Jin L J, Söder P O, Leung W K, Corbet E F, Samaranayake L P, Söder B, Davies W I
Faculty of Dentistry, The University of Hong Kong, Hong Kong.
J Clin Periodontol. 1999 Aug;26(8):531-40. doi: 10.1034/j.1600-051x.1999.260807.x.
This study aimed to determine the association between the levels of granulocyte elastase and prostaglandin E2 (PGE2) in GCE and the concomitant presence of periodontopathogens in untreated adult periodontitis (AP). GCF and subgingival plaque were sampled by paper strips and paper points respectively, from various periodontal sites in 16 AP subjects. Granulocyte elastase activity in GCF was analyzed with a low molecular weight substrate specific for granulocyte elastase, pGluProVal-pNA, and the maximal rate of elastase activity (MR-EA, mAbs/min/site) was calculated. PGE2 levels in GCF were determined by radioimmunoassay. 5 species-specific DNA probes were used to detect the presence of A. actinomyceterncomitans (A.a., ATCC 43718), B. forsythus (B.f, ATCC 43037), P. gingivalis (P.g., ATCC 33277), P. intermedia (P.i., ATCC 33563), and T. denticola (T.d., ATCC 35405), with a sensitivity of 10(3) cells/paper point. No A.a. was detectable from all sites sampled. The predominant combination of species detected was B.f., P.g., P.i. & T.d. and it was significantly higher at periodontitis sites (68%) than at healthy (7%) or gingivitis sites (29%) (p<0.05). Overall, MR-EA values were strongly correlated with PGE2 levels (r=0.655, p<0.001), especially at these periodontitis sites co-infected by B.f., P.g., P.i. & T.d. (r=0.722, p<0.001). The periodontitis sites co-infected by the 4 species were observable from 15 subjects. These sites were sub-grouped into 8 subjects with a high MR-EA and 7 subjects with a low MR-EA. The PGE2 levels in the high MR-EA group were significantly higher than in the low MR-EA group (p<0.05). No significant differences in clinical or bacterial data were found between the two groups. While within the high MR-EA group, similar results were found between the paired periodontitis sites in each subject with highest and lowest MR-EA values. This study shows that the local host response to bacterial challenge in untreated periodontal pockets is diverse in terms of the intensity of inflammatory response measured by granulocyte elastase and PGE2 levels in GCE A more thorough evaluation of the risk for active periodontal disease may involve the combined approaches to the test of the dynamic bacteria-host relations.
本研究旨在确定未经治疗的成人牙周炎（AP）患者龈沟液（GCF）中粒细胞弹性蛋白酶和前列腺素E2（PGE2）水平与牙周病原体共存之间的关联。分别用纸条和纸尖从16例AP患者的不同牙周部位采集GCF和龈下菌斑。用一种对粒细胞弹性蛋白酶特异的低分子量底物pGluProVal-pNA分析GCF中的粒细胞弹性蛋白酶活性，并计算弹性蛋白酶活性的最大速率（MR-EA，mAbs/min/部位）。通过放射免疫测定法测定GCF中的PGE2水平。使用5种物种特异性DNA探针检测伴放线放线杆菌（A.a.，ATCC 43718）、福赛坦氏菌（B.f，ATCC 43037）、牙龈卟啉单胞菌（P.g.，ATCC 33277）、中间普氏菌（P.i.，ATCC 33563）和具核梭杆菌（T.d.，ATCC 35405）的存在，灵敏度为10(3)个细胞/纸尖。在所有采样部位均未检测到A.a.。检测到的主要菌种组合是B.f.、P.g.、P.i.和T.d.，在牙周炎部位（68%）显著高于健康部位（7%）或牙龈炎部位（29%）（p<0.05）。总体而言，MR-EA值与PGE2水平密切相关（r=0.655，p<0.001）, 尤其是在被B.f.、P.g.、P.i.和T.d.共同感染的牙周炎部位（r=0.722，p<0.001）。15例患者中可观察到被这4种菌种共同感染的牙周炎部位。这些部位被分为8例MR-EA高的患者和7例MR-EA低的患者。高MR-EA组的PGE2水平显著高于低MR-EA组（p<0.05）。两组之间在临床或细菌学数据方面未发现显著差异。在高MR-EA组内，在每个患者MR-EA值最高和最低的配对牙周炎部位之间发现了相似的结果。本研究表明，就通过GCF中粒细胞弹性蛋白酶和PGE2水平衡量的炎症反应强度而言，未经治疗的牙周袋中局部宿主对细菌攻击的反应是多样的。对活动性牙周疾病风险进行更全面的评估可能需要采用综合方法来检测动态的细菌-宿主关系。
