Interleukin-1 beta and IgG subclass concentrations in gingival crevicular fluid from patients with adult periodontitis

Interleukin-1 beta (IL-1 beta) and the four IgG subclasses were measured in gingival crevicular fluid (GCF) at 35 sites in 19 patients with adult periodontitis. Serum concentrations of the IgG subclasses were assayed in 16 patients. IL-1 beta was detected in GCF at 88.6% of sites at concentrations ranging from 12.38-420.90 pg/microliters (mean 138.35 +/- 112.61 pg/microliters). IgG1 was detected at 81.2% sites, IgG2 at 93.6%, IgG3 at 71% and IgG4 at 71%. Absolute concentrations in GCF were: IgG1--2.419 g/l +/- (SD) 3.389; IgG2--2.945 +/- 6.434; IgG3--0.118 +/- 0.144; IgG4 0.864 +/- 1.336. There were no significant correlations between IL-1 beta concentrations, GCF volume or the clinical status of the sample site. IL-1 beta was not correlated with any of the IgG subclasses. The absolute concentrations of all subclasses in GCF were significantly negatively correlated with GCF volume and positively correlated with the Bleeding Index. Only IgG4 was significantly negatively correlated with the probeable crevice depth index. The concentration of each IgG subclass was positively correlated with the other three IgG subclasses. Subclass concentrations in GCF, relative to serum concentrations, were not correlated with GCF volume or clinical status. Relative concentrations of IgG1, IgG2 and IgG3 showed significant positive correlation with each absolute concentration of the other subclasses but IgG4 did not show this relation. It was concluded that IL-1 beta is not related to clinical measurements of inflammation or previous attachment loss. The data suggest that IgG in GCF is largely derived from plasma but that some IgG4 may be locally synthesized.

Interleukin-1 beta (IL-1 beta) levels in gingival crevicular fluid from adults with previous evidence of destructive periodontitis. A cross sectional study

We have estimated the levels of Interleukin-1 beta (IL-1 beta) by ELISA in gingival crevicular fluid (GCF) at 58 sites from 37 patients with adult periodontitis. GCF was collected for 5 s on filter papers and a 2nd sample was collected for 30 s 1 min later. 68/116 strips yielded detectable levels of IL-1 beta. IL-1 beta was present in both the 1st and 2nd samples at 28 sites, in the 1st only at 4 sites and in the 2nd only at 8 sites; 18 sites were below the level of detection for the assay. When the concentrations of IL-1 beta were calculated in the original volume of GCF on each strip, the mean value for positive strips was 34.16 +/- 29.45 (SD) pg/microliters with a range from 1.75 to 97.13 pg/microliters. There were no statistically significant correlations with the plaque index, bleeding index or probable crevice depth (pocket depth). The results indicate that IL-1 is present in the GCF from a proportion of sites with evidence of previous periodontal destruction.

Human junctional epithelium: demonstration of a new marker, its growth in vitro and characterization by lectin reactivity and keratin expression

We have studied lectin reactivity in normal human junctional, sulcular, and attached gingival epithelia with 15 lectins and identified the epithelia by parallel staining with monoclonal anti-keratin antibodies. Dolichos biflorus agglutinin reacted uniquely with junctional epithelium, not staining other gingival cells of non-blood group A1 donors. We have demonstrated that the moiety recognized in junctional epithelium is not blood group A1 antigen or Tn antigen. Using a panning technique with this lectin to isolate the cells, we have grown keratinocytes from human junctional epithelium, and compared their phenotype in vitro to that of cells grown from the sulcular and attached gingival epithelium. Colonies established from each epithelial type were examined in frozen section with the anti-keratin antibodies. All expressed keratin 14 (keratinocyte marker), keratins 4 and 13 (suprabasal non-cornification markers), and keratins 7, 18, and 19 (simple epithelia keratins). Keratins 1, 10, and 8 were not expressed. Vimentin, the intermediate filament of mesenchymal cells, was also expressed by all types of cells in culture. Thus we have shown that when cells from the three areas of the gingiva were grown in culture they revert to one phenotype, at least with respect to their keratin expression. These results support the hypothesis that the epithelial phenotype is influenced by the sub-epithelial mesenchyme, and it is this that is responsible for the unique phenotype of the junctional epithelium.

Specific antibody responses to subgingival plaque bacteria as aids to the diagnosis and prognosis of destructive periodontitis

We have reviewed the recent literature on the humoral immune responses to a variety of subgingival plaque bacterial species in patients with destructive periodontal diseases. We do not feel that the information presently available on the specific antibody responses to proposed pathogens such as Bacteroides gingivalis and Actinobacillus actinomycetemcomitans allows antibody responses to be diagnostic. All control subjects without periodontal destruction have antibodies to candidate pathogens but the generally higher levels in patients are not sufficiently elevated to be diagnostic. Nor can they be used to predict the initiation of disease or the onset of new episodes of destruction where disease had previously occurred. Successful treatment of patients may lead to lower levels of antibodies to some organisms, including possible pathogens, and thus support a given species in the aetiopathogenesis of disease. It appears that unsuccessful treatment may be accompanied by continuing high antibody levels to some organisms and further studies may enable this observation to be used to monitor therapy. There is some evidence from serological studies that each destructive episode may be induced by a different bacterial species or consortium. The start of studies using single antigens and the techniques of molecular biology will provide not only antibody-based diagnostic methods but also allow us to determine which bacterial antigens are virulence factors and thus the role of the antibody responses, whether protective or damaging, in the periodontal diseases.

The role of histopathology in the diagnosis and prognosis of periodontal diseases

The histological evaluation of surgical biopsies from affected tissues is a standard way of assessing pathological change and determining treatment in many diseases. In most forms of periodontal disease, however, this approach finds limited application. Here, we review what uses the histopathological approach has in the study and evaluation of the periodontal diseases. Current understanding of the changes in epithelial anatomy during pocket formation, the cellular composition and dynamics of the inflammatory infiltrate and the mechanisms of bone resorption and repair are reviewed from the perspective of the information available from microscopical investigation, including the uses and potential application of modern immunocytochemical methods to these questions. The usefulness of histological study of biopsy material is reassessed in the light of advances made in immunohistochemical techniques and their application to gingival inflammatory infiltrates and epithelia. Such techniques offer immediately valuable research opportunities with potential for diagnostic applications, noteably the recognition of phases of destructive activity and their differentiation from periods of effective host defence.

Measurement of rheumatoid factors by an enzyme-linked immunosorbent assay (ELISA) and comparison with other methods

IgM rheumatoid factor (RF) was measured in the sera of 48 rheumatoid patients and of 48 age and sex-matched normal controls by the Rose-Waaler and latex agglutination tests, a rate nephelometer, and an enzyme-linked immunosorbent assay (ELISA). Good correlation was obtained between all assays. The rate nephelometer assay was the easiest and quickest to perform and gave results in international units/ml. The Rose-Waaler was the least sensitive assay and the most difficult to perform and interpret. Both the latex agglutination and the ELISA were sensitive, though some overlap of patient and control sera was seen with all the assays. In addition to IgM RF the ELISA was used to measure IgG RF and IgA RF in both rheumatoid and control sera. Although some normal sera had detectable amounts of IgG and IgA RF, the levels of both were significantly raised in the rheumatoid sera. IgG RF levels were lower after pepsin digestion of the sera, suggesting that IgM RF interfered with the assay for IgG RF unless this treatment was included.