Avaliação metabolômica de biofluido alveolar pós-exodontia associada à terapia fotodinâmica em pacientes vivendo com HIV/Aids

Resumo (EN)

Objective: To evaluate the clinical efficacy of Photodynamic Therapy (aPDT) as an adjunct in post-extraction tissue repair in patients living with HIV/AIDS (PLHIV), correlating the clinical outcomes of pain and edema with the salivary metabolomic profile identified by gas chromatography coupled with mass spectrometry (GC–MS).
Methods: A randomized, controlled, and prospective clinical trial was conducted with a sample of 40 patients divided into four groups: G1 (HIV+ aPDT), G2 (HIV− aPDT), G3 (HIV+ Control), and G4 (HIV− Control). Biofluid (saliva) samples were collected during the pre- and postoperative periods, along with clinical assessments of pain (VAS scale) and edema (Willis compass). Metabolomic analysis investigated biomarkers of inflammation and tissue repair.
Results: Clinical outcomes demonstrated that group G1 (HIV+ treated) showed a significant reduction in edema and pain on the 7th postoperative day compared to G3 (control), reaching levels comparable to the systemically healthy patient group (G2). Metabolomic analysis revealed a common basal core among the groups but with critical quantitative differences: G3 exhibited inflammatory stagnation marked by increased isoquinoline levels, whereas G1 presented a repair-associated profile with a predominance of fatty acids (stearic acid), suggesting activation of membrane biosynthesis pathways.
Conclusion: aPDT proved to be an effective tool in modulating the inflammatory response in immunosuppressed patients, acting as a metabolic switch that favors the transition from the inflammatory to the resolution phase and equalizes the surgical prognosis of PLHIV with that of immunocompetent individuals.