Immunobiological Studies on Root Canal Anaerobic Bacteria in the Mechanism of Development of Periapical Lesion

人们强烈认为，根尖周围病变是免疫病理反应对持续抗原刺激的结果。来自根管系统的厌氧菌可能是最重要的发病机制，能够诱导根尖周围组织的免疫反应。因此，本研究的目的是阐明厌氧菌的免疫潜力，厌氧菌经常从慢性根尖周围病变的根管中分离出来。从根管中分离出高比例的厌氧菌，尤其是拟杆菌。研究了厌氧细菌细胞组分的免疫生物学活性，包括促进单核细胞迁移、诱导白细胞介素1的产生、有丝分裂性和多克隆B细胞活化。革兰氏阴性菌布氏拟杆菌（Bacteroides buccae）、口腔芽孢杆菌（b.s oralis）和小舌细孔芽孢杆菌（Veillonella paruvula）的细胞组分的免疫生物学活性较其他菌种强，因此对其免疫活性进行了研究。结果表明，脂多糖和38K蛋白制备的布氏杆菌均能诱导免疫生物学活性。免疫组织化学方法检测了慢性根尖周病变中免疫功能细胞和根管细菌的定位，发现主要来自感染根管的细菌、拟杆菌、细络杆菌、胃链球菌和真杆菌最常被泡沫细胞和/或结缔组织的细胞间隙吞噬，并证实泡沫细胞周围积聚了大量T、B淋巴细胞。根尖周围病变均可见大量t淋巴细胞，但根尖周围肉芽肿中B淋巴细胞和巨噬细胞明显多于根尖囊肿和根尖瘢痕。提示改变浸润的免疫活性细胞可能是改变病变的重要途径。提示感染根管内细菌的免疫反应可能是诱发根尖周围组织免疫反应的潜在抗原。少

It has been strongly suggested that the periapical lesion develop as a result of immunopathological response to continuous antigenic stimulation. Anaerobic bacteria from root canal systems might be most important pathogenesis capable of inducing immunological reactions in periapical tissue. The purpose of this study, therefore, was clarify the immunological potentials of anaeobic bacteria, was frequently isolated from root canals with chronic periapical lesion. Obligated anaerobes, espcially bacteroides, were isolated in high percentage from root canals. Immunobiological activities of anaerobic bacteria cellular components were investigated on the enhancement of monocytes migration, induction of interleukin 1 production, mitogenicity and oplyclonal B cell activation. Immunobiological activities of cellular components from gram negativebacteria such as Bacteroides buccae, B.oralis and Veillonella paruvula, were stronger than that of other species, and it therefore was investigated the i … More mmunological potentials of B.buccae, was frequently isolatedfrom root canals. It shows that both LPS and 38K protein prepartions from B.buccae induced immunobiological activities. The localization of immunocomptent cells and root canal bacteria in human chronic periapical lesions were examined immunohistochemically, the bacteria predominantly isolated from infected root canals, Bacteroides, Veillonella, Peptostreptococcus and Eubacterium, were found most commonly engulfed materials within the foam cell and/or intercellular space in connective tissue, and it was confirmed that many T,B lymphocytes were accumlated around the foam cells.The presence of high number of t lymphocytes was observed in all of the periapical lesion, but, B lymphocytes and macrophage were significantly more prevalent in periapical granuloma than radicular cyst or apical scar. It suggests that altering the infiltrated immunocompetent cells may be important in changing pathema. These finding indicate that periapical lesion is developed as a result of immunological reactions in bacteria from infected root canals may be potential antigens which induce the immunological reactions in periapical tissue. Less