Collagen turnover in the gingiva and other mature connective tissues of the marmoset Saguinus oedipus

Matrix Metalloproteinases in the Periodontium-Vital in Tissue Turnover and Unfortunate in Periodontitis

The extracellular matrix (ECM) is a complex non-cellular three-dimensional macromolecular network present within all tissues and organs, forming the foundation on which cells sit, and composed of proteins (such as collagen), glycosaminoglycans, proteoglycans, minerals, and water. The ECM provides a fundamental framework for the cellular constituents of tissue and biochemical support to surrounding cells. The ECM is a highly dynamic structure that is constantly being remodeled. Matrix metalloproteinases (MMPs) are among the most important proteolytic enzymes of the ECM and are capable of degrading all ECM molecules. MMPs play a relevant role in physiological as well as pathological processes; MMPs participate in embryogenesis, morphogenesis, wound healing, and tissue remodeling, and therefore, their impaired activity may result in several problems. MMP activity is also associated with chronic inflammation, tissue breakdown, fibrosis, and cancer invasion and metastasis. The periodontium is a unique anatomical site, composed of a variety of connective tissues, created by the ECM. During periodontitis, a chronic inflammation affecting the periodontium, increased presence and activity of MMPs is observed, resulting in irreversible losses of periodontal tissues. MMP expression and activity may be controlled in various ways, one of which is the inhibition of their activity by an endogenous group of tissue inhibitors of metalloproteinases (TIMPs), as well as reversion-inducing cysteine-rich protein with Kazal motifs (RECK).

Single-Cell RNA-seq Identifies Cell Diversity in Embryonic Salivary Glands

Branching organs, including the salivary and mammary glands, lung, and kidney, arise as epithelial buds that are morphologically very similar. However, the mesenchyme is known to guide epithelial morphogenesis and to help govern cell fate and eventual organ specificity. We performed single-cell transcriptome analyses of 14,441 cells from embryonic day 12 submandibular and parotid salivary glands to characterize their molecular identities during bud initiation. The mesenchymal cells were considerably more heterogeneous by clustering analysis than the epithelial cells. Nonetheless, distinct clusters were evident among even the epithelial cells, where unique molecular markers separated presumptive bud and duct cells. Mesenchymal cells formed separate, well-defined clusters specific to each gland. Neuronal and muscle cells of the 2 glands in particular showed different markers and localization patterns. Several gland-specific genes were characteristic of different rhombomeres. A muscle cluster was prominent in the parotid, which was not myoepithelial or vascular smooth muscle. Instead, the muscle cluster expressed genes that mediate skeletal muscle differentiation and function. Striated muscle was indeed found later in development surrounding the parotid gland. Distinct spatial localization patterns of neuronal and muscle cells in embryonic stages appear to foreshadow later differences in adult organ function. These findings demonstrate that the establishment of transcriptional identities emerges early in development, primarily in the mesenchyme of developing salivary glands. We present the first comprehensive description of molecular signatures that define specific cellular landmarks for the bud initiation stage, when the neural crest-derived ectomesenchyme predominates in the salivary mesenchyme that immediately surrounds the budding epithelium. We also provide the first transcriptome data for the largely understudied embryonic parotid gland as compared with the submandibular gland, focusing on the mesenchymal cell populations.

Gingiva as a source of stem cells with therapeutic potential

Postnatal connective tissues contain phenotypically heterogeneous cells populations that include distinct fibroblast subpopulations, pericytes, myofibroblasts, fibrocytes, and tissue-specific mesenchymal stem cells (MSCs). These cells play key roles in tissue development, maintenance, and repair and contribute to various pathologies. Depending on the origin of tissue, connective tissue cells, including MSCs, have different phenotypes. Understanding the identity and specific functions of these distinct tissue-specific cell populations may allow researchers to develop better treatment modalities for tissue regeneration and find novel approaches to prevent pathological conditions. Interestingly, MSCs from adult oral mucosal gingiva possess distinct characteristics, including neural crest origin, multipotent differentiation capacity, fetal-like phenotype, and potent immunomodulatory properties. These characteristics and an easy, relatively noninvasive access to gingival tissue, and fast tissue regeneration after tissue biopsy make gingiva an attractive target for cell isolation for therapeutic purposes aiming to promote tissue regeneration and fast, scar-free wound healing. The purpose of this review is to discuss the identity, phenotypical heterogeneity, and function of gingival MSCs and summarize what is currently known about their properties, role in scar-free healing, and their future therapeutic potential.

Activation of matrix metalloproteinase-2 by a novel oral spirochetal species Treponema lecithinolyticum

BACKGROUND

Periodontal tissue destruction is a characteristic of periodontitis. This can be caused by either bacterial enzymes or host cell-derived matrix metalloproteinases (MMPs). In order to elucidate the etiologic role of oral spirochetes, we investigated the effects of Treponema lecithinolyticum, a novel saccharolytic species, on MMP-2 activation.

METHODS

Gingival fibroblasts (GFs) and periodontal ligament (PDL) cells obtained from healthy human subjects were cultured to confluence in alpha-minimal essential medium (alpha-MEM) supplemented with 10% fetal bovine serum. After serum starvation for a day, the cultures were treated with whole cell sonicates, heat-denatured whole cell sonicates, outer membrane fraction (OMF) or formaldehyde-fixed cells of T. lecithinolyticum. Culture supernatants were collected after incubation for 24 to 48 hours and analyzed for MMP-2 activation by gelatin zymography. Collagenolytic activity was quantitatively measured using human [3H] type IV collagen as a substrate.

RESULTS

Treatment of GFs and PDL cells with whole cell sonicates, formaldehyde-fixed whole cells, or the OMF of T. lecithinolyticum resulted in the production of MMP-2 partly in the fully active form with a molecular mass of 62 kDa, whereas non-treated control cultures and cultures treated with a heat-denatured fraction did not show the active form. Cultures exposed to T. lecithinolyticum had higher collagenolytic activity than non-treated cultures.

CONCLUSIONS

Our results demonstrate that T. lecithinolyticum, possibly mediated by proteinaceous cell surface-associated components, may participate in extracellular matrix degradation by activation of MMP-2 during periodontal inflammation.

Anti-proliferative capsular-like polysaccharide antigen from Actinobacillus actinomycetemcomitans induces apoptotic cell death in mouse osteoblastic MC3T3-E1 cells

Actinobacillus actinomycetemcomitans (A. actinomycetemcomitans) has been implicated in the etiology of localized juvenile periodontitis (LJP), and produces a multiplicity of tissue-damaging products. Among those products, the capsular-like polysaccharide antigen (CPA) from A. actinomycetemcomitans is a potent mediator of bone resorption. In fact, this CPA (serotype b) is known to promote osteoclast-like cell formation via interleukin (IL)-1alpha production in mouse marrow cultures. Although osteoblasts complete bone formation, there are few reports focusing on the effect of CPA in bone-forming activity of osteoblasts in inflammatory disease sites. We hypothesized that CPA plays a mediating role in osteoblastic cells. Therefore, the purpose of this study was to examine the effect of CPA from A. actinomycetemcomitans on the mouse osteoblastic cell line MC3T3-E1 and human osteosarcoma SaOS-2 cells. A. actinomycetemcomitans serotype c resulted in a potent dose-dependent inhibition of cell proliferation of both cell lines. Characterization of the antiproliferative activity in the CPA demonstrated that it was not cytotoxic for MC3T3-E1. A 20-hour incubation with CPA-c resulted in a significant increase in apoptotic cell death in the cells, as evaluated by both cellular DNA fragmentation ELISA and FACS analysis. In contrast to the results obtained with a cytokine mixture (tumor necrosis factor-alpha, IL-1beta, and interferon-gamma), no inducible nitric oxide (NO) synthase gene expression or NO release could be detected in MC3T3-E1 after incubation with CPA-c. Further, both CPA-b and -c caused potent induction of apoptosis-related modifiers, e.g., Fas mRNA, whereas bcl-2 mRNA levels were unchanged. Therefore, this study has shown that CPA from A. actinomycetemcomitans contains a potent antiproliferative polysaccharide whose activity is associated with apoptotic cell death in MC3T3-E1, and that CPA per se is an inducer of apoptosis mediated by the Fas system but not by NO.

Cyclosporin A regulates interleukin-1beta and interleukin-6 expression in gingiva: implications for gingival overgrowth

BACKGROUND

Gingival overgrowth is a common side effect following the administration of cyclosporin A (CsA); however, the cellular mechanisms remain poorly understood. CsA's immunosuppressant properties involve the regulation of synthesis and cellular response to cytokines. A CsA-induced alteration in the cytokine profile within gingival tissue could provide a mechanism for gingival hyperplasia. The aim of this study was to investigate the effects of CsA on the production of 2 cytokines - interleukin-1beta (IL-1beta) and interleukin-6 (IL-6) - by both gingival fibroblasts and peripheral blood mononuclear cells (PBMC).

METHODS

Cells were stimulated for 24 hours in the presence of CsA over a concentration range of 100 to 2,000 ng/ml and the resultant cytokine production determined by ELISA. In addition, levels of both cytokines within normal, inflamed, and overgrown gingival tissue were determined.

RESULTS

CsA inhibited IL-6 production by gingival fibroblasts in a dose-dependent manner. In contrast, at a concentration of 2,000 ng/ml, CsA stimulated IL-6 production by PBMC (P <0.05). Fibroblasts derived from overgrown gingiva produced significantly higher levels of IL-6 than their normal counterparts (P <0.05). CsA inhibited IL-1beta production by PBMC over the whole concentration range (P <0.05). IL-1beta was not found in measurable quantities in any of the fibroblast cultures. Levels of IL-6 extracted from overgrown gingival tissue were significantly higher than in inflamed or normal tissue. In contrast IL-1beta levels in overgrown tissue were not statistically significantly greater than those in inflamed tissue.

CONCLUSIONS

These results show that CsA does regulate cytokine expression in gingival tissue. This effect may play an important role in the pathogenesis of CsA-induced gingival overgrowth.

In situ localization of cell synthesis and proliferation in periodontitis gingiva and tonsillar tissue

OBJECTIVE

Previous work indicates that large numbers of B and T cells accumulate in the periodontal soft tissues although we know little about cellular synthetic activity and proliferation in this site. The aim of this study was to examine lymphocytic cell synthetic activity and proliferation in periodontitis gingiva and compare this to a known site of leucocyte proliferation, namely the oropharyngeal tonsils.

MATERIALS AND METHODS

Messenger RNA (mRNA) and 28S ribosomal (28S rRNA) expressing cells in formalin-fixed/paraffin-embedded gingival and tonsillar tissue sections were detected by in situ hybridisation (ISH) using poly-deoxyribothymidine and 28S probes respectively. In addition S-phase proliferating and cycling cells were also detected by ISH with histone probes and by Ki-67 immunohistochemistry. Ten gingival biopsy samples were obtained from adult periodontitis patients and five tonsillar biopsies from tonsillectomy patients.

RESULTS

Both mRNA and 28S rRNA-expressing cells were detected in all the samples tested. Plasma cells showed the strongest signal for the two probes and slight to moderate staining could be seen in epithelium, fibroblasts and endothelial cells. In contrast, gingival lymphocytes were either weakly stained or were unstained for these probes of synthetic activity. In tonsils, most lymphocytes in germinal centres showed moderate staining and mantol zone cells were much more weakly stained. In gingival samples, histone mRNA-expressing and cycling (Ki-67) cells were detected in 4/10, 10/10 cases respectively. These positive cells were mainly basal and suprabasal epithelial cells and a few mononuclear cells, whereas most germinal centre lymphocytes (B cells) were positive for this probe. The number of Ki67 positive cells was greater than histone mRNA bearing cells both in gingiva and tonsillar tissue. In contrast, mantol zone cells (mainly T cells) were sparsely stained by probes of cell proliferation.

CONCLUSION

These results indicate that local proliferation of B cells does not occur in periodontitis gingiva in contrast with tonsillar tissue, although plasma cells showed strong synthetic activity in both tissues. T cells did not appear to proliferate greatly nor undergo active synthesis in either of these tissues. These findings substantiate previous hypotheses that specific leucocytes predominate in the gingival tissue through selective homing rather than by local proliferation.

Elevated conversion of alpha-2-macroglobulin to the complexed form in gingival crevicular fluid from adult periodontitis patients

The broad spectrum protease inhibitor, alpha 2-macgrolobulin (alpha 2M), is one of the host's principal regulators of both endogenous and exogenous proteases and is likely to have an important role in the regulation of proteolytic activity at inflammatory sites. We have determined the amount of complexed (com alpha 2M) and total alpha 2M (tot alpha 2M) in gingival crevicular fluid (GCF) harvested from shallow and deep sites in adult periodontitis (AP) patients (n = 21). An ELISA technique was developed to measure both forms of alpha 2M in the same sample utilizing a monoclonal antibody (MAb) specific for the complexed form. In addition, protease activity towards human serum albumin (Prot1), transferrin (Prot2) and N alpha-benzoyl-L-arginine 7-amido-4-methylcoumarin-hydrochloride (BAAMc; Prot3) were determined in a second GCF sample from the same site. Plasma alpha 2M concentrations were only positively correlated (p = 0.0163) with GCF tot alpha 2M from highly inflamed sites. We observed a significant positive correlation between tot alpha 2M and proteolytic activity in GCF from deep sites but not from shallow sites (Prot1: p = 0.002; Prot2: p = 0.005). A similar correlation between tot alpha 2M and proteolytic activity was found at highly inflamed sites (Prot1: p = 0.014; Prot2: p = 0.002). A very high proportion of the tot alpha 2M in GCF was in the complexed form at both shallow (71.14% +/- 29.13) and deep sites (68.17% +/- 28.5) Com alpha 2M was positively correlated with proteolytic activity only in deep sites (Prot1: p = 0.015; Prot2: p = 0.031). Our results suggest that the concentration of tot alpha 2M in the gingival crevice is positively associated with the amount of proteolytic activity at the site and that protease activities in GCF may only partly explain the high percentage conversion alpha 2M to the complexed form. The high level of alpha 2M inactivation in GCF from AP patients reported here may have significance not only in view of its role as a broad spectrum protease inhibitor but also through the differential effects of native vs complexed alpha 2M on the regulation of immune responses.

Characterization of an antiproliferative surface-associated protein from Actinobacillus actinomycetemcomitans which can be neutralized by sera from a proportion of patients with localized juvenile periodontitis

The gentle agitation of suspensions of Actinobacillus actinomycetemcomitans serotype a, b, or c in saline resulted in the release of a proteinaceous surface-associated material (SAM) which produced a dose-dependent inhibition of tritiated thymidine incorporation by the osteoblast-like cell line MG63 in culture. This cell line was sensitive to low concentrations of SAM (50% inhibitory concentration, 200 ng/ml for serotype c). Immunoglobulin G antibodies to constituents of the SAM were found in the blood of patients with localized juvenile periodontitis (LJP). Sera from 9 of 16 patients with LJP significantly neutralized the antiproliferative activity of the SAM, while sera from 15 controls, with no evidence of periodontal disease, were unable to neutralize this activity. Neutralization was not directly related to the patient's antibody titer to the whole SAM. Characterization of the antiproliferative activity in the SAM demonstrated that it was not cytotoxic and was heat and trypsin sensitive. The active component separated in a well-defined peak in anion-exchange high-performance liquid chromatography (HPLC) which, when further analyzed by size exclusion HPLC, revealed a single active peak, which had an apparent molecular mass of approximately 8 kDa. The lipopolysaccharide from A. actinomycetemcomitans was only weakly active. SAM from Porphyromonas gingivalis W50 and Eikenella corrodens NCTC 10596 did not exhibit any antiproliferative activity with this cell line, even at concentrations as high as 10 micrograms/ml. This study has shown that SAM from A. actinomycetemcomitans contains a potent antiproliferative protein whose activity can be neutralized by antibodies in the sera from some patients with LJP.

Donor variability in the proliferation of human dental pulp fibroblasts

Fibroblasts were isolated from human dental pulps of healthy third molars from 49 donors of ages ranging from 17 to 68. Significant variability was noted in the success of obtaining primary cultures from these pulps. Variability between the various cultures was also observed in the reliability of maintaining subcultures of the primary cultures as well as recovery from frozen stocks of established cell lines. Of the original 49 explant cultures studied, only three survived long-term passage and freezing. In addition to difficulties and variability in establishing cell lines, the human pulp fibroblasts also showed great variability in proliferative activity which could not be accounted for by donor age, source, or passage number. These findings highlight significant difficulties in establishing reliable human pulp fibroblast cultures and the need for great care in interpreting any in vitro data.

Pathogenic mechanisms in periodontal disease

Periodontal diseases have been considered as "infections" in which micro-organisms initiate and maintain the destructive inflammatory response. Host-mediated tissue destruction occurs via complement activation and the release of lysosomal enzymes, and connective tissue matrix metalloproteinases. Microbial enzymes may damage connective tissues directly, and, together with toxic metabolites and structural materials, are thought to disrupt the reparative activities of fibroblasts and cells of the immune defenses. The significance and relative contributions of host and microbial factors to the disease process remain unresolved. Environmental changes in the gingival sulcus and periodontal pocket and tissues, the degree of the host response and nutrient availability, concomitant with disease progression, compromise tissue metabolism and repair, and allow for enhanced or de novo expression of microbial virulence factors, such as proteases, which alter microbial pathogenicity. Proteolytic destruction of specific antibodies and complement by both viable and non-viable bacterial cells may retard phagocytic killing and removal of pathogens, thus prolonging the inflammatory response. Bacterial products may indirectly mediate tissue destruction by stimulating release of matrix metalloproteinases or by proteolytically inactivating the specific inhibitors of these enzymes.

Hydroxyproline and total protein levels in gingiva and gingival crevicular fluid in patients with juvenile, rapidly progressive, and adult periodontitis

The aim of this study was to compare hydroxyproline (Hyp) and total protein levels both in the gingiva and gingival crevicular fluid (GCF) from juvenile (JP), rapidly progressive (RPP), and adult periodontitis (AP) patients and periodontally healthy controls (C). A total of 60 individuals, 15 from each group, were studied. GCF was obtained before gingival sampling. Clinical measurements were recorded. The gingival samples were harvested by full thickness flap operation from patients and immediately after the extraction of the teeth for orthodontic reasons from controls. The samples were analyzed biochemically. GCF Hyp levels were significantly higher in the AP group than those of the RPP and C groups. The strong positive correlations between gingival and GCF Hyp levels were determined in the disease groups. Total protein levels in both the gingiva and GCF were significantly higher in disease groups. However, the differences between the disease groups were not statistically significant. Correlations between the clinical parameters and Hyp levels in gingiva and GCF were determined. The findings indicate the Hyp and total protein levels both in the gingiva and GCF appeared to be increased in the disease groups. These findings suggest that both the synthesis and degradation of collagen and total protein are elevated in periodontal disease. However, our findings do not support the concept that measurement of either Hyp or total protein levels in gingiva or GCF is a suitable or reliable criterion in determination of disease activity.

Wound healing in the tissues of the periodontium following periradicular surgery. 2. The dissectional wound

Wound healing responses of the tissues of the periodontium following periradicular surgery in rhesus monkeys were evaluated by light microscopy. Part II of this investigation reports the responses of mucoperiosteal and osseous tissues to blunt dissectional wounding resulting from the reflection of triangular or submarginal rectangular flaps. Healing of the dissectional wound is rapid, although slower than the incisional wound. Granulation tissues replaces the fibrin clot in the wound site as early as 4 days after surgery, and is replaced by fibrous connective tissue by 14 days. Minimal differences were found in the temporal and qualitative dissectional wound-healing responses to the two types of flap designs. The periosteum does not survive the flap reflection procedure. The cells of the cambium layer are destroyed and the collagen of the fibrous layer undergoes depolymerization. It is postulated that the depolymerized periosteal collagen plays a role in rapid reattachment of flapped tissues to cortical bone.

Role of fibroblast subpopulations in periodontal physiology and pathology

Fibroblasts are the principal cell type in the soft connective tissues of the periodontium; they perform important functions in development, physiology, and disease. A growing number of reports have indicated site-specific phenotypic variation of fibroblasts. Heterogeneity of metabolic traits has been demonstrated in cells from healthy and diseased tissues. The tissue distribution and relative proportions of fibroblast subpopulations have a significant impact on the regulation of connective tissue function in health and disease.

Immunohistochemical localization of tenascin and fibronectin in the dentine and gingiva of Canis familiaris

Specific, well-characterized antisera to the extracellular matrix glycoprotein tenascin were used. Immunoreactivity was detected in association with dentinal tubules; it was particularly prominent in the tooth crown, and was stronger within matrix than within predentine. In contrast, there was no anti-fibronectin staining in dentinal tubules. In periodontium, anti-tenascin immunoreactivity was stronger in the oral and sulcular gingival epithelia than in the underlying connective tissue, in contrast to the strong staining of connective tissue by anti-fibronectin. The appearance of tenascin immunoreactivity in gingival epithelia indicates that this protein is not exclusively a component of mesenchymal extracellular matrix.

Collagen cross-linking in bovine gingiva

Tissue samples from 5 different sites of 6 bovine mandibles were used to quantify collagen cross-links as moles cross-link per mole of collagen. Gingiva contained primarily 3 reducible cross-links, deH-DHLNL, deH-HHMD, and deH-HLNL, and relatively small amounts of non-reducible cross-links. The cross-link density varied from site to site within the same mandible. DeH-DHLNL showed the most significant increase from anterior to posterior; the content in the retromolar region was 3-fold greater than in the anterior lingual site. Histologically, the posterior samples, especially the retromolar gingiva, contained less mature (thinner) collagen bundles. These findings suggest that the maturity of bovine mandibular gingival collagen varies at different sites.

The role of histopathology in the diagnosis and prognosis of periodontal diseases

The histological evaluation of surgical biopsies from affected tissues is a standard way of assessing pathological change and determining treatment in many diseases. In most forms of periodontal disease, however, this approach finds limited application. Here, we review what uses the histopathological approach has in the study and evaluation of the periodontal diseases. Current understanding of the changes in epithelial anatomy during pocket formation, the cellular composition and dynamics of the inflammatory infiltrate and the mechanisms of bone resorption and repair are reviewed from the perspective of the information available from microscopical investigation, including the uses and potential application of modern immunocytochemical methods to these questions. The usefulness of histological study of biopsy material is reassessed in the light of advances made in immunohistochemical techniques and their application to gingival inflammatory infiltrates and epithelia. Such techniques offer immediately valuable research opportunities with potential for diagnostic applications, noteably the recognition of phases of destructive activity and their differentiation from periods of effective host defence.

The protein composition of gingival crevicular fluid sampled from male adolescents with no destructive periodontitis: baseline data of a longitudinal study

Gingival crevicular fluid (GCF) is a promising source for markers of destructive periodontal diseases activity. As the initial stage of a longitudinal study into the characterization of disease markers, GCF sampled from 104 sites in 74 adolescents was examined via sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS/PAGE). In this population, which had varying degrees of gingivitis but little evidence of destructive periodontitis, there was a highly homologous GCF protein profile. The plasma components, albumin, transferrin and IgG, were major constituents of all samples. In addition, a second group of non-plasma derived proteins, with molecular weights 37 kDa, 47 kDa, 57 kDa and 59 kDa, was also commonly detected. The high frequency of occurrence of these components suggests that they may represent products of normal turnover of the periodontal tissues. Analysis of GCF sampled from patients with progressing destructive disease revealed a different SDS/PAGE profile particularly with respect to proteins of non-plasma origin. It is anticipated that the major metabolic changes which accompany the destruction of the tissues during future disease episodes in the adolescent study population will be discernible as alterations to the GCF protein profile.

Biosynthesis of collagen crosslinks. II. In vivo labelling and stability of lung collagen in rats

Rat lung collagen was labelled in vivo by a single intraperitoneal injection of [3H]lysine at several key timepoints in lung development: days 11 (alveolar proliferation), 26 (start of equilibrated growth), 42 (end of equilibrated growth), and 100 (adult lung structure present). The rates of deposition of labelled hydroxylysine and the difunctional, Schiff base-derived crosslinks hydroxylysinonorleucine (HLNL) and dihydroxylysinonorleucine (DHLNL) were quantified. We also measured total lung content of the trifunctional, mature crosslink hydroxypyridinium (OHP) in these same animals. While the relative rates of accumulation of labelled collagen [3H]hydroxylysine differed by a factor of about 6 at the different times of injection of labelled precursor, quantitative and qualitative patterns of collagen crosslinking were very similar at all of the lung developmental stages studied. Furthermore, there was little or no breakdown of the lung collagen pool as defined by the presence of labelled crosslinks; changes in lung DHLNL content could be completely accounted for by its maturation to OHP, regardless of the age of the rats when injected with the radioactive precursor. We conclude that mature, crosslinked collagen in the lungs of rats, which is obligatorily an extracellular pool, is not being degraded at a measurable rate. Therefore, studies of others that have shown apparent high rates of breakdown of newly synthesized collagen in lungs of whole animals using different methods are probably not reflective of the metabolic fate of total lung collagen, and may indicate that degradation of normal lung collagen occurs predominantly or exclusively intracellularly.

Gingivitis

Gingivitis is caused by substances derived from microbial plaque accumulating at or near the gingival sulcus; all other suspected local and systemic etiologic factors either enhance plaque accumulation or retention, or enhance the susceptibility of the gingival tissue to microbial attack. Microbial species specifically associated with gingival health include Streptococcus sanguis 1, S. D-7, and Fusobacterium naviforme. Bacteria involved in the etiology of gingivitis include specific species of Streptococcus, Fusobacterium, Actinomyces, Veillonella, and Treponema and possibly Bacteroides, Capnocytophaga, and Eikenella. Microbial colonization and participation is sequential, with the complexity of the associated flora increasing with time. The pathogenesis has been separated into the initial, early, and established stages, each with characteristic features. The initial lesion is an acute inflammation which can be induced experimentally by application of extracts of plaque bacteria to normal gingiva. The early lesion is characterized by a lymphoid cell infiltrate predominated by T lymphocytes, characteristic of lesions seen at sites of cell-mediated hypersensitivity reactions. The early lesion can be induced by application of purified contact antigens to the gingival tissues of previously sensitized animals. As the clinical condition worsens, the established lesion appears, predominated by B lymphocytes and plasma cells. Established lesions may remain stable for indefinite periods of time, they may revert, or they may progress. Periodontal destruction does not result from the conversion of a predominantly T cell to a predominantly B cell lesion as has been suggested, but rather from episodes of acute inflammation. Clinical manifestations of gingivitis are episodic phenomena characterized by discontinuous bursts of acute inflammation. Most lesions are transient or persistent but not progressive. Attachment loss may precede alveolar bone loss and may occur without the manifestations of a concurrent or a precursor gingivitis. On the other hand, the evidence indicates that a portion of gingivitis lesions can and does progress to periodontitis. Gingivitis and the periodontal microflora differ in children and adults. Clinical signs of gingivitis either do not appear as plaque accumulates, or they are greatly delayed in children, and the inflammatory infiltrate consists mostly of T lymphocytes. The conversion to a B cell lesion does not appear to occur. The evidence supports the conclusion that gingivitis is a disease, and that control and prevention is a worthwhile goal and a health benefit.(ABSTRACT TRUNCATED AT 400 WORDS)

The effect of alloxan diabetes on prolyl and lysyl hydroxylase activity in uninflamed and inflamed rat gingiva

The influence of diabetes on gingival inflammation was studied through its effect on prolyl and lysyl-hydroxylase activities and on tissue-collagen content. Inflammation induced for 7 days with either endotoxin or antigen-antibody complexes reduced the activity of both enzymes by about 45 per cent, and decreased the concentration of soluble and insoluble collagens. Diabetes alone decreased the enzyme activity by more than 50 per cent but prevented the loss of the soluble and insoluble collagens which occurs during inflammation. The complex interaction of diabetes and inflammation on collagen metabolism in gingival tissue may be explained in part by abnormalities of collagen synthesis; alterations in collagen maturation and degradation, and in leukocyte function, may also occur.

The use of in vitro models for investigating the response of fibrous joints to tensile mechanical stress

To clarify the role of mechanical deformation in the remodeling of fibrous joints, organ culture systems have been developed to apply mechanical stress to cranial sutures under controlled experimental conditions. Tensile mechanical stress applied to cranial sutures from newborn rabbits produces a two- to threefold increase in protein synthesis and a twofold increase in collagen synthesis that can be detected within 6 hours. There is also a threefold increase in the DNA content of the sutures after 48 hours. Under normal conditions sutural fibroblasts synthesize type I collagen but respond to tensile deformation by synthesizing significant amounts of type III collagen. This suggests that the biomechanical environment of a connective tissue cell is an important determinant of the collagen type synthesized. However, the effect is likely to be an indirect one by virtue of its influence on the metabolic activity of the cells. Mechanically activated cells do not preferentially synthesize structural proteins, since mechanical stress stimulates the synthesis not only of structural macromolecules but also of the enzymes responsible for their specific hydrolysis. This is not accompanied by increased degradation, however, perhaps because the metalloproteinase inhibitor TIMP synthesized by the tissues is also increased. Confluent rabbit and mouse periosteal fibroblasts synthesize and release into the culture medium factors that can inhibit bone cell proliferation and stimulate bone resorption in vitro. It seems likely that further investigation of the interaction between fibroblasts and osteoblasts at the bone--fibrous tissue interface will require a reassessment of current thinking concerning the mechanisms regulating sutural osteogenesis.

Extensive degradation of recently synthesized collagen in gingiva of normal and streptozotocin-induced diabetic rats

The degradation of recently synthesized collagen (probably procollagen) in rat incisor gingiva was three times greater than that in skin. Concomitantly, the formation of undegraded (intact) collagen molecules in gingiva was slower than that in skin. This high basal rate of degradation in gingiva was just slightly increased in streptozotocin-induced diabetic rats, whereas the low basal rate in skin was dramatically increased by the diabetic state. The degradation of recently synthesized collagen was measured by the relative amounts(%) of [3H]hydroxyproline-containing material in the TCA-soluble fraction of a tissue, compared with the total amount (TCA-soluble + TCA-insoluble) of [3H]hydroxyproline-containing material. Separation of the TCA fractions allowed the formation of collagen degradation products (TCA-soluble) to be viewed separately from the formation of undegraded collagen molecules (TCA-insoluble). The [3H]hydroxyproline-containing material in the TCA-soluble fraction was greatest in amount and in specific activity, 30 min after [3H] proline injection, supporting the origin of this material as being procollagen. At this time period, the relative amounts of TCA-soluble [3H]hydroxyproline-containing material were 40.3% (gingiva) and 12.7% (skin). For diabetic rats, the values were 55% and 48.8%, respectively. For the [3H]hydroxyproline-containing material in the TCA-insoluble fraction, at 30 min, the specific activity of [3H]hydroxyproline was 4.3 for gingiva and 7.4 for skin. At all other time periods, the values were also greater for skin than for gingiva, making it unlikely that the formation of intact collagen molecules occurred faster in gingiva than in skin.(ABSTRACT TRUNCATED AT 250 WORDS)

Autoradiographic and cytochemical studies of phagocytic cells in selected fibre tracts of the mouse periodontium

Proliferative and protein synthetic activities of phagocytic cells of specific fibre tracts of the periodontium of C57Bl mice were employing autoradiographic techniques; these were combined with a histochemical technique for horseradish peroxidase (HRP) as a marker for phagocytic activity. Animals were injected either with [3H]thymidine as a marker for proliferative activity, or with [3H]proline as a marker for protein synthetic activity prior to HRP injection. Blocks from the maxillae of experimental and control animals were fixed, decalcified, and sectioned at 50 micrometers. These were incubated with HRP localization media, dehydrated and flat embedded in Epon 812 wafers. The entire length of the periodontium, including adjacent tooth and bone, were selectively cut from the wafers, mounted on epoxy blocks and serially sectioned at 2 micrometers. Slides containing these sections were then dipped in NTB-3 nuclear track emulsion, and after appropriate exposure times, were developed and post-stained. Sections were examined microscopically, employing an ocular grid, and phagocytic cells within each area examined were delineated as either 'fibroblast-like' (FL cells) or 'endothelial/macrophage-like' (EML cells) according to criteria such as morphology, location, orientation and proximity to a vascular channel. They were then subclassified as labelled or unlabelled with respect to the autoradiographic markers. The thymidine labelling index obtained for non-phagocytic FL cells was 3.09%; this was more than twice that for phagocytic FL cells (1.35%). Similarly phagocytic FL cells in all regions studied incorporated less than half as much [3H]proline as did their non-phagocytic counterparts. This was determined by silver grain counts over HRP-stained and unstained cells using a matched pair system. In addition, the variation of the relative number of phagocytic FL cells in specific fibre tracts suggested a relationship to functional demand. The distribution of these cells was closely related to experimentally determined rates of protein turnover. Phagocytic FL cells have a markedly reduced proliferative rate and synthesize proline-containing proteins at a reduced rate. This may reflect protein production primarily for the purpose of cell maintenance. These findings are consistent with the presence of subpopulations of fibroblasts (or fibrocytes) developmentally or functionally modified for phagocytosis; alternatively, this could signify modulation of fibroblasts from primarily biosynthetic activities to degradative functions in response to varying microenvironmental conditions.

Evidence that healthy human gingiva contains functionally heterogeneous fibroblast subpopulations

Six mass cultures of human fibroblasts derived from a single biopsy of a normal gingival papilla tip were studied with regard to their protein, collagen and glycosaminoglycan synthesis in vitro, using incorporation of radiolabelled substances. The proliferation rates, replicative life-spans and cell-size distributions of these mass cultures were determined. There were significant differences among the 6 cultures and these differences persisted throughout numerous cell replications in vitro. It is suggested that functional heterogeneity exists among phenotypically stable fibroblast subpopulations or subpopulation mixtures from normal tissue. The concept of participation of fibroblast subpopulations in disease pathogenesis is supported by these preliminary findings.

Collagen fibril diameter and its relation to collagen turnover in three soft connective tissues in the rat

Collagen fibril diameters were measured in electron micrographs of rat skin, gingiva and periodontal ligament. Gingiva was divided into two zones, termed elastin-containing gingiva and attached gingiva, depending on the presence or absence of elastic fibrils. The results revealed that skin had the largest fibrils, followed by elastin-containing gingiva, attached gingiva and periodontal ligament respectively. These differences in fibril diameter were highly significant. The observed trend in fibril diameter was the inverse of that documented for collagen turnover and collagen phagocytosis in the same tissues. A link between fibril diameter and collagen turnover is discussed.

Evidence for production of an inactive collagenase by fibroblasts from phenytoin-enlarged human gingivae

When measured by radioimmunoassay, fibroblasts derived from the overgrown gingivae of phenytoin-treated epileptic individuals synthesize and release elevated amounts of collagenase in vitro, as compared to similar-appearing fibroblasts from normal, non-phenytoin-treated persons. However, it appears that much of the immunoreactive enzyme is unable to degrade reconstituted collagen in culture. This preliminary finding in 9 different strains of cells indicates that reduced collagenase activity by a subpopulation of cells may contribute to the development of phenytoin-induced gingival overgrowth.

Crosslink analysis as an indicator of collagen turnover in periodontal ligament from functioning and non-functioning teeth in the dog

The assay of transiently-occurring reducible collagen crosslinks was used as an indication of collagen turnover in the periodontium from individual teeth. A tooth was removed on one side of the jaw to relieve the antagonist tooth of all occlusal forces. This did not influence the very high rate of collagen turnover observed in periodontal ligaments. It is concluded that this high rate of turnover is an intrinsic property of the tissue and is uninfluenced by occlusal or eruptive forces.

Rabbit cranial suture fibroblasts under tension express a different collagen phenotype

We present evidence that cells in fibrous joints respond to tensile mechanical stress by synthesizing significant quantities of type III collagen. Under normal conditions sutural fibroblasts synthesize type I collagen. Type III comprised some 20 per cent of the newly synthesized collagen in stressed joints, a level that was achieved within 24 h of the onset of tension and remained unchanged throughout a 4-day experimental period. These findings suggest that the biomechanical environment of a connective tissue cell is an important determinant of the type of collagen synthesized. However, we propose that the effect is likely to be an indirect one by virtue of its influence on the metabolic activity of the cells.

Characterization of collagens of diseased human gingiva

In the gingiva and other connective tissues, alteration in the collagens is primarily responsible for their functional impairment during disease. To study the collagen alterations, we extracted diseased human gingival tissue with neutral and acidic solvents and then with pepsin. The pepsin extract was separated into proteins soluble in 2.5 and 1.5 M NaCl and proteins insoluble in 1.5 M NaCl. By the criteria of solubility behavior in NaCl solutions, elution from (carboxymethyl)cellulose (CM-cellulose) columns, sodium dodecyl sulfate (NaDodSO4)-polyacrylamide gel electrophoresis, CNBr peptide pattern, and amino acid composition, the collagens of acidic and neutral solvent extracts and 1.5 M soluble fraction of pepsin extract were characterized as type I collagen and the 1.5 M NaCl insoluble collagen as type III. The 2.5 M NaCl fraction contained alpha 2, A, and B chains. The alpha 1 chains resembled alpha 1[I] in amino acid composition, and, since alpha 2 chains were lacking, it appeared that these chains derived from type I trimer collagen. The A and B chains were purified from the 2.5 M NaCl fractions by salting out at acidic pH. The final (A plus B) chain fraction was resolved into two major and one minor protein peaks by phosphocellulose chromatography. The major peaks were characterized as A and B chains on the basis of amino acid composition and CNBr peptide patterns. The minor peak had electrophoretic mobility slightly less than B chains, and the amino acid composition was different. Analysis of the proportion of different collagen types extracted indicated that type III collagen, which is the second major fraction in other connective tissues, is only a minor constituent in the gingiva. More interestingly, A and B chains accounted for a greater proportion than type III. Unlike the fibroblast cultures, the type I trimer formed only a small proportion of collagens of diseased gingival tissue.

Radiochemical determination of the metabolic activity of collagen in mature dentin

Tritiated proline was administered to domestic cats during the development of their permanent premolars. The metabolic activity of collagen in the mature premolar dentin was determined by quantitating the amount of tritiated hydroxyproline in the dentin as a function of time. It has been demonstrated that the metabolic activity of the dentinal collagen was extremely low and remained within the experimental error for a period of 45 weeks.

Rabbit cranial sutures in vitro: a new experimental model for studying the response of fibrous joints to mechanical stress

An organ culture system has been developed whereby mechanical stress can be applied to cranial sutures under controlled experimental conditions. The application of a continuous tensile mechanical stress (30 g) to cranial sutures from newborn rabbits (1--2 days) was accompanied by a significant increase in the incorporation of 3H-leucine and 3H-proline into suture protein. The specific activities of 3H-hydroxyproline indicated that mechanical stress produced a two-fold increase in the incorporation of 3H-proline into collagen. However, the proportion of the total radioactivity recoverable in collagen (45.63 +/- 2.33% for nonstressed; 40.58 +/- 2.17% for stressed sutures) was not significantly different. These data suggest that the increase in collagen synthesis occurs as part of a general stimulation of protein synthesis, and do not support the view that mechanical stress is the principal mechanism regulating the turnover of collagen in fibrous joints. These initial studies demonstrate that an in vitro experimental model has considerable potential for investigating the morphological and metabolic response of fibrous joints to mechanical deformation.

Metabolism of gingival collagen in a rat

The remodeling of gingival tissue was measured by determining the incorporation of tritiated proline and the disappearance of tritium activity from proline and hydroxyproline for 18 days after administration of label. There was a rapid decrease in the tritium activity from gingiva which was paralleled by a decrease in the total activity of proline. The activity in collagen decreased sharply between the second and the fourth day but thereafter there was no change. The relative amount of activity increased from 24% at day 2 to 82% at 18 days postinjection, and as a result the specific activities of hydroxyproline and proline were similar after 12 days. Thus collagen appeared to be the more stable component in the gingivae than previously reported. However, the rapid loss of label in the first four days suggested that there may be very marked regional variation in the metabolism of collagen and that more than one metabolic pool of collagen was present.

A new approach to assessing collagen turnover by using a micro-assay. A highly efficient and rapid turnover of collagen in rat periodontal tissues

Measurement of [3H]proline incorporation into newly synthesized and mature collagen in connective tissues was used to compare rates and efficiency of collagen turnover. The approach minimizes label-recycling problems. By using a micro-assay to determine hydroxyproline specific radioactivities, a highly efficient and rapid collagen turnover in rat periodontal tissues was demonstrated.

Diphenylhydantoin (dilantin) gingival hyperplasia: drug-induced abnormality of connective tissue

Various degrees of gingival overgrowth may occur in individuals taking diphenylhydantoin, a drug used widely in the treatment of epilepsy. The tissue overgrowth is made up predominantly of collagen, and may therefore be a useful model for analysis of fibrosis and some other connective tissue abnormalities. Fibroblasts derived from the overgrown tissue exhibit a level of protein synthetic activity approximately twice that of comparable cells obtained from nonepileptic control individuals and from the gingiva of age-matched epileptics taking the drug but not exhibiting gingival enlargement. In addition, 20% of the protein synthesized by cells from the affected tissue is collagen, whereas collagen accounts for only about 11% of the total protein produced by control cells of both types. The drug appears to induce or select for fibroblasts characterized by enhanced levels of protein synthesis and collagen production. This alteration persists through several cell replications in vitro in the absence of drug.

Collagen resorption by fibroblasts. A theory of fibroblastic maintenance of the periodontal ligament

Periodontal ligament fibroblasts contain numerous intracellular or cytosegragated collagen fibrils. These fibrils appear to be broken down within the lysosomal apparatus of the cells. There is an increase in this activity in fibroblasts associated with osteoclastic bone resorption. Cytoplasmic microfilaments and attachments to substrata indicate that the fibroblasts of the ligament have the potential of migration and cytoplasmic contraction. A theory of collagen fiber maintenance within the periodontal ligament is proposed which takes into account: (1) the motility and contractility of fibroblasts, (2) the phagocytic and degradative potential of fibroblasts, (3) the presence of intracellular collagen and (4) the reported high turnover rate of acid-insoluble collagen within the periodontium.