Immunological profile of periapical endodontic infections from HIV- and HIV+ patients.

AIM: To evaluate CD4(+) CD28(+) and CD8(+) T-cell genes and the gene expression of IFN-γ, TNF-α, IL-1-ß, IL-17A, IL-10, CCL-2/MCP-1, CCL-4, CCL-5 (RANTES), CXCR4, CCR5 and RANKL from cells in the periapical interstitial fluid from root canal infections in healthy patients (HIV-) and HIV-positive individuals (HIV+). METHODOLOGY: Subjects included 20 HIV- and 23 HIV+ patients referred to the School of Dentistry at the Universidade Federal de Minas Gerais (Belo Horizonte, MG, Brazil). Almost all HIV+ patients were undergoing highly active antiretroviral therapy (HAART). Clinical samples were taken from teeth with pulp necrosis, and no patients had acute periapical symptoms at the time of the appointments. After cleaning and drying, 3 paper points were introduced into the root canal, passing passively through the root apex (2 mm) into the periapical tissues for 1 min. The samples were collected immediately after root canal cleaning and 7 days later (restrained root canal bacterial load) to characterize those gene expressions using real-time PCR. RESULTS: Significantly higher levels of CD4(+) CD28(+) and CD8(+) T cells in teeth with restrained bacterial loads (second collection) compared with the first collection were observed in both HIV- and HIV+ samples. In HIV- patients, an increase in IL-10 and CXCR4 expression was demonstrated as well as a decrease in pro-inflammatory cytokines such as RANKL, IFN-γ, IL1-ß and CCL5. However, in HIV+ patients an increase in cytokines IFN-γ, IL-1-ß, TNF-α and IL-17A, and chemokines CCL-2, CXCR4 and CCR5 were observed. The chemokine CCL-5 was not detected in HIV+ individuals. CONCLUSIONS: These findings suggest that after reducing the root canal bacterial load in HIV- individuals an anti-inflammatory response is generated whilst in HIV+ patients a pro-inflammatory response is sustained in the periapical area.

Improved immunodiagnosis of human cysticercosis with scolex protein antigens.

Crude antigenic extract (CAE) and a scolex protein antigen (SPA) of Taenia solium cysticerci were used in indirect haemagglutination (IH) and enzyme-linked immunosorbent assay (ELISA) to detect serum antibodies in cysticercosis patients. Complement fixation (CF) was used for comparison with antigens obtained as an alcoholic extract of CAE (ACAE) and SPA (ASPA). For each test, a dilution was chosen which showed no cross-reactivity with sera from patients with other parasitic diseases such as taeniasis, schistosomiasis, ancylostomiasis, ascaridiasis, strongyloidiasis, Chagas' disease and syphilis. For the CF, 1:4 was the discriminative dilution determined; for IH, 1:16 and for ELISA, 1:256. The CF could detect serum antibodies to cysticerci in 45% of patients when ACAE antigen was used and 73% using ASPA. In the IH, serum antibody was detected in 73% of patients when CAE was used and 86% using SPA. In ELISA 63% of patients were positive when CAE was used and 91% using SPA. The use of SPA improved the serological distinction between infected and uninfected patients in all tests and the ELISA showed a significantly higher capacity to detect infected patients.