INFLAMMATORY AND IMMUNE MEDIATORS IN CREVICULAR FLUID FROM HIV-INFECTED INJECTING DRUG-USERS

GINGIVAL CREVICULAR FLUID (GCF) levels of the polymorphonuclear leukoc yte (PMN) lysosomal enzyme beta-glucuronidase (beta G), the pro-inflam matory cytokine interleukin 1 beta (IL-1 beta), and immunoglobulins (I gA, IgG, and IgM) were examined in 16 HIV seropositive (HIV+) and 10 H IV seronegative (HIV-) injecting drug users (IDU). Each subject receiv ed a periodontal examination including assessment of probing depth, at tachment level, bleeding on probing, and plaque and calculus accumulat ion. GCF was collected from the mesial surfaces of premolar and molar teeth using filter paper strips. Although HIV+ subjects had a signific antly lower number of peripheral blood CD4+ T cells/mm3 compared to HI V- subjects, there were no significant differences in mean probing dep th, percentage of sites exhibiting bleeding on probing, or plaque and calculus accumulation between HIV- and HIV+ subjects. When the GCF com ponents were analyzed, we found no significant differences between HIV - and HIV+ subjects in GCF levels of beta G, IL-1 beta, IgA or IgM, bu t GCF levels of IgG were significantly increased in HIV+ subjects. Whe n sites were categorized by probing depth, no differences in the level s of PG, IgA, IgG, and IgM existed between sites with probing depth le ss than or equal to 3 mm compared to sites with probing depth greater than or equal to 4 mm in both HIV- and HIV+ IDU. However, levels of IL -1 beta in GCF were increased in the deeper sites (greater than or equ al to 4 mm) in HIV+ IDU when compared to sites with PD less than or eq ual to 3 mm. Analyzing GCF constituents in relation to the CD4 cell nu mber, no differences were found between subjects with less than or equ al to 400 or > 400 CD4 cells/mm(3) with respect to the levels of IL-1 beta, IgG, and IgM. However, the level beta G was significantly decrea sed in the HIV+ IDU with less than or equal to 400 CD4 cells when comp ared to those with > 400 CD4 cells/mm(3), while levels of IgA were sig nificantly higher in HIV+ subjects with less than or equal to 400 CD4 cells/mm(3). Our results suggest that levels of IgG, and in immunodefi cient subjects IgA were increased in GCF of HIV+ IDU while decreased l evels of PG were found in immunodeficient HIV+ IDU. These findings may be local manifestions of systemic alterations and suggest that analys is of GCF may provide insight into the immune and inflammatory respons es of HIV-infected individuals to periodontal microorganisms.