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Parodontologie > Etiopatogenie BP > Flashcards

Etiopatogenie BP Flashcards

1
Q

Compozitie matrice extracelulara a biofilmului x4

A
  1. Majoritar PZ-de origine microbiana (dextran, levan, glicogen, mutan)
  2. GP de origine salivara
  3. Lipide din liza bacterii
  4. Proteine din liza GP salivare
  5. Comp. anorganica (Ca ,K, ioni fluorura sau fosfat)
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2
Q

Rol matrice celulara

A
  1. Mentinere integritate film
  2. Sursa energie pt bacterii comunitare
  3. Prevenire desicare bacterii
  4. Legare substante nutritive ionice
  5. Organizare spatiala a speciilor bacteriene in raport cu altele
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3
Q

Factori inhibitori produsi de bacteriile biofilmului x4

A
  • acizi organici
  • peroxis de H
  • enzime
  • bacteriocine
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4
Q

Ce produc unii streptococi?

A

Peroxid de H

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5
Q

Ce produc Streptococii si Actinomyces?

A
  • lactat si farmat (pt Veillonela si Agg.Act)
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6
Q

Ce produce Treponema Denticola>?

A

Acid succinic

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7
Q

Ce produce Campylobacter Rectus?

A

Protohem

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8
Q

Ce produsi de alte bacterii favorizeaza rata de zvoltarii a Prophiromonas Gingivalis?

A
  • Protohem
  • acid succinic
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9
Q

Ce produce Porphiromonas GIngivalis?

A

Acid izobutiric (pt crestere Treponema)

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10
Q

Ce produce FUsobacterium Nucleatum?

A

amoniac (creste ph pt a facilita actiuna P.g.)

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11
Q

Care sunt mecanismele explanatorii pt rezistenta la AB a bacteriilor din biofilm?

A
  1. Crestere redusa bacterii biofilm (fara diviziune, susceptibilitate scazuta la AB)
  2. Enzime bacteriene degradeaza unele AB (Beta-lactamaza si formaldehid-dehidrogenaza)
  3. Populatia bacteriana “super rezistenta” la AB–>elimina AB in exteriorul celulei cu pompele de eflux
  4. Schimburi de informatie genetica (ADN bacterian)
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12
Q

Complexul Rosu x3 plus asocieri x2

A
  1. Tannarella Forsythia
  2. Porphiromonas gingivalis
  3. Treponema Denticola
  • pungi profunde
  • zone cu pierdere atasament
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13
Q

Complex Portocaliu x6

A
  1. Campylobacteri spp.
  2. Eubacterium nodatum
  3. Fusobacterium spp.
  4. Peptostreptococus micros (parvimonas micra)
  5. Prevotalla intermedia
  6. Streptoccocus intermedia
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14
Q

Ce este A.A?

A
  • cocobacil G(-), non-motil, capnofil (are nevoie de CO2)
  • facultativ anaerob
  • zaharolitic
  • nu face parte din niciun complex (serotipul b)
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15
Q

Ce este Porphiromonas gingivalis?

A
  • cocobacil G(-), strict anaerob
  • formeaza colonii maro inchis-negre
  • majoritar in Parodontita cronica
  • prezent si la pacienti sanatosi, PAL, parodontite cu evolutie rapida
  • Factori de virulenta: capsula, fimbrii, LPZ, arsenal proteolitic(Gingipaine) si produsi de metabolsim toxici ce pot evita sistemul imun al organismului
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16
Q

Mecanismul in cazul dezvoltarii parodontitei cu P.g. ca patogen cheie

A
  • declansare raspuns imun
  • stabilire comunitate microbiana disbiotica→inflamatie intensa
  • inhiba imunitatea innascuta→cresterea intregului biofilm
  • distrugere consecutiva a relatiilor homeostatice normale
  • P.g. sustine si stabilizeaza restul florei microbiene
17
Q

Care sunt factorii de virulenta ai bacteriilor subgingivale?

A
  1. Produsi de metabolism si substante toxice produse de bacterii
  2. Proteaza bacteriene
  3. Fimbrii bacteriene
  4. Capacitate de evitare sistem imun organism
  5. LPZ
18
Q

Care sunt produsii de metabolism si substante toxice produse de bacterii?

A
  • Hidrogen Sulfuret(Pg)
  • Metil-mercaptan(Pg)→largire spatii intercel., alterare metab fb
  • acid acetic-efect toxic
  • acid propionic- efect toxic
  • acid butiric→apoptoza fb., cel epit. ging., limfovite B/T
19
Q

Exemple de proteaza bacteriene

A
  • 2 cistein-proteaza produse de P.g., denumite gingipaine
20
Q

Ce actiuni au gingipainele?

A
  • distrug TNF-alfa
  • activeaza secretia citokinelor(IL-6, IL-8) de catre monocite
  • rol in adeziunea bacteriei si degradarea tisulara
  • degradeaza componente Complement: C3, C4, C5, factor B→protejeaza bacteria de fagocitoza mediata de complement
21
Q

Ce fac fimbriile lui P.g.?

A
  • favorizeaza adeziunea bacteriana
  • intens imunogene
22
Q

Cum evita bacteriile sistemul imun?

A
  • Capsula bacteriana
  • Sistem proteolitic
  • Invazia tisulara
22
Q

Cum evita bacteriile sistemul imun?

A
  • Capsula bacteriana
  • Sistem proteolitic
  • Invazia tisulara
23
Q

Ce sunt LPZ?

A
  • molecule mari
  • componenta lipidica(lipid A)+componenta polizaharidica
24
Q

Cum actioneaza LPZ?

A
  • LPZ de pe mb. ext a bacteriilor G(-)→raspuns imun putenic
  • LPZ interactioneaza cu receptorii de pe suprafata celulelor imune (MF, monocite, celule dendritice, LB)
  • rezulta o eliberare de mediatori proinflamatori-Citokine
  • rezulta reactii in cascada →distructie parodontiu
25
Q

Schimbari de la sanatatea parodontala catre cea de parodontita:

A
  • G(+)→G(-)
  • coci→bacili
  • bacterii non-motile→motile
  • facultativ anaerobe→strict anaerobe
  • specii fermentative→ specii proteolitice
26
Q

Prin ce se caracterizeaza inflamatia locala cronica, stimulata bacterian? (x6)

A
  • clearence insuficient neutrofile
  • dereglare/intarziere apoptoza neutrofile si degranluarea lor
  • supraproductie radicali liberi
  • supraproductie mediatori proinflamatori(citokine)
  • faza de rezolutie (stingere) ineficienta
27
Q

Ce sunt citokinele si de cine sunt secretate?

A

Sunt polipeptide, ce permit celulelor sa comunice intre ele.

  • secretate de cel. inflamatorii(neutrofile, MF, limfocite)
  • secretate de celule constitutive ale parodontiului(fb, cel. epiteliale) ca raspuns la stim. LPZ
28
Q

Care sunt efectele citokinelor?

A
  • reglare raspuns inflamator
  • combatere infectii
  • efecte biologice→ leziuni in inflamatii cronice
29
Q

IL-1beta, secretie si efecte

A

Secretata de monocite, MF, neutrofile

  • creste expresia moleculelor de adeziune ICAM si sinteza chemokinei CXCL8
  • rol in imunitate adaptativa: dezvoltarea cel. prezentatoare de antigen, stim. MF sa sintettizeze IL-6→stim activarea LB
  • stim. diferentierea celulelor T helper
  • efect sinergic cu PGE2
  • stim celule parodontale locale sa secrete metaloproteinaze
30
Q

TNF-alfa

A

are multe din efectele IL-1beta

  • creste act neutrofile
  • stim. sinteza metaloproteinazei
  • induce apoptoza fb
  • stim productia de IL-1beta si PGE2
  • act. osteoclastele→resorbtia osoasa asociata bolii parod
31
Q

PGE2:

A

metabolit lipidic

  • vasodilatatie
  • resorbtie osoasa osteoclastica
  • sinteza crescuta de metaloproteinaze
32
Q

Ce sunt metaloproteinazele?

A
  • endopeptidaze zinc-dependente→responsabile de degradarea constituentilor matricii extracelulare
  • fb→ mp-1 (colanogenaza 1)
  • neutrofilele→ mp-8, mp-9→eficienta crescuta in distrugere colagen I (constituent principal al LP)
32
Q

Ce sunt metaloproteinazele?

A
  • endopeptidaze zinc-dependente→responsabile de degradarea constituentilor matricii extracelulare
  • fb→ mp-1 (colanogenaza 1)
  • neutrofilele→ mp-8, mp-9→eficienta crescuta in distrugere colagen I (constituent principal al LP)
33
Q

Ce reprezinta TIMP?

A
  • =inhibitori tisulari ai mp
  • parod. sanatos=echilibreaza actiunea mp
  • in parodontita= sinteza mp depaseste act. TIMP
34
Q

Care sunt semnele clinice ale parodontitelor?

A
  • moblitate
  • migrari secundare
  • pungi parodontale
  • recesii gingivale
  • pierderea dentara

Parodontologie (4 decks)

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