Expression of Inflammatory Markers RANK, MMP-9 and PTHrP in Chronic Apical Periodontitis from People Living with HIV Undergoing Antiretroviral Therapy.

Marcio Francisco Pereira,Denis Bourgeois,Dennis Carvalho Ferreira,Lucio Souza Gonçalves,Luciana Armada,Fabio Ramoa Pires,Florence Carrouel

doi:10.3390/jcm9113611

Marcio Francisco Pereira, Denis Bourgeois + Show 5 more

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https://doi.org/10.3390/jcm9113611

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Abstract

To compare the expression of the receptor activator of nuclear factor-kappa B (RANK), matrix metalloproteinase 9 (MMP-9) and parathyroid hormone-related protein (PTHrP) in primary chronic apical periodontitis lesions (CAPLs) between people living with HIV (PLWHIV) undergoing antiretroviral therapy (ART) and HIV- individuals, 32 CAPLs (16 lesions from each group) were submitted to histopathological and immunohistochemical analyses and compared between groups. The majority of the PLWHIV group had undetectable plasma viral loads (n = 13; 81.3%). The means of TCD4+ lymphocytes, exposure to HIV-1 and the time of the use of ART were 542.1 cells/mm3 (SD = 256.4), 6.3 years (SD = 2.9) and 5.0 years (SD = 2.5), respectively. Of all variables studied, only histopathological diagnosis showed a significant difference between groups (LWHIV: granuloma n = 11 (68.0%); cyst n = 5 (31.2%); HIV-: granuloma n = 15 (93.8%); cyst n = 1 (6.2%); p = 0.015). When comparing the expressions of the three inflammatory markers between the groups, no significant differences were seen. There was no difference in the expression of RANK, PTHrP and MMP-9 in primary chronic apical periodontitis lesions between PLWHIV under ART and HIV- individuals.

Highlights

Oral lesions are an especially important marker of immunosuppression [1]
The specific characteristics only related to the people living with HIV (PLWHIV) group were the following: most had an undetectable plasma viral load (n = 13; 81.3%) with a mean of 1062.50 copies/mL (SD = 2619.64) and TCD4 + lymphocytes with a mean of 542.1 cells/mm3 of blood (SD = 256.4)
According to Desta et al (2019), one-third of the population living with HIV-1, undergoing antiretroviral therapy (ART), had full or partial recovery of the immune system, that is, TCD4 + cell count above 500 cells/mm3 of blood, while only 2% of this population remained at critical levels [20]

Summary

Introduction

Oral lesions are an especially important marker of immunosuppression [1]. For HIV/AIDS patients, as the CD4+ cell count decreases, the severity and appearance of specific oral lesions are increased [2]. The spread of HIV/AIDS infection is associated with a high frequency of oral lesions, including hairy leukoplakia, candidiasis, periodontal diseases and Kaposi’s sarcoma [3]. Forty-two HIV-related oral lesions have been identified by the WHO. Classified into three categories, they are categorized as strongly associated lesions, less commonly associated lesions and lesions found during HIV-1 infection [4]. More than 20 years have passed, this classification remains valid [1]

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