INITIAL LESION OF ADULT PERIODONTITIS

这项提案的总体目标是评估微生物风险因素。 对于最初的牙周病变。具体目标将决定 牙周病变的潜在微生物风险标志物是否可以 也是最初皮损的危险因素。此外，两者之间的关联 白介素1(IL-1)基因突变的作用 IL-1a和IL-1b在龈沟液中的表达 将确定牙周炎的流行和进展情况。 然后，可以使用初始损伤的可靠风险因素来识别 发病前或发病早期的易感人群。 组织破坏发生前的预防性干预将是 比治疗病变部位更好，也更便宜。此外， 牙周病原菌及其发病机制的初步探讨 可以定义损伤，可以进行其他研究和治疗研究 针对适当的物种和组织破坏的介体。 300名受试者的疑似病原体和细胞因子将通过 用于物种快速分析的新分子生物学技术， 包括新的螺旋体分类群、细胞因子的检测和改变 产生细胞因子的基因。目标1检查患病率 具有牙周缺失或改变的微生物风险标志的受试者 在一项横断面研究中，将受试者与 牙周健康的最小牙周附着丧失(病例) 受试者(对照)。需要检验的假设是风险(或 可疑)牙周附着丧失的标记物在 病例数明显高于健康对照组。AIM 2是一项前瞻性队列研究 监测从第一个目标中选择的200名受试者，以确定 无论是带有依恋丧失的微生物风险标记的受试者还是 IL-1基因突变表现为更广泛的依恋丧失 没有这些风险标记的受试者。受试者将接受 全面的临床和微生物监测及测量 每隔6个月重复一次，为期两年。临床特点 初始损伤对象，包括不同的依恋模式 损失将被定义。第三个目标将针对具体地点进行评估 牙周初始病变与可培养牙周病变的关系 牙龈下微生物区系，培养的和未培养的螺旋体分类群， 以及细胞因子IL-1a和IL-1b。微生物学、遗传学和临床 来自这项提案的信息将大大促进人们对 初始牙周炎的微生物病原学，这将有 基础研究在牙周研究中的深远意义。

The broad objective of this proposal is to assess microbial risk factors for the initial periodontal lesion. The specific aims will determine whether putative microbial risk markers for periodontal lesions could also be risk factors for initial lesions. Also, the association between the role of an altered interleukin-1 (IL-1) genotype, with increased expression of IL-1a and IL-1b in gingival crevicular fluid, and prevalence and progression of periodontitis will be determined. Reliable risk factors for initial lesions can then be used to identify susceptible individuals either before or in early phases of disease. Preventive intervention before tissue destruction occurs would be better, and less expensive, than treating diseased sites. Furthermore, if periodontal pathogens and mechanisms of pathogenesis of initial lesions could be defined, other research and treatment studies can be targeted to the appropriate species and mediators of tissue destruction. Putative pathogens and cytokines in 300 subjects will be examined using new molecular biology technologies for rapid assays of species, including new spirochete taxa, detection of cytokines and altered genotype for cytokine production. Aim 1 examines the prevalence of subjects with microbial risk markers for periodontal loss or an altered IL-1 genotype, in a cross-sectional study comparing subjects with minimal periodontal attachment loss (cases) with periodontally healthy subjects (controls). The hypothesis to be tested is that the risk (or suspected) marker for periodontal attachment loss will be higher in cases than in healthy controls. Aim 2 is a prospective cohort study monitoring 200 subjects selected from the first aim, to determine whether subjects with microbial risk markers for attachment loss or an altered IL-1 genotype demonstrate more extensive attachment loss than subjects without these risk markers. Subjects will undergo comprehensive clinical and microbial monitoring with measurements repeated at 6-month intervals for two years. Clinical characteristics of initial lesion subjects, including different patterns of attachment loss will be defined. The third aim will evaluate site-specific associations of initial periodontal lesions and the cultivable subgingival microbiota, cultivated and uncultivated taxa of spirochetes, and cytokines IL-1a and IL-1b. Microbiologic, genetic and clinical information from this proposal will significantly advance understanding of the microbial etiology of initial periodontitis, which will have profound significance for basic studies in periodontal research.