Putative periodontal pathogens, antibody titres and avidities to them in a longitudinal study of patients with resistant periodontitis

OBJECTIVE: To study changes in antibody titres and antibody avidities to putative periodontal pathogens in patients with resistant periodontitis and to compare these findings with the result of culture of these pathogens.
SUBJECTS AND METHODS: Patients meeting strict clinical criteria in whom periodontal therapy had failed to prevent disease progression were studied microbiologically and immunologically over a 75-week period. Particular reference was made to the isolation of Actinobocillus actinomycetemcomitons (Aa) and Porphyromonos gingivalis (Pg) together with changes in antibody titres and avidities to these organisms between baseline examination and week 75.
RESULTS: Pg was eliminated following antibiotic treatment but metronidazole and amoxycillin therapy failed to remove Aa in all cases. Antibody avidities to these pathogens were higher in patients than in matched controls but no change in avidity was noted during the course of treatment. Most antibody titres were not significantly higher in patients than in controls.
CONCLUSIONS: Continued disease progression characterised these patients who, nevertheless, mounted an immune response to the periodontal pathogens but this appeared to be inadequate to stop the disease.     

Conformational states of vitronectin: preferential expression of an antigenic epitope when vitronectin is covalently and noncovalently complexed with thrombin-antithrombin III or treated with urea

A difference in recognition of the adhesive glycoprotein vitronectin (also called S-protein, serum spreading factor, and epibolin) by monoclonal antibody 8E6 (Hayman EG, et al, Proc Natl Acad Sci USA 80:4003, 1983) was investigated using a competitive enzyme- immunosorbent assay and immunoaffinity chromatography. Recognition of vitronectin in serum was approximately 50-fold greater than recognition of vitronectin in plasma. Recognition of vitronectin incubated with heparin, thrombin-antithrombin III complex, or heparin and thrombin- antithrombin III complex together was 2.5-, 7-, or 32-fold greater, respectively, than recognition of vitronectin alone. Thrombin or antithrombin III by itself did not induce the antigenic change. Factor Xa-antithrombin III was less effective than thrombin-antithrombin III in induction of the change. Dextran sulfate and fucoidan were more potent than heparin in induction of the antigenic change, whereas dermatan sulfate, hyaluronic acid, heparan sulfate, chondroitin sulfate, or keratan sulfate were less effective. Immunoblotting analysis of serum and of vitronectin incubated with thrombin and antithrombin III demonstrated the presence of complexes composed of vitronectin and thrombin-antithrombin III that could only be dissociated with reducing agent. N-ethylmaleimide completely blocked the formation of the presumably disulfide-bonded complexes and partially blocked the antigenic change. Both non-disulfide-bonded and disulfide-bonded vitronectin bound to antibody-Sepharose from a mixture of vitronectin and thrombin-antithrombin III. Treatment of vitronectin with 8 mol/L urea resulted in enhanced recognition by the monoclonal antibody. Thus, the 8E6 antibody reacts with an epitope that is preferentially expressed by noncovalently and covalently linked vitronectin/thrombin-antithrombin III complexes and by urea-treated vitronectin. The change in vitronectin induced by thrombin-antithrombin III, therefore, is a physiological correlate of urea treatment and of adsorption of vitronectin onto tissue culture plastic (as is done in cell adhesion assays). The change may be important for expression of vitronectin activity.     

Intraventricular mass lesions

Determining the precise etiology of an intraventricular mass can be a difficult diagnostic problem. CT and angiographic findings were reviewed in a series of 73 patients who had intraventricular masses. The histologic diagnosis can be suggested preoperatively by an analysis of the frequency of lesions occurring at a given ventricular location, lesion density before and after administration of contrast material, age and sex of the patient, morphologic appearance of the mass, and presence or absence of hydrocephalus. Angiography is useful when meningioma, choroid plexus papilloma and carcinoma, or arteriovenous malformation are considered. The differential features of each diagnostic entity are discussed.