Antibody-based diagnostic for 'refractory' periodontitis.
Antibody-based diagnostic for 'refractory' periodontitis.
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基于抗体的“难治性”牙周炎诊断。
DOI：
10.1034/j.1600-051x.2002.291009.x
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发表时间：
2002
影响因子：
6.7
通讯作者：
Socransky,SS
中科院分区：
文献类型：
--
作者：
Levine,M;LaPolla,S;Owen,WL;Socransky,SS
摘要目的：大约10 - 15%的美国成年人对慢性牙周炎的治疗是“难治性”的。最近，研究表明，这些患者在沟微生物群中具有升高的赖氨酸脱羧酶活性。本研究的目的是确定是否一个升高的IgG抗体反应赖氨酸脱羧酶，单独或与抗体的其他细菌抗原和基线临床测量，将预测'难治性' patientswithhighaccuracy. Methods：慢性牙周炎患者进行治疗，采用刮治和根面平整（SRP），其次是维护SRP和3个月复查。如果在一年内出现平均全口附着丧失或超过3个部位出现> 2.5 mm的新丧失，则受试者接受重新治疗（改良Widman瓣手术和全身给予四环素）。 如果上述附着丧失复发，则受试者为"难治性"。基线临床测量和特异性抗体反应被用于逻辑回归模型来预测"难治性" subjects.Results：赖氨酸脱羧酶肽部分抗体（HKL-Ab）和基线探诊出血（BOP）患病率测量预测初始治疗后3个月的附件丢失[pIAL =丢失（0）或获得（1）]。 抗放线菌纯化抗原的IgG抗体含量。在"难治性"患者中，链球菌丙氨酰甘油脂磷壁酸（A-Ab）和链球菌丙氨酰甘油脂磷壁酸（S-Ab）相关（R2 = 0.37，p <0.01）。 根据回归方程，将抗体之间的关系定义为线性（pLA/S-Ab = 0）或非线性（pLA/S-Ab = 1）。 使用pLA/S-Ab、pIAL和年龄，从48例患者中推导出logistic回归方程。在59名受试者中，37名有2 - 4 mm的附着丧失，并被指定为"难治性"或成功治疗，准确率为86%。结论：HKL ‐ Ab有助于准确预测中度牙周炎受试者的治疗结果。
AbstractObjective:About 10–15% of US adults are ‘refractory’ to therapy for chronic periodontitis. Recently, studies suggest that these patients have elevated lysine decarboxylase activity in the sulcular microbiota. The aim of this study was to determine whether an elevated IgG antibody response to lysine decarboxylase, alone or with antibody to other bacterial antigens and baseline clinical measurements, would predict ‘refractory’ patients with high accuracy.Methods:Chronic periodontitis patients were treated using scaling and root planing (SRP) followed by maintenance SRP and 3‐monthly re‐examinations. If there was a loss of mean full mouth attachment or more than three sites appeared with > 2.5 mm new loss within a year, the subjects were re‐treated (modified Widman flap surgery and systemically administered tetracycline). If attachment loss as above recurred, the subjects were ‘refractory’. Baseline clinical measurements and specific antibody responses were used in a logistic regression model to predict ‘refractory’ subjects.Results:Antibody to a peptide portion of lysine decarboxylase (HKL‐Ab) and baseline bleeding on probing (BOP) prevalence measurements predicted attachment loss 3 months after initial therapy [pIAL = loss (0) or gain (1)]. IgG antibody contents to a purified antigen fromActinomycesspp. (A‐Ab) and streptococcald‐alanyl glycerol lipoteichoic acid (S‐Ab) were related in ‘refractory’ patients (R2= 0.37,p< 0.01). From the regression equation, the relationship between the antibodies was defined as linear (pLA/S‐Ab = 0) or non‐linear pLA/S‐Ab = 1). Using pLA/S‐Ab, pIAL and age, a logistic regression equation was derived from 48 of the patients. Of 59 subjects, 37 had 2–4 mm attachment loss and were assigned as ‘refractory’ or successfully treated with 86% accuracy.Conclusion:HKL‐Ab facilitated an accurate prediction of therapeutic outcome in subjects with moderate periodontitis.