periodontal pathogenesis

Question 1

describe the pathogenesis of human periodontitis

Answer 1

microbes release LPS’s & Ag’s which causes the body to launch immuno inflammatory response( antibodies, cytokines, prostanoids MMPs) this affects connective tissue and bone metabolism which causes the clinical signs of the disease and progression.

Question 2

what do environmental risk ( smoking)factors affect?

Answer 2

host immunoinflammatory response and connective tissue and bone metabolism

Question 3

Whats the non-specific plaque hypothesis?

Answer 3

its the high number of bacteria that cause the problems

Question 4

whats the specific plaque hypothesis?

Answer 4

its the quality of bacteria that causes problems

Question 5

whats the ecological plaque hypothesis?

Answer 5

environment shifts from aerobic to anerobic

Question 6

What are some bacterial virulence factors associated with plaque?

Answer 6

exotoxins and endotoxins

Question 7

Innate immunity factors in defense

Answer 7

1st line of defense, present at birth, not enhanced by prior exposure, lacks memory, fast but lacks specificity

Question 8

examples of innate immunity

Answer 8

saliva, GCF, epithelium, commensal microflora

Question 9

explain why innate immunity can cause damage?

Answer 9

its not specific,

Question 10

Epitheliums role

Answer 10

barrier( tight jxns), high turnover rate,

Question 11

Salivas role

Answer 11

prevents bacterial attachment, contains IgA, IgM, IgG

Question 12

charecteristics of adaptive immunity

Answer 12

specific, memory, diverse, recognition of self cells, humoral( antibodies), cell mediated( immune cells)

Question 13

inflammatory mediators purpose is…

Answer 13

to initiate, perpetuate, and terminate an inflammatory response.

Question 14

what are the pro-inflammatory cytokines?

Answer 14

interleukins, chemokines, interferins

Question 15

Interleukin 1-

Answer 15

major mediator of periodontitis

Question 16

Which cells does IL1 target?

Answer 16

T-cells, epithelial cells ,endothelial cells, fibroblasts

Question 17

IL1 induces what?

Answer 17

proinflammatory proteins, hematopoesis, differentiation of Th17 cells

Question 18

IL 2-5 are all what?

Answer 18

lymphocyte signaling cytokines

Question 19

IL2 is produced by what?

Answer 19

CD4, CD8, and activated T lymphocytes

Question 20

what does IL4 do?

Answer 20

regulated immunoglobilin production, suppresses activated macrophages and causes their apoptosis

Question 21

TNF-a is produced by what and does what?

Answer 21

macrophages, works like IL1 and mediates inflammatory response and connective tissue destruction

Question 22

what are the 2 key mediators of chronic inflammatory diseases?

Answer 22

TNFa, IL-1

Question 23

what does IL6 do?

Answer 23

causes fusion of monocytes to form osteoclasts

Question 24

what does IL8 do?

Answer 24

induces directional migration of PMNs, monocytes, Tcells to accumulat at inflammation sites

Question 25

what does IL10 do?

Answer 25

suppresses immune and inflammatory response,

Question 26

what does transforming growth factor B do?

Answer 26

its a chemoattractant for monocytes and suppreses their activation

Question 27

prostaglandins are ________ derivatives?

Answer 27

arachidonic, important inflammation mediators

Question 28

matrix metalloproteinases do what?

Answer 28

tissue remodeling and degradation of ECM. Their regulated by hormones, growth factors and cytokines

Question 29

Bone loss in response to inflammation depends on ….

Answer 29

concentration of inflammatory mediators in gingival tissues.

Question 30

what are the proinflammatory cytokines that lead to bone resorption?

Answer 30

IL1, 6, 11, 17, TNFα, Oncostatin M, Leukemia inhibitory factor, Bradykinin, Kallidin and Chemokines

Question 31

what are antiinflammatory cytokines that inhibit bone resorption?

Answer 31

IL4, 10, 12, 13, 18, IFN-β, IFN-γ

Question 32

whats RANKL

Answer 32

receptor activator of nuclear factor kappa B ligand, its expressed by osteoblasts, fibroblasts, tcells, bcells

Question 33

RANK

Answer 33

the receptor for RANKL and is on osteoclasts

Question 34

OPG

Answer 34

osteoprotegerin, expressed by osteoblasts, it binds to RANKL to prevent it from activating osteoclasts

Question 35

RANKL, RANK, OPG and bone resorption

Answer 35

elevated RANKL / =OPG or =RANKL / lowerOPG

Question 36

RANKL, RANK, OPG and bone formation

Answer 36

lowered RANKL / =OPG or =RANKL / elevated OPG