS', 'oral candidiasis', 'Kaposi Sarcoma', 'LinearGingival Erythema' and OR operators, AND and NOT. After the elimination of duplicate documents, articles that met the inclusion criteria were selected. Quality assessment was performed based on the Newcastle-Ottawa Scale. After combining the results of preliminary studies, an overall estimate of each lesion was reported. Ninety-five studies met the criteria for inclusion in this meta-analysis.Results The global prevalence of 21 oral lesions in HIV-infected patients was estimated. The overall prevalence of oral candidiasis, pseudomembranous candidiasis, oral hairy leukoplakia, Kaposi sarcoma and erythematous candidiasis was as follows: 35% (95% CI: 28-42), 19% (95% CI: 15-22), 12% (95% CI: 11-14), 5% (95% CI: 4-6) and 18% (95% CI: 14-22).Conclusion The present meta-analysis showed that oral lesions have a high prevalence in patients with AIDS. Dentists should consider that the clinical appearance of the oral cavity reflects the overall systemic health of the patient. As such, oral lesions may be linked to underlying immunosuppression caused by AIDS.
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Affiliation(s)
- Mahmood Moosazadeh
- PhD in Epidemiology, Associate Professor, Gastrointestinal Cancer Research Centre, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Malekzadeh Shafaroudi
- Dentistry Student, Student Research Committee, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Nadia Elyassi Gorji
- Dentistry Student, Student Research Committee, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Saeed Barzegari
- PhD in Health Information Management, Department of Paramedicine, Amol School of Paramedical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
| | - Pegah Nasiri
- Dentistry Student, Student Research Committee, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran.
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