Salivary secretory leukocyte protease inhibitor and oral candidiasis in human immunodeficiency virus type 1-infected persons

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dc.contributor.authorChattopadhyay, A.
dc.contributor.authorGray, L.
dc.contributor.authorPatton, L.
dc.contributor.authorCaplan, D.
dc.contributor.authorSlade, G.
dc.contributor.authorTien, H.
dc.contributor.authorShugars, D.
dc.date.issued2004
dc.description.abstractOropharyngeal candidiasis, typically caused by Candida albicans, is the most common oral disease associated with human immunodeficiency virus type 1 (HIV-1) infection. Secretory leukocyte protease inhibitor (SLPI), a 12-kDa antiprotease, suppresses the growth of C. albicans in vitro. To determine whether the mucosal protein plays a role in protecting oral tissues against fungal infection, we conducted a cross-sectional study investigating the oral and systemic health and salivary SLPI levels in 91 dentate HIV-1-infected adults receiving medical care in the southeastern United States. Participants with a self-reported history of clinical oropharyngeal candidiasis during the previous 2 years constituted the test group (n = 52), while the comparison group (n = 39) had no oropharyngeal candidiasis during that period. Data collected from medical records, oral examination, and SLPI enzyme-linked immunosorbent assay quantitation of whole saliva were analyzed by t test, analysis of variance, linear regression, and unconditional logistic regression. The test group had a significantly higher mean salivary SLPI level than the comparison group (1.9 microg/ml versus 1.1 microg/ml, P < 0.05). Linear regression modeling identified CD4 cell count and history of oropharyngeal candidiasis as key predictors of salivary SLPI and revealed a significant interaction (P < 0.05) between immunosuppression (CD4 cell count below 200 cells/ microl) and positive history of oropharyngeal candidiasis in predicting salivary SLPI level. By logistic regression modeling, a salivary SLPI level exceeding 2.1 microg/ml, low CD4 count, antiretroviral monotherapy, and smoking were key predictors of oropharyngeal candidiasis. These data support a key role for SLPI in the oral mucosal defense against C. albicans. The antimicrobial mucosal protein may serve as an indicator of previous oropharyngeal candidiasis infection among immunosuppressed persons.
dc.description.statementofresponsibilityAmit Chattopadhyay, Laurie R. Gray, Lauren L. Patton, Daniel J. Caplan, Gary D. Slade, Hsaio-Chuan Tien, and Diane C. Shugars
dc.identifier.citationInfection and Immunity, 2004; 72(4):1956-1963
dc.identifier.doi10.1128/IAI.72.4.1956-1963.2004
dc.identifier.issn0019-9567
dc.identifier.issn1098-5522
dc.identifier.urihttp://hdl.handle.net/2440/3941
dc.language.isoen
dc.publisherAmer Soc Microbiology
dc.rights© 2004, American Society for Microbiology. All Rights Reserved.
dc.source.urihttps://doi.org/10.1128/iai.72.4.1956-1963.2004
dc.subjectSaliva
dc.subjectHumans
dc.subjectCandida albicans
dc.subjectAIDS-Related Opportunistic Infections
dc.subjectCandidiasis, Oral
dc.subjectHIV Infections
dc.subjectProteins
dc.subjectCD4 Lymphocyte Count
dc.subjectCross-Sectional Studies
dc.subjectAdolescent
dc.subjectAdult
dc.subjectFemale
dc.subjectMale
dc.subjectProteinase Inhibitory Proteins, Secretory
dc.subjectSecretory Leukocyte Peptidase Inhibitor
dc.titleSalivary secretory leukocyte protease inhibitor and oral candidiasis in human immunodeficiency virus type 1-infected persons
dc.typeJournal article
pubs.publication-statusPublished

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