Morinushi T, Lopatin D E, Van Poperin N
Department of Pediatric Dentistry, Kagoshima University Dental School, Japan.
J Periodontol. 1997 Jul;68(7):626-31. doi: 10.1902/jop.1997.68.7.626.
Gingival inflammation in Down's syndrome children (DS) develops earlier and is more rapid and extensive than in non-DS children. Abnormalities in host response to the oral flora have been proposed as etiological factors of this gingival inflammation. However, the relationship between gingivitis and the host response to oral microorganisms in DS by age has not been determined. The objective of this study was to clarify this relationship. Sera were obtained from 75 DS subjects (aged 2 to 18 years) and their gingival health assessed using a modified PMA Index (M-PMA). Antibody titers to Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Treponema denticola (Td), Fusobacterium nucleatum (Fn), Selenomonas sputigena (Sel), Actinobacillus actinomycetemcomitans (Aa), and Streptococcus mitis (Mi) were determined using the micro-ELISA. DS subjects under 4 years old were found to have significantly more gingival inflammation than did normal children the same age. A significant positive correlation (r = 0.548, P < 0.0001) existed in the relationship between M-PMA score and plaque score for subjects in the G1 age group (deciduous dentition). At G1, the average antibody titers to Aa, Mi, and Fn exceeded those of the normal adult reference serum pool. In addition, IgG antibody titers to Pg, Aa, Fn, Sel, and Mi correlated significantly with the M-PMA scores in the G1 age group. There was a correlation between age (2 to 18 years) and these antibody titers. IgG antibody titers to Pg, Aa, Sel, and Mi increased significantly with increasing M-PMA score. Furthermore, the IgG antibody titers to Pg were higher (P < 0.05) in the most extensive disease group compared to the DS no-disease group. The IgG antibody titers to Pg at G3 (early puberty) were significantly higher when compared to G1 (preschool children). The IgM antibody titers to Aa at G3 were higher (P < 0.05) when compared to G1. This study suggests that colonization by Aa and Fn are closely associated with the onset of gingival inflammation in DS patients under 5 years old. Colonization by Pg, Aa, Sel, and Mi in DS appears to be associated with gingivitis at puberty.
唐氏综合征（DS）患儿的牙龈炎症比非DS患儿出现得更早，发展更快且更广泛。宿主对口腔菌群反应异常被认为是这种牙龈炎症的病因。然而，DS患儿中牙龈炎与宿主对口腔微生物的反应随年龄的关系尚未确定。本研究的目的是阐明这种关系。从75名DS受试者（年龄2至18岁）获取血清，并使用改良的菌斑、牙石和牙龈指数（M-PMA）评估其牙龈健康状况。采用微量酶联免疫吸附测定法测定牙龈卟啉单胞菌（Pg）、中间普氏菌（Pi）、具核梭杆菌（Fn）、齿垢密螺旋体（Td）、口腔栖瘤菌（Sel）、伴放线放线杆菌（Aa）和缓症链球菌（Mi）的抗体滴度。发现4岁以下的DS受试者比同龄正常儿童有明显更多的牙龈炎症。在G1年龄组（乳牙列）受试者中，M-PMA评分与菌斑评分之间存在显著正相关（r = 0.548，P < 0.0001）。在G1时，对Aa、Mi和Fn的平均抗体滴度超过正常成人参考血清池。此外，G1年龄组中对Pg、Aa、Fn、Sel和Mi的IgG抗体滴度与M-PMA评分显著相关。年龄（2至18岁）与这些抗体滴度之间存在相关性。对Pg、Aa、Sel和Mi的IgG抗体滴度随M-PMA评分增加而显著升高。此外，与DS无疾病组相比，在最广泛疾病组中对Pg的IgG抗体滴度更高（P < 0.05）。与G1（学龄前儿童）相比，G3（青春期早期）时对Pg的IgG抗体滴度显著更高。与G1相比，G3时对Aa的IgM抗体滴度更高（P < 0.05）。本研究表明，Aa和Fn的定植与5岁以下DS患者牙龈炎症的发生密切相关。DS患者中Pg、Aa、Sel和Mi的定植似乎与青春期牙龈炎有关。
