Path 2 Flashcards
Matrix Metaloproteinases (MMPs)
Proteases – degrade extracellular matrix
* collagen, gelatin, elastin
Use ions – Ca, Mg
Inhibitors of MMPs
chemically modified tetracycline (stains teeth because binds to Ca in HA crystal?)
low dose doxycycline
Binds to Ca found in MMPs
good for inhibiting the destruction of periodontal structures
Diagnosis of Periodontal disease – CREVICULAR FLUID
Enzymes, Ig molecules, infalmmatory mediators
Fluid increases with inflammation
Arrestin
tetracyline powder
Inhibits MMP activity
Injected into periodontal pocket
Inflammation
visually –> redness, spongy, bleeding on probing
Arachidonic acid metabolites
PGE2 –> inflamed tissues express many PGE2
Capable of gingival inflammation and bone resorption
Leukotrienes –> inflammatory reaction
Marker for disease activity
Pathology in periodontal disease is contributed to….
PGE2, IL-1, TNF alpha
PGE2 (arachidonic acid metabolites)
vasopermeability
Vasodilation
inducer of MMP secretion – monocytes and fibroblasts
osteoclast bone resorption (action with IL1 and TNF alpha)
Histamine acts on the MAST CELL
releases leukotrienes
Acrachidonic acid metabolites 2-3 FOLD INCREASE
gingivitis
Arachidonic acid metabolites 5-6 FOLD INCREASE
active diesase progression – based on longitudinal attachment loss
GCF PGE2 levels ______ prior to attachement level changes
INCREASES
Suppresion of PGE2 synthesis (COX 1 COX2)
NSAIDS
diminishes attachment and bone loss
GCF PGE2 levels are substanitally higher in _____ risk patients
HIGH
Refractory – pts not responding to treatment
Early onset
diabetic
Associated with hyperresponisve monocyte PGE2 traits systemically
Hyperresponsiveness
Chronic infection and LPS exposure –> systemic elevations of TNF alpha IL 1 and GM CSF (all capable of up regulating PGE2 secretion)
Genetic region of the HLA -DR – TNF beta genes
Primarily see EDEMA in preriodontal disease
TRUE
PGE2 and Leukotrienes
cause edema, fever, and pain
Lipoxins
turn off inflammation
Come from endogenous fatty acids
Resolvins
omega 3
anti-inflammatory
PGE2
proinflammatory
Disease results when there is too much “on” signals or not enough “off” signal, which results in chronic inflammation.
TRUE
Systemic modifications of periodontal disease status
Host stress
Physical stress
Social effectors
Environmental stress
Host stress
Mediated by CNS neuropeptides
* corticotropin releasing factor
CRF
depresses lymphocyte function
Inhibit antibody secretion
impairs neutorphil phagocytic and killing function
Up regulates realase of IL1 and TNF alpha from monocytes
