Department of Clinical Medicine, State University of Campinas, UNICAMP, Campinas, São Paulo, Brazil.
J Periodontal Res. 2012 Feb;47(1):114-20. doi: 10.1111/j.1600-0765.2011.01413.x. Epub 2011 Sep 5.
Human chronic periodontitis is an inflammatory process characterized by dense accumulation of immune cells in the periodontal tissue. The periodontitis can lead to loss of teeth in the patient and the pathogenesis of this disease is not completely known. This study tested the hypothesis that chronic periodontitis-affected sites can harbor betaherpesviruses and that viruses are linked to a profile of the inflammatory infiltrate.
Biopsies of periodontal tissue were taken from periodontitis-affected patients and from healthy subjects. Immunohistochemistry was performed to count CD19(+) B cells, CD3(+) total T cells, T-CD4(+) and T-CD8(+) cell subsets, and PCR was performed to detect cytomegalovirus and human herpesvirus 6 and 7 in the samples. One slide of each sample was stained with Giemsa for histopathological examination and to evaluate the quality of the cellular infiltrate.
As expected, tissues collected from healthy subjects presented no significant level of inflammatory infiltration and were therefore excluded from immunostaining procedures. Results showed that CD19(+) B cells were in higher number than CD3(+) T cells in the periodontitis-affected tissue, but this was not statistically significant. The T-CD4(+) lymphocyte subset was significantly higher than the T-CD8(+) lymphocyte subset (p = 0.004) in the samples. Cytomegalovirus and human herpesvirus 7 were found at periodontitis-affected sites, but not in tissue collected from healthy subjects (p = 0.04 and p = 0.04, respectively). Human herpesvirus 6 was rarely detected. We found a correlation between cytomegalovirus and lower CD19(+) /CD3(+) ratios (ratio < 0.9, p = 0.003) and between human herpesvirus 7 and lower CD19(+) /CD3(+) ratios (ratio < 0.9, p = 0.003) and higher CD4(+) /CD8(+) ratios (ratio > 1.1, p = 0.002).
This study shows that cytomegalovirus and human herpesvirus 7 can be present at periodontitis-affected sites but are uncommon at healthy periodontal sites. Moreover, our data suggest that cytomegalovirus can be related to an inflammatory infiltrate with predominance of CD3(+) T cells, whereas human herpesvirus 7 can be associated with an infiltrate with predominance of T-CD4(+) cells. However, further studies are necessary to support this hypothesis. Herpesviruses could play a role in human chronic periodontitis by modulation of the T cell response.
人类慢性牙周炎是一种炎症过程,其特征是牙周组织中免疫细胞的密集堆积。牙周炎可导致患者牙齿脱落,其发病机制尚不完全清楚。本研究检验了以下假设:慢性牙周炎病变部位可能存在β疱疹病毒,并且病毒与炎症浸润的特征有关。
从牙周炎患者和健康受试者中采集牙周组织活检。进行免疫组织化学染色以计数 CD19(+)B 细胞、CD3(+)总 T 细胞、T-CD4(+)和 T-CD8(+)细胞亚群,并进行聚合酶链反应以检测样本中的巨细胞病毒和人类疱疹病毒 6 和 7。对每个样本的一张切片进行吉姆萨染色,以进行组织病理学检查和评估细胞浸润的质量。
正如预期的那样,从健康受试者中采集的组织没有明显的炎症浸润水平,因此不进行免疫染色程序。结果表明,在牙周炎病变组织中,CD19(+)B 细胞的数量高于 CD3(+)T 细胞,但这没有统计学意义。T-CD4(+)淋巴细胞亚群明显高于 T-CD8(+)淋巴细胞亚群(p=0.004)。在病变部位发现了巨细胞病毒和人类疱疹病毒 7,但在健康受试者的组织中未发现(p=0.04 和 p=0.04)。很少检测到人类疱疹病毒 6。我们发现巨细胞病毒与较低的 CD19(+) /CD3(+)比值(ratios<0.9,p=0.003)之间存在相关性,人类疱疹病毒 7 与较低的 CD19(+) /CD3(+)比值(ratios<0.9,p=0.003)和较高的 CD4(+) /CD8(+)比值(ratios>1.1,p=0.002)之间存在相关性。
本研究表明,巨细胞病毒和人类疱疹病毒 7 可存在于牙周炎病变部位,但在健康牙周部位不常见。此外,我们的数据表明,巨细胞病毒可能与以 CD3(+)T 细胞为主导的炎症浸润有关,而人类疱疹病毒 7 可能与以 T-CD4(+)细胞为主导的浸润有关。然而,需要进一步的研究来支持这一假设。疱疹病毒可能通过调节 T 细胞反应在人类慢性牙周炎中发挥作用。