Combined abnormality of neutrophil chemotaxis and bactericidal activity in a child with chronic skin infections

Neutrophil function and oral disease

The pathological sequela of reduced neutrophil function in the oral cavity and the mechanisms behind dysfunction have added to our understanding of infectious diseases. Numerous examples have been given, and the overriding conclusion must be that any impairment of neutrophil function will lead to some degree of increased susceptibility to infection. Perhaps the tissue most sensitive to pathological changes in the oral cavity is the periodontium. In cases of severe neutrophil dysfunction, there is severe periodontal breakdown, but also in cases of "mild" neutrophil dysfunction, where there is no other infection, such as in individuals with LJP, there is severe periodontal breakdown. The molecular basis of neutrophil dysfunction is beginning to be understood in individuals with LJP, LAD, CGD, and AIDS. It is our hope that further research in this area will help to delineate the pathogenesis of these and other oral diseases.

Effects of levamisole on experimental periodontitis

Although the chemotaxis and efflux of functionally normal polymorphonuclear leukocytes (PMN) into the periodontal sulcus may have a protective role in periodontitis, these cells are also associated with periodontal tissue destruction. The immunomodulating agent, levamisole hydrochloride, is known to enhance PMN chemotaxis. The present study was designed to evaluate the effects of enhanced PMN chemotaxis on the tissue destruction associated with an experimental periodontitis. Levamisole was administered by oro-gastric intubation to 4 squirrel monkeys (experimental) at 3 mg/kg/bw every 2 days for 18 days. After 2 doses of levamisole, marginal periodontitis was induced around maxillary and mandibular bicuspids and the maxillary first molars by tying plaque-retentive ligatures at the gingival margins. Periodontitis was induced around corresponding teeth in 4 animals (control) which had not received levamisole. All animals were killed 2 weeks after induction of periodontitis. Clinically, gingival inflammation was more pronounced in experimental animals at both 7 and 14 days after periodontitis induction. The progression of periodontitis was evaluated histometrically and alterations in the cell populations characterized using step serial sections. The results were analyzed statistically. No significant differences were observed between the groups with respect to areas of infiltrated supracrestal connective tissue and total numbers of cells present, loss of connective tissue attachment and loss of coronal alveolar bone. However, in experimental specimens, a much denser band of inflammatory cells was evident between the apical extent of the bacterial plaque and the gingival sulcular tissues the connective tissue of which contained significantly fewer inflammatory cells and demonstrated more pronounced fibrogenesis.(ABSTRACT TRUNCATED AT 250 WORDS)

Heterogeneous mutations in the beta subunit common to the LFA-1, Mac-1, and p150,95 glycoproteins cause leukocyte adhesion deficiency

Leukocyte adhesion deficiency (LAD) is a heritable disease involving deficient expression of three related leukocyte adhesion glycoproteins: LFA-1, Mac-1, and p150,95. These proteins are alpha beta heterodimers containing identical 95,000 dalton beta subunits. Here we demonstrate that the primary defect in LAD is in the beta subunit gene. We identified five distinct beta subunit phenotypes in LAD patients: undetectable beta subunit mRNA and protein precursor; low levels of beta subunit mRNA and precursor; an aberrantly large beta subunit precursor, probably due to an extra glycosylation site; an aberrantly small precursor; and a grossly normal precursor. Mutant beta subunit precursors from LAD patients failed to associate with the LFA-1 alpha subunit. In family studies, inheritance of the aberrant precursors correlates with the known inheritance of the LAD defect.

Neutrophil function and oral disease

The pathologic sequela of reduced neutrophil function have been reviewed. In each case, the mechanism for the reduction in function has been elaborated when known. Special emphasis has been placed upon the pathologic changes in the oral cavity as a result of neutrophil dysfunction. Numerous examples have been given, and the overriding conclusion must be that any impairment of neutrophil function will lead to some degree of increased susceptibility to infection. Perhaps the tissue most sensitive to pathologic changes in the oral cavity is the periodontium. In cases of severe neutrophil dysfunction there is severe periodontal breakdown. But also in cases of "mild" neutrophil dysfunction, where there is no other infection, such as in individuals with LJP, there is severe periodontal breakdown. The molecular basis of neutrophil dysfunction is beginning to be understood in individuals with LJP. It is our hope that further research in this area will help to delineate the pathogenesis of periodontal diseases.

Neutrophil receptor modulation in the pathogenesis of periodontal diseases

The role of the neutrophil as a primary protective cell in the pathogenesis of periodontal disease has been well established. In this paper, the role of receptor modulation on the neutrophil surface is discussed as a possible mechanism for neutrophil functional abnormalities. Using localized juvenile periodontitis (LJP) as a model, the direct inhibition of neutrophils by bacterial products is discussed as a possible mechanism for local neutrophil dysfunction. In both disease processes, neutrophil receptor modulation plays a central role.