Polyclonal activation of human peripheral blood B lymphocytes by Fusobacterium nucleatum

Fusobacterium nucleatum Alters Atherosclerosis Risk Factors and Enhances Inflammatory Markers with an Atheroprotective Immune Response in ApoE(null) Mice

The American Heart Association supports an association between periodontal disease (PD) and atherosclerotic vascular disease (ASVD) but does not as of yet support a causal relationship. Recently, we have shown that major periodontal pathogens Porphyromonas gingivalis and Treponema denticola are causally associated with acceleration of aortic atherosclerosis in ApoEnull hyperlipidemic mice. The aim of this study was to determine if oral infection with another significant periodontal pathogen Fusobacterium nucleatum can accelerate aortic inflammation and atherosclerosis in the aortic artery of ApoEnull mice. ApoEnull mice (n = 23) were orally infected with F. nucleatum ATCC 49256 and euthanized at 12 and 24 weeks. Periodontal disease assessments including F. nucleatum oral colonization, gingival inflammation, immune response, intrabony defects, and alveolar bone resorption were evaluated. Systemic organs were evaluated for infection, aortic sections were examined for atherosclerosis, and inflammatory markers were measured. Chronic oral infection established F. nucleatum colonization in the oral cavity, induced significant humoral IgG (P=0.0001) and IgM (P=0.001) antibody response (12 and 24 weeks), and resulted in significant (P=0.0001) alveolar bone resorption and intrabony defects. F. nucleatum genomic DNA was detected in systemic organs (heart, aorta, liver, kidney, lung) indicating bacteremia. Aortic atherosclerotic plaque area was measured and showed a local inflammatory infiltrate revealed the presence of F4/80+ macrophages and CD3+ T cells. Vascular inflammation was detected by enhanced systemic cytokines (CD30L, IL-4, IL-12), oxidized LDL and serum amyloid A, as well as altered serum lipid profile (cholesterol, triglycerides, chylomicrons, VLDL, LDL, HDL), in infected mice and altered aortic gene expression in infected mice. Despite evidence for systemic infection in several organs and modulation of known atherosclerosis risk factors, aortic atherosclerotic lesions were significantly reduced after F. nucleatum infection suggesting a potential protective function for this member of the oral microbiota.

The epigenetic paradigm in periodontitis pathogenesis

Epigenome refers to “epi” meaning outside the “genome.” Epigenetics is the field of study of the epigenome. Epigenetic modifications include changes in the promoter CpG Islands, modifications of histone protein structure, posttranslational repression by micro-RNA which contributes to the alteration of gene expression. Epigenetics provides an understanding of the role of gene-environment interactions on disease phenotype especially in complex multifactorial diseases. Periodontitis is a chronic inflammatory disorder that affects the supporting structures of the tooth. The role of the genome (in terms of genetic polymorphisms) in periodontitis pathogenesis has been examined in numerous studies, and chronic periodontitis has been established as a polygenic disorder. The potential role of epigenetic modifications in the various facets of pathogenesis of periodontitis is discussed in this paper based on the available literature.

Polyclonal B cell activators and in vitro induction of auto-antibody reactive with collagen

Cells producing autoantibodies are known to be present in chronically inflamed periodontal tissues. In sites of chronic inflammation, polyclonal B cell activators (PBA) are known to exhibit adjuvant activity when combined with foreign antigens. These results prompted an examination of PBA in eliciting an antibody response to an autoantigen (i.e. collagen type I). Rat lymphocytes were stimulated with rat collagen (type I), microbial PBA (LPS) or the combination of LPS plus rat collagen in vitro. Anti-collagen antibody-forming cells (AFC) were enumerated using an ELISPOT assay. Collagen or LPS alone elicited few anti-collagen AFC but the addition of LPS to collagen resulted in a substantial adjuvant effect and yielded maximal responses to collagen. Comparisons of anti-collagen AFC from short-term immunized (2-6 wk after booster), non-immunized and long-term immunized (3-4 months after booster) animals were performed. It revealed that cells from recently immunized rats were significantly easier to activate than the other 2 groups. The adjuvant effect of microbial PBA may be important in anti-collagen antibody production and thus the localization of PBA in periodontal pockets may explain why anti-collagen AFC are restricted to the chronically inflamed periodontal tissues.

Taxonomy, biology, and periodontal aspects of Fusobacterium nucleatum

The pathogenic potential of Fusobacterium nucleatum and its significance in the development of periodontal diseases, as well as in infections in other organs, have gained new interest for several reasons. First, this bacterium has the potential to be pathogenic because of its number and frequency in periodontal lesions, its production of tissue irritants, its synergism with other bacteria in mixed infections, and its ability to form aggregates with other suspected pathogens in periodontal disease and thus act as a bridge between early and late colonizers on the tooth surface. Second, of the microbial species that are statistically associated with periodontal disease, F. nucleatum is the most common in clinical infections of other body sites. Third, during the past few years, new techniques have made it possible to obtain more information about F. nucleatum on the genetic level, thereby also gaining better knowledge of the structure and functions of the outer membrane proteins (OMPs). OMPs are of great interest with respect to coaggregation, cell nutrition, and antibiotic susceptibility. This review covers what is known to date about F. nucleatum in general, such as taxonomy and biology, with special emphasis on its pathogenic potential. Its possible relationship to other periodontal bacteria in the development of periodontal diseases and the possible roles played by OMPs are considered.

Induction of systemic murine B-cell responses by Fusobacterium nucleatum and Porphyromonas gingivalis

The purpose of this study was to examine the antigenic abilities of Fusobacterium nucleatum strain ATCC 25586 and Porphyromonas gingivalis strain W50 black inbred BALB/cABom mice immunized subcutaneously. Furthermore, we aimed to analyze whether the outer membranes (OM) and whole cells (WC) of F. nucleatum or P. gingivalis had an effect on the levels of antibody response and whether a combination of both could either enhance or suppress the B-cell response. A single-cell assay, solid-phase enzyme-linked immunospot (ELISPOT), was used to analyze the splenic B-cell response (immunoglobulin A (IgA), IgG and IgM). Enzyme-linked immunosorbent assay (ELISA) and immunoblotting were used to verify the specific antibody response in the sera. A statistically significant lower level of spontaneous antibody production was observed in the group immunized with P. gingivalis OM compared with groups immunized with F. nucleatum and saline. The specific antibody titers measured by ELISA indicated that the bacterial preparations were able to induce IgG and IgM response. The preparations containing P. gingivalis OM induced higher humoral response than the preparations containing P. gingivalis WC, but for F. nucleatum such a difference was not observed. The prominent proteins revealed had apparent molecular masses of 40 kDa for F. nucleatum and 115, 55-56 and 43 kDa for P. gingivalis; whereas the immunoreactive proteins were 70, 65 and 40 kDa for mice immunized with F. nucleatum and 115, 55-56, 43 and 33-34 kDa for mice immunized with P. gingivalis. Quantitative analysis of B-cell response at the single cell level with ELISPOT revealed that some component(s) of P. gingivalis OM may have a suppressive ability on splenocytes incubated for a short time.

Taxonomy, biology, and periodontal aspects of Fusobacterium nucleatum

The pathogenic potential of Fusobacterium nucleatum and its significance in the development of periodontal diseases, as well as in infections in other organs, have gained new interest for several reasons. First, this bacterium has the potential to be pathogenic because of its number and frequency in periodontal lesions, its production of tissue irritants, its synergism with other bacteria in mixed infections, and its ability to form aggregates with other suspected pathogens in periodontal disease and thus act as a bridge between early and late colonizers on the tooth surface. Second, of the microbial species that are statistically associated with periodontal disease, F. nucleatum is the most common in clinical infections of other body sites. Third, during the past few years, new techniques have made it possible to obtain more information about F. nucleatum on the genetic level, thereby also gaining better knowledge of the structure and functions of the outer membrane proteins (OMPs). OMPs are of great interest with respect to coaggregation, cell nutrition, and antibiotic susceptibility. This review covers what is known to date about F. nucleatum in general, such as taxonomy and biology, with special emphasis on its pathogenic potential. Its possible relationship to other periodontal bacteria in the development of periodontal diseases and the possible roles played by OMPs are considered.

A non-lectin-like mechanism by which Fusobacterium nucleatum 10953 adheres to and activates human lymphocytes

Most (approximately 80%) strains of Fusobacterium nucleatum adhere to human erythrocytes in a lectin-like manner that is strongly inhibited by N-acetyl-D-galactosamine (GalNAc). In this study, we investigated the capacity of F. nucleatum 10953, a strain that is weakly inhibited by GalNAc, to adhere to and activate human lymphocytes in vitro. Experiments using [3H]-labeled bacteria and scanning electron microscopy clearly showed that 10953 adhered to lymphocytes and that adherence was blocked by L-arginine+GalNAc greater than L-arginine much greater than GalNAc. Adherence was Ca(2+)-dependent, inhibited by pretreatment of the bacteria with proteases or heat, and unaffected by paraformaldehyde fixation of the bacteria. Strain 10953 induced lymphocyte mitogenesis that was blocked by L-arginine but not by GalNAc. These results suggest that certain strains of F. nucleatum, such as 10953, express a distinct, non-lectin-like mechanism by which they adhere to and activate lymphocytes. Activation of lymphocytes may be an important mechanism in the pathogenesis of periodontal diseases associated with these bacteria.

Accumulation of plasma cells in inflamed sites: effects of antigen, nonspecific microbial activators, and chronic inflammation

Plasma cells are common in chronically inflamed sites, including periodontal lesions. The aim of this study was to determine which factors contribute to this local accumulation of plasma cells. Specifically, we sought to evaluate the effects of specific antigen and nonspecific activators from an infectious agent associated with chronic inflammation (Fusobacterium nucleatum, an organism prominent in chronic periodontal lesions) and the effect of the chronic inflammation itself. Chronic inflammation (14 to 17 days) was induced in horseradish peroxidase (HRP)-immune rabbits by subcutaneous injection of 50 microliters of sterile alum in several sites in their backs. Controls included sites injected with saline or more acute sites examined after 3 days of alum inflammation. Sites were challenged with HRP (the antigen), sonicated F. nucleatum (the nonspecific activator), or both together to see whether F. nucleatum has an adjuvant effect. Three days after challenge, HRP-specific antibody-forming cells (AFC) were enumerated after peroxidase histochemistry. In noninflamed sites or sites with acute inflammation, virtually no HRP-specific AFC were evident. In contrast, chronic inflammation alone was sufficient to elicit a specific AFC response (congruent to 10 cells per mm2). Addition of either F. nucleatum or HRP to the chronic lesion about doubled the number of HRP-specific AFC. However, a dramatic 8- to 15-fold (80 to 150/mm2) increase was seen in chronically inflamed sites challenged with antigen and activator together. Interestingly, the activator did not have this adjuvant effect in the acute sites or in normal skin. In short, accumulation of plasma cells in inflamed sites is promoted by chronic inflammation, activators of microbial origin, and specific antigen. This milieu can be expected to develop in some periodontal lesions and could help explain why gingival crevicular fluid from some sites may contain extraordinary levels of locally produced specific antibodies for certain antigens.

Interaction of Fusobacterium nucleatum 191 with human peripheral blood lymphocytes

Fusobacterium nucleatum is frequently isolated in high numbers from the subgingival plaque of patients with periodontal diseases. Adherence of these bacteria to several host tissues is lectin-like in that it is inhibited by galactose, lactose, and N-acetyl-galactosamine. Since F. nucleatum has the capacity to activate human peripheral blood lymphocytes, the purpose of this study was to determine whether F. nucleatum adheres to lymphocytes and, if so, to determine whether lectin-like interactions facilitate lymphocyte activation. Adherence of F. nucleatum strain 191 to lymphocytes was confirmed by agglutination assays, scanning electron microscopy, and by using fluorescein- or [3H]-labeled bacteria. Saturation of adherence was reached at about 35 bacteria per lymphocyte. F. nucleatum adhered to greater than 90% of the lymphocytes, and adhered in higher numbers to B cell-enriched subpopulations than to T cell-enriched subpopulations. Adherence was inhibited by N-acetyl-galactosamine, lactose greater than galactose, alpha- and beta-methyl galactoside, but not by 100 mM glucose, mannose, N-acetyl-glucosamine, or other sugars tested. Lymphocytes underwent mitogenesis when preincubated with bacteria and washed to remove weakly adherent and non-adherent bacteria. Mitogenesis induced by low concentrations of F. nucleatum was reduced, but not completely eliminated, by N-acetyl-galactosamine. However, N-acetyl-galactosamine had no effect on mitogenesis induced by preincubation with high concentrations of bacteria. These results suggest that adherence of F. nucleatum facilitates activation of lymphocytes, particularly at low concentrations of bacteria.

Lectinlike interactions of Fusobacterium nucleatum with human neutrophils

Fusobacterium nucleatum expresses lectinlike adherence factors which mediate binding to a variety of human tissue cells. Adherence is selectively inhibited by galactose, lactose, and N-acetyl-D-galactosamine. In this study, adherence of F. nucleatum to human peripheral blood polymorphonuclear neutrophils (PMNs) was investigated. The results indicated that the fusobacteria adhered to live and metabolically inactivated or fixed PMNs. Adherence of F. nucleatum resulted in activation of PMNs as determined by PMN aggregation, membrane depolarization, increased intracellular free Ca2+, superoxide anion production, and lysozyme release. Transmission electron micrographs showed that F. nucleatum was phagocytized by the PMNs. Microbicidal assays indicated that greater than 98% of F. nucleatum organisms were killed by PMNs within 60 min. Adherence to and activation of PMNs by F. nucleatum were inhibited by N-acetyl-D-galactosamine or lactose greater than galactose, whereas equal concentrations of glucose, N-acetyl-D-glucosamine, mannose, and fucose had little or no effect on F. nucleatum-PMN interactions. Pretreatment of the fusobacteria with heat (80 degrees C, 20 min) or proteases inhibited adherence to and activation of PMNs, but superoxide production was also stimulated by heated bacteria. The results indicate that interaction of F. nucleatum with PMNs is lectinlike and is probably mediated by fusobacterial proteins which bind to other human tissue cells. Adherence of F. nucleatum to PMNs in the absence of serum opsonins, such as antibodies and complement, may play an important role in PMN recognition and killing of F. nucleatum in the gingival sulcus and in the subsequent release of PMN factors associated with tissue destruction.

Polyclonal B-cell activation in periodontitis

The evidence that periodontitis-associated bacteria contain potent PBA factors is very strong. Clearly, antibodies directed against non-oral antigens are produced in the inflamed periodontal lesion, and PBA appears to contribute to that production. It is also clear that B cells and plasma cells are the major cell types in the periodontal lesion. Furthermore, alterations in the regulation of B-cell responses to PBA factors are associated with severe periodontal disease. However, evidence demonstrating that activated B cells and plasma cells are directly involved in the pathogenic mechanisms leading to destruction of the periodontal support is still circumstantial. Polyclonal B-cell activation and potential pathways by which PBA-stimulated cells could be involved in periodontal destruction remain largely hypothetical. It appears that IL-1 is an important osteoclast-activating agent, and that LPS, which is a potent PBA factor in many systems, can elicit IL-1 production by B cells as well as by the monocyte/macrophage lineage. Recent data indicating that IL-1 is produced by numerous malignant B-cell lines lend support for the idea that B-cell IL-1 could be important in bone resorption. It is also likely that polyclonal activation may lead to production of autoantibody such as anti-type I and anti-type III collagens, and the destruction of self tissues through ADCC reactions, immune complex formation, and complement activation. Further research is needed to determine how the B cell/plasma cell may participate in tissue injury in periodontitis, and how the B-cell response to PBA factors is regulated.

The function of gingival lymphocytes on the establishment of human periodontitis

Human periodontitis has been confirmed to be an IgG plasma cell-rich lesion. However, we also detected many T cells, both CD4-positive and CD8-positive cells, in periodontal lesions. Some of these T cells expressed HLA-DR (la-like) antigen on their surfaces, and the proportion of HLA-DR+ cells was approximately equal in both CD4+ and CD8+ cell populations (Okada et al., 1983, 1984). Consequently, both helper and suppressor T cells were believed to participate in the establishment of periodontal lesions.

On the other hand, B cells were thought to be activated polyclonally in periodontal lesions, because a variety of periodontal florae possessed polyclonal B-cell-activating activity. We demonstrated that Actinomyces viscosus T14V stimulated mouse spleen B cells polyclonally and induced many IgM-producing cells but few IgG-producing cells. Moreover, IgG-producing cells were differentiated from only surface IgG-positive B cells but not from surface IgG-negative B cells-namely, surface IgM- or IgA-positive B cells (Harada et al., 1988). These results suggested that memory B cells, which had already been primed with appropriate antigens, might migrate into periodontal lesions, and then be activated polyclonally and develop into IgG-producing cells.

The periodontal lesion could, therefore, be induced by the interactions of immunoregulatory mechanisms of T cells and polyclonal B cell activity of periodontal florae. In fact, L3T4-positive T cells (helper-inducer T cells) enhanced IgG synthesis of mouse spleen B cells which had been activated with T-independent B cell activators such as LPS and A. viscosus preparations (Okada et al., 1987; Ito et al., 1988). We hypothesized from the above results that autoreactive T cells recognized the increasing self-MHC class II(Ia) antigen on B cells which had been activated with polyclonal B cell activators, and then produced soluble factors, which could enhance IgG synthesis of these B cells. Autoreactive T cells as well as PBAs, thus, may play an important role in the establishment of the IgG plasma cell-rich periodontal lesion.

Antibody synthesis specific for nonoral antigens in inflamed gingiva

In vitro experimentation indicates that periodontitis-associated bacteria contain potent polyclonal B-cell activators (PBA). We reasoned that if PBA were operative in vivo, plasma cells specific for nonoral antigens should be present in the inflamed gingival tissues, which are characterized by a plasma cell infiltrate. To test this, rabbits with experimental periodontitis were immunized in the hind legs with the histochemically detectable antigen horseradish peroxidase (HRP) or glucose oxidase (GO). At various times after secondary immunization, inflamed gingival tissue was removed, sectioned, and treated histochemically to reveal plasma cells that specifically bound HRP or GO. Remarkably, by 9 days after secondary immunization, hundreds of HRP- or GO-binding plasma cells were found in the inflamed gingival tissue of immunized rabbits. The presence of these plasma cells, observed 7 to 10 days after booster immunization, was further substantiated by the presence of large amounts of locally produced HRP- or GO-specific antibody in gingival crevicular fluid. By 1 month after secondary immunization, the number of antigen-binding plasma cells had decreased dramatically, but a small number of antigen-specific plasma cells were detected for as long as 9 months after secondary immunization. The large number of HRP- or GO-specific plasma cells observed 9 days after immunization led us to see whether recently stimulated cells were more susceptible to PBA. Peripheral blood lymphocytes (PBL) were obtained at different times after booster immunization and cultured in the presence or absence of a PBA from Fusobacterium nucleatum. At 7 days after immunization, PBL spontaneously differentiated into antibody-forming cells in culture, and this process was enhanced by PBA. In contrast, PBL taken months after immunization produced little antibody in culture, and enhancement by PBA was difficult to detect. Compared with resting B cells, the recently stimulated B cells clearly differentiated more readily into antibody-forming cells. In conclusion, antibody synthesis specific for nonoral antigens did occur in inflamed gingival tissue, and a number of mechanisms, including PBA, probably contributed to this phenomenon.

Tropical ulcer--a reappraisal based on recent work

Tropical ulcer is a disease which predominantly affects young children in the tropics. The course of the disease can be interrupted in the early stages by the administration of antibiotics so it seems likely that infection may play a role. The disease extends rapidly from the initial lesion, a tiny papule, to a large area of necrosis. This makes a toxic factor likely in the pathogenesis. The epidemiology and some of the causative factors of this disease are currently being investigated. Patients with tropical ulcers were assessed, in areas where the disease is still endemic (Gambia, Papua New Guinea, southern India and Fiji), by a paediatrician or a dermatologist. All patients had swabs taken from the ulcers for bacteriological examination. Skin biopsies were taken from the edge of the ulcers as often as possible. The bacteriological samples were transported anaerobically to London where the laboratory work was performed. The results are discussed in relation to previously reported work.

Production of monoclonal antibodies that recognize specific and cross-reactive antigens of Fusobacterium nucleatum

Monoclonal antibodies (MAbs) against the cell surface antigens of Fusobacterium nucleatum 263 were obtained by fusion of murine myeloma cells (P3-NSI/1-Ag4-1) with the splenocytes of BALB/c mice immunized with whole cells of F. nucleatum 263. Screening was performed using an enzyme-linked immunosorbent assay (ELISA) against the immunizing strain, F. nucleatum 263. Further selection was done using a bacterial panel consisting of Bacteroides, Actinomyces, Streptococcus, Fusobacterium, and Escherichia species. Twelve MAbs were selected on the basis of this screening procedure, seven of which reacted specifically with F. nucleatum 263. Two reacted with F. nucleatum 263 and ATCC 25586, and three reacted with F. nucleatum 263, ATCC 25586, and UQD-003 (a clinical isolate) and also cross-reacted with Fusobacterium russii ATCC 25533. The selected MAbs were then further characterized by absorption experiments with suspensions of intact whole bacterial cells, and the residual binding activity of the supernatants was determined in an ELISA. To determine whether the MAbs reacted with the same or different epitopes, pairs of MAbs were reacted together and independently in a checkerboard manner in an ELISA. The additive or nonadditive nature of the reactivity was determined. A competitive inhibition assay was performed using one labeled and selected unlabeled MAbs. The results of these experiments suggested some epitope sharing among the selected MAbs that reacted with a specific antigen on F. nucleatum and also shared cross-reactive antigens with the three strains of F. nucleatum and F. russii.

Microbe-induced lymphocyte blastogenesis enhancement after preculture

The in vitro blastogenic response of human peripheral blood mononuclear cells to Fusobacterium nucleatum and other oral microorganisms was enhanced if the peripheral blood mononuclear cells were cultured for 24 h at 37 degrees C prior to the addition of stimulant. The enhancement which occurred at optimal and supraoptimal concentrations of F. nucleatum (10 to 100 micrograms/ml) was detected after a preculture period of as little as 2 h. The blastogenic response was a result of T-cell proliferation, and enhancement occurred independently of monocytes. Suppressor activity was induced by culturing fresh lymphocytes for 24 h in the presence of supraoptimal concentrations of F. nucleatum. The enhancement phenomenon occurred independently of the prostaglandin effects on lymphocyte blastogenesis and was not abrogated by treatment with indomethacin.

Monocyte suppression of Fusobacterium nucleatum-induced human polyclonal B-lymphocyte activation

Previous studies reported that Fusobacterium nucleatum induced polyclonal B-lymphocyte activation (PBA) as determined by immunoglobulin M production in cultures of human peripheral blood mononuclear cells. However, the PBA response was greatly enhanced when the cells were depleted of esterase-positive, adherent cells (i.e., monocytes). The purpose of this study was to confirm and further examine the suppression of F. nucleatum-induced PBA (F. nucleatum-PBA) by blood monocytes. For comparison, PBA induced by pokeweed mitogen (PWM-PBA), which is enhanced by monocytes, was assessed in some experiments. We found the removal of monocytes from unfractionated cells by (i) Sephadex G-10, (ii) anti-monocyte specific OM-1 monoclonal antibody plus complement, or (iii) L-leucine methyl ester, a compound which selectively kills lysosome-rich cells, resulted in a population of cells responsive to F. nucleatum-PBA and unresponsive to PWM-PBA. The addition of double adherence-purified monocytes (greater than 85% esterase-positive cells), particularly in concentrations of greater than 10%, to lymphocytes depleted of monocytes by G-10, OM-1, or L-leucine methyl ester treatments, suppressed F. nucleatum-PBA and enhanced PWM-PBA. Monocytes also suppressed a mixture of isolated T and B cells combined in a T/B cell ratio of 3:1, which is an optimal ratio for F. nucleatum-PBA. Allogeneic monocytes suppressed F. nucleatum-PBA, although at low numbers these cells were not as suppressive as autologous monocytes. Heating at 56 degrees C for 15 min, sonicating, or freeze-thawing the monocyte preparations resulted in an abrogation of monocyte-induced suppression of F. nucleatum-PBA. Kinetic studies in which fresh monocytes were added daily to lymphocytes stimulated with F. nucleatum or PWM showed that the monocytes must be added within the first 2 days of culture to suppress F. nucleatum-PBA or enhance PWM-PBA. Monocytes incubated with F. nucleatum for 48 h released into the culture medium a soluble factor that suppressed F. nucleatum-PBA. The results from this study demonstrate a potent mechanism by which the host might prevent exaggerated nonspecific immunoglobulin responses when exposed to PBA-inducing concentrations of F. nucleatum. On the other hand, the induction of suppressive monocytes (or monocyte-mediated suppressive factors) by interaction with F. nucleatum might result in the inhibition of host protective immune reactions.

Effects of an immunomodulating agent on peripheral blood lymphocytes and subgingival microflora in ligature-induced periodontitis

The peripheral blood lymphocyte populations and the subgingival levels of black-pigmented Bacteroides species were monitored during the conversion of chronic gingivitis to progressing periodontitis in cynomolgus monkeys. In addition, the effects of an immunomodulating agent, the pentapeptide of thymopoietin (TP5), were determined. After the induction of active periodontitis, proportions of helper T-cells (OKT-4 positive) decreased from 31.5 to 26.4%, and proportions of B-cells (surface immunoglobulin positive) increased from 44.5 to 51.8%. Proportions of suppressor T-cells (OKT-8 positive) remained unchanged, but the numbers of OKT-8-positive cells increased. During this same time period the total cultivable subgingival flora increased from 1.5 X 10(6) to 3.5 X 10(6) per sample, with Bacteroides gingivalis increasing from 5.3 to 16.6% of the total cultivable subgingival flora. After 10 weeks of active periodontitis, animals were treated with either TP5 or placebo. Treatment with TP5 produced an increase in helper T-cells but had no effect on B-cells. The OKT-4/OKT-8 cell ratio, which decreased from 1.3 to 0.8 with disease induction, was increased to 1.1 after TP5 treatment but remained at 0.9 in placebo-treated animals. TP5 had no effect on the total cultivable subgingival flora but significantly decreased the subgingival proportions of B. gingivalis and other black-pigmented Bacteroides species. In this model system, active periodontitis was associated with an increase in B. gingivalis, a decreased helper/suppressor T-cell ratio, and increased levels of B-cells. Treatment with TP5 increased the helper/suppressor T-cell ratio and decreased B. gingivalis levels, suggesting that lymphocyte subsets have the potential to influence subgingival levels of potential periodontal pathogens.

Nonspecific induction of immunoglobulin M antibodies to periodontal disease-associated microorganisms after polyclonal human B-lymphocyte activation by Fusobacterium nucleatum

The production of antibodies to oral bacteria was determined in lymphocyte cultures stimulated with sonicated Fusobacterium nucleatum, a potent inducer of polyclonal B-cell activation. After 9 days the cultures were examined by a microenzyme-linked immunosorbent assay for immunoglobulin M (IgM) antibodies to F. nucleatum, Bacteroides gingivalis, Actinomyces viscosus, and Streptococcus sanguis. Antibodies to these four bacteria were detected in cultures stimulated with polyclonal B-cell activation-inducing concentrations of F. nucleatum. However, significant concentrations of antibodies to F. nucleatum, but not to the other three microorganisms, were produced in cultures that received suboptimal polyclonal B-cell activation-inducing doses of F. nucleatum. Absorption studies indicated the specificity of the antibodies to each of the bacteria tested. IgM antibody production induced by F. nucleatum was enhanced by the addition of T cells. The production of IgM antibodies to the bacteria was reproducible in cultures from a single person tested on 3 consecutive days. The concentration of antibodies in replicate cultures, however, fluctuated greatly. To obtain consistent responses on successive days, multiple replicate cultures were required. These results suggest that F. nucleatum, which is frequently present in subgingival plaque, could induce the production of antibodies not only to F. nucleatum, but also to other microorganisms associated with periodontal diseases.