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Bhatavadekar NB, Williams RC. New directions in host modulation for the management of periodontal disease. J Clin Periodontol 2009; 36:124-6. [PMID: 19207887 DOI: 10.1111/j.1600-051x.2008.01354.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND New strategies for periodontal disease management have been emerging as more is learned about the role of the host response. Our increasing understanding of inflammation and its resolution has opened the door to the study of new periodontal treatment strategies. This commentary examines periodontal disease in light of a new understanding of the role of inflammation in disease expression, thus setting the stage for the development of new prevention and treatment strategies of a widespread disease. METHODS We examined current publications and focused on articles relating to anti-inflammatory and pro-resolution mechanisms in periodontal disease. RESULTS Recent research has examined the inflammatory and resolution cascade in greater detail while looking at endogenous and exogenous mediators that can be utilized to achieve therapeutic end-points. The possible introduction of "resolution indices" for drug testing warrants a new look at pharmacologic agents that might have been overlooked for their beneficial effects in periodontal disease treatment. CONCLUSION The emerging awareness of inflammation and its control in periodontal disease management underscores the importance of exploring inflammatory pathways and mediators, thus exploring new ways to control inflammation. This direction of research promises a new era in drug discovery and therapeutics for periodontal disease treatment.
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Affiliation(s)
- Neel B Bhatavadekar
- Department of Periodontology, University of Texas Health Science Center, Houston, TX, USA.
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302
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303
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Omega-3 PUFA derived anti-inflammatory lipid mediator resolvin E1. Prostaglandins Other Lipid Mediat 2009; 89:126-30. [PMID: 19737659 DOI: 10.1016/j.prostaglandins.2009.03.002] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2009] [Revised: 02/28/2009] [Accepted: 03/14/2009] [Indexed: 12/13/2022]
Abstract
Inflammation is a defensive response to injury and infection, but excessive or inappropriate inflammation contributes to a range of acute and chronic human diseases. Clinical assessment of dietary supplementation of omega-3 polyunsaturated fatty acids (PUFA) including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) indicate their beneficial impact on human diseases in which inflammation is suspected as a key component of the pathogenesis. Although the mechanism of EPA and DHA action is still not fully defined in molecular terms, recent studies have revealed that, during the course of acute inflammation, omega-3 PUFA-derived mediators including resolvins and protectins with potent anti-inflammatory and pro-resolving properties are produced. In this review, we provide an overview of the formation and actions of EPA-derived anti-inflammatory lipid mediator resolvin E1.
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304
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Kasuga K, Yang R, Porter TF, Agrawal N, Petasis NA, Irimia D, Toner M, Serhan CN. Rapid appearance of resolvin precursors in inflammatory exudates: novel mechanisms in resolution. THE JOURNAL OF IMMUNOLOGY 2009; 181:8677-87. [PMID: 19050288 DOI: 10.4049/jimmunol.181.12.8677] [Citation(s) in RCA: 195] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Resolution of inflammation is essential. Although supplementation of omega-3 fatty acids is widely used, their availability at sites of inflammation is not known. To this end, a multidisciplinary approach was taken to determine the relationship of circulating omega-3 to inflammatory exudates and the generation of resolution signals. In this study, we monitored resolvin precursors in evolving exudates, which initially paralleled increases in edema and infiltrating neutrophils. We also prepared novel microfluidic chambers to capture neutrophils from a drop of blood within minutes that permitted single-cell monitoring. In these, docosahexaenoic acid-derived resolvin D1 rapidly stopped neutrophil migration, whereas precursor docosahexaenoic acid did not. In second organ injury via ischemia-reperfusion, resolvin metabolically stable analogues were potent organ protectors reducing neutrophils. Together, these results indicate that circulating omega-3 fatty acids rapidly appear in inflammatory sites that require conversion to resolvins that control excessive neutrophil infiltration, protect organs, and foster resolution.
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Affiliation(s)
- Kie Kasuga
- Department of Anesthesiology, Center for Experimental Therapeutics and Reperfusion Injury, Brigham and Women's Hospital, Boston, MA 02115, USA
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305
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Abstract
Toll-like receptors (TLRs) are central mediators of innate antimicrobial and inflammatory responses and play instructive roles in the development of the adaptive immune response. Thus when stimulated by certain agonists, TLRs serve as adjuvant receptors that link innate and adaptive immunity. However, when excessively activated or inadequately controlled during an infection, TLRs may contribute to immunopathology associated with inflammatory diseases, such as periodontitis. Moreover, certain microbial pathogens appear to exploit aspects of TLR signalling in ways that enhance their adaptive fitness. The diverse and important roles played by TLRs suggest that therapeutic manipulation of TLR signalling may have implications in the control of infection, attenuation of inflammation, and the development of vaccine adjuvants for the treatment of periodontitis. Successful application of TLR-based therapeutic modalities in periodontitis would require highly selective and precisely targeted intervention. This would in turn necessitate precise characterization of TLR signalling pathways in response to periodontal pathogens, as well as development of effective and specific agonists or antagonists of TLR function and signalling. This review summarizes the current status of TLR biology as it relates to periodontitis, and evaluates the potential of TLR-based approaches for host-modulation therapy in this oral disease.
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Affiliation(s)
- George Hajishengallis
- Department of Periodontics/ Oral Health and Systemic Disease, School of Dentistry, University of Louisville Health Sciences Center, Louisville, KY 40292, USA
- Department of Immunology and Microbiology, School of Medicine, University of Louisville Health Sciences Center, Louisville, KY 40292, USA
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306
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Pontes-Arruda A, DeMichele S, Seth A, Singer P. The Use of an Inflammation-Modulating Diet in Patients With Acute Lung Injury or Acute Respiratory Distress Syndrome: A Meta-Analysis of Outcome Data. JPEN J Parenter Enteral Nutr 2008; 32:596-605. [DOI: 10.1177/0148607108324203] [Citation(s) in RCA: 178] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Alessandro Pontes-Arruda
- From Intensive Care Department, Fernandes Távora Hospital, Fortaleza, Ceará, Brazil; Research and Development, Abbott Nutrition, Abbott Laboratories, Columbus, Ohio; Department of General Intensive Care, Rabin Medical Center, Tel Aviv, Israel
| | - Stephen DeMichele
- From Intensive Care Department, Fernandes Távora Hospital, Fortaleza, Ceará, Brazil; Research and Development, Abbott Nutrition, Abbott Laboratories, Columbus, Ohio; Department of General Intensive Care, Rabin Medical Center, Tel Aviv, Israel
| | - Anand Seth
- From Intensive Care Department, Fernandes Távora Hospital, Fortaleza, Ceará, Brazil; Research and Development, Abbott Nutrition, Abbott Laboratories, Columbus, Ohio; Department of General Intensive Care, Rabin Medical Center, Tel Aviv, Israel
| | - Pierre Singer
- From Intensive Care Department, Fernandes Távora Hospital, Fortaleza, Ceará, Brazil; Research and Development, Abbott Nutrition, Abbott Laboratories, Columbus, Ohio; Department of General Intensive Care, Rabin Medical Center, Tel Aviv, Israel
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307
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Abstract
It has become clear in recent years that periodontitis is an inflammatory disease initiated by oral microbial biofilm. This distinction implies that it is the host response to the biofilm that destroys the periodontium in the pathogenesis of the disease. As our understanding of pathways of inflammation has matured, a better understanding of the molecular basis of resolution of inflammation has emerged. Resolution of inflammation is an active, agonist-mediated, well-orchestrated return of tissue homeostasis. There is an important distinction between anti-inflammation and resolution; anti-inflammation is pharmacologic intervention in inflammatory pathways, whereas resolution is biologic pathways restoring homeostasis. A growing body of research suggests that chronic inflammatory periodontal disease involves a failure of resolution pathways to restore homeostasis. This article reviews the resolution of inflammation in the context of periodontal disease and the potential for the modification of resolution pathways for the prevention and treatment of periodontal diseases. Proof-of-concept studies in the 1980s demonstrated that pharmacologic anti-inflammation prevented and slowed the progression of periodontal diseases in animals and man. However, the side-effect profile of such therapies precluded the use of non-steroidal anti-inflammatory drugs or other enzyme inhibitors or receptor antagonists in periodontal therapy. The isolation and characterization of resolving agonist molecules has opened a new area of research using endogenous lipid mediators of resolution as potential therapeutic agents for the management of inflammatory periodontitis. Work in animal models of periodontitis has revealed the potential of this therapeutic approach for its prevention and treatment and forced the reconsideration of our understanding of the pathogenesis of human periodontal diseases.
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Affiliation(s)
- Thomas E Van Dyke
- Division of Periodontology and Oral Biology, Goldman School of Dental Medicine, Boston University, 100 E. Newton Street, Boston, MA 02118, USA.
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308
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Herrera BS, Ohira T, Gao L, Omori K, Yang R, Zhu M, Muscara MN, Serhan CN, Van Dyke TE, Gyurko R. An endogenous regulator of inflammation, resolvin E1, modulates osteoclast differentiation and bone resorption. Br J Pharmacol 2008; 155:1214-23. [PMID: 18806821 DOI: 10.1038/bjp.2008.367] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND AND PURPOSE The inflammation-resolving lipid mediator resolvin E1 (RvE1) effectively stops inflammation-induced bone loss in vivo in experimental periodontitis. It was of interest to determine whether RvE1 has direct actions on osteoclast (OC) development and bone resorption. EXPERIMENTAL APPROACH Primary OC cultures derived from mouse bone marrow were treated with RvE1 and analysed for OC differentiation, cell survival and bone substrate resorption. Receptor binding was measured using radiolabelled RvE1. Nuclear factor (NF)-kappaB activation and Akt phosphorylation were determined with western blotting. Lipid mediator production was assessed with liquid chromatography tandem mass spectrometry. KEY RESULTS OC growth and resorption pit formation were markedly decreased in the presence of RvE1. OC differentiation was inhibited by RvE1 as demonstrated by decreased number of multinuclear OC, a delay in the time course of OC development and attenuation of receptor activator of NF-kappaB ligand-induced nuclear translocation of the p50 subunit of NF-kappaB. OC survival and apoptosis were not altered by RvE1. Messenger RNA for both receptors of RvE1, ChemR23 and BLT(1) is expressed in OC cultures. Leukotriene B(4) (LTB(4)) competed with [(3)H]RvE1 binding on OC cell membrane preparations, and the LTB(4) antagonist U75302 prevented RvE1 inhibition of OC growth, indicating that BLT(1) mediates RvE1 actions on OC. Primary OC synthesized the RvE1 precursor 18R-hydroxy-eicosapentaenoic acid and LTB(4). Co-incubation of OC with peripheral blood neutrophils resulted in transcellular RvE1 biosynthesis. CONCLUSIONS AND IMPLICATIONS These results indicate that RvE1 inhibits OC growth and bone resorption by interfering with OC differentiation. The bone-sparing actions of RvE1 are in addition to inflammation resolution, a direct action in bone remodelling.
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Affiliation(s)
- B S Herrera
- Department of Periodontology and Oral Biology, Goldman School of Dental Medicine, Boston University, Boston, MA 2118, USA
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309
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Vassiliou EK, Kesler OM, Tadros JH, Ganea D. Bone Marrow-Derived Dendritic Cells Generated in the Presence of Resolvin E1 Induce Apoptosis of Activated CD4+ T Cells. THE JOURNAL OF IMMUNOLOGY 2008; 181:4534-44. [DOI: 10.4049/jimmunol.181.7.4534] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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310
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Serhan CN. Systems approach with inflammatory exudates uncovers novel anti-inflammatory and pro-resolving mediators. Prostaglandins Leukot Essent Fatty Acids 2008; 79:157-63. [PMID: 19008087 PMCID: PMC2629741 DOI: 10.1016/j.plefa.2008.09.012] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Using a systems approach to mine spontaneously resolving inflammatory exudates, novel families of lipid- derived mediators were identified in animal systems that control both the duration and magnitude of acute inflammation. These new families were coined with the resolvins and protectins because they possess potent bioactions and novel chemical structures. The mapping of these new resolution circuits has already provided new avenues for appreciating the molecular basis of many inflammatory diseases. This presentation/mini review gives recent advances from our studies on resolvin and protectin biosynthesis and the actions of these novel mediators. These previously unappreciated families of lipid-derived mediators were originally isolated from murine models of acute inflammation captured during the natural spontaneous resolution phase. They are biosynthesized from omega-3 fatty acids and possess potent anti-inflammatory, pro-resolving and anti-fibrotic in vivo actions. These new families of endogenous pro-resolving and anti-inflammatory agonists were also used as biotemplates to design potent mimetics/analogs which were used to confirm each of their structures and specific functions. Moreover, together the identification of these mediators indicate that resolution is an active process at the tissue level in vivo as well as constitute a new genus of anti-inflammatories with a previously unknown pro-resolving mechanism of action.
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Affiliation(s)
- Charles N Serhan
- Center for Experimental Therapeutics and Reperfusion Injury, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital and Harvard Medical School, Thorn 724, MA 02115, USA.
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311
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Chen Y, Wang J, Nie R, Zhou S. Endogenous pro-resolving and anti-inflammatory lipid mediators: The new hope of atherosclerotic diseases. Med Hypotheses 2008; 71:237-40. [DOI: 10.1016/j.mehy.2008.03.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2008] [Revised: 03/05/2008] [Accepted: 03/10/2008] [Indexed: 12/17/2022]
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312
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Wu C, Sun A, Zou Y, Ge J. “Pro-resolution” and anti-inflammation, a role of RvE1 in anti-atherosclerosis and plaque stabilization. Med Hypotheses 2008; 71:252-5. [DOI: 10.1016/j.mehy.2008.03.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2008] [Revised: 02/20/2008] [Accepted: 03/14/2008] [Indexed: 10/22/2022]
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313
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Serhan CN, Chiang N, Van Dyke TE. Resolving inflammation: dual anti-inflammatory and pro-resolution lipid mediators. Nat Rev Immunol 2008; 8:349-61. [PMID: 18437155 PMCID: PMC2744593 DOI: 10.1038/nri2294] [Citation(s) in RCA: 2054] [Impact Index Per Article: 128.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Active resolution of acute inflammation is a previously unrecognized interface between innate and adaptive immunity. Once thought to be a passive process, the resolution of inflammation is now shown to involve active biochemical programmes that enable inflamed tissues to return to homeostasis. This Review presents new cellular and molecular mechanisms for the resolution of inflammation, revealing key roles for eicosanoids, such as lipoxins, and recently discovered families of endogenous chemical mediators, termed resolvins and protectins. These mediators have anti-inflammatory and pro-resolution properties, thereby protecting organs from collateral damage, stimulating the clearance of inflammatory debris and promoting mucosal antimicrobial defence.
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Affiliation(s)
- Charles N Serhan
- Center for Experimental Therapeutics and Reperfusion Injury, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA.
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