SALIVA AND ANTICANDIDAL DEFENSE MECHANISMS IN HIV/AIDS

描述：这项提案将测试假设中的更改 唾液腺功能与HIV感染的进展有关 唾液腺功能的这种变化容易发生在口腔中 念珠菌病。其次，随着艾滋病毒感染的日益严重，患者 发展Sjogren综合征样特征。这项研究将借鉴一项 患者群体已被分成九个临床类别和 每个受试者都有详细的病史和治疗史。 腮腺和下颌下/舌下腺功能将在 基线和两个额外的时间点，相隔18个月。念珠菌 将通过口腔的酵母菌计数和细胞学涂片来确定状态 粘膜。将分析数据以确定关键主机防御之间的关联 唾液成分和艾滋病毒感染阶段，以及与 与HIV疾病的进展和口腔念珠菌病的易感性有关 考虑到HIV疾病的分期。拟议的研究将提供基本的 对口腔免疫系统失调的洞察 HIV+和干燥症患者口腔问题的核心 综合症。它还将提供对唾液的作用的理解 腺体功能与此类患者的念珠菌病易感性有关，并可能 引导治疗方法，可能改善患者的生活质量 这些人。具体目标是：具体目标1：确定 唾液腺的横断面和纵向变化(唾液流率， 唾液化学和抗HIV成分)在HIV不同阶段 感染。对唾液腺功能的如此系统的研究 在一个大的研究小组中，艾滋病毒感染的进展还没有完成， 之前。具体目标2：确定唾液中抗念珠菌的变化 随着艾滋病毒感染的进展而开展的活动。这一目标将考验 假说对念珠菌感染的易感性是由于 唾液抗真菌活性。将寻求两国之间的直接关联 唾液抗念珠菌成分损害与临床念珠菌 感染。组抑素、溶菌酶的浓度和功能活性 将对乳铁蛋白进行评估。具体目标3：确定 HIV感染者唾液腺功能的异同 患者和干燥综合征。该提案的这一目标将评估 常规唾液化学以及唾液促炎和 HIV+和干燥综合征患者的抗炎细胞因子。

DESCRIPTION: This proposal will test the hypotheses that alterations in salivary gland function are associated with the progression of HIV infection and that such alterations in salivary gland function predispose to oral candidiasis. Secondly, with increasing severity of HIV infection, patients develop Sjogren's Syndrome-like features. The study will draw upon a patient population that has been staged into nine clinical categories and detailed medical and treatment histories are available for each subject. Parotid and submandibular/sublingual gland function will be assessed at baseline and at two additional times points, 18 months apart. Candida status will be determined by yeast counts and cytological smears of oral mucosa. Data will be analyzed for correlation between key host defense components in saliva and the stage of HIV infection, as well as with regard to progression of HIV disease and susceptibility to oral candidiasis at any given stage of HIV disease. The proposed study will provide fundamental insights into the dysregulation of the oral immune system which is at the core of oral problems in individuals who are HIV+ and have Sjogren's Syndrome. It will also provide an understanding of the role of salivary gland function in the predisposition to candidiasis in such patients and may lead to therapeutic approaches that may improve the quality of life for these individuals. The specific aims are: Specific Aim 1: Determine cross-sectional and longitudinal salivary gland changes (salivary flow rate, sialochemistry, and anti-HIV components) during the different stages of HIV infection. Such a systematic study of salivary gland function with progression of HIV infection has not been completed in a large study group, previously. Specific Aim 2: Determine changes in salivary anti-candidal activities with the progression of HIV infection. This aim will test the hypothesis that the predisposition to Candida infection is due to changes in salivary anti-fungal activity. A direct correlation will be sought between impairment of salivary anti-candidal components and clinical candidal infection. The concentration and functional activity of histatins, lysozyme and lactoferrin will be evaluated. Specific Aim 3: Determine the similarities and differences in salivary gland function of HIV infected patients and Sjogren's Syndrome. This aim of the proposal will evaluate routine sialochemistry as well as salivary proinflammatory and anti-inflammatory cytokines in both HIV+ and Sjogren's Syndrome patients.