Systemic antibody response of clinically characterized patients with antigens of Eubacterium brachy initially and following periodontal therapy

Eubacterium brachy, a gram-positive anaerobic rod, has been implicated by cultural studies to be associated with the microflora of periodontal diseases. Serum samples from 184 clinically characterized patients were evaluated in a standardized enzyme-linked immunosorbent assay (ELISA) for reactivity to E. brachy antigens. Sera from clinically healthy subjects (HS) served as controls. Sera from rapidly progressive periodontitis (RP) patients demonstrated significantly greater reactivity by ELISA than did HS when reactivity with E. brachy antigens was determined (P less than 0.05). Juvenile periodontitis (JP) and adult periodontitis (AP) patients did not differ in reactivity by ELISA from HS (P greater than 0.05). Three to 4 years following successful periodontal therapy, reactivity was not significantly altered in any patient group (P greater than 0.05). The possible significance of these findings and the importance of an extracellular antigen of E. brachy in the immunopathology of periodontal diseases are discussed.     

Serum antibody levels to 4 periodontal pathogens remain unaltered after mechanical therapy of juvenile periodontitis

Serum antibody titers to Actinobacillus actinomycetemcomitans (A.a.) Y4, Bacteroides gingivalis, Capnocytophaga ochracea and Eubacterium saburreum were determined with an enzyme immunoassay in 12 patients with juvenile periodontitis (JP) at the beginning of treatment and 16 to 32 months later after clinically successful mechanical therapy without antibiotics. The values were compared to corresponding data obtained from 26 age- and sex-matched individuals with a healthy periodontium. 6 JP patients had significantly increased levels of IgG and IgA antibodies to A.a. and 2 patients had increased IgG and IgA antibodies to C.ochracea. About 75% of the JP patients had a level of IgG antibody to B.gingivalis and E.saburreum which was more than one SD lower than the mean of the healthy controls, and in the IgA class 80-100% had such decreased levels of antibodies to these bacteria. In the IgM class, the JP patients by and large had normal levels of antibodies to the 4 bacteria. After treatment, antibodies to A.a. had decreased in only 3 patients, but the levels were still significantly higher than in healthy controls. Minimal alterations were observed in the levels of antibodies to B.gingivalis, C.ochracea and E.saburreum after treatment.     

Salivary IgG,a parameter of periodontal disease activity?

The concentration of salivary IgG and IgA and the levels of salivary IgG and IgA antibodies to Actinobacillus actinomycetemcomitans Y4 were measured by ELISA in 205 persons including patients with juvenile and adult periodontitis as well as healthy subjects. Compared to the concentration observed in subjects with a healthy periodontium, a significantly increased concentration of salivary IgG was found in 34% of the patients with moderate adult periodontitis and in 57% of the patients with severe adult periodontitis. The level of salivary IgA was less influenced by the periodontal condition. The level of salivary IgG antibody to A. actinomycetemcomitans was significantly elevated in 55% of the patients with untreated juvenile periodontitis and in 28% of the patients treated for JP. 28% of the patients with adult periodontitis had a significantly elevated level of IgG antibody to A. actinomycetemcomitans Y4. Significantly elevated levels of IgA antibody to this bacteria was found less frequently, 27% in untreated JP, 20% in treated JP and 17% in adult periodontitis.     

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目的研究牙周基础治疗对血清超敏C反应蛋白(Hs-CRP)的影响。方法选择2007年9月至2008年9月中日友好医院口腔科收治的未经过牙周治疗的40岁以上的中、重度慢性牙周炎患者35例,分为以下3组:单纯慢性牙周炎组(即牙周炎组,6例)、慢性牙周炎伴冠心病危险因素组(即高血压/高血脂组,22例)及慢性牙周炎伴冠心病组(即冠心病组,7例)。所有患者均进行牙周基础和维护治疗。治疗前、治疗后3个月均进行牙周检查[菌斑指数(PLI)、出血指数(BI)、探诊深度(PD)、附着丧失(AL)]和静脉血Hs-CRP检测。结果与治疗前比较,牙周基础治疗后3个月各组患者牙周指标均明显改善,PD、PLI、BI、AL均显著减小(P<0.05),但各组间各牙周指标差异无统计学意义(P>0.05);高血压/高血脂组Hs-CRP明显降低(P<0.05);冠心病组和牙周炎组Hs-CRP均略有下降(P>0.05)。Hs-CRP的变化与治疗前Hs-CRP显著相关,相关系数为0.811(P<0.05)。结论对于有冠心病危险因素或冠心病的牙周炎患者,牙周治疗可降低其血清Hs-CRP,提示牙周治疗可降低冠心病发病或再发的风险。     

Effect of periodontal therapy on spontaneous lymphocyte response and neutrophil chemotaxis in localized and generalized juvenile periodontitis patients

The etiology and pathogenesis of juvenile periodontitis may involve dysfunctions of the host response. In particular, the neutrophil and the lymphocyte have been implicated in the disease. The purpose of the present study was to examine the in vitro spontaneous lymphocyte response and neutrophil chemotaxis in populations of localized juvenile periodontitis (LJP) and generalized juvenile periodontitis (GJP) patients and age- and sex-matched healthy subjects (HS). These laboratory values were also evaluated immediately following and 1 year after periodontal therapy. The results show that spontaneous lymphocyte responses reflecting the autologous mixed lymphocyte reaction (AMLR) are depressed for GJP patients. The decreased AMLR in the GJP group appears to represent an abnormal T-cell function which may reflect activity of the periodontal lesion. LJP patients have an increased AMLR response, although it was not statistically significant. 1 year following active periodontal therapy, spontaneous lymphocyte responsiveness returned to normal in most GJP patients. The increased spontaneous lymphocyte responsiveness of LJP patients was not changed either immediately following active periodontal therapy or 1 year later. LJP and GJP patients exhibited a neutrophil chemotaxis defect when compared to cells from HS. This neutrophil defect was still observed 1 year following active therapy.     

Effects of race and periodontal status on antibody reactive with Actinobacillus actinomycetemcomitans strain Y4

Higher levels of serum antibody reactive with Actinobacillus actinomycetemcomitans strain Y4 (AAY4) have been demonstrated in localized juvenile periodontitis than in other forms of periodontal diseases. However, in studies which reported the racial distribution of the clinical groups, a predominantly black juvenile periodontitis population has been compared with a non-periodontitis control population that was predominantly white. The purpose of this study was to determine the effect of race (black or white) on antibody reactivity to AAY4 for subjects with clinical diagnoses of adult periodontitis (AP), non-periodontitis (NP), juvenile periodontitis (JP) and severe generalized periodontitis in young adults (SP). A radioimmunoassay (RIA) was utilized to detect and quantitate antibody to AAY4. Within clinical groups of NP, JP and SP a higher prevalence of seropositive black subjects than white subjects was found. The association between a high prevalence of positive antibody responses to AAY4 in JP subjects compared to NP subjects still exists, but was reduced compared to previous reports. White non-periodontitis subjects, used as control subjects in previous reports, were found to have a significantly lower frequency of seropositivity to AAY4 than black non-periodontitis subjects. This relationship held whether the periodontatly healthy subject was ascertained from a family with a JP or SP family member or was ascertained solely on the basis of a diagnosis of non-periodontitis. The difference in the prevalence of seropositivity to AAY4 between JP and SP subjects was entirely due to the racial composition of the two groups, as nearly half the SP subjects were white compared with only 15% of the JP subjects. Thus, antibody reactivity to AAY4 was found to be related to both clinical diagnosis and race.     

Healing following surgical and non-surgical treatment of juvenile periodontitis

The patient sample used in the present study comprised 16 young individuals who were referred for treatment of advanced periodontal disease. Based upon the age of the patients and the location of the diseased sites, the patients were divided into 2 groups; a juvenile periodontitis group (JP) and a post-juvenile periodontitis group (post-JP). The patients in the JP group had periodontal lesions only at first molars and incisors. All 16 subjects were in excellent general health and none had been treated with antibiotics during a period of at least 12 months prior to the 1st examination. At a baseline examination and 6, 24 and 60 months after active therapy, the diseased sites were examined regarding plaque, gingivitis, probing pocket depths, probing attachment level, recession of the gingival margin and marginal alveolar bone level. Following a case presentation and instruction in proper oral hygiene measures, the 16 subjects were subjected to periodontal treatment, utilizing a split mouth design. By random selection, the diseased sites in one side of the jaws were treated by scaling and root planing in conjunction with a "modified Widman flap" procedure, while in the contralateral jaw quadrants treatment was restricted to scaling and root planing. During the 1st 6 months following active therapy, the patients were subjected to professional tooth cleaning once every 4 weeks. Subsequently, the interval between the recall appointment was 3 months. 2 years after treatment, this maintenance care program was terminated. A final examination was performed 5 years after therapy. None of the patients involved in the trial received antibiotic treatment during the 5 years of observation. The findings of the present study revealed that the response of the periodontal tissues to therapy, both in the JP and the post-JP group of patients, was almost identical to that found for similar types of treatment in patients with adult periodontitis. The re-examinations performed after 6, 24 and 60 months following active therapy of JP and post-JP lesions revealed that excision of the granulation tissue in conjunction with flap elevation did not enhance the degree of probing pocket depth reduction, probing attachment gain and bone fill that occurred following meticulous root surface instrumentation.     

Serum levels of antibodies against Actinobacillus actinomycetemcomitans in various forms of human periodontitis

Serum levels of IgG, IgA, and IgM antibodies against extracts from Bacteroides gingivalis PER8, Actinobacillus actinomycetemcomitans Y4, and Bacteroides fragilis NCTC 9343 were determined in three categories of periodontitis patients by means of enzyme-linked immunosorbent assay. The test groups comprised 10 patients with juvenile periodontitis (JP), 18 young patients with severe periodontitis (YP), and 31 patients with adult periodontitis (AP). Nine subjects with healthy periodontium (HP) served as a reference group. Increased frequencies of patients with significantly elevated IgG and IgA antibody values against B. gingivalis and A. actinomycetemcomitans were found in the three periodontitis groups as compared with the HP group. The AP group, however, showed lower IgM values than the other groups. The results support the contention that A. actinomycetemcomitans may play a contributory role in adult periodontitis and that B. gingivalis is a suspected periopathogenic bacterium in juvenile periodontitis. The clinical YP classification was not supported by the present serologic findings.     

Serum IgG reactivity to subgingival bacteria in initial periodontitis, gingivitis and healthy subjects

BACKGROUND/AIMS: Established periodontal diseases may be associated with antibody responses to periodontal pathogens, but it is not known at which stage of disease this antibody response is initiated. This study aimed to characterize the host systemic response in initial periodontitis, gingivitis, and periodontal health, to evaluate whether elevated serum antibodies to subgingival species could be detected in initial periodontitis. METHOD: Human systemic immune response were evaluated to 40 subgingival bacterial species in 16 healthy, 21 gingivitis, 11 initial periodontitis and 5 progressing recession adults. Subjects had minimal periodontal attachment level (AL) loss at baseline. Disease categories were determined after 12 months monitoring at three-month intervals. Increased AL loss > or = 1.5 mm (disease activity) at interproximal sites defined initial periodontitis, recession was characterized by AL loss at buccal sites. Serum IgG antibodies were evaluated semi-quantitatively by immunoblot from blood taken at baseline, active and final visits. RESULTS: No antibody was detected from 55% of reactions. When detected, levels were below those reported for advanced periodontitis subjects. There were no major differences in serum antibody levels between healthy, gingivitis and initial periodontitis subjects, despite differences in the subgingival microbiota. Serum antibodies for more species were detected in recession subjects, compared with the other study subjects. No changes in antibody levels were detected between baseline, active, and final visits. No systematic association between species colonization and presence of systemic antibody was observed. CONCLUSIONS: This study did not detect differential elevation of mean serum antibody levels in initial periodontitis subjects, suggesting that serum antibody levels are not sensitive risk markers for initial periodontitis.     

Determination of serum antibody against Bacteroides gingivalis from rapidly progressive periodontitis and juvenile periodontitis patients

Bacteroides gingivitis (Bg) is one of the major pathogens associated with periodontitis. This is the first report in China on serum antibody level against Bg from patients with rapidly progressive periodontitis (RPP) and juvenile periodontitis (JP) using ELISA method. 21 RPP patients, 20 JP patients and 30 healthy subjects (H) were involved in this study. The results showed that the ratio of positive antibody response was 100% in RPP, 80% in JP and 30% in control group. The antibody response in both RPP and JP groups were significantly greater than that in healthy group (P less than 0.001). The difference between RPP and JP groups were also statistically significant (P less than 0.05).     

Blastogenic responsiveness of peripheral blood mononuclear cells from individuals with various forms of periodontitis and effects of treatment

Abstract Experiments were done to learn whether or not the blastogenic responsiveness of peripheral blood mononuclear cells (PBM) from 34 patients to mitogens and homogenates of a panel of periodontal bacteria differs significantly from that of cells from 16 normal individuals. Groups of control individuals and patients with juvenile (JP), rapidly progressive (RP) and adult periodontitis (AP) were formed. Blastogenic responsiveness was assessed after 72 and 120 h incubation by measuring the uptake of radioactive precursor into DNA. Bacterial preparations and mitogens used as stimulators included Bacteroides melaninogemcus (BMEL), Capnocytophaga (CAPNO), Fusobacterium nucleatum (FUSO), Actinomyces viscosus (AVIS), phytohemagglutinin (PHA), and pokeweed mitogen (PWM). When the data were calculated as Stimulation Index (E/C), responsiveness of cells from patients with AP and JP was enhanced relative to that of cells from normal control subjects, but the enhancement was not statistically significant. In contrast, responsiveness of cells from RP patients to FUSO and AVIS was significantly suppressed. Except in the case of AP cells activated with PHA, mitogenic responsiveness of all patient cells was significantly suppressed. When responsiveness was calculated as E minus C, these differences between patient and control cells disappeared except for suppression of the level of blastogenesis by AP and RP cells exposed to AVIS. After 120 h incubation, unstimulated cultures of AP cells incorporated significantly less, and RP cells significantly more, radioactivity than did unstimulated cultures from normal individuals indicating an abnormal autologous mixed lymphocyte reaction. Cells were harvested and tested from a group of AP patients before, during and following periodontal therapy. PBM responsiveness to horaogenates of CAPNO did not change significantly during therapy, but responsiveness to all of the other bacterial preparations including autologous plaque increased following initial therapy. Values for AVIS, FUSO, and PLAQ were statistically significant. Responsiveness to the bacterial preparations either remained at the enhanced levels or increased to even greater levels following completion of therapy, except in the case of autologous plaque, where the values had begun to return toward pretreatment levels. In addition, responsiveness to PWM and PHA dropped to about one-half the pretreatment values and responsiveness of unstimtilated cultures increased significantly to levels observed in cultures of ceils from normal donors.     

Comparative antibody titers to Actinobacillus actinomycetemcomitans in juvenile periodontitis, chronic periodontitis and periodontally healthy subjects

Abstract Circulating antibody levels to four strains of Actinobacillus actinomycetemcomitans (Aa) were determined by means of an indirect immunofluorescent technique in three groups of 21 subjects each, including one with juvenile periodontitis (JP), one with chronic periodontitis (CP) and one free of periodontal disease (N). Mean levels of antibody to Aa were significantly elevated in the JP group as compared to the CP and N groups with respect to strains Y4, 29522 and 29524, but not strain 29523. Since strains Y4, 29522 and 29524 contain a leukotoxin that is missing from strain 29523, the results suggest that the leukotoxin could account for the difference in the immune response among the three groups of subjects. Varying the end-point considered to represent positive fluorescence did not significantly affect the results, although discrimination among the three groups appeared to be somewhat better at lower intensities of fluorescence. Because of wide variations in antibody titers recorded in individual subjects, elevated levels of antibody to certain strains of Aa may not be useful as a primary diagnostic test for JP, but may be of value in confirming an otherwise uncertain clinical diagnosis.     

The gingival immune response to Actinobacillus actinomycetemcomitans in juvenile periodontitis.

The established and advanced lesions of juvenile periodontitis-localized form (JP) are predominated by B-lymphocytes and plasma cells. Local immune processes may participate in protective or immunopathologic roles in the pathogenesis of this disease. Actinobacillus actinomycetemcomitans (A.a.) is implicated as a primary etiologic agent in JP. An in vitro gingival explant culture system was utilized to study the specificity of immunoglobulins produced by diseased JP tissues. A dot-immunobinding assay demonstrated that 46% of the supernatant fluids (SF) from explant cultures of diseased tissues (n = 39) were positive for the presence of antibody to A.a. Y4, while 61% of autologous JP sera (n = 39) tested positive. For rapidly progressive (RP) and adult periodontitis (AP) SF, 50% and 40% were positive for A.a. Y4, respectively. Seventeen percent of SF from healthy tissue were positive for A.a. Y4. There was no significant difference between JP SF reactivities to A.a. Y4 when compared to reactivities of SF from AP and RP patients. Only 10% of JP SF were positive for Porphyromonas asaccharolytica, a non-oral control microorganism. The de novo biosynthesis of antibody in JP tissue, reactive with A.a. Y4, was demonstrated with Staph Protein A isolated 14C-labeled IgG (SPAG) and the use of a dot-immunobinding assay and autoradiography. The in vitro gingival tissue explant culture system described provides a useful model for the study of the synthesis and specificity of localized immunoglobulins produced by diseased tissues of JP patients.     

Detection of a highly toxic clone of Actinobacillus actinomycetemcomitans (JP2) in a Moroccan immigrant family with multiple cases of localized aggressive periodontitis

The JP2 clone of Actinobacillus actinomycetemcomitans, a high-leukotoxin-producing strain, characterized by a 530-basepair (bp) deletion in the promoter region of the leukotoxin gene operon and mainly found among individuals with African origin, is associated with localized aggressive periodontitis. The objective of the study was to examine the occurrence of periodontal disease in a Moroccan immigrant family living in Denmark in which the oldest son (14 year) was referred and treated for localized aggressive periodontitis. Further, the potential occurrence of the JP2 clone of A. actinomycetemcomitans in the family was examined. Here we present the clinical, radiographic, and microbiological findings from the family. Clinical and radiographic examination of the other family members revealed that 3 of 5 younger siblings had localized aggressive periodontitis, one had gingivitis and the mother had chronic periodontitis. Despite scaling followed by intensive maintenance therapy several family members, including the sibling with gingivitis, had further attachment loss at the 1-year examination. The JP2 clone of A. actinomycetemcomitans was isolated from subgingival plaque samples from 4 children with periodontitis. In contrast, it was not detected in plaque from the oldest boy, who had been treated for localized aggressive periodontitis by surgery combined with antibiotic therapy. The 4 children with periodontitis and colonized with the JP2 clone were treated by scaling and antibiotic administration. One month later the JP2 clone could still be detected in plaque samples. In conclusion, it is confirmed that members of immigrant families with African origin are potential carriers of the JP2 clone and that those families often have multiple family members with localized aggressive periodontitis. It is proposed that those families are given periodontal examination frequently to benefit from early diagnosis and treatment of the disease.     

Assessment of in vitro interleukin-2-producing capacity of peripheral blood lymphocytes from patients with periodontitis.

Abstract In this cross-sectional study, we assessed the in vitro interleukin-2 (IL-2) producing capacity of peripheral blood mononuclear cells (PBMC) and lymphocytes from patients with different forms of periodontitis. 45 patients (12 with localised early onset periodontitis (LEOP), 20 with generalised early onset periodontitis (GEOP), and 13 with adult periodontitis (AP), and 20 periodontally healthy subjects (HS), participated in this study. PBMC and lymphocytes were isolated from the subjects and their cells were stimulated with an anti-CD3 monoclonal antibody (anti-CD3 MoAb) and the secreted IL-2 levels in the culture were bioassayed. No significant differences could be found in IL-2 producing activity of PBMC between the patients and HS group. There was wide interindividual variation and high and low “IL-2 producers” were noted. We found a LEOP patient who was a high producer of IL-2 (>mean+8 SD) and 2 LEOP patients and a HS who were low producers of IL-2 (相似文献   

Subgingival microflora and antibody responses against periodontal bacteria of young Japanese patients with type 1 diabetes mellitus

Periodontal disease is a complication of patients with type 1 diabetes mellitus (T1DM), although the mechanisms responsible for this relationship remain unclear. The aim of this study was to examine oral manifestations and the prevalence of periodontal pathogens from subgingival plaque samples and serum IgG antibody levels against them in young Japanese type 1 diabetic subjects. One hundred and seventeen Japanese T1DM subjects (53 male, 64 female, mean age +/- SD, 16 +/- 6.5 years) participated in this study. Thirty-nine periodontally healthy, age-matched nondiabetics served as controls. T1DM subjects were clinically assigned into three groups: 12 periodontitis, 32 gingivitis and 73 periodontally healthy. Microbiological tests for four periodontal pathogens, Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Prevotella intermedia and Capnocytophaga ochracea were performed using 16S ribosomal RNA-based polymerase chain reaction methods. Serum IgG antibody levels against 12 periodontal bacteria including the four species assessed by polymerase chain reaction were measured by enzyme-linked immunosorbent assay. In the T1DM subjects, the Periodontitis group had a significantly longer mean duration of diabetes and a higher percentages of subjects harbouring P. gingivalis and P. intermedia than the Periodontally Healthy group. Serum IgG antibody levels against P. gingivalis were significantly elevated in the Periodontitis group compared with Gingivitis and Periodontally Healthy groups. These results indicate that Japanese T1DM subjects are a high-risk group for periodontal disease and both P. gingivalis infection and duration of T1DM are risk factors for the progression of periodontitis in patients with T1DM.     

Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis subgingival presence, species-specific serum immunoglobulin G antibody levels, and periodontitis disease recurrence

BACKGROUND AND OBJECTIVE: The biological and clinical effects of antibody against periodontal pathogenic bacteria are incompletely understood. This study evaluated the inter-relationships among periodontal levels of cultivable Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis, species-specific serum immunoglobulin G (IgG) antibody levels, and periodontitis disease activity. MATERIAL AND METHODS: Forty-three adults who had previously been treated for periodontitis and who also harbored cultivable A. actinomycetemcomitans or P. gingivalis were evaluated semiannually for clinical disease recurrence over a 36-month period. Each patient provided subgingival microbial samples, for the recovery of A. actinomycetemcomitans and P. gingivalis, from the two deepest pockets in each dentition sextant. A. actinomycetemcomitans and P. gingivalis serum IgG antibody levels were assessed using enzyme-linked immunosorbent assay (ELISA), together with whole-cell sonicate extracts from A. actinomycetemcomitans serotypes a-c and P. gingivalis ATCC 33277. Data were analyzed using the Mantel-Haenszel chi-square and Fisher exact two-tailed tests. RESULTS: Eighteen (60.0%) of 30 A. actinomycetemcomitans-positive subjects, and 10 (76.9%) of 13 P. gingivalis-positive subjects, exhibited recurrent periodontal breakdown within 36 months of periodontal therapy. Nineteen (67.9%) of the 28 patients with active periodontitis had A. actinomycetemcomitans or P. gingivalis serum antibody levels below designated threshold values. In comparison, 10 (66.7%) of 15 culture-positive clinically stable subjects showed A. actinomycetemcomitans or P. gingivalis serum antibody levels above threshold values. The difference between specific antibody levels in periodontitis-active and periodontitis-stable patients was statistically significant (p = 0.032). CONCLUSIONS: Serum levels of IgG antibodies against A. actinomycetemcomitans or P. gingivalis in periodontitis-stable patients were higher than those in patients with active periodontitis. The results suggest that elevated levels of IgG antibody against A. actinomycetemcomitans and P. gingivalis have a detectable protective effect against periodontal infections with these microorganisms.     

Effect of periodontal treatments on serum IgG antibody titers against periodontopathic bacteria

Abstract. Serum IgG antibody titers to 7 periodontopathic bacteria in periodontitis patients were measured at the Is1 visit and after various periodontal treatments with clinically successful improvement, in order to evaluate what kind of factors are associated with changes of serum antibody titers. 20 patients (10 male and 10 female from 23 to 61 years old) with adult, rapidly progressive periodontitis were enrolled in this study. All patients received initial preparation and most of them also underwent surgical procedure. After the treatments, the mean probing pocket depths decreased from 3.72 mm to 1.56 mm. Serum samples were collected from patients at the initial and final examinations. Serum IgG antibody titers against sonicated antigens of Porphyromonas gingivalis FDC 381, Prevotella intermedia ATCC 25611. Prevotella loescheii ATCC 15930. Fusobacterium nucleatum subspecies nucleatum ATCC 25586. Actinobacillus actinomycetemcomitans FDC Y4. Eikenella corrodens FDC 1073 and Capnocylophaga ochracea #M 12 were determined by enzyme-linked immunosorbent assay. The mean antibody titers to P. gingivalis and P. intermedia decreased significantly after the treatment as compared to their pretreatment levels. The antibody titer to P. gingivalis, especially, decreased in all of the patients examined. A significant relationship was found between the decreased antibody titer to P. gingivalis and the number of teeth which received periodontal surgery, as well as treatment length, and the relationship between the decreased antibody titer to P. intermedia and the number of extracted teeth was also significant. These results suggest that the changes of serum IgG titers against P. gingivalis and P. intermedia are related to the suppression of such pathogens in subgingival plaque.     

Antibody responses against Porphyromonas gingivalis infection in patients with early-onset periodontitis

BACKGROUND, AIMS: The aim of this study was to evaluate antibody responses against Porphyromonas gingivalis (P. gingivalis) infection in early-onset periodontitis (EOP) patients to elucidate further the host-parasite interactions in the pathogenesis of EOP. METHOD: 16 P. gingivalis-infected EOP and 20 adult periodontitis (AP) patients, and 18 periodontally healthy subjects (HS) participated in this study. Serum immunoglobulin G (IgG) antibody levels and avidities against extracted P. gingivalis whole cells were measured. The components of P. gingivalis outer membrane antigens (OMA) reacting to patients' sera were analysed from the molecular weights by Western blotting. Serum antibody levels against P. gingivalis lipopolysaccharide (LPS) were also measured. The ability of the patients' sera to block interleukin-1beta (IL-1beta) production by human mononuclear cells in response to P. gingivalis LPS was examined. RESULTS: Antibody levels were positively correlated with antibody avidities in both EOP and AP patients (r=0.91, r=0.72, p<0.0005, respectively), while not significantly so in HS (r=0.09). There was variability in the antigen recognition of P. gingivalis OMA in EOP and AP patients. Smear and 53-kDa protein were more frequently recognized by sera of EOP and AP patients rather than that of HS (p<0.05). The smear was partly diminished by absorption with P. gingivalis LPS, indicating the smear antigen was partly composed of LPS. There was high correlation between antibody levels against P. gingivalis whole-cell extracts and LPS in EOP and AP patients (r=0.81, p=0.0002, r=0.87, p<0.0001, respectively), while not significant in HS (r=0.22). The sera of EOP and AP patients with high IgG titre to P. gingivalis LPS blocked IL-1beta production more effectively than that of the patients with low IgG titre to P. gingivalis LPS. CONCLUSIONS: These results indicate that EOP patients' antibody response against P. gingivalis infection does not differ significantly from that of AP patients. The person-to-person heterogeneous antibody production against P. gingivalis LPS could contribute to our understanding of the relationship between the defensive ability of EOP patients and their chronic infection with this pathogen.     

Microbiological evaluation of initial preparation for adult periodontitis patients

The microbial flora from 46 adult periodontitis lesions of 23 patients and 18 sites in 9 healthy persons were examined and levels of serum IgG antibody to gram negative periodontal disease-associated bacteria were measured by enzyme-linked immunosorbent assay. Plaque samples and serum samples were taken 40-50 days after initial preparation consisting of scaling and root planing. To evaluate the effects of the therapy on 10 patients with adult periodontitis, changes in clinical parameters were compared with alterations of the microbial flora and serum IgG antibody levels. Black-pigmented Bacteroides species, mainly Bacteroides gingivalis, were found to be predominant in periodontitis lesions. A significant relationship was found between the prevalence of B. gingivalis and elevated titers of serum IgG antibody against the microorganism. No relationships between Bacteroides intermedius, Actinobacillus actinomycetemcomitans and elevated titers of serum IgG antibody to them were detected. The fact that there was no marked reduction of serum IgG antibody to B. gingivalis after initial preparation suggests that a more extended, longitudinal study is required. Although brushing resulted in a significant reduction of the number of total cultivable organisms in samples from periodontal pockets, no significant proportional changes in gram-negative bacteria in the lesional flora were found. Initial preparation was not effective in eliminating gram-negative bacteria from deep periodontal pockets. However, the microbiological shifts, especially the reduction in the proportion and frequency of detection of B. gingivalis in periodontal pockets, was paralleled by significant improvement in the clinical parameters.