Chattopadhyay, A.Gray, L.Patton, L.Caplan, D.Slade, G.Tien, H.Shugars, D.2007-02-242007-02-242004Infection and Immunity, 2004; 72(4):1956-19630019-95671098-5522http://hdl.handle.net/2440/3941Oropharyngeal 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.en© 2004, American Society for Microbiology. All Rights Reserved.SalivaHumansCandida albicansAIDS-Related Opportunistic InfectionsCandidiasis, OralHIV InfectionsProteinsCD4 Lymphocyte CountCross-Sectional StudiesAdolescentAdultFemaleMaleProteinase Inhibitory Proteins, SecretorySecretory Leukocyte Peptidase InhibitorJournal article002004028510.1128/IAI.72.4.1956-1963.20040002204816000132-s2.0-184253636257155