Ultrastructural evidence of large granular lymphocyte (LGL) activity in lesions of chronic adult periodontitis

Citation classics in periodontology: a controlled study

AIM

The aims of this study were to identify the most cited articles in Periodontology published from January 1990 to March 2005; and to analyse the differences between citation Classics and less cited articles.

MATERIAL AND METHODS

The search was carried out in four international periodontal journals: Journal of Periodontology, Journal of Clinical Periodontology, International Journal of Periodontics and Restorative Dentistry and Journal of Periodontal Research. The Classics, that are articles cited at least 100 times, were identified using the Science Citation Index database. From every issue of the journals that contained a Classic, another article was randomly selected and used as a Control.

RESULTS

Fifty-five Classics and 55 Controls were identified. Classic articles were longer, used more images, had more authors, and contained more self-references than Controls. Moreover Classics had on the average a bigger sample size, often dealt with etiopathogenesis and prognosis, but were rarely controlled or randomized studies.

CONCLUSIONS

Classic articles play an instructive role, but are often non-Controlled studies.

Relevance of Fc gamma RIIIa-158V-F polymorphism to recurrence of adult periodontitis in Japanese patients

The immunoglobulin receptor Fc gamma RIIIa (CD16) is distributed on natural killer (NK) cells, macrophages, and gamma delta T cells, and is polymorphic. Fc gamma RIIIa-158V has a higher affinity for both monomeric and immune complexed IgG1, IgG3, and IgG4 than IIIa-158F. We determined Fc gamma RIIIa-158V/F genotypes of Japanese patients with adult periodontitis. A significant over-representation of Fc gamma RIIIa-158F was found in patients with recurrence, compared with patients without recurrence, making Fc gamma RIIIA a candidate gene for recurrence risk of adult periodontitis.

Cell-mediated immune system regulation in periodontal diseases

The adaptive immune system consists of humoral and cell-mediated immunity. T-lymphocytes are the key components of cell-mediated immunity. CD4+ helper T-lymphocytes facilitate B-cells to differentiate and produce specific antibodies, whereas CD8+ cytotoxic T-lymphocytes kill virally infected cells. Periodontal diseases have been associated with a variety of imbalances in the regulation of immune responses. Changes in the ratios of peripheral blood CD4+ and CD8+ T-lymphocytes, depressed proliferative responses of peripheral blood lymphocytes, and increased frequency of CD45RO+ memory T-lymphocytes in diseased tissues have been reported in individuals with various forms of periodontal disease. While some studies have shown an increased frequency of gamma delta + T-cells in periodontal lesions, the role of gamma delta + T-cells in periodontal disease remains controversial. The ability of putative periodontopathic bacteria selectively to stimulate certain V beta-expressing T-cells is intriguing and could determine whether a CD4+ Th1 or a CD4+ Th2 cell response is elicited. The prominence of a particular subset of helper T-cells within the periodontal lesion could be a reflection of the stage and activity of the disease, or the types of bacteria present. Regardless, longitudinal studies of the involvement of T-cell subsets and cytokines in periodontal disease are clearly needed.

Extracts of periodontopathic microorganisms lack functional superantigenic activity for murine T cells

Products of periodontopathic bacteria exert immunomodulatory effects on various lymphoid cell populations, some of which have been implicated in the pathogenesis of periodontitis. It has recently been suggested that some of these bacterial products may possess superantigenic (SAg) activity. SAg bind simultaneously to the V beta chain of T cell receptors and to class II major histocompatibility complex molecules, thereby activating as many as 35% of T cells to proliferate and produce cytokines. In order to examine this question, the proliferation of splenic and thymic T cells from immunologically naive, 3-6-wk-old Balb/c (H-2d), C57BL/6 (H-2b) and C3H/HeJ (H-2k) mice was assessed in response to sonic extracts of periodontopathogens. Laboratory and/or reference strains of a.o. Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia and Prevotella nigrescens were used as stimulants. Staphylococcal enterotoxin B (SEB), a known superantigen, was utilized as a positive control. Unfractionated spleen cells responded to several of the tested preparations of the different bacteria, as well as to SEB, Con A and Escherichia coli LPS. Thymocytes responded to Con A and SEB, but not to LPS or to any sonic extract. Spleen cells depleted of B cells by panning responded to SEB and Con A, but not to LPS and showed a reduced response to sonicates. The residual response of B cell-depleted spleen cells was reduced essentially to background by treatment with anti-Thy 1.2 + C'. Similar results were obtained in the presence of 5% added mitomycin-treated antigen presenting cells, indicating that these cells were not limiting. These results demonstrate that extracts of periodontopathic bacteria do not stimulate murine T cells in a manner consistent with superantigenic activation.

Presence of natural killer cells in human chronic periapical lesions

Natural killer (NK) cells are lymphoid in nature and appear to kill target cells (neoplastic and virus-infected cells) without apparent prior immunization. Ten human chronic periapical lesions were examined for the presence of these cells. The lesions were collected, frozen in liquid nitrogen, and sectioned. They were then stained with an indirect immunoperoxidase procedure for the presence of human NK cells. Human tonsils and human periapical scar tissue were used as positive and negative controls. The results showed absence of NK cells in scar tissue and the presence of NK cells in tonsils and all samples of human periapical lesions. NK cells may play a defensive role in controlling root canal infections or, possibly, a role in its pathogenesis.

Distribution of natural killer cells in periodontal diseases: an immunohistochemical study

We studied the distribution and incidence of natural killer (NK) cells in gingiva affected with adult periodontitis (AP) and rapidly progressive periodontitis (RP) with immunohistochemical methods using antibodies Leu-7 and Leu-11b. The incidence of Leu-7 positive cells revealed no significant difference among mild AP, severe AP, and RP. On the other hand, Leu-11b positive cells were frequently found in severe AP and RP. The accumulation of NK cells reacting with Leu-11b in the infiltrated connective tissue was greater in severe forms of periodontal disease (severe AP and RP) than in mild AP. These results suggest that Leu-11b positive NK cells may play a role in the destruction of tissues in periodontal diseases.

Immunologic mechanisms of pathogenesis in periodontal diseases: an assessment

Principal lines of evidence that immune reactions are central to the pathogenesis of periodontitis are reviewed. Necessary components of immunologic reactions are present in gingiva in the periodontal diseases. Differences between healthy and periodontitis patients with respect to some measures of immune function further indicate that immune reactions do occur in the gingiva during periodontitis. They are probably responsible for at least some of the destruction of connective tissue and bone that occurs. Classical antibody-mediated hypersensitivity reactions probably do not provide the reasons. Mechanisms are more likely to be found in the pro-inflammatory and tissue-degrading effects of cytokines released in host-protective, antigen-specific and polyclonal responses to oral bacterial constituents or products. Some evidence suggests that limitation of clinical destruction in localized early onset periodontitis (JP) may in part be a function of a protective antibody response which develops after an initial rapidly progressive infection. A relatively deficient immune responsiveness may allow progression to more severe and generalized disease (RPP). Suggestions are made for studies needed to confirm suspected pathogenetic mechanisms, approach resultant targeted therapies, and test hypotheses for contrasting roles of immune reactions in different clinical expressions of periodontitis.