Papapanou P N, Neiderud A M, Disick E, Lalla E, Miller G C, Dahlén G
Division of Periodontics, Section of Oral and Diagnostic Sciences, Columbia University School of Dental and Oral Surgery, New York, NY 10033, USA.
J Clin Periodontol. 2004 Nov;31(11):985-90. doi: 10.1111/j.1600-051X.2004.00599.x.
The value of seroepidemiology in the study of periodontal infections has not been adequately explored. This study examined serum immunoglobulin (IgG) responses to periodontal bacteria in patients with periodontitis and periodontitis-free individuals over a 30-month period.
Eighty-nine patients with chronic periodontitis and 42 control subjects with no deep periodontal pockets and no or minimal attachment loss (30-72 years old, 43% men) were included. Patients were examined at baseline, after completed periodontal therapy 4 months post-baseline, and at 30 months, and controls, at baseline and 30 months. IgG antibodies to 19 periodontal species were determined by checkerboard immunoblotting.
On average, patients displayed at baseline up to 800-fold higher titers than controls to all but three species. Over the 30-month period, titers remained stable at low levels in controls. In patients, periodontal conditions improved from a baseline mean probing depth of 3.6 mm, bleeding on probing of 62% and an average of 21.5 pockets of=6 mm/person, to 2.5 mm mean pocket depth, 30% bleeding on probing, and 1.2 deep pockets, at 30 months. Over time, antibody titers showed a modest decline in patients, but remained significantly elevated at 30 months in comparison with controls. Antibody-level changes over time were not significantly different between subjects that did and did not receive adjunctive systemic antibiotics.
Conspicuous differences in IgG titers to periodontal bacteria exist between periodontitis patients and periodontally healthy controls. Despite successful periodontal therapy, titers remained elevated over a 30-month period, suggesting that serology may mark the history of past periodontal infection.
血清流行病学在牙周感染研究中的价值尚未得到充分探索。本研究在30个月的时间里,检测了牙周炎患者和无牙周炎个体对牙周细菌的血清免疫球蛋白(IgG)反应。
纳入89例慢性牙周炎患者和42例无深牙周袋且无或仅有轻微附着丧失的对照者(年龄30 - 72岁,43%为男性)。患者在基线、基线后4个月完成牙周治疗后以及30个月时接受检查,对照者在基线和30个月时接受检查。通过棋盘免疫印迹法测定针对19种牙周菌种的IgG抗体。
平均而言,除三种菌种外,患者在基线时对所有其他菌种的滴度比对照者高800倍。在30个月期间,对照者的滴度在低水平保持稳定。在患者中,牙周状况从基线时平均探诊深度3.6 mm、探诊出血62%以及平均每人21.5个≥6 mm的牙周袋,改善至30个月时平均牙周袋深度2.5 mm、探诊出血30%以及1.2个深牙周袋。随着时间推移,患者的抗体滴度略有下降,但在30个月时仍显著高于对照者。接受和未接受辅助全身抗生素治疗的受试者之间,抗体水平随时间的变化无显著差异。
牙周炎患者与牙周健康对照者在针对牙周细菌的IgG滴度上存在显著差异。尽管牙周治疗成功,但滴度在30个月期间仍保持升高,这表明血清学可能标志着过去牙周感染的病史。