REFRACTORY PERIODONTAL DISEASE

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 中心，但不一定是研究者所在的机构。 目前，约15%的牙周炎患者无法通过常规治疗，被认为是“难治性”。 本研究探讨了难治性牙周病与非难治性牙周病不同的假设，并寻求前瞻性识别这些患者的方法。 我们将测试的假设，难治性疾病的受试者可以区分与可治疗的牙周炎和牙周健康的基础上，微生物档案。 这将确定那些细菌物种，用于区分难治性和可治疗的牙周炎，并确定健康。 第二，我们将测试的假设，难治性疾病的受试者可以区分与可治疗的牙周炎，牙周健康，牙周细菌的抗体水平和外周血单核细胞产生的细胞因子的基础上。 这将确定关键的主机标记。 第三，我们将开发一种人类口腔微生物微阵列（HOMM），用于检测人类口腔中发现的600种微生物。 上述使用的微生物样品将使用这种新微阵列提供的基本上完全的微生物覆盖进行重新分析。 第四，我们将使用上述综合数据来区分难治性牙周炎与可治疗的牙周炎和健康，并确定难治性综合征。 本项目的完成将填补我们对口腔总植物群和细胞因子、趋化因子及其受体的作用的知识的主要空白，以更好地阐明人类与其常驻口腔微生物之间的相互作用。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Currently about 15% of periodontitis patients fail conventional therapy and are deemed "refractory". This study examines the hypothesis that refractory periodontal disease is distinct from non-refractory periodontal disease and seeks means for prospectively identifying these patients. We will test the hypothesis that subjects with refractory disease can be distinguished from subjects with treatable periodontitis and with periodontal health, based on microbial profiles. This will identify those bacterial species that are useful for distinguishing between refractory and treatable periodontitis and identifying health. Second, we will test the hypothesis that subjects with refractory disease can be distinguished from those with treatable periodontitis, and with periodontal health, based upon antibody levels to periodontal bacteria and cytokine production by peripheral blood monocytes. This will identify key host markers. Third, we will develop a Human Oral Microbe Microarray (HOMM) for the detection of the 600 species found in the human oral cavity. The microbial samples used above will be re-analyzed using the essentially complete microbial coverage provided by this new microarray. Fourth, we will use the above combined data to differentiate refractory periodontitis from treatable periodontitis and health, and to identify refractory syndromes. Completion of this project will fill major gaps in our knowledge of the role of the total oral flora and of cytokines, chemokines, and their receptors, to better clarify the interaction between humans and their resident oral microorganisms.