Specific Aims/Hypothesis: The overall goal of this proposal will be to evaluate the relationship between race, lymphocyte activation and periodontal status in subjects presenting with HIV infection compared to age-sex-race matched control subjects.
The specific aims of this proposal are as follows: To measure the numbers of lymphocyte subpopulations, lymphocyte activation, and WBC and differential counts in peripheral blood in HIV-seropositive and HIV-seronegative subjects relative to their race and clinical periodontal presentation. Background and Significance: Progressive depletion of CD4 lymphocytes, as well as dysfunction of lymphocytes, macrophages, and monocytes, are the basic manifestations of HIV infection. Preliminary data from an ongoing study of necrotizing ulcerative gingivitis (NUG) in the PI's laboratory indicate racial differences in IL2 production as well as IL4 serum levels. The lymphoproliferative response within the periodontium has been shown to be associated with release of systemic markers of lymphocyte activation such as interleukin-2 receptor and interleukin-4 (IL4). Differences in systemic antibody response to dental plaque bacteria associated with periodontal disease have been reported to occur when black subjects are compared to white subjects. It is plausible that lymphocyte activation/function secondary to dental plaque stimulation is influenced by ethnicity of the subjects. Research Design: The MCV AIDS program currently follows 900 patients. Over 60% of these patients are black. Control subjects who are age-sex- race matched volunteers are obtained from the dental clinics at MCV/VCU, University of Maryland, and Howard University, Schools of Dentistry. It is anticipated that following calibration of examiners, subjects will also be recruited from Howard University. This will most likely occur during the second year of the pilot study. Lymphocyte activation will be assessed by measuring serum levels of soluble sIL2R and IL4. To be included in this study, all HIV seropositive subjects need to have CD4 counts > 300 mm3. Once a subject had been identified, informed consent and venous blood will be obtained. Venous blood samples will be obtained from HIV infected subjects and age-sex-race matched control subjects (HIV seronegative). CBC and Differential blood counts as well as CD4/CD8 profiles will be performed. Serum IL4 and sIL2R will be measured by ELISA systems. Each subject will be examined for the following measures on four surfaces per tooth: pocket depths; plaque index (PI) of Silness and Loe; and gingival index (GI). Each dependent variable (HIV-serostatus, sIL2R, IL4, white blood cell profile, and CD4/CD8 counts and ratios) will be analyzed with ANOVA. If CD4/CD8 counts and ratios are different between races, they will be used as covariates when comparing the other dependent variables between races using ANCOVA.
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