Microbial Markers for Periodontal Disease in Children

描述(由申请人提供)：这项初步研究的主要目标是确定伴生放线杆菌(AA)、AA的毒力克隆(JP2克隆)或特定的微生物复合体的存在是否可以预测牙周健康的非洲裔和西班牙裔儿童局部侵袭性牙周炎(LAP)的开始和发展，这两个人群是LAP的高发人群。第一个目标是调查健康儿童中再生障碍性贫血的存在与随后疾病发生之间的关系。第二个目标将是确定特定的AA毒力克隆的存在是否会在这些儿童中启动从健康到疾病的转化。第三个目标将是确定在两个研究人群中特定的致病微生物复合体是否与疾病有关(横断面研究)，如果是，这些“致病复合体”是否与疾病启动有关(前瞻性研究)。来自纽瓦克的1200名年龄在11岁至14岁之间的学生将接受基线牙周检查。将从每名学生身上采集细菌，用培养方法鉴定AA，并用DNA/DNA棋盘杂交方法鉴定其他40种菌斑细菌。选择240名AA培养阳性的牙周健康学生和240名AA培养阴性的对照进行前瞻性研究，每6个月检查一次，为期两年。通过增加探头附着水平和骨丢失的放射证据，可以检测到疾病的发生。统计分析将确定携带目标微生物(AA、AA克隆或特定微生物复合体)的学生与疾病始发之间是否存在关系，并将被用于确定拟议的后续临床试验的设计：该提案的长期目标是使用生成的试验数据来计划最终的临床试验，旨在设计策略，以早期识别有LAP风险的儿童，以便开发成本效益高的预防干预措施，显著减轻这一服务不足的人群的疾病负担。

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.