Tsilingaridis G, Yucel-Lindberg T, Concha Quezada H, Modéer T
Division of Paediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden; Department of Paediatric Dentistry, Eastmaninstitutet, Stockholm, Sweden.
J Periodontal Res. 2014 Dec;49(6):742-50. doi: 10.1111/jre.12157. Epub 2013 Dec 28.
Altered immune response may be a major contributor to periodontal disease in Down syndrome. This study investigated the relationship between peripheral lymphocytes and matrix metalloproteinases (MMPs) in serum in Down syndrome children with gingivitis.
Children with Down syndrome (n = 10) and healthy controls (n = 10) were clinically and radiographically examined during dental treatment under general anaesthesia. Peripheral blood and gingival crevicular fluid were collected from each subject and concentrations were determined: serum MMP-2, -3, -8 and -9; serum tissue inhibitors of metalloproteinases (TIMP) -1, -2 and -3; and gingival crevicular fluid. Leukocytes were isolated from peripheral blood and the relative amounts (%) of the various cell phenotypes were analysed using flow cytometry. In addition, peripheral blood cells were treated with Porphyromonas gingivalis lipopolysaccharide and levels of MMPs and TIMPs measured.
Concentrations of MMP-3, MMP-8 and TIMP-1 in serum were significantly higher (p < 0.05) in the Down syndrome group compared to the controls. When peripheral blood leukocytes were cultured in the presence or absence of P. gingivalis lipopolysaccharide, MMP-8 levels were significantly (p < 0.05) higher in the Down syndrome group compared to controls. Children with Down syndrome exhibited significant positive correlations between CD8(+) T cells and MMP-8 (r = 0.630; p = 0.050), between CD8(+) T cells and MMP-9 (r = 0.648; p = 0.043), and between CD56(+) NK cells and MMP-3 (r = 0.828; p = 0.003) compared to controls.
The positive relationship of serum MMP-3, -8 and -9 with immune cells in children with Down syndrome may facilitate migration of CD8(+) T cells and CD56(+) NK cells into the periodontal tissue, which may contribute to the increased degradation of periodontal tissue in individuals with Down syndrome.
免疫反应改变可能是唐氏综合征患者牙周病的主要促成因素。本研究调查了唐氏综合征牙龈炎患儿外周淋巴细胞与血清中基质金属蛋白酶（MMPs）之间的关系。
在全身麻醉下进行牙科治疗期间，对唐氏综合征患儿（n = 10）和健康对照者（n = 10）进行临床和影像学检查。从每个受试者采集外周血和龈沟液，并测定其浓度：血清MMP-2、-3、-8和-9；血清金属蛋白酶组织抑制剂（TIMP）-1、-2和-3；以及龈沟液。从外周血中分离白细胞，并使用流式细胞术分析各种细胞表型的相对含量（%）。此外，用牙龈卟啉单胞菌脂多糖处理外周血细胞，并测定MMPs和TIMPs的水平。
与对照组相比，唐氏综合征组血清中MMP-3、MMP-8和TIMP-1的浓度显著更高（p < 0.05）。当外周血白细胞在有或无牙龈卟啉单胞菌脂多糖的情况下培养时，与对照组相比，唐氏综合征组的MMP-8水平显著更高（p < 0.05）。与对照组相比，唐氏综合征患儿的CD8(+) T细胞与MMP-8之间（r = 0.630；p = 0.050）、CD8(+) T细胞与MMP-9之间（r = 0.648；p = 0.043）以及CD56(+) NK细胞与MMP-3之间（r = 0.828；p = 0.003）呈现显著正相关。
唐氏综合征患儿血清MMP-3、-8和-9与免疫细胞之间的正相关关系可能促进CD8(+) T细胞和CD56(+) NK细胞迁移到牙周组织，这可能导致唐氏综合征个体牙周组织降解增加。
