Uticaj HIV infekcije i antiretrovirusnih lekova na starenje parodontalnih tkiva

Abstract

Starenje parodontalnih tkiva, kao i čitavog organizma, je prirodan, nezaustavljiv proces koji se karakteriše nakupljanjem neželjenih promena koje dovode do poremećaja homeostaze, gubitka funkcije i većom verovatnoćom za pojavu oštećenja, bolesti i smrti jedinke. Dinamika ovog procesa se razlikuje među jedinkama, ali postoje razlike i u samom organizmu jer organi, tkiva, ćelije, pa čak i subcelularne strukture ne stare istom brzinom. Posledično, biološka starost jedinke ne mora da odgovara njenoj hronološkoj starosti. Dalje, pojedina stanja i patološki procesi mogu dovesti do ubrzanog starenja. Pokazano je da osobe zaražene virusom humane imunodeficijencije (engl. Human Immunodeficiency Virus, HIV) fenotipski brže stare od neinficiranih osoba što može da bude posledica same infekcije i/ili primene antiretrovirusnih lekova, koji su značajno produžili životni vek pacijentima sa HIV-om. Upotrebom različitih markera starenja moguće je razlikovati biološku od hronološke starosti individue, ali i razlikovati prerano starenje odnosno bolesti koje su u vezi sa starenjem od fiziološkog starenja. Cilj ovog istraživanja bio je da se utvrdi veza između starenja parodontalnih tkiva i različitih bioloških markera starenja kao što su dužina telomera, parametri metabolizma gvožđa i dobno zavisna smena prisustva parodontopatogena kod HIV-om inficiranih pacijenata i neinficiranih kontrola. Istraživanje je dizajnirano kao studija preseka. U studiju je bilo uključeno 105 HIV-om inficiranih i 100 neinficiranih ispitanika muškog pola podeljenih u dve starosne grupe: mlađu sa ispitanicima do 35 godina života i stariju sa ispitanicima koji imaju više od 50 godina. Nakon potpisanog informisanog pristanka od ispitanika su dobijeni anamnestički podaci, uzorci krvi i bris oralne sluzokože, a odrađen je i detaljan stomatološki pregled. Iz uzoraka krvi određivani su relativna dužina telomera leukocita i parametri metabolizma gvožđa, serumsko gvožđe, ukupni kapacitet transferina za vezivanje gvožđa, saturacija transferina i koncentracije transferina i feritina. Iz briseva oralne sluzokože detektovani su sledeći parodontopatogeni mikroorganizmi: Prevotella intermedia, Peptostreptococcus micros, Aggregatibacter actinomycetemcomitans, Eikenella corrodens, Porphyromonas gingivalis, Tannerella forsythia i Treponema denticola. Inspekcijom usne duplje utvrđivano je prisustvo oralnih manifestacija karakterističnih za HIV-infekciju dok je parodontološki pregled poslužio za procenu stanja potpornog aparata zuba...

Aging of periodontal tissues, as well as organism as a whole, is natural, unstoppable process of accumulation of undesirable changes which lead to disturbancy of chomeostasis, loss of function and increased susceptibility to diseases and death. Dynamic of this process is often unpredictable because individuals, organs, tissues, cells, and even subcellular structures do not have the same rate of aging. Considering that, the biological aging of the individuals does not neccesarily match their chronological aging. Furthermore, some conditions and pathological processes could increase the speed of aging. It has been shown that patients with human immunodeficency virus (HIV) infection age faster than their non-infected counterparts. The altered aging in HIV-infected patients could be triggered by infection itself or due to usage of antiretroviral drugs, which increased life expectancy in these patients. Various biological markers of aging could be used in order to determine the difference between biological and chronological age of the patient, and to differ premature aging or aging-related diseases from physiological aging. The aim of this research was to identify the relations between periodontal tissue aging and biomarkers of aging such as, relative telomere length, iron metabolism parameters and presence of periodontal pathogens within oral cavity. Investigation was designed as a cross-sectional study. The study enrolled 105 HIV-infected and 100 non-infected male subjects subdivided in two age groups: younger (<35 years of age) and older (>50 years of age). After signing the informed consent, anamnestic data, blood samples and buccal swabs were collected from each patient and detailed oral examinations were performed. The blood samples were used for relative telomere length and iron metabolism parameters (serum iron, total iron binding capacity, transferrin saturation and concentrations of transferrin and ferritin) analyses. The buccal swabs were used for the identification of periodontal pathogens: Prevotella intermedia, Peptostreptococcus micros, Aggregatibacter actinomycetemcomitans, Eikenella corrodens, Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola. Oral manifestations of HIV-infection were detected by inspection and periodontal parameters were determined by probing. Results of this study indicate that relative telomere length is longer in younger patients in both, HIV-infected and non-infected group, compared to their older counterparts...