Microbial Markers for Periodontal Disease in Children

描述（由申请人提供）：本初步研究的主要目的是确定放线菌（放线菌），放线菌的毒性克隆（JP2克隆），或特定微生物复合物的存在是否可以预测牙周健康的非洲裔和西班牙裔儿童的局限性侵袭性牙周炎（LAP）的发生和进展，这两个人群的LAP患病率很高。第一个目的是调查健康儿童中Aa的存在与随后的疾病发生之间的关系。第二个目标将是确定特定的Aa毒性克隆是否会在这些儿童中引发从健康到疾病的转变。第三个目标将是确定在两个研究人群中特定的致病微生物复合物是否与疾病相关（横断面研究），如果是，这些“致病复合物”是否与疾病发生有关（前瞻性研究）。来自纽瓦克的1200名11-14岁的学生将接受基本牙周检查。从每个学生身上收集细菌，用培养法鉴定Aa，用DNA/DNA棋盘杂交法鉴定40种菌斑细菌。选择240名Aa培养阳性牙周健康学生和240名Aa阴性对照进行前瞻性研究，每6个月进行一次检查和抽样，为期两年。疾病的开始将通过探测附着水平的增加和骨质流失的x线证据来检测。统计分析将确定携带目标微生物（Aa、Aa克隆或特定微生物复合物）的学生与疾病发生之间是否存在关系，并将用于确定建议的后续临床试验的设计：这项建议的长期目标是利用所产生的试点数据来规划一项明确的临床试验，旨在设计早期识别有LAP风险的儿童的战略，以便能够制定具有成本效益的预防性干预措施，以显着减轻这一服务不足人群的疾病负担。

DESCRIPTION (provided by applicant): The primary objective of this pilot study is to determine whether the presence of Actinobacillus actinomycetemcomitans (Aa), a Virulent" clone of Aa (the JP2 clone), or specific microbial complexes could be predictive of the initiation and progression of Localized Aggressive Periodontitis (LAP) in periodontally healthy African-American and Hispanic children, two populations with a high prevalence of LAP. The first aim will be to investigate the relationship between the presence of Aa in healthy children and subsequent disease initiation. The second aim will be to determine whether the presence of specific virulent clones of Aa will initiate conversion from health to disease in those children. The third aim will be to determine whether specific pathogenic microbial complexes are associated with disease in the two study populations (crosssectional study) and, if so, whether these "pathogenic complexes" are related to disease initiation (prospective study). 1,200 students, ages 11-14, from Newark will receive a baseline periodontal exam. Bacteria will be collected from each student for identification of Aa by cultural methods and 40 other plaque bacteria by DNA/DNA checkerboard hybridization. 240 Aa culture positive periodontally healthy students and 240 Aa negative matched controls will be selected for the prospective study and examined and sampled every 6 months for two-years. Disease initiation will be detected by increased probing attachment levels and radiographic evidence of bone loss. Statistical analysis will determine whether there is a relationship between students who harbor the target microorganisms (Aa, clones of Aa, or specific microbial complexes) and disease initiation and will be used to determine the design of the proposed follow-up clinical trial: The long-term goal of this proposal is to use the pilot data generated to plan for a definitive clinical trial intended to design strategies for early identification of children at risk for LAP so that cost effective preventive interventions can be developed to significantly reduce the burden of disease in this underserved population.