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Perio #1 > Host Response to Periodontal Bacteria > Flashcards

Host Response to Periodontal Bacteria Flashcards

1
Q

How do Bacteria induce damage to periodontal tissues?

A
  1. Bacteria attache and colonize the gingival crevice, some species invade periodontal soft tissue.
  2. Bacteria release substances that directly damage host cells.
  3. Bacteria activate the host’s own inflammatory systems leading to host tissue damage.
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2
Q

What are the 4 Major Microbial virulence factors?

A
  1. Ability to invade periodontal epithelium
  2. Direct cytotoxic effects of bacterial metabolic waste products ( ammonia, indole compounds, hydrogen sulfide)
  3. Damaging bacterial enzymes (leukotoxin and Gingipains)
  4. Immunostimulatory molecules
    - LPS (endotoxin) from gram -
    - Lipoteichoic acids from gram +
    - Gingipains
    - formylpeptides
    - other surface antigens
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3
Q

What are the main mechanisms of periodontal defense?

A
  1. Prevention of bacterial entry
  2. Innate immune response (nonspecific, first line of defense)
  3. Acquired immune response (specific, second line of defense)
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4
Q

How can bacterial entry be prevented?

A
  • Shedding of epithelial cells in oral cavity (happens fairly rapidly) and gets rid of attached bacteria
  • Intact epithelial barrier
  • Positive fluid flow into the gingival crevice
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5
Q

Gingival crevicular fluid originates as _________.

A

gingival tissue interstitial fluid

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6
Q

Inflammation is associated with increased ______.

A

Permeability

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7
Q

How does the innate immune response respond to bacteria?

A
  • Complement system = induces bacterial lysis through phagocytosis and activates most cells
  • Oral mucosa produces anti-bacterial peptides (Defensins)
  • Oral epithelium produces pro-inflammatory cytokines
  • Antimicrobial effect of antibodies, lactoferrin, lysozyme.
  • Phagocytic function of neutrophils (PMN’s) and macrophages
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8
Q

How does the adaptive or acquired immunity respond to bacteria?

A
  • Specific response to bacterial antigen

- Antigen recognition, immune memory and clonal expansion are hallmarks of adaptive immunity

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9
Q

Can bacteria colonize both supra and sub gingival environments?

A

Yes.

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10
Q

What do Toll-like receptors do?

A

Major role in induction of innate immune response

  • Recognize conserved microbial-associated molecular patterns including LPS.
  • TLR’s signal for cells to produce cytokines, chemokines, antimicrobial peptides, nitric oxide and eicosanoids
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11
Q

What cells express TLR’s?

A

Almost all cells

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12
Q

What are the biological activities of LPS?

A
  • Complement activation
  • PMN activation
  • Macrophage activation
  • B-cell mitogen activation
  • Pyrogenicity
  • Stimulation of bone resorption
  • stimulate prostaglandin synthesis
  • induction of Tumor Necrosis factor
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13
Q

What are the mediators of innate immunity?

A

Cytokines and Prostaglandins

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14
Q

What do Cytokines do in regards to innate immunity?

A

Cytokines = involved in the coordination of inflammatory and immune response.

  • Pro-inflammatory activity: IL-1, TNF-alpha
  • Chemotactic activity: IL-8
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15
Q

What do prostaglandins do in regards to innate immunity?

A
  • Induce vasodilation and cytokine production

- Induces production of matrix

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16
Q

What are defensins made by? What does it do?

A

Saliary glands…..

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17
Q

What do Matrix Metalloproteinases do in regards to innate immunity?

A
  • Degrade extracellular matrix

* Concentrations are higher in inflamed gingiva than in healthy.

18
Q

What do Proteinase inhibitors do in regards to innate immunity?

A
  • antagonize inflammation

- inhibit degradation of matrix proteins

19
Q

What are the main 2 Proteinase inhibitors?

A

Alpha-2 macro globulin = broad spectrum proteinase inhibitor.
Alpha-1 antitrypsin = broad spectrum proteinase inhibitor and potent inhibitor of PMN collagenase.

20
Q

***What are the 2 most important Antimicrobial peptides in regards in innate immunity?

A
  1. Defensins

2. Calprotectin

21
Q

What does Defensins do?

A

Inhibit bacteria and fungi

22
Q

Where is Defensins produced?

A

Salivary gland epithelium

23
Q

What does Calprotectin do?

A

Inhibits bacteria and fungi by chelating Zinc.

24
Q

Where is Calprotectin produced?

A

By epithelium, PMNS, monocytes and macrophages

25
Q

Describe the three cellular elements of the innate immunity….

A
  • Neutrophils (PMNs-Polymorphonucleocytes) = deployed from blood.
  • Macrophages = are found in organs and tissues
  • Mast cells = are found throughout the body, esp. in connective tissue adjacent to mucosal surfaces.
26
Q

What are the 4 methods that PMN’s can use to combat bacteria?

A
  1. Secretion
  2. Respiratory burst
  3. Phagocytosis
  4. Lysis or apoptosis
27
Q

_____ and _____ function as antigen presenting cells.

A

Macrophages and langerhans cells

28
Q

What do T-help 1 cells do?

A

Regulate cell mediated immune rxns.

29
Q

What do T-helper 2 cells do?

A

Regulate the production of cytokines that regulate B cells.

30
Q

What determines the type of immune response?

A

Variable regions of T-helper cells

31
Q

What cytokines are made by Th1?

A

IL-2, IFN-gamma, TNF-Alpha

*Stimulate cell mediated immunity

32
Q

What cytokines are made by Th2?

A

IL-4, 5, 6, 10, 13

*Stimulate humeral immune function

33
Q

What do T-cells do?

A

Respond to intracellular pathogens

*Antigens from pathogens bind MHC1 molecules to stimulate T-cells…

34
Q

Cytotoxic T-cells are activated by _______.

A

cytokines

35
Q

T or F, there are many T-cells found in the periodontitis.

A

False, this suggest that viruses and invasive bacteria are not major players.

36
Q

B cells are part of ______ immunity and are triggered in response to ________.

A

Humoral immunity (antibody mediated) and triggered in response to soluble antigens .

37
Q

What are the 2 types of B cells?

A

Conventional = produce antibodies against bacteria, levels decrease in healthy sites.
Auto reactive = produce auto-antibodies, levels do not decrease after treatment

38
Q

_______ activate B cells to plasma cells.

A

Th-2 cytokines

39
Q

The Antigen-Antibody complex activates _______ and facilitates _________.

A
  • Activates complement

- Facilitates opsonization

40
Q

Which #’s are greater in chronic periodontal lesions? Th2 or Th1?

A

Th2

41
Q

What are the most predominant and active secretory cells in advanced periodontal lesions?

A

Plasma cells

Perio #1 (9 decks)

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