Bah Periodontal Immunity

Front 1

What type of infection is fungi, like C. Albicans that reside in people's mouths but don't result in fungal infections due to other organisms keeping them in check?

Back 1

Oportunistic infection

Front 2

What plays the biggest roles in opportunistic infections the microbe or the host?

Back 2

The Host

Front 3

What is meant by the statement that PD is time dependent?

Back 3

PD is cyclic not constant breakdown

Front 4

What immune defense system most likely has failed when an opportunistic infection occurs?

Back 4

Innate Immune mechanisms

Front 5

What state is a person in who is phenotypically normal, but is infected with opportunistic microbes?

Back 5

Carrier State

Front 6

What are the Socransky Criteria to implicate a microbe in the etiology of a form of periodontal disease?

Back 6

1. Microbe in high concentration close to lesion
2. Microbe absent or very few in healthy subjects
3. Microbe must have high levels of serum, salivary and gingival crevicular fluid antibodies against it
4. Virulent in-vitro
5. Animal Model
6. Clinical improvement following treatment must eliminate the pathogen from the lesion

Front 7

What are the Socransky Criteria for associating organisms with PD? (Abbreviated List)

Back 7

1. Association
2. Elimination
3. High titer antibodies
4. Virulence factors associated with PD
5. Animal models

Front 8

What type of organisms are found in Supragingival plaque?

Back 8

Supra: Gram +, aerobic, fermentative organisms

Front 9

What type of organisms are found in Subgingival plaque?

Back 9

Sub: Gram -, anaerobic, proteolytic

Front 10

The switch from fermentative organisms to _____ organisms is what we are looking for in PD?

Back 10

Proteolytic

Front 11

What type of perio disease is Pophyromonas Gingivalis associated with?

Back 11

Adult periodontitis

Front 12

What type of perio disease is Actinobacillus Actinomycetemcomitans associated with?

Back 12

Localized Juvenile Periodontitis

Front 13

What are the red group microbes?

Back 13

Tremonema Denticola
PG
Bacteroides Forcythis

Front 14

What complement component is found in high levels within gingival crevicular fluid that functions as chemotaxis and vasodilation?

Back 14

C3a

Front 15

What neutrophil secretions in Gingival Crevicular Fluid are antimicrobial?

Back 15

Lactoferrin
Calprotectin
alpha-defensins

Front 16

What does PG do to complement within the GCF?

Back 16

PG cleaves C3 resulting in inactive C3a

Front 17

What is the component in PG that is different from other LPS components that is involved in NOT inducing selectin molecules in epithelial cells?

Back 17

Lipid A

Front 18

What is the most chemotactic agent for transepithelial migration for the periodontium?

Back 18

IL-8 (also ICAM-1 but not as important)

Front 19

What grabs the PMNs and pulls it through the endothelium?

Back 19

E-Selectin

Front 20

What are MMPs?

Back 20

Proteases produced by the epithelium when they are under severe stress and can break down the tissue

Matrix Metalo Proteases

Front 21

T/F
People with Neutropenia or agranulocytopenia have low levels of neutrophils and are very prone to severe periodontal disease.

Back 21

True
PMNs play a tremendous role in PD, including resolution

Front 22

Name the Primary PMN abnormalities that lead to periodontal disease.

Back 22

1. Neutropenia and agranulocytopenia
2. Chediak Higashi Syndrome
3. G-CSF treated Kostmann Syndrome
4. Specific granule deficiency (SGD)
5. Palillon LeFevre syndrome (PLS); Haim Munk syndrome (HMS); Non Syndromic Prepubertal Periodontitis (NS-PPP)

Front 23

T/F
Chronic granulomatous disease (CGD) is strongly associated with periodontitis

Back 23

False
It is not. So, it is more important to protect against anaerobic bacteria in hypoxic gingival crevice.

Front 24

What subtle neutrophil defect related perio disease is attributed to AA?

Back 24

Localized Juvenile Periodontitis

Front 25

What is the major defect in LJP-1, which is the majority of Localized Juvenille Periodontal disease?

Back 25

There is a decrease in PMN chemotaxis ti C5a due to Decreased expression of GP110.

This was proven when MAbs were used against GP110 and chemotaxis was inhibited.

Front 26

What periodontal disease is associated with GP110 levels decreased?

Back 26

LJP-1

GP110 is associated with chemotaxis of PMNs

Front 27

Which Serotype of AA produces a Leukotoxin that binds to PMNs resulting in lysis?

Back 27

Serotype B

Front 28

What are some ways that microbes can induce PMN defects?

Back 28

1. Leukotoxin binds PMNs resulting in lysis (AA)
2. Immunosuppresive Factor delays antigen presentation to T-cells (AA)
3. Inhibition of neutrophil migration into gingival crevice (PG, E. coli)

Front 29

What does PG prevent the gingival epithelium from secreting?

Back 29

IL-8

Front 30

What happens when CD4+ lymphocytes and monocytes are altered, like in oral manifestations of AIDS?

Back 30

1. Inadequate defense against mucocutaneous infection
2. Disorganization of the local immune response

Front 31

What do SCID mice lack?

Back 31

Mature T and B cells

cannot initiate a T-cell mediated or humoral response

Front 32

What did the the SCID mice experiment infected with PG experience and what is the significance?

Back 32

The mice experienced bone loss, so since there were no T or B cells monocytes may have a role in periodontal bone loss.

Front 33

What are the defects in that cause Papillon-Lefevre and results in periodontal disease?

Back 33

Cathepsin C (dysfunction of PMNs associated with a SNP in the Cathepsin C gene)

Front 34

T/F
Hyporesponsiveness of lymphocytes and monocytes is related to decreased gingival inflammation and the over expression of these cells leads to severe PD

Back 34

True

Front 35

T/F
Lymphocyte and monocyte hyperfunction can induce PD without neutrophils and without a microbial challenge.

Back 35

True

Front 36

What is the most important cytokine known to date for bone destruction and periodontal disease that is induced when macrophages come in contact with LPS?

Back 36

IL-1beta Osteoclast activating factor

Front 37

How does IL-1beta affect monocyte/macrophage activity?

Back 37

1. Monocyte/Macrophage releases IL-1beta
2. IL-1beta triggers fibroblasts to secrete collagenase which causes tissue break down
3. IL-1beta triggers osteoblasts to become osteoclasts and resorb bone

Front 38

What do macrophages of patients with chronic PD produce 2-3 times more of?

Back 38

IL-1beta

Front 39

What happens if there is a genetic polymorphism (variation in a sequence of a gene) like a SNP that results in an amino acid change?

Back 39

If in promoter region it increases or decreases expression levels
If in exon region it results in a conformational change

i.e. papillon lefevre and cathepsin C leading to periodontal disease