Th1/Th2 Cytokine Levels in Saliva of AIDS/HIV Patients with Candidiasis

1Peking University School and Hospital of Stomatology, Beijing, China, 2College of Stomatology,Jiamusi University, Beijing, China, 3Contagious Hospital of Henan Province, Beijing, China

Objective: To evaluate cell-mediated immunity (CMI) state in saliva among AIDS/HIV patients with oral candidiasis (OC).

Methods: There were four groups of subjects: 13 AIDS/HIV patients with OC (Group 1), 26 AIDS/HIV patients without OC (Group 2), 22 HIV-negative individuals with OC (Group 3) and 27 HIV-negative individuals without OC in (Group 4). All the subjects completed questionnaires. Oral examinations were undertaken and unstimulated saliva was collected for fungal culture. The colony forming units (CFU) were then counted and candidal infection classified. The levels of IL-2, IL-4, IL-6, IL-10, TNF-α, IFN-α, sIgA were measured by enzyme-linked immunosorbent assay (EHSA).

Results: The level of IL-2, TNF-α,IFN-α in AIDS/HIV patients was significantly lower than that in HIV-negative individuals (p<0.05), but the level of IL-4, IL-6, IL-10, sIgA was not significantly different between the them. The level of IFN-α in Group 1 was significantly lower than that in Group 3 (p<0.05). Group 1 had a significantly lower CD4 cell count (145.75+80.76/ml) than those of group 2 (243.33+173.96/ml) (p<0.05). CFU of candida in saliva did not show to be significantly related to the CD4 cell count and level of cytokines. In AIDS/HIV patients, the level of IFN-α had a negative correlation with the course of HIV-infection and unstimulated salivary flow rate, and a positive correlation with pH of saliva (p<0.05).

Conclusions: AIDS/HIV patients had a dominant lack of Th1-type cytokines rather than enhanced Th2-type cytokines. This study represents a potential indicator to evaluate the degree of immunity of AIDS/HIV patients. These results suggest that the Th1/Th2 cytokine dichotomy, especially IFN-α, in AIDS/HIV patients is detectable in saliva and may be a useful indicator of oral-associated CMI. This amy lead to a better understanding of resistance/susceptibility of HIV-positive individuals to oral opportunistic infections, including OC.