Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

AU14 - Periodontology Exam 1 > 09/10 - Host Responses to Periodontal Bacteria > Flashcards

09/10 - Host Responses to Periodontal Bacteria Flashcards

1
Q

How do bacteria induce damage to periodontal tissues?

A
  • bacteria attach and colonize the gingival crevice; some species can invade periodontal soft tissue
  • bacteria release substances that directly damage host cells
  • bacteria activate the host’s own inflammatory and immune systems, leading to host tissue damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the (4) major microbial virulence factors?

A
  • ability to invade periodontal epithelium
  • direct cytotoxic effects of bacterial metabolic waste products (ammonia, intole compounds, fatty acids, hydrogen sulfide)
  • damaging bacterial enzymes (leukotoxin, gingipains)
  • immunostimulatory molecules (LPS from gram-negative, lipoteichoic acids from gram-positive, gingipains, formylpeptides, other surface antigens)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the (3) mechanisms of periodontal defense?

A
  • prevention of bacterial entry (passive protection by periodontal epithelium)
  • innate immune responses (non-specific, first line of active defense)
  • acquired (adaptive) immune responses (specific, second line of active defense)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the (3) ways to prevent bacterial entry?

A
  • shedding of epithelial cells into the oral cavity (inhibits bacterial colonization of mucosa)
  • intact epithelial barrier
  • positive fluid flow into the gingival crevice
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Gingival crevicular fluid originates as ___.

A

gingival tissue interstitial fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the 4 effects of the complement system?

A
  • induces bacterial lysis
  • promotes phagocyte recruitment (chemotaxis)
  • promotes phagocytosis by opsonization of bacteria
  • helps activate mast cells, which increases vascular permeability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

During the innate immune response, oral mucosa produces ___ and the oral epithelium produces ___.

A
  • antimicrobial peptides

- pro-inflammatory cytokines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

___ and ___ are universal signals of infection that help recruit inflammatory cells. ___ attracts neutrophils in the early stages of infection.

A
  • IL-1beta
  • TNF-alpha
  • IL-8
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

The innate immune response has the antimicrobial effect of ___, ___, and ___ as well as the phagocytic effects of ___ and ___.

A
  • antibodies
  • lactoferrin
  • lysozyme
  • neutrophils
  • macrophages
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

___, ___, and ___ are hallmarks of adaptive immunity.

A
  • antigen recognition
  • immune memory
  • clonal expansion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Serum complement and neutrophils cause ___. Monocytes and macrophages and lymphocytes cause ___.

A
  • acute inflammation resolution

- chronic inflammation resolution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the (5) reservoirs of supragingival bacteria?

A
  • tongue
  • oral mucosa
  • tonsils
  • saliva
  • supragingival plaque
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the (4) reservoirs of subgingival bacteria?

A
  • periodontal soft tissues
  • dentinal tubules
  • furcations
  • subgingival calculus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

___ plays a major role in defense of the oral cavity.

A

innate immunity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Toll-like receptors (TLRs) have a major role in ___. They recognize ___.

A
  • induction of innate immune response

- conserved microbial-associated molecular patterns (including LPS, lipoteichoic acid and flagellas)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What cells express toll-like receptors?

A

all cells, including epithelial cells, PMNs, monocytes, and macrophages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

TLRs signal for cells to produce ___, ___, ___, ___, and ___.

A
  • cytokines
  • chemokines
  • antimicrobial peptides
  • nitric oxide
  • eicosanoids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the (8) biological activities of LPS (endotoxin)?

A
  • complement activation
  • PMN activation
  • macrophage activation
  • B-cell mitogen activity
  • pyrogenicity
  • stimulation of bone resorption
  • stimulation of prostaglandin synthesis
  • induction of Tumor Necrosis Factor (TNF-alpha)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the 2 pathways of the complement system?

A
  • classical pathway

- alternative pathway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What cytokines are involved in pro-inflammatory activity?

A

IL-1beta, TNF-alpha

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What cytokine is used for chemotactic activity?

A

IL-8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Prostaglandins are derived from ___ and produced by ___ and other cells.

A
  • arachidonic acid

- activated macrophages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What do prostaglandins induce, especially PGE2?

A
  • vasodilation
  • cytokine production
  • production of matrix metalloproteinases by fibroblasts and osteoclasts which damage periodontal tissues
24
Q

What do matrix metalloproteinases do? Where are the concentrations the highest? Name an example of a metalloproteinase.

A
  • degrade extracellular matrix
  • concentrations are higher in inflamed gingiva than in healthy gingiva
  • PMN collagenase (degrades the major structural protein in gingiva)
25
Q

What does proteinase inhibitors do? What are 2 examples and what does each example do?

A
  • antagonize inflammation; inhibit degradation of matrix proteins
  • alpha-2 macroglobulin: broad spectrum proteinase inhibitor
  • alpha-1 antitrypsin: broad spectrum proteinase inhibitor and potent inhibitor of PMN collagenase
26
Q

What are the 2 types of antimicrobial peptides discussed in lecture? What does each do? Where is each produced?

A
  • DEFENSINS: inhibit bacteria and fungi; produced by salivary gland epithelium
  • CALPROTECTIN: inhibits bacteria and fungi by chelating zinc; produced by epithelium, PMNs, monocytes, and macrophages
27
Q

Neutrophils are deployed from ___. Macrophages are found in ___. Mast cells are found ___, especially ___.

A
  • blood
  • organs and tissues
  • throughout the body
  • connective tissue subjacent to mucosal surface
28
Q

Acute inflammation or injury increases ___, resulting in ___, ___, and ___.

A
  • vascular permeability
  • redness
  • edema
  • increased gingival crevicular fluid flow
29
Q

PMN deliver ___ to bacteria in the ___ stages of infection.

A
  • antimicrobial substances

- early

30
Q

True or false: PMNs kill only by oxidative mechanisms.

A

FALSE. PMNs kill by oxidative and non-oxidative mechanisms.

31
Q

PMN activities are triggered by ___. PMN surface has many ___.

A
  • receptor binding events

- high affinity receptors

32
Q

Describe the process of PMN recruitment to the gingival crevice.

A
  • LPS proteases
  • release of proinflammatory cytokines (IL-1, TNF)
  • endothelial cells increase their adhesion molecule expression (CAM-1, ELAM-1)
  • neutrophil-endothelial cell binding occurs and migration begins
  • neutrophils follow chemotactic gradient through the junctional epithelium into the crevice
33
Q

What are the steps in PMN extravasation?

A
  • random contact
  • rolling
  • sticking
  • extravasation
34
Q

Rank the numbers of T lymphocytes, B lymphocytes, and plasma cells from most to least in chronic periodontitis.

A

plasma cells > B lymphocytes > T lymphocytes

35
Q

In the adaptive immune response, ___ and ___ function as antigen presenting cells.

A
  • macrophages

- Langerhans cells

36
Q

The T-cell receptor has 2 ___ chains (alpha and beta). The variable segments determine ___.

A
  • glycoprotein

- the type of immune response

37
Q

True or false: TCR are different between chronic and aggressive periodontitis.

A

true

38
Q

What are the cytokines associated with Th1 cells? With Th2 cells? What cytokine is associated with both?

A
  • Th1: IL-2, IFN-gamma, TNF-alpha
  • Th2: IL-4, 5, 6, 10, 13
  • IL-10
39
Q

Which helper T-cell has to do with cell-mediated immunity? Which has to do with antibody production?

A
  • Th1

- Th2

40
Q

Cytotoxic T-cells are activated by ___. Tc cells respond to ___. Antigens from these pathogens bind ___.

A
  • cytokines
  • intracellular pathogens
  • MHC I molecules
41
Q

True or false: Tc cells are found in high numbers in periodontitis.

A

FALSE. Not many Tc cells are found in periodontitis, suggesting that viruses and invasive bacteria are not major players.

42
Q

Humoral immunity is triggered in response to ___. Antigen-antibody complex activates ___ and facilitates ___. Th2 cytokines activate ___.

A
  • soluble antigens
  • complement
  • opsonization
  • B cells to plasma cells
43
Q

What are the 2 types of B cells? What does each do? Do their levels ever decrease?

A
  • CONVENTIONAL: produce antibodies against bacteria; levels decrease in healthy and treated sites
  • AUTOREACTIVE: produce auto-antibodies; levels do not decrease after treatment
44
Q

What antibodies are prevalent in the primary response? In the secondary response?

A
  • primary: IgM (first) and then IgG

- secondary: IgG (predominantly) and a little IgM

45
Q

What are the mechanisms of antibodies acting alone? Antibody plus complement? Antibody plus cells?

A
  • ANTIBODY ALONE: block entry of toxins and viruses; immobilizes bacteria; agglutinates bacteria
  • ANTIBODY PLUS COMPLEMENT: lyses bacteria
  • ANTIBODY PLUS CELLS: opsonizes bacteria and fungi for phagocytosis; activates extracellular killing
46
Q

True or false: The avidity, or antigen binding, differs among antibody subclasses. Not all are capable of effective opsonization or complement activation.

A

true

47
Q

Which antibody, IgG1 or IgG2, is more prevalent in chronic periodontitis? In aggressive periodontitis?

A
  • chronic: IgG1

- aggressive: IgG2

48
Q

IgG2 recognizes ___ while other subclasses mainly recognize ___.

A
  • carbohydrate antigens (LPS)

- protein antigens

49
Q

Describe the steps of a systemic humoral immune response to plaque antigens in the gingival crevice.

A
  • plaque antigens diffuse through the JE
  • Langerhans cells within the epithelium capture and process the antigens
  • antigen-presenting cells (macrophages and Langerhans) leave the gingiva in the lymph
  • antigen-presenting cells reach the lymph node and begin to stimulate lymphocytes to produce a specific immune response
  • periodontal microbe specific antibodies are produced by plasma cells within the lymph nodes and travel back to the gingiva via blood vessels
  • antibodies leave the circulation and are carried to the crevice in the transudate from the inflamed and dilated blood vessels
  • antibody action on microbes in the crevice can result in killing, aggregation, precipitation, detoxification, opsonization, and phagocytosis of bacteria
50
Q

Describe the steps of a local cellular immune response to plaque antigens in the gingival crevice.

A
  • plaque antigens diffuse through the JE
  • Langerhans cells within the epithelium capture and process the antigens
  • antigen-presenting cells (macrophages and Langerhans) leave the gingiva in the lymph
  • antigen-presenting cells reach the lymph node and begin to stimulate lymphocytes to produce a specific immune response
  • periodontally specific B cells and T cells proliferate within the lymph nodes and enter the blood
  • periodontally-specific lymphocytes “home” back to the periodontium and locate within the tissues where they begin their humoral and cell-mediated immune functions
  • antibodies are produced locally by plasma cells which are controlled by Th2 cells; cell-mediated immune activity is regulated by Th1 helper cells
51
Q

Homing of relevant immune cells takes place ___.

A

within the periodontal lesion

52
Q

Which Th cells are more prevalent in chronic periodontal lesions?

A

Th2

53
Q

Which cells are among the most predominant active secretory cells in advanced periodontal lesions?

A

plasma cells

54
Q

True or false: The ratio of IgG subclasses are similar in serum and gingival crevicular fluid.

A

true

55
Q

True or false: An individual’s ability to mount a specific antibody response to bacteria in the subgingival biofilm may indicate a patient’s susceptibility to the disease and ability to respond to treatment.

A

true

56
Q

You can diagnose active periodontitis by screening ___ or screening ___.

A
  • whole saliva

- gingival crevicular fluid

AU14 - Periodontology Exam 1 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions