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Oral Biology > Periodontal Immunology > Flashcards

Periodontal Immunology Flashcards

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1
Q

Compare gingivitis to periodontitis (6)

A

GINGIVITIS

  1. Inflammation localised to gingival tissues
  2. Acute inflammation
  3. Normal protective, physiological response to infection or injury

PERIODONTITIS

  1. Inflammation of gingival tissues + supporting periodontal structures
  2. Chronic inflammation
  3. Pathological inflammatory response associated with tissue destruction
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2
Q

What environmental factors trigger gingival inflammation?

A
  1. Smoking
  2. Age
  3. Diabetes
  4. Pregnancy (hormonal changes can make gums more vulnerable)
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3
Q

What factors determine whether inflammation resolves or progresses?

A

Host-bacterial interactions

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4
Q

Describe the term virulence factors

A

Factors that are produced by a microorganism and evoke disease

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5
Q

Name examples of virulence factors (4)

A
  1. Assaccharolytic
  2. Gingipains
  3. Atypical LPS
  4. Inflammophilic
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6
Q

Define what assacharolytic means

A

Nutrients from breakdown of proteins and peptides

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7
Q

Define what gingipains are

A

Proteases with broad-specificity
> Degrade host proteins
> Activate MMPs

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8
Q

What factors trigger gingival inflammation?

A
  1. Changes in oral biofilm which can be due to
    > Accumulation
    > Composition
    > Expression of virulence
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9
Q

Function of saliva

A

contains lots of enzymes + antimicrobial peptides and bicarbonate buffers that protect the integrity of teeth

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10
Q

What is released in response to gingivitis? (6)

A
  1. Increased TLR stimulation
  2. Increased production of pro-inflammatory mediators
  3. This triggers acute inflammatory response
  4. Neutrophils remain the predominant cell type in lesion
  5. Monocytes activated and differentiate into macrophages
  6. Lymphocytes are recruited to fine tune immune response
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11
Q

What does attachment loss indicate?

A

Evidence of true pocket formation

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12
Q

What does an INCREASE in immune and inflammatory cells in the periodontist lead to?

A

Periodontitis

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13
Q

Function of neutrophils in periodontal tissue destruction

A

No’s are increased during gingivitis:

> If they contain infection = return to health

> If they are unable to contain infection = predispose to disease progression

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14
Q

What is an excessive infiltration of neutrophils associated with?

A

Chronic inflammation, excessive amounts contributes to tissue destruction

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15
Q

What enzymes are involved with chronic inflammation

A
  1. Degradative enzymes

2. Inflammatory cytokines and O2 radicals

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16
Q

Describe the role of adaptive immunity in periodontal destruction (5)

A
  1. T + B lymphocytes present in early lesion
  2. CD4 T cells, B cells and dendritic cells present as lesion progresses
  3. They are unable to regulate symbiotic biofilm
  4. B cell/ plasma cells predominate advanced lesions
  5. IgG fails to regulate dysbiotic biofilm
17
Q

What imbalance leads to bone loss?

A

An imbalance between bone resorption and bone formation

18
Q

Function of osteoblasts

A

Synthesise + secrete bone tissue (osteoid)

19
Q

Function of osteoclasts

A

Resorbs bone

> Derived from monocyte/macrophage lineage

20
Q

What regulates bone formation and bone resorption?

A

RANKL/RANK/OPG triad

21
Q

How does inflammation lead to bone loss?

A
  1. Activated T/B cells in periodontal lesion secrete RANKL
  2. RANKL binds to RANK to induce osteoclast differentiation
  3. OPG prevents RANKL binding to RANK
  4. This inhibits osteoclast differentiation and leads to alveolar bone resorption
  5. Pro-inflammatory cytokines contribute to bone resorption by inhibiting bone formation by interacting with osteoclasts
22
Q

What does high levels of RANKL lead to?

A

Bone resorption

23
Q

What does low levels of OPG lead to?

A

Bone formation

24
Q

What microbe causes periodontitis?

A

P. gingivalis

25
Q

Compare:
Colonisation (3)
Infection (3)

A

COLONISATION

  1. Microbial presence on a body surface without clinical sign of inflammation
  2. Commensal = part of normal flora in the mouth
  3. Commensal organisms can become pathogenic if conditions favour expression of virulence

INFECTION

  1. Microbial invasion of host tissues
  2. Involves pathogens
  3. Pathogens can behave like commensal if conditions do NOT favour the expression of virulence
26
Q

Name immune defences present in the oral cavity (3)

A
  1. Gingival crevicular fluid
    - AMPS, Cytokines, IgG
  2. Oral mucosa
    - AMPS, Cytokines, Chemokines
  3. Saliva
    - S-IgA, Lysozyme, Histatins + Cystatins

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