Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
J Dent Res. 2021 Nov;100(12):1405-1413. doi: 10.1177/00220345211009767. Epub 2021 Apr 27.
Precise classification of periodontal disease has been the objective of concerted efforts and has led to the introduction of new consensus-based and data-driven classifications. The purpose of this study was to characterize the microbiological signatures of a latent class analysis (LCA)-derived periodontal stratification system, the Periodontal Profile Class (PPC) taxonomy. We used demographic, microbial (subgingival biofilm composition), and immunological data (serum IgG antibody levels, obtained with checkerboard immunoblotting technique) for 1,450 adult participants of the Dental Atherosclerosis Risk in Communities (ARIC) study, with already generated PPC classifications. Analyses relied on tests and generalized linear models with Bonferroni correction. Men and African Americans had higher systemic antibody levels against most microorganisms compared to women and Caucasians ( < 0.05). Healthy individuals (PPC-I) had low levels of biofilm bacteria and serum IgG levels against most periodontal pathogens ( < 0.05). Subjects with mild to moderate disease (PPC-II to PPC-III) showed mild/moderate colonization of multiple biofilm pathogens. Individuals with severe disease (PPC-IV) had moderate/high levels of biofilm pathogens and antibody levels for orange/red complexes. High gingival index individuals (PPC-V) showed moderate/high levels of biofilm and . Biofilm composition in individuals with reduced periodontium (PPC-VI) was similar to health but showed moderate to high antibody responses. Those with severe tooth loss (PPC-VII) had significantly high levels of multiple biofilm pathogens, while the systemic antibody response to these microorganisms was comparable to health. The results support a biologic basis for elevated risk for periodontal disease in men and African Americans. Periodontally healthy individuals showed a low biofilm pathogen and low systemic antibody burden. In the presence of PPC disease, a microbial-host imbalance characterized by higher microbial biofilm colonization and/or systemic IgG responses was identified. These results support the notion that subgroups identified by the PPC system present distinct microbial profiles and may be useful in designing future precise biological treatment interventions.
牙周病的精确分类一直是共同努力的目标，并导致了新的基于共识和数据驱动的分类方法的引入。本研究的目的是描述基于潜在类别分析（LCA）的牙周分层系统（牙周剖面分类（PPC）分类法）的微生物特征。我们使用人口统计学、微生物（龈下生物膜组成）和免疫学数据（使用棋盘式免疫印迹技术获得的血清 IgG 抗体水平），对已经生成的 PPC 分类的 1450 名社区牙周炎风险（ARIC）研究的成年参与者进行分析。分析依赖于 t 检验和广义线性模型，并用 Bonferroni 校正。与女性和白种人相比，男性和非裔美国人的大多数微生物的系统性抗体水平更高（<0.05）。健康个体（PPC-I）的生物膜细菌水平较低，对大多数牙周病原体的血清 IgG 水平也较低（<0.05）。轻度至中度疾病（PPC-II 至 PPC-III）的患者表现出多种生物膜病原体的轻度/中度定植。患有严重疾病（PPC-IV）的个体具有中度/高度生物膜病原体和橙色/红色复合物的抗体水平。牙龈指数高的个体（PPC-V）表现出中度/高度的生物膜和。牙周组织减少的个体（PPC-VI）的生物膜组成与健康相似，但表现出中度至高度的抗体反应。严重牙齿缺失的个体（PPC-VII）具有多种生物膜病原体的显著高水平，而这些微生物的系统性抗体反应与健康相当。结果支持男性和非裔美国人患牙周病风险增加的生物学基础。牙周健康的个体表现出低生物膜病原体和低系统性抗体负担。在存在 PPC 疾病的情况下，确定了以更高微生物生物膜定植和/或全身性 IgG 反应为特征的微生物-宿主失衡。这些结果支持这样一种观点，即 PPC 系统确定的亚组具有不同的微生物特征，可能有助于设计未来精确的生物学治疗干预措施。
