Adhesive Properties ofStreptococcus sanguisIsolated from Patients with Behçet's Disease

Intermediate Uveitis: What is the Natural Course of the Disease and Its Relationship with Other Systemic Diseases?

This study examined the natural course of intermediate uveitis, to find a possible correlation with systemic diseases and to identify the ocular complications. Patients were classified according to follow-up time in three groups: A (1-5 years) 12 pts, B (6-10 years) 10 pts, C (11-15 years or more) 6 pts for a total of 28 patients (52 eyes). We studied the recurrences, the complications of the disease and the overall prognosis. Eight patients were found to be suffering from systemic diseases: sarcoidosis 2, Adamantiades-Behcet 2, multiple sclerosis 3 and Lyme disease 1. Cataract was found in 21 eyes (40.5%) and macular changes in 20 eyes (38.4%) but chronic cystoid macular edema persisted in only six cases (12.5%). Group C presented more complications than group B. Group A had the fewest. The frequency of recurrences was 1-5 for group A. 1-3 for group B and 1-2 for group C. Four patients received no therapy, 15 received steroids and nine received cyclosporine and steroids. In this series intermediate uveitis was bilateral in 85.8% of patients and related with systemic diseases in 28.5%. Recurrences appeared mainly during the first five years. The longer the presence of the disease the more frequent were complications and the final visual acuity depended mostly on the severity of the initial attack and the number of exacerbations.

Perceived oral health status, oral function and related behaviour among the patients of Behçet's disease

The majority of patients with Behçet's disease (BD) suffers from oral ulcers. The aim of the present study was to survey self-rated oral health status, oral function, and oral health behaviour of patients with BD in eastern Japan. Subjects were 33 BD patients and 101 healthy individuals ranging in age from 20 to 59 years. The survey was conducted using a self-administered questionnaire. The items of oral health in the questionnaire included subjective symptoms, self-rated dental problems and oral health behaviour. We found that compared to the healthy subjects, BD patients experienced more severe physical limitations, mainly involving difficulty in pronouncing words (p < 0.01) and the pain of oral mucosa and gingival tissue caused by oral ulcers (p < 0.01). Based on the results of oral health behaviour, BD patients did not behave positively with regard to maintaining oral health including regular tooth brushing despite relatively higher risk of dental diseases that they face. The present results suggest that oral ulcers due to BD induced dental disorder such as the pain of gingiva, oral mucosa, and difficulty in the pronouncing of words. In spite of this, their oral health behaviour is not positive compared to the healthy subjects. Thus, the need to develop a more active pragramme for oral health education for patients with BD is indicated.

Cloning and sequencing of BeS-1 gene encoding the immunogenic antigen of Streptococcus sanguis KTH-1 isolated from the patients with Behçet's disease

In order to analyze the immunopathologic mechanisms of Behçet's disease, the gene (bes-1) encoding a streptococcal antigen correlated with the disease was cloned and sequenced, and protein produced by this clone was identified by Western immunoblotting using serum antibody from the patient. Cellular DNA of Streptococcus (S.) sanguis serotype KTH-1 (uncommon serotype 1, strain 113-20) from the patient was extracted and digested with EcoRI. The digested fragments were cloned into the cloning vector lambda gt11, and then the resulting DNA library was immunoscreened using the patient's serum antibody to serotype KTH-1. The immunopositive clone of the 1.5 kbp fragment was subcloned into pUC 118 plasmid (pU8BeS1-1) and sequenced. The sequence showed that the 3'-terminal half side region of this insert contained 962bp of open-reading frame (ORF) discontinued at the EcoRI restriction site, and the stop codon was not found. The nucleotide sequence of the remaining additional 3'-terminal region of this gene encoding whole BES-1 was determined by genome walking. The whole ORF of bes-1 consisted of 849 amino acid residues with a calculated molecular mass of 95 kDa. The residues in a portion of the amino acid sequence showed a 60% correspondence to those of the human intraocular peptide Brn-3b.

Demonstration of antigen-specific immune response against Streptococcus sanguis

The genetic control of Streptococcus sanguis antigen response was studied. Mice sensitized with inactivated S. sanguis organisms antigen-injected at the base of the tail developed footpad swelling. Those with an I-Ak,q,r region of H-2 showed a strong footpad response, whereas those with an I-Ab,d,s region showed a weak response to S. sanguis cell wall antigen. Footpad response was mediated by CD4+,8- T cells by using in vitro monoclonal antibody treatment. Similar evidence of genetic control was obtained with an in vitro T cell proliferation assay. However, quantitation of antibodies against S. sanguis showed that antibody production was not controlled by H-2. These results indicated that both in vivo footpad swelling and in vitro T cell proliferation responses were functions of helper (CD3+,4+,8-) T cells and controlled by the I-A region of H-2.

Three types of binding by Porphyromonas gingivalis and oral bacteria to fibronectin, buccal epithelial cells and erythrocytes

This study showed that the interaction of oral bacteria with fibronectin differed with the type of organism examined. Significant binding of fibronectin was found with Porphyromonas gingivalis non-fimbriated (F-) strain in comparison with the fimbriated strain (F+). However, the F+ strain adhered to buccal epithelial cells in significantly larger numbers than the F- strain. Fibronectin binding and epithelial cell adherence were not associated with haemagglutinating activity. These assays clearly define at least three distinct types of binding by oral bacteria: to fibronectin, buccal epithelial cells and erythrocytes.