Periodontal diseases: to protect or not to protect is the question?
Periodontal diseases: to protect or not to protect is the question?
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DOI：
10.1080/000163501750266756
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发表时间：
2001-06-01
影响因子：
2
通讯作者：
Holt, SC
中科院分区：
文献类型：
--
作者：
Ebersole, JL;Cappelli, D;Holt, SC
几十年来，研究已经确定了局部和全身的体液免疫反应的微生物组成的龈上和龈下的生物膜在口腔中。牙周组织的炎症和组织破坏伴随着抗体的数量、质量和特异性的改变。这种情况下的难题是在牙周病变部位存在大量浆细胞浸润，并且在口腔和血清中存在看似强大的抗体应答，显然与疾病进展一致。因此，已经花费了大量的努力来阐明保护性体液反应的关键特征，并开发用于增强这些独特特征的策略。我们和其他人已经进行了一些研究，试图区分与以下因素相关的疾病易感性：i）反应水平的变化--对某些患病物种显著增加，对其他物种的反应最小; ii）抗体亚类差异、遗传调节和反应成熟的功能比较; iii）抗体的微生物和抗原特异性-集中于特定病原体和鉴定作为免疫保护靶标的选定抗原;和iv）疾病和治疗干预期间的反应动力学--将免疫变化与感染联系起来并作为治疗成功的量度。本报告总结了不同的研究设计和结果，提供了健康，牙龈炎和牙周炎的抗体概况。这些配置文件可用于提供一个框架，重点是体液反应的肠道微生物和可能的病原体，因为它们出现在生物膜病原学的疾病过程或响应。模型抗体作为诊断辅助和预测保护性抗体反应的建议。这些概念可能与考虑牙周炎的疫苗方法有关。
For decades, investigations have identified local and systemic humoral immune responses to microorganism comprising the supra- and subgingival biofilms in the oral cavity. Inflammation and tissue destruction in the periodontium are accompanied by alterations in the quantity, quality, and specificity of antibody. The conundrum in this scenario is the existence of a substantial plasma cell infiltrate at sites of periodontal lesions and a seemingly robust antibody response in the oral cavity and the serum, apparently coincident with progressing disease. Consequently, much effort has been expended to elucidate the critical characteristics of protective humoral responses and to develop strategies for enhancing these unique features. We and others have conducted studies attempting to distinguish disease susceptibility associated with: i) variations in response levels-significantly increased to some species with disease, minimal response to others; ii) functional comparisons of antibody-subclass differences, genetic regulation, and maturation of responses; iii) microbial and antigenic specificity of the antibody-focus on specific pathogens and identification of selected antigens as targets for immunoprotection; and, iv) kinetics of responses during disease and therapeutic interventions-linking immune changes with infection and as a measure of treatment success. This report summarizes varied research designs and results, to provide a profile of antibody in health, gingivitis, and periodontitis. These profiles may be used to provide a framework focusing on the humoral response to commensal microorganisms and likely pathogens, as they emerge in the biofilm-etiologic for or in response to disease processes. Models for antibody as a diagnostic adjunct and for predicting protective antibody responses are suggested. These concepts are likely relevant for considering vaccine approaches to periodontitis.