Salivary IgA responses to Porphyromonas gingivalis in the cynomolgus monkey. 1. Total IgA and IgA antibody levels to P. gingivalis

Oral microbiome interactions with gingival gene expression patterns for apoptosis, autophagy and hypoxia pathways in progressing periodontitis

Oral mucosal tissues must react with and respond to microbes comprising the oral microbiome ecology. This study examined the interaction of the microbiome with transcriptomic footprints of apoptosis, autophagy and hypoxia pathways during periodontitis. Adult Macaca mulatta (n = 18; 12-23 years of age) exhibiting a healthy periodontium at baseline were used to induce progressing periodontitis through ligature placement around premolar/molar teeth. Gingival tissue samples collected at baseline, 0·5, 1 and 3 months of disease and at 5 months for disease resolution were analysed via microarray. Bacterial samples were collected at identical sites to the host tissues and analysed using MiSeq. Significant changes in apoptosis and hypoxia gene expression occurred with initiation of disease, while autophagy gene changes generally emerged later in disease progression samples. These interlinked pathways contributing to cellular homeostasis showed significant correlations between altered gene expression profiles in apoptosis, autophagy and hypoxia with groups of genes correlated in different directions across health and disease samples. Bacterial complexes were identified that correlated significantly with profiles of host genes in health, disease and resolution for each pathway. These relationships were more robust in health and resolution samples, with less bacterial complex diversity during disease. Using these pathways as cellular responses to stress in the local periodontal environment, the data are consistent with the concept of dysbiosis at the functional genomics level. It appears that the same bacteria in a healthy microbiome may be interfacing with host cells differently than in a disease lesion site and contributing to the tissue destructive processes.

Salivary IgA in response to periodontal treatment

There is evidence that the quantity of antigen load is crucial for the activation of IgA immune responses. In order to investigate the relevance of these findings in aggressive periodontitis, salivary antibody responses were measured during non-surgical and antibiotic treatment. Twenty-one patients with generalized aggressive periodontitis were monitored for total salivary IgA and IgA reactive to Porphyromonas gingivalis in resting and stimulated whole saliva. Non-surgical treatment included full-mouth professional tooth cleaning and subgingival scaling and root planing (SRP) under local anesthesia. Patients were recalled at 3 months and 6 months following systemic antibiotic treatment. Non-parametric statistics showed significant improvements in the clinical parameters in all patients. Between baseline and 4 wk following SRP, median concentrations of total IgA decreased both in resting (-46%) and in stimulated (-33%) saliva. The P. gingivalis-specific IgA activity showed a twofold increase at 4 wk after SRP. In addition to these changes, periodontal treatment of aggressive periodontitis did not appear to affect salivary IgA, and there were no significant correlations of IgA to the clinical parameters. In conclusion, salivary IgA responses during periodontal treatment were not found to have a diagnostic or prognostic significance.

Effect of host responses on the pathogenicity of strains of Porphyromonas gingivalis

Porphyromonas gingivalis is implicated in the etiology of periodontitis. Strains of P. gingivalis have been classified as invasive or noninvasive based on their ability to form abscesses in a mouse model. The purpose of this study was to investigate the ability of P. gingivalis strains to cause abscesses and periodontal bone loss in an experimental rat model and the effect of serum and salivary responses on the pathogenicity of these strains. Subcutaneous injection of animals with P. gingivalis 33277, A7A1-28, W50 or 381 resulted in abscesses in a higher percentage of mice than rats. P. gingivalis 33277 caused lesions at the site of injection, whereas strains A7A1-28 and W50 induced abscesses at distant sites in both mice and rats. Local lesions were seen in rats injected with strain 381, whereas lesions formed distant from the site of injection in mice. When periodontal bone loss was assessed in the experimental rat model, animals challenged with 33277 had the highest amount of horizontal and vertical bone loss. Rats challenged with strain A7A1-28, W50 or 381 had some or no periodontal bone loss compared with controls. Assessment of antibody responses to P. gingivalis in these animals revealed that rats challenged with 33277 had lower levels of serum immunoglobulin G-(IgG) and especially salivary IgA antibody activity than A7A1-28-challenged rats. Serum IgG and in particular salivary IgA anti-P. gingivalis responses were seen in W50- and 381-challenged rats. These results indicate that the ability of P. gingivalis strains to cause abscesses does not relate directly to their periodontal pathogenicity as assessed by periodontal bone loss in the same animal model. The results further suggest the importance of salivary IgA antibody responses in protection against experimental periodontal bone loss after challenge with P. gingivalis.

Systemic antibody responses to oral microorganisms in the cynomolgus monkey: development of methodology and longitudinal responses during ligature-induced disease

Systemic antibody responses to oral microorganisms were studied during ligature-induced periodontal disease in a non-human primate (Nhp) model. Methodology was developed using ELISA techniques to assess total IgG and IgM levels in the serum from the Nhp. In addition, an ELISA was developed utilizing affinity-purified anti-human isotype reagents to detect Nhp serum antibody responses to Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Prevotella intermedia and Fusobacterium nucleatum. Results showed that the anti-human reagents detected IgG and IgM from Macaca fascicularis with an efficiency of 25-35% and 50-60%, respectively. Following ligation, groups of Nhp were treated with an immunomodulator ("Thymopentin", TP5) or placebo to examine the effect of the T-cell stimulating agent on periodontitis and host responses. No differences were noted in total serum IgG and IgM levels for individual Nhp or between groups when baseline, ligation and treatment intervals were compared. However, following ligation, 8/12 Nhp exhibited significant increases in IgG and/or IgM antibody to P. gingivalis that were coincident with increases in the percentage of this microorganism in the subgingival plaque from the ligated sites. During the treatment phase, the antibody levels in the placebo group continued to increase, while the levels in the TP5-treated group stabilized. The findings in this study indicate that the emergence of a microorganism in the subgingival plaque (P. gingivalis) during the conversion from gingivitis to progressing periodontitis in the Nhp, elicits a systemic antibody response that is specific for the microorganism.