Immunohistochemical study of types I, III and IV collagen in fibrosis of diseased gingiva during chronic periodontitis: a light and electron microscopic study

Macrophage Polarization in Chronic Inflammatory Diseases: Killers or Builders?

Macrophages are key cellular components of the innate immunity, acting as the main player in the first-line defence against the pathogens and modulating homeostatic and inflammatory responses. Plasticity is a major feature of macrophages resulting in extreme heterogeneity both in normal and in pathological conditions. Macrophages are not homogenous, and they are generally categorized into two broad but distinct subsets as either classically activated (M1) or alternatively activated (M2). However, macrophages represent a continuum of highly plastic effector cells, resembling a spectrum of diverse phenotype states. Induction of specific macrophage functions is closely related to the surrounding environment that acts as a relevant orchestrator of macrophage functions. This phenomenon, termed polarization, results from cell/cell, cell/molecule interaction, governing macrophage functionality within the hosting tissues. Here, we summarized relevant cellular and molecular mechanisms driving macrophage polarization in "distant" pathological conditions, such as cancer, type 2 diabetes, atherosclerosis, and periodontitis that share macrophage-driven inflammation as a key feature, playing their dual role as killers (M1-like) and/or builders (M2-like). We also dissect the physio/pathological consequences related to macrophage polarization within selected chronic inflammatory diseases, placing polarized macrophages as a relevant hallmark, putative biomarkers, and possible target for prevention/therapy.

Macrophage Polarization in Chronic Inflammatory Diseases: Killers or Builders?

Macrophages are key cellular components of the innate immunity, acting as the main player in the first-line defence against the pathogens and modulating homeostatic and inflammatory responses. Plasticity is a major feature of macrophages resulting in extreme heterogeneity both in normal and in pathological conditions. Macrophages are not homogenous, and they are generally categorized into two broad but distinct subsets as either classically activated (M1) or alternatively activated (M2). However, macrophages represent a continuum of highly plastic effector cells, resembling a spectrum of diverse phenotype states. Induction of specific macrophage functions is closely related to the surrounding environment that acts as a relevant orchestrator of macrophage functions. This phenomenon, termed polarization, results from cell/cell, cell/molecule interaction, governing macrophage functionality within the hosting tissues. Here, we summarized relevant cellular and molecular mechanisms driving macrophage polarization in “distant” pathological conditions, such as cancer, type 2 diabetes, atherosclerosis, and periodontitis that share macrophage-driven inflammation as a key feature, playing their dual role as killers (M1-like) and/or builders (M2-like). We also dissect the physio/pathological consequences related to macrophage polarization within selected chronic inflammatory diseases, placing polarized macrophages as a relevant hallmark, putative biomarkers, and possible target for prevention/therapy.

Porphyromonas gingivalis lipopolysaccharide weakly activates M1 and M2 polarized mouse macrophages but induces inflammatory cytokines

Porphyromonas gingivalis is associated with chronic periodontitis, an inflammatory disease of the tooth's supporting tissues. Macrophages are important in chronic inflammatory conditions, infiltrating tissue and becoming polarized to an M1 or M2 phenotype. As responses to stimuli differ between these phenotypes, we investigated the effect of P. gingivalis lipopolysaccharide (LPS) on M1 and M2 macrophages. M1 and M2 polarized macrophages were produced from murine bone marrow macrophages (BMMϕ) primed with gamma interferon (IFN-γ) or interleukin-4 (IL-4), respectively, and incubated with a low or high dose of P. gingivalis LPS or control TLR2 and TLR4 ligands. In M1-Mϕ, the high dose of P. gingivalis LPS (10 μg/ml) significantly increased the expression of CD40, CD86, inducible nitric oxide synthase, and nitric oxide secretion. The low dose of P. gingivalis LPS (10 ng/ml) did not induce costimulatory or antibacterial molecules but did increase the secretion of IL-1α, IL-6, IL-12p40, IL-12p70, and tumor necrosis factor alpha (TNF-α). P. gingivalis LPS marginally increased the expression of CD206 and YM-1, but it did enhance arginase expression by M2-Mϕ. Furthermore, the secretion of the chemokines KC, RANTES, eotaxin, and MCP-1 from M1, M2, and nonpolarized Mϕ was enhanced by P. gingivalis LPS. TLR2/4 knockout macrophages combined with the TLR activation assays indicated that TLR2 is the main activating receptor for P. gingivalis LPS and whole cells. In conclusion, although P. gingivalis LPS weakly activated M1-Mϕ or M2-Mϕ compared to control TLR ligands, it induced the secretion of inflammatory cytokines, particularly TNF-α from M1-Mϕ and IL-10 from M2-Mϕ, as well as chemotactic chemokines from polarized macrophages.

The scarring processes in mucosal tissues after immune injury

OBJECTIVES

An important feature of the healing processes is scar formation which may be necessary for organism survival. If it proceeds to the pathological state, it may impair normal function. The purpose of this review is to focus on some of the factors that may influence this process after immune injury, comparing it in the skin and mucosa.

METHODS

A detailed literature search of peer-reviewed journals was conducted. Studies reported in all languages considered relevant and important were used, including humans, animals, and tissue culture.

RESULTS

Analysis of the data indicate that the scarring process is mainly dependent on (1) the type of the lesion, (2) the cause and duration of injury, and (3) the tissue involved and its microenvironment. Equally important is the large spectrum and heterogenicity in the biological activity of fibroblasts and their role in scar formation.

CONCLUSIONS

The process of scar formation is complex and multistep process and is affected and influenced by local and systemic factors. Although it appears irreversible, there are pharmacological agents available, and under investigation, that may minimize its detrimental effects.

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.

Effect of periodontal disease ("broken mouth") on the distribution of matrix macromolecules in the sheep periodontium

A topographical, biochemical analysis of the soft connective tissues of sheep periodontia diagnosed clinically as showing periodontitis was carried out and compared with healthy periodontal tissue. Protein content was mapped on a site-to-site basis and compared with the distribution of collagen for both healthy and diseased tissue using amino acid analysis. Diseased tissue was more biochemically homogeneous than corresponding healthy tissue. Protein content per cent was in general greater but collagen content was greatly reduced. Tissue adjacent to radicular cementum appeared to be most markedly affected by the disease process. The apparent selective loss of non-proteinaceous components along with loss of collagen attachment may explain the direction in which periodontal disease is propagated through the tissue.

Altered distribution of type I collagen mRNA in periodontal disease

Earlier studies on collagen metabolism in the periodontium have suggested that periodontal disease is associated with reduced amounts of type I collagen in the pocket walls, and with an overall increase in collagen synthesis. In this study we analyzed gingival biopsies of patients suffering from adult type chronic periodontal disease by in situ hybridization, which permitted localization of fibroblasts containing different amounts of proa(I) collagen mRNA. The results showed that expression of type I collagen mRNA is reduced in the vicinity of periodontal pockets and dental plaque. Deeper in the connective tissue, high levels of proa(I) collagen mRNA were observed particularly around inflammatory cell infiltrates which may contribute to the fibrotic reaction observed. In all areas studied the levels of type I collagen mRNA in periodontal fibroblasts varied considerably, supporting previous views about their heterogeneity.

Site-specific variations in the biochemical composition of healthy sheep periodontium

A topographical biochemical analysis of the periodontal soft tissues was carried out. The protein distribution in the tooth-supporting structures was determined from site by amino acid analysis and was compared with the collagen distribution in tissue protein, based upon hydroxyproline content. The biochemical composition of the periodontal ligament was heterogeneous but some specific patterns of protein and collagen distribution emerged. Protein concentration was highest at the gingival epithelium and adjacent to the cementum. Collagen concentrations were highest at the alveolar bone and below the junctional epithelium adjacent to the tooth. Such patterns may influence the way in which periodontal disease is propagated through the tissue.