Host responses in patients with generalized refractory periodontitis
The purpose of the present study was to evaluate host responsiveness of a well-defined group of refractory periodontitis patients by determining the effect of a lipopolysaccharide (LPS) challenge of monocyte surface receptor density and on the release of inflammatory mediators. Seven documented refractory patients, eight stable maintenance patients, and eight patients with gingivitis but no periodontitis participated in this study. Venous blood was drawn from each patient, and mononuclear cells were separated out. Mononuclear cells were cultured in either control media or media treated with Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, or Salmonella typhimurium LPS. Supernatants were collected at O and 24 hours and assayed for prostaglandin E2 and interleukin 1-beta content by an ELISA. In addition, flow cytometry analysis of Mo3E and LeuM3 expression was done as well as for CD4 and CD8 expression by Iymphocytes.
The mean percentage of monocytes within the mononuclear cell preparation, as determined by LeuM3 positive cells of flow cytometry, was 15.1% for the gingivitis group, 20.1% for the stable maintenance patients, and 20.9% for the refractory group. These groups were not statistically different. There was a trend toward less response in the monocytes from refractory patients. The CD4/CD8 ratio was decreased in the periodontitis group, when compared with the gingivitis and stable maintenance groups. Another finding was that monocytes from all patients with a previous history of periodontitis, both refractory and stable maintenance cases, released higher levels of IL-1 and PGE2 than cells from patients with gingival inflammation but no previous periodontitis. Levels of release were higher for the P. gingivalis and S. typhimurium groups. [P.W.]
Hernichel-Gorbach, E., K.S. Kornman, S.C. Holt, F. Nichols, H. Meador, J.T. Kung, and C.A. Thomas, J Periodont, 65:8, 1994