牙周炎患者特异抗体水平与相应细菌的关系初探

本文选择了17名成人牙周炎(AP)患者的14个患牙及10名快速进展型牙周炎(RPP)患者的22个患牙,检测了龈下菌斑中牙龈类杆菌(Bg)及龈沟液(GCF)中和血清(Sr)中的抗BgIgG水平。结果发现Bg在两组患牙龈下菌斑中广泛存在,AP组的Bg检出量与牙周袋深度呈正相关,RPP组的Bg检出量与GCF中抗Bg IgG水平有负相关趋势。     

牙周炎患者GCF及血清中IL-6测定及其与牙周炎的关系

目的：研究龈沟液（GCF）中白细胞介素－6（IL－6）的来源及其与牙周炎的关系。方法：采用双抗夹心酶联免疫吸附法（ELISA）测定了72例成人牙周炎，13例牙龈炎，18例健康对照组GCF IL－6含量，及17例牙周炎患者，7例健康人血清IL－6水平。结果：牙周炎患者GCF IL－6水平显著高于健康人，牙周炎患者GCF IL－6II与牙周炎患者血清中IL－6含量有显著性差异，牙龈炎患者血清IL－6含量比正常对照组含量高，牙周炎患者GCF IL－6含量与牙龈炎患者有显著性差异，重度牙周炎患者GCF中IL－6含量高于轻度牙周炎患者，牙周炎患者GCF中IL－6含量与出血指数（BI）、牙周袋深度（PD）、附着丧失（AL）有正相关关系。结论：龈沟液中IL－6主要来源于局部牙龈组织，IL－6在牙周炎的发生，发展过程中起一定作用。     

慢性重度牙周炎患牙龈沟液中sICAM-1的浓度

目的:比较慢性重度牙周炎病人和健康人龈沟液(gingival crevicular fluid,GCF)中可溶性细胞间黏附分子1(soluble intercellular adhesion molecule-1,sICAM-1)的浓度.研究牙周炎是否会引起GCF中的sICAM-1含量改变.方法:纳入慢性重度牙周炎病人和健康人各30例共182个牙,记录临床牙周检查指标,用滤纸条法收集GCF,GCF测量仪Periotron 8000测量GCF总量,用ELISA法测定GCF中sICAM-1浓度.结果:牙周炎病人的GCF总量较健康人高(P＜0.01),牙周炎病人的sICAM-1浓度较健康人高(P＜0.01).结论:GCF中的sICAM-1浓度的升高可能是由牙周炎症反应引起的,其浓度与GCF总量无明显相关性.     

慢性牙周炎伴2型糖尿病患者龈沟液中脂联素水平的检测及意义

目的：探究牙周炎伴2型糖尿病患者龈沟液中脂联素水平及意义。方法：纳入慢性牙周炎伴糖尿病患者（DM&CP）、慢性牙周炎患者（CP）、健康对照者（H）各20例,记录其临床指标（SBI、PLI、PD 和 AL）,并收集龈沟液（GCF）样本,用龈沟液测量仪 periotron8000对 GCF 进行定量,用脂联素 ELISA 试剂盒检测样本中脂联素含量,比较组间检测指标的差异以及临床指标与 GCF 中脂联素水平的相关性。结果：DM&CP 组 GCF 中脂联素水平显著低于其他2组（P ＜0．05）,CP 患者龈沟液脂联素水平与牙周健康组相比无统计学差异（P ＞0．05）。GCF 中脂联素水平与临床指标 PD 值、AL 值有负相关性（P ＜0．05）,与 SBI、PLI 无明显相关（P ＞0．05）。结论：龈沟液中脂联素水平降低可能与 DM&CP 发生发展有关。     

基质金属蛋白酶9在慢性牙周炎及类风湿关节炎患者中的水平及相关性分析

目的检测慢性牙周炎(chronic periodontitis, CP)患者和类风湿关节炎(rheumatoid arthritis,RA)患者龈沟液及血清中基质金属蛋白酶9(MMP-9)的含量,探讨MMP-9与CP及RA之间的相关关系。方法按纳入标准选取RA患者(RA组)23人、CP患者(CP组)18人、CP伴RA患者(CP+RA组)24人和健康对照组(H组)16人;记录4组受试者一般信息、牙周探诊深度(PD)、临床附着丧失(CAL)、、龈沟出血指数(SBI)、简化牙石指数(CI-S)、简化软垢指数(DI-S);收集各组受试者龈沟液及血清,采用ELISA法检测分析龈沟液及血清中的MMP-9的表达水平,并分析MMP-9与牙周指标的相关性。采用SPSS 20.0软件包对数据进行统计学分析。结果 CP+RA组CAL、SBI、DI-S高于RA组、CP组与H组(P<0.05)。血清中MMP-9的水平CP+RA组((2 671.71±1 258.33)μg/L)高于RA组((1 444.54±770.03)μg/L)、CP组((492.41±485.04)μg/L)、H组((67.14±34.95)μg/L)(P<0.05)。龈沟液中MMP-9的水平CP+RA组((26.11±5.25)μg/L)高于CP组((18.83±11.87)μg/L)及H组((1.04±0.58)μg/L)(P<0.05)。CP+RA组CAL、SBI与血清中MMP-9的表达呈正相关,CP组CI-S、DI-S与血清中MMP-9表达呈正相关(P<0.05)。结论 CP与RA之间具有相关性,MMP-9在CP和RA中表达显著升高,MMP-9可能与CP和RA的发生发展存在相关关系。     

牙周炎基础治疗配合PVP-I局部应用后龈沟液中GPx水平的变化

目的 :了解聚维酮碘 (PVP -I)和生理盐水配合基础治疗后龈沟液中GPx的变化和临床意义。方法 :2 3名慢性成年性牙周炎 (AP)患者 ,每一测试者选取不同象限的 1～ 2个患牙 ,总共 44颗 2 2对牙在基础治疗完成后 ,一组用 10 % (PVP -I) ,另一组用生理盐水冲洗 ,记录临床指标GI、PD、AL ,并测定治疗前后龈沟液中GPx水平。结果 :两组治疗前后临床指标均明显下降 (p <0.001) ;GPx水平明显上升 (p <0.001) ;PVP - Ⅰ组和生理盐水组 ,各临床指标和GPx水平无显著差异。结论 :AP患者基础治疗后临床指标和生化指标GPx有明显改善 ,但配合使用PVP - Ⅰ和生理盐水冲洗对GCF -GPx水平无明显改善 ,GCF -PGx可能是反映牙周组织状态的一项有意义的指标。     

FiltekTM Z350对犬龈沟液中天冬氨酸转氨酶和碱性磷酸酶的影响

目的:探讨纳米复合树脂FiltekTMZ350(Z350)和临床常用牙体充填材料Dyract-AP复合体(AP)、TPH复合树脂(TPH)、玻璃离子Ⅱ型水门汀(GIC)修复后,犬龈沟液中天冬氨酸转氨酶和碱性磷酸酶的变化,评价FiltekTM Z350作为修复材料对牙周组织健康的影响。方法:3只比格犬,每只选择20个健康牙作为实验牙,分别在颊侧颈部齐龈缘处制备相同大小的洞形后,按象限随机分为4组,分别用Z350、AP、TPH、GIC修复,在术前和术后7、30、90 d测量龈沟液(GCF)量,并检测龈沟液中天冬氨酸转氨酶(AST)和碱性磷酸酶(ALP)的水平。结果:修复后7 d其GCF量、GCF中AST和ALP总量较修复前明显增高,但各组间没有显著性差异(P>0.05);修复后30 d和90 d,GIC组GCF量、GCF中AST和ALP总量均高于其他材料组(P<0.05),FiltekTM Z350组GCF量、GCF中AST和ALP总量低于其他材料组(P<0.05)。结论:在本实验条件下,FiltekTMZ350纳米复合树脂对牙周组织健康的影响小于其他常用修复材料。     

牙龈卟啉单胞菌与龈沟液中白细胞介素8关系的研究

目的:探讨龈沟液(GCF)中白细胞介素8(IL -8)在慢性牙周炎病程中的变化、IL- 8与牙周临床检测指标以及同龈下菌斑中细菌含量的相关关系。方法: 5名非牙周炎患者的10颗牙周健康牙和30名慢性牙周炎(CP)患者的70颗牙(其中10颗为健康牙, 60颗为牙周炎患牙)纳入本研究。采集观察牙的GCF样本、龈下菌斑样本,同时记录所有牙的牙龈指数(GI)、牙周袋探诊深度(PPD)、临床附着丧失水平(CAL)。用ELISA法检测样本中IL -8的水平,用厌氧菌培养技术培养菌斑标本,用PCR法检测菌斑中的牙龈卟啉单胞菌(Pg),结果:慢性牙周炎组的GCF中IL -8的总量高于临床牙周健康组,而IL -8的质量浓度在各组中无差异。GCF中IL- 8浓度与GI、PPD、CAL无相关关系,而IL -8的总量与GI、PPD、CAL呈正相关关系。龈下菌斑中Pg的检出量与GCF中IL- 8的含量间未发现有相关关系。结论:慢性牙周炎患者龈沟液中IL- -8量增加与龈沟液分泌增加有关而与牙龈卟啉单胞菌检出CFU无关。     

龈沟液中IL-1β与2型糖尿病和牙周病相关性的研究

目的：比较2型糖尿病患者（DM）、2型糖尿病伴牙周病患者（DM＆AP）及牙周病患者（AP）龈沟液（GCF）中的白细胞介素-1β（IL-1β）水平,探讨DM和DM＆AP糖化血红蛋白（HbAlc）浓度与IL-1β的相关性。方法：使用滤纸条法采集GCF,DM、DM＆AP、AP患者及正常对照组各30例;ELISA法测定GCF中IL-1β含量;运用高效液相层析法测定DM和DM＆AP的糖化血红蛋白水平。结果：DM、DM＆AP、AP的GCF量和IL-1β量均高于正常对照组（P〈0．05）;DM＆AP、AP组GCF量显著高于DM组（P〈0．05）;DM＆AP组IL-1B含量高于DM组和AP组（P〈0．05）。结论：糖尿病患者和糖尿病伴牙周病患者IL-1β均高于正常人,长期的高血糖会使糖尿病患者易患牙周病,提示糖尿病患者在关注血糖控制的同时还高度关注牙周健康。     

腮腺肿瘤患者唾液及腮腺液中 IgA 和 IgG 含量的初步研究

对正常人31名,腮腺肿瘤患者44名(良性25名,恶性19名)的混合唾液和腮腺液中 IgA,IgG 含量进行了测定,结果表明:腮腺恶性肿瘤患者第一、二段腮腺液中 IgG 浓度比正常组、良性腮腺肿瘤组明显升高。腮腺良、恶性肿瘤腮腺液中 IgA 浓度无显著差别。影响混合唾液中 IgA 和 IgG 的含量因素多,对诊断和鉴别肿瘤性质意义不大。     

龈沟液中存在白细胞介素8降解酶及其自身抗体

目的探究龈沟液中是否存在白细胞介素８（ｉｎｔｅｒｌｅｕｋｉｎ８,ＩＬ８）的抑制因子。方法（１）将１３例成人牙周炎的１４份及８例牙周健康者的９份龈沟液样本各自一分为二,１／２加入丝氨酸蛋白酶抑制剂──苯甲基磺酰氟,另１／２加入等量的磷酸盐缓冲液作为对照。ＥＬＩＳＡ法检测各样本中的ＩＬ８含量。（２）对１５例成人牙周炎的４１份龈沟液样本,用间接ＥＬＩＳＡ法测定龈沟液中的ＩＬ８自身抗体（ＩｇＧ）。结果（１）加入酶抑制剂的龈沟液中ＩＬ８的检出量（３．０１ｍｇ／Ｌ±５．７９ｍｇ／Ｌ）显著高于对照组（０．０５ｍｇ／Ｌ±０．１５ｍｇ／Ｌ）,Ｐ＜０．００１。（２）龈沟液中ＩＬ８自身抗体水平高于阴性对照标准差３倍。龈沟液中加入大肠杆菌超声粉碎液对此检测结果无明显影响。结论龈沟液中存在能降解ＩＬ８的丝氨酸蛋白酶;成人牙周炎的龈沟液中存在ＩＬ８自身抗体     

BNT162b2 mRNA Vaccine–Induced Immune Response in Oral Fluids and Serum

ObjectivesThe COVID-19 vaccine is currently being administered worldwide to address the ongoing pandemic. Although these vaccines have proven effective in preventing severe disease, the level of immunity required to prevent respiratory mucosal infection remains less well understood. Therefore, it is desirable to develop a noninvasive screening strategy such as oral fluid to monitor secreted antibodies longitudinally as potential surrogates of mucosal immunity.MethodsWe evaluated the anti-spike protein antibodies in gingival crevicular fluid (GCF) and saliva and compared them to immune responses in the blood of 50 healthy health care workers following 2 doses of intramuscular Pfizer/BioNTech-BNT162b2 vaccine.ResultsThe antibodies to SARS-CoV-2 spike and subdomain proteins (RBD, S1, S2, and NTD) were significantly higher in serum than oral fluids but showed a greater detection rate and higher median titres in GCF than saliva. For all tested SARS-CoV-2 antigens, IgG in GCF (as opposed to saliva) showed a more significant and stronger correlation with IgG in serum. Serum-neutralising antibodies (Nab) titres also displayed a significant and stronger correlation with anti-spike protein and their subdomains in GCF than saliva. Interestingly, the time post–second dose of vaccine and sex had a similar influence on IgG in serum and GCF. However, interferon (IFN)-γ–producing T-cell responses showed no association with SARS-Cov-2 IgG antibodies in serum, GCF, or saliva and neutralisation antibodies in serum. The correlation matrix of all measured parameters grouped serum and GCF IgG parameters separately from salivary IgG parameters indicating that GCF better represents the humoural response in serum than saliva.ConclusionsWithin limitations, we propose that GCF could be a less invasive alternative to serum and more appropriate than saliva to detect antibody responses by current COVID-19 vaccines if the GCF collection procedure could be standardised. Further research is needed to investigate the suitability of GCF for community immune surveillance for vaccines.     

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.     

Serum antibodies against the trypsin-like protease of Bacteroides gingivalis in periodontitis

Antibody levels of IgG, IgA and IgM reactive to the trypsin-like enzyme of B. gingivalis were measured by enzyme-linked immunosorbent assay in serum samples from control subjects with clinically healthy gingiva, patients with adult periodontitis (AP) and patients with rapidly progressive periodontitis (RPP). Both AP and RPP patients had significantly higher levels of specific IgG and IgA antibodies than control subjects with healthy gingiva (p<0.001 in both cases). No significant difference was observed between the specific IgM antibody activity in the AP group compared to the control group. However, a significant difference was seen (p<0.01) for IgM activity in the RPP group compared to controls. The results indicate that the trypsin-like enzyme of B. gingivalis is produced in vivo in sufficient amounts to be immunogenic to the host and particularly in patients with AP or RPP.     

Evaluation of gingival crevicular fluid and serum levels of high-sensitivity C-reactive protein in chronic periodontitis patients with or without coronary artery disease

BACKGROUND: Most studies have evaluated serum C-reactive protein (CRP) levels in chronic periodontitis (CP) patients, and a few investigations have examined gingival crevicular fluid (GCF) CRP levels. The aims of this study were to determine GCF and serum levels of high-sensitivity CRP (HsCRP) in CP patients with or without coronary artery disease (CAD) and to investigate the relationship between the GCF and serum HsCRP levels in CP patients with and without CAD. METHODS: Thirty CP patients with angiographically proven CAD, 20 CP patients, and 17 healthy individuals were included in the study. Clinical parameters were recorded, and serum and GCF samples were collected. The level of HsCRP in GCF was assayed by a high-sensitivity enzyme-linked immunosorbent assay. The HsCRP level was assayed in the plasma on a nephelometer. RESULTS: The serum HsCRP levels were significantly higher in CP patients with or without CAD than in the control group, and there was a correlation between serum HsCRP levels and clinical parameters and between serum HsCRP levels and GCF volume. There was no statistically significant difference in GCF HsCRP levels between the groups. There was no correlation between GCF HsCRP levels and clinical parameters, GCF volume, or serum HsCRP levels. CONCLUSIONS: Patients with CP and CP + CAD had statistically significant elevations in serum HsCRP levels compared to healthy subjects. However, HsCRP levels of GCF did not differ from those of the control and CP groups or the control and CP + CAD groups. Further studies are needed to clarify the relationship between GCF CRP levels and periodontal diseases.     

Crevicular fluid and serum IgG subclasses and corresponding mRNA expressing plasma cells in periodontitis lesions

Recent reports suggest that specific serum IgG subclasses are a feature of several forms of periodontitis. GCF antibodies are both serum-derived and locally produced by the abundant plasma cells of the diseased periodontal tissue. Previous work has shown that crevicular fluid (GCF) levels of IgG may be reduced in active and deep periodontal pockets when compared to other sites in chronic periodontitis patients (7). These findings, and more recent findings for IgA levels in GCF (5), suggest that GCF immunoglobulins may indicate "high risk" sites for periodontitis. In these studies, the relative distribution of IgG isotypes was not investigated, nor was the relative contribution of local and serum antibodies to the GCF immunoglobulin profile. Therefore, more precise investigation of the tissue distribution of local gingival IgG subclass producing plasma cells and their protein levels in the GCF from the same sites and in serum, was undertaken.     

Clinical expression of TNF-α in smoking-associated periodontal disease

Abstract. The level of TNF-α in gingival crevicular fluid (GCF) was analyzed with respect to smoking in patients with untreated moderate to severe periodontal disease including 30 current smokers, 19 former smokers and 29 non-smokers, in the age range 31–79 years, Concomitantly the occurrence of the periopathogens Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg) and Prevotella intermedia (Pi) and the GCF levels of albumin, IgA and IgG were analyzed. With regard to clinical characteristics, there were no statistically significant differences between smoking groups. The occurrence of patients positive for the periopathogens Aa, Pg and Pi was 28.2%, 41.0% and 91.0%, respectively. There were no statistically significant differences between smoking groups with regard to occurrence or relative frequency of these periopathogens. An exception was a significantly lower occurrence of Aa in former smokers as compared to non-smokers. The chief novelty of the study was the observation of a clearly increased level of TNF-α in GCF associated with smoking. Both current and former smokers exhibited significantly higher levels of TNF-α in comparison to non-smokers, whereas the levels of albumin, IgA and IgG were the same irrespective of smoking. In conclusion, the present observations in patients with moderate to severe periodontal disease suggest that smoking is associated with elevated GCF levels of the cytokine TNF-α.     

Tumor necrosis factor-alpha-converting enzyme (TACE) levels in periodontal diseases

Tumor necrosis factor-alpha-converting enzyme (TACE) is a metalloprotease which can shed several cytokines from the cell membrane, including receptor activator of NF-kappaB ligand (RANKL). This study aimed to investigate the hypothesis that TACE would be elevated in the gingival crevicular fluid (GCF) of persons with periodontitis. Total TACE amounts in GCF were higher in persons with chronic and aggressive periodontitis than in those with gingivitis or in healthy persons. TACE concentrations in GCF were higher in persons with chronic and aggressive periodontitis than in those with gingivitis, although not significantly higher than in healthy persons. Persons with chronic periodontitis receiving immunosuppressive treatment exhibited over 10-fold lower TACE levels than the other periodontitis groups. TACE was positively correlated with probing pocket depth, clinical attachment levels, and RANKL concentrations in GCF. In conclusion, the increased GCF TACE levels in persons with periodontitis and their positive correlation with RANKL may indicate an association of this enzyme with alveolar bone loss, and may warrant special attention in future therapeutic approaches.     

Can Apical Periodontitis Modify Systemic Levels of Inflammatory Markers? A Systematic Review and Meta-analysis

Introduction

This systematic review and meta-analysis investigated evidence to support whether apical periodontitis (AP) can modify the systemic levels of inflammatory markers (IM) in humans.

Methods

The MEDLINE, Embase, Cochrane, and PubMed databases were searched between 1948 and 2012, with no language restriction. Additionally, the bibliography of all relevant articles and textbooks were manually searched. Based on inclusion and exclusion criteria, 2 reviewers independently rated the quality of each study based on the Newcastle-Ottawa Scale. The primary outcome variable for meta-analysis was determined by the serum levels of IMs in AP subjects versus healthy controls or in AP subjects before versus after treatment intervention.

Results

Among the 531 initially identified articles, 20 comprised the final analysis. Thirty-one different IMs were analyzed, with immunoglobulin (Ig) A, IgM, IgG, and C-reactive protein (CRP) being the most commonly investigated. CRP, interleukin (IL)-1, IL-2, IL-6, asymmetrical dimethylarginine, IgA, IgG, and IgM were shown to be increased in patients with AP compared with controls in most studies. Meta-analyses showed that serum levels of IgA (P = .001), IgG (P = .04), and IgM (P < .00001) were increased in humans with AP compared with healthy controls and serum levels of CRP, IgA, IgE, IgG, and IgM were not significantly different between patients with AP before and after treatment (P > .05).

Conclusions

Available evidence is limited but consistent, suggesting that AP is associated with increased levels of CRP, IL-1, IL-2, IL-6, asymmetrical dimethylarginine, IgA, IgG, and IgM in humans. These findings suggest that AP may contribute to a systemic immune response not confined to the localized lesion, potentially leading to increased systemic inflammation.     

Serum immunoglobulins and autoantibodies in patients with oral lichen planus

A qualitative and quantitative determination of serum immunoglobulins was made in 34 patients (27 female, 7 male) with histologically verified oral lichen planus (OLP). The subjects ranged in age from 33 to 80 years and 28 of the cases had OLP changes of atrophic-erosive type. The possible presence of rheumatoid factors (RF), antinuclear antibodies (ANA) or antibodies to mitochondrias, renal glomeruli and smooth muscles was studied in 30 of the patients. The investigation also comprised a control group of 23 patients (17 female, 6 male) without mucosal changes. Immunoelectrophoresis showed an abnormal pattern in 10 OLP cases (29%), the most common change being a polyclonal increase of IgG in 8 persons. Elevated levels of serum IgG (greater than 15 g/l) were seen in a total of 9 OLP patients (26%), but only in 1 of the control cases (4%). The mean IgG value was significantly higher in the OLP than in the control group, 13.4 and 10.3 g/l, respectively. Regarding levels of IgA and IgM, no difference was noted between the groups. Autoantibodies were registered in 27% of the OLP patients and in 9% of the controls. The immune changes could be correlated in some respect to positive fungal cultures, allergies and decreased unstimulated saliva, but not to age, endocrine disorders or joint diseases.