SALIVA AND ANTICANDIDAL DEFENSE MECHANISMS IN HIV/AIDS

描述：本提案将测试以下假设： 唾液腺功能与HIV感染的进展有关 唾液腺功能的这种改变使口腔 念珠菌病 其次，随着艾滋病毒感染的日益严重， 会出现干燥综合征的症状 该研究将利用一个 患者人群分为9个临床类别， 每名受试者均有详细的病史和治疗史。 腮腺和颌下腺/舌下腺功能将在 基线和两个额外的时间点，间隔18个月。 念珠菌 状态将通过酵母菌计数和口腔粘膜细胞学涂片确定。 粘膜 将对数据进行分析，以确定关键宿主防御之间的相关性 唾液中的成分和艾滋病毒感染的阶段，以及关于 艾滋病毒疾病的进展和对口腔念珠菌病的易感性， 艾滋病病毒感染的阶段。 这项研究将提供基本的 深入了解口腔免疫系统的失调， 艾滋病毒阳性和干燥综合症患者口腔问题的核心 综合征 它还将提供一个了解的作用，唾液 腺体功能与此类患者患念珠菌病的易感性有关，并且可能 导致治疗方法，可以改善生活质量， 这些人。 具体目标1：确定 横截面和纵向唾液腺变化（唾液流速， 唾液酸化学和抗HIV成分）在HIV的不同阶段 感染 唾液腺功能的系统研究， HIV感染的进展尚未在大型研究组中完成， 以前。 具体目标2：确定唾液抗念珠菌 随着艾滋病毒感染的进展。 这一目标将考验 假设念珠菌感染的易感性是由于 唾液抗真菌活性。 将在以下方面寻求直接的相关性： 唾液抗念珠菌成分损伤与临床念珠菌感染 感染 组胺、溶菌酶的浓度和功能活性 和乳铁蛋白。 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。 该提案的目的是评估 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.