Primary defence Barriers in Periodontal Pathogenesis (1) Flashcards
What patients are seen to have periodontal disease?
have an exaggerated inflammatory/immune response to bacterial biofilm
have reduced levels of antioxidant defences.
What causes tissue damage in periodontal disease?
The tissue damage in periodontal disease is mainly caused by the host response, accounting to 80% of the tissue damage.
Direct effect of the bacteria in the biofilm
contributes to only 20% of the tissue damage.
What causes the host to respond?
The bacterial biofilm
Biofilm antigens
What disease does innate early response cause?
Early gingival inflammation
What disease does the adaptive immune response cause?
Moderate to advanced gingival and periodontal disease (Chronic inflammation)
What response does bacterial biofilms in plaque cause?
inflammatory immune response
What response does plaque antigens cause?
immune response
What is the innate immune response mainly associated with?
intact epithelial barrier
saliva
gingival crevicular fluid
What does the intact epithelial barrier include?
junctional epithelium
sulcular epithelium
oral epithelium
(protect underlying connective tissue)
What is involved in innate immunity?
Innate immunity involves:
Fluid lubrication (Saliva and
Gingival Crevicular) fluid
Epithelial barriers
Complement cascade
Cell signalling
Vasoactive peptides
Adhesion molecules
Neutrophils
Macrophages
Mast cells
What is the role of mucin in saliva?
Saliva contains mucin, which acts as a lubricant
facilitating mastication, swallowing and speech.
It forms a mucous film that protects the mucosa and
keeps it moist.
What are the antibacterial agents of saliva?
lysozyme histatin and lactoferrin
What is the role of growth factors in saliva?
important in wound healing and maintaining the epithelial integrity
What is the role of cystatin in saliva?
inhibits harmful cysteine-proteinases produced by bacteria and dying neutrophils
Where are IgA produced in saliva?
Immunoglobulins especially those involved in mucosal immunity (IgA). Produced by plasma cells within salivary glands and secreted
Where do the materials for the GCF pass from?
Materials and cells pass from the lamina propria into the sulcus
In health what materials are found in the GCF?
Immunoglobulins
Complement
Neutrophils (polymorphonuclear cells)
Epithelial squames
Plaque bacteria
Bacterial products
What molecules will be present in the GCF ill-health? (periodontal ligament break down or remodelling)
Cathepsin B
Prostaglandins
Interleukins
TNF
EGF
Breakdown products of the extracellular matrix
What are other inflammatory products present in the GCF in host defence?
Cytokines
neutrophils
What effect can the innate immune (inflammatory) system have on the periodontium?
The products of the inflammatory reaction could lead to tissue damage
What part of the epithelium plays a role in inflammatory response?
junctional epithelium
How does the junctional epithelium play a role in the inflammatory response?
Junctional epithelium allows fluids and cells to pass through it.
Role in the inflammatory response through cytokine release in response to bacterial products (e.g. LPS).
Release of antibacterial peptides (β-defensins).
What is an example of cytokines and antibacterial peptides the junctional epithelium release?
cytokine = LPS
ANTIBACTERIAL PEPTIDES = beta-defensins
signalling molecules released by the epithelial cells results in what?
Vascular changes
Detection of bacteria (TLRs on junctional epithelium and fibroblasts)
Cytokines
Chemokines
What is an example of an anti-inflammatory cytokine?
IL-10
What cytokine is involved in B and T cell activation?
IL-6
What cytokine is involved in CD8+ T cell maturation?
IL-2
What cytokine is involved in CD4+ T cell maturation?
IL-4,5,13
What cytokine is involved in IL-6 synthesis by periodontal fibroblasts?
IL-1
What is an example of a vasoactive peptide?
histamine
What triggers the release of histamine from mast cells?
response to C3a and C5a or Prostaglandin
E2.
What does histamine do?
Histamine increases vascular permeability thus facilitating diapedesis and chemotaxis
What is the role of adhesin molecules?
facilitates inflammatory cell contact with endothelial cells thus facilitating migration into the tissues
What are 3 examples of adhesin molecules?
Intercellular adhesion molecules I and II
Endothelial adhesion molecule I
Leucocyte function antigen I
