title: Immunological profile of periapical endodontic infections from HIV- and HIV+ patients.
abstract: OBJECTIVE
  To evaluate CD4(+) CD28(+) and CD8(+) T-cell genes and the gene expression of IFN-γ, TNF-α, IL-1-β, 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+).
  
  
  METHODS
  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-β and CCL5. However, in HIV+ patients an increase in cytokines IFN-γ, IL-1-β, 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.
authors: Faculdade de Odontologia, Universidade de Itaúna, Itaúna, Brazil.
authors: L C N
authors: LC
authors: de Brito
authors: Departament of Applied Oral Sciences, The Forsyth Institute, Boston, MA, USA.|Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA.
authors: F R
authors: FR
authors: Teles
authors: Departament of Applied Oral Sciences, The Forsyth Institute, Boston, MA, USA.|Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA.
authors: R P
authors: RP
authors: Teles
authors: Departamento de Odontologia Restauradora, Faculdade de Odontologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors: P M
authors: PM
authors: Nogueira
authors: Departamento de Bioquímica e Imunologia Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.|Nucleo de Pesquisa em Ciências Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Brazil.
authors: L Q
authors: LQ
authors: Vieira
authors: Departamento de Odontologia Restauradora, Faculdade de Odontologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors: A P
authors: AP
authors: Ribeiro Sobrinho
mesh_terms: D000293:Adolescent; D000328:Adult; D058491:Bacterial Load; D001938:Brazil; D002648:Child; D016207:Cytokines / Q000378:metabolism; D003790:Dental Pulp Necrosis / Q000235:genetics / Q000276:immunology* / Q000628:therapy*; D005260:Female; D015870:Gene Expression; D018023:HIV Seronegativity; D006679:HIV Seropositivity; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D060888:Real-Time Polymerase Chain Reaction; D012390:Root Canal Therapy; D013601:T-Lymphocytes / Q000378:metabolism
chemical_list: D016207:Cytokines
keywords: T-cell expression; chemokines; cytokines; human immunodeficiency virus (HIV); periapical lesion