REFRACTORY PERIODONTAL DISEASE

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 目前，约有15%的牙周炎患者常规治疗失败，被认为是难治性牙周炎。这项研究检验了难治性牙周病与非难治性牙周病不同的假设，并寻求前瞻性地识别这些患者的方法。 我们将基于微生物图谱来检验这一假设，即难治性疾病的受试者可以与可治疗的牙周炎和牙周健康的受试者区分开来。这将识别那些对区分难治性和可治疗的牙周炎和识别健康有用的细菌种类。 其次，我们将根据牙周细菌的抗体水平和外周血单核细胞产生的细胞因子来检验这一假设，即患有难治性疾病的患者可以与可治疗的牙周炎患者区分开来，并与牙周健康患者区分开来。这将识别关键的宿主标记。 第三，我们将开发一种人类口腔微生物微阵列(HOMM)，用于检测在人类口腔中发现的600种微生物。上面使用的微生物样本将使用这种新的微阵列提供的基本完整的微生物覆盖范围进行重新分析。 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，并识别难治性综合征。该项目的完成将填补我们在口腔总菌群以及细胞因子、趋化因子及其受体的作用方面的主要知识空白，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.