歯周病ハイリスク患者における宿主応答の解析

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  • Host Immune Responses in Gruop Patients at High Risk for Periodontal Disease.

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In the previous study, we demonstrated the presence of individuals at high risk for periodontal disease among long-term periodontitis patients and evaluated clinical factors to predict the recurrence of periodontal diseases in these patients. However, none of the clinical factors before and after periodontal treatment showed an ability to predict patients at risk for future progression of periodontal isease in the maintenance period. Thisd study was performed to evaluate the host-immune responses in individuals at high risk for periodontal disease. Twenty-one individuals with advanced periodontitis were monitored for changes in probing pocket depth (PD) after periodontal therapy for a 5-year period. A threshold of 5% deterioration was chosen to determine the “high risk” and “low risk” individuals among these subjects, and they were divided into 9 high risk and 12 low risk group patients. Clinical parameters, subgingival plaque samples and venous blood were obtained from these patients at the recall visit 5 years after re-evaluation. High risk group patients showed a significantly higher frequency of sites with bleeding on probing than low risk group patients. However, there were no significant differences the responsiveness of autologous mixed lymphocyte reaction (AMLR), the percentages of CD 4+ CD 45 RA+ and CD 4+ CD 45 RO+ T cell and the CD 4+/CD 8+ ratio of peripheral blood lymphocytes from the two groups of patients. Sera from high risk group patients exhibited a significantly lower level of and -A . viscosus (Av) IgG, however, no differences were detected in the levels of serum antibodies specific to P. gingivalis (Pg), P. intermedia (Pi) and A. actinomycetemcomitans (Aa) between high- and low risk groups patients. Indirect immunofluorescence microscopy reveal that there were no differences in the mean percent of Av, Pg, and Aa in the subgingival microflora of the two groups of patients. It is conceivable that some alterations in the host response to specific periodontopathic bacteria may occur in individuals at hih risk for periodontal disease and these alterations may result in the recurrence of inflammation in the periodontal pockets of the patients.

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