TH1 TH2 CYTOKINE EXPRESSION IN SALIVA OF HIV-POSITIVE AND HIV-NEGATIVE INDIVIDUALS - A PILOT-STUDY IN HIV-POSITIVE INDIVIDUALS WITH OROPHARYNGEAL CANDIDIASIS/

Current data suggest that T-helper (Th)2-type cytokine responses are o ften associated with progression to AIDS in HIV-positive individuals. Similarly, Th2-type cytokines are associated with susceptibility to mu cosal candidiasis, of which oropharyngeal candidiasis (OPC) is one of the most common opportunistic infections in HIV-positive individuals. Although little information is available on host defense mechanisms at the level of the oral mucosa, recent studies suggest that local cell- mediated immunity (CMI) is equally or more important than that in the periphery for host defense against mucosal Candida albicans infections . This study investigated the potential presence of oral-associated CM I through the expression of Th1/Th2-type cytokines in saliva of immuno competent and immunocompromised individuals with and without OPC. Resu lts showed a constitutive mixed Th1/Th2 cytokine expression (Th0) in w hole saliva of healthy HIV-negative individuals. In contrast, HIV-posi tive individuals had a dominant Th2-type salivary cytokine profile (in terleukin-4 [IL-4], IL-10) (IL-2, interferon-gamma [IFN-gamma], IL-12) that seemingly resulted from a lack of Th1-type cytokines rather than enhanced Th2-type cytokines. Moreover, pilot analyses of those with O PC showed evidence for a more profound salivary Th2-type profile. Both HIV-positive and HIV-negative patients, irrespective of CD4 counts, h ad some level of positive in vitro systemic lymphocyte proliferative r esponses to C albicans antigens, These results suggest that the Th1/Th 2 cytokine dichotomy in HIV disease is detectable in situ in oral secr etions and may be a useful indicator of oral-associated CMI to better understand resistance/susceptibility of HIV-positive individuals to or al opportunistic infections, including OPC.