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伴放线放线杆菌（Aa）、Aa的毒性克隆（JP 2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裔美国人和西班牙裔儿童（两个牙周炎高发人群）局部侵袭性牙周炎（牙周炎）的发生和进展。第一个目的是调查健康儿童中Aa的存在与随后疾病发生之间的关系。第二个目标将是确定是否存在特定的毒性克隆的Aa将启动转换从健康的疾病在这些儿童。第三个目标是确定特定的病原微生物复合体是否与两个研究人群中的疾病相关（横断面研究），如果是，这些“病原复合体”是否与疾病的发生有关（前瞻性研究）。来自纽瓦克的1,200名11-14岁的学生将接受基线牙周检查。将从每个学生中收集细菌，通过培养方法鉴定Aa，并通过DNA/DNA棋盘杂交鉴定40种其他牙菌斑细菌。选择240名Aa培养阳性的牙周健康学生和240名Aa阴性的对照者进行前瞻性研究，每6个月检查一次，连续两年。通过增加探测附着水平和骨丢失的放射学证据来检测疾病的开始。统计分析将确定是否有学生之间的关系谁窝藏目标微生物（Aa、Aa克隆或特定微生物复合物）和疾病起始，并将用于确定拟定随访临床试验的设计：很长的-本提案的长期目标是利用产生的试点数据来计划一项明确的临床试验，旨在设计早期识别因此，我们需要对有可能患上疟疾的儿童进行监测，以便制定具有成本效益的预防干预措施，大大减轻这一得不到充分服务的人口的疾病负担。

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.