Immunological Study on the Establishment of Human Chronic Periapical Periodontitis

最近的观察表明，人类根尖周围病变的发展是免疫病理反应的结果，从感染的根管持续抗原刺激。本研究的目的是阐明免疫机制在根尖周围病变发病机制中的作用。首先，我们从临床角度研究了感染根管内容物的抗原性。结果表明，根管内容物的湿润状态、黑色色素沉着、恶臭等特征与根尖周病变的存在密切相关。这些发现表明细菌可能是根管内容物中重要的抗原物质。因此，研究了根管内的微生物。结果表明，包括拟杆菌在内的厌氧革兰氏阴性棒与根尖周围病变的存在密切相关。因此，厌氧革兰氏阴性棒在根尖周围病变的发展中作为抗原刺激是重要的。其次，我们利用免疫组织化学方法对根尖周围病变的免疫活性细胞进行了表征，并检查了它们与临床表现的相关性。结果显示，这些免疫活性细胞的比例与一些临床表现有关。这些观察结果表明免疫应答与根尖周围病变的发病密切相关。最后，我们用酶联免疫吸附法测量了感染根管根尖周渗出物中免疫球蛋白和白细胞介素-1（IL-1）的浓度，并研究了这些免疫成分与临床表现的相关性。结果表明，在根尖周渗出液中检测到的IL-1和免疫球蛋白与一些临床表现有关。随着根尖周围病变的愈合，IL-1水平升高，IL-1、IgG、IgA水平降低。因此，免疫应答在根尖周围病变不同的病理根尖周围损伤。以上结果提示免疫应答在根尖周围病变的发病机制中起重要作用。少

Recent observations suggested that human periapical lesions developed as a result of immunopathological responses to continuous antigenic stimuli from infected root canals. The purpose of this study was to clarify the involvement of immune mechanisms in the pathogenesis of periapical lesions.First, we investigated the property of infected root canal contents from a clinical point of view in terms of antigenicity. It revealed that some qualities of root canal contents, namely wet condition, black pigmentation and foul odors, were closely related to existence of periapical lesions. These findings suggested that bacteria might be the crucial antigenic substance in the canal contents. Therefore microorganisms in the root canals were investigated. Results showed anaerobic gram-negative rods including bacteroides species had closely relation to the existence of periapical lesions. Consequently, anaerobic gram-negative rods were important as the antigenic stimuli in development of periapical … More lesions.Second, we characterized the immunocompetent cells in periapical lesions by using immunohistochemical methods, and examined their correlation with clinical findings. Results showed the proportion of these immunocompetent cells related to some clinical findings. These observations suggested that immune responses closely related to the pathosis of periapical lesions.Finally, we measured the concentration of immunoglobulins and Interleukin-1(IL-1) in the periapical exudates of infected root canals by enzyme-linked immunosorbent assay and examined the correlation of these immune components to clinical findings. Results showed that IL-1 and immunoglobulines detected in periapical exudates were related with some clinical findings. Moreover, as the healing of periapical lesions, an increase of the level of IL-1 and a decrease of the levels of IL-1 , IgG and IgA were observed. Consequently immune responses in periapical lesions varied according to the pathosis of periapical lisions.Above findings suggested immune responses played a important role in the pathogenesis of the periapical lesions. Less