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Impaired bactericidal activity of PMN from two brothers with necrotizing ulcerative gingivo-periodontitis
C W Cutler1, M O Wasfy, K Ghaffar
1University of Texas, Department of Stomatology, Houston.
Abstract:
The purpose of this study was to investigate the pathogenesis of necrotizing ulcerative gingivo-periodontitis (ANUP) diagnosed in two brothers, age 9 (ANUP1) and 14 (ANUP2) from rural Egypt. Complete blood count, differential and blood chemistry were within normal limits for both brothers and they were not malnourished. The phagocytosis and killing function of their polymorphonuclear leukocytes (PMN) towards four bacterial species were assessed using a fluorochrome microassay. The selection of bacterial species was based on preliminary microbiological results in early onset periodontitis in Egypt. Fluorochrome-labeled Prevotella intermedia, Peptostreptococcus micros, Campylobacter rectus, and Porphyromonas gingivalis were pre-opsonized with ANUP serum and added to PMN from both ANUP patients, as well as PMN from three sex-matched and two sex- and age-matched healthy Egyptian control (CTL) subjects. We found significant depressions (P < 0.05) in PMN phagocytosis and killing of C. rectus and P. intermedia by ANUP1 and ANUP2, when compared to all CTL PMN. An assessment of the Gram-negative subgingival microflora present in both ANUP patients (in colony forming unit percent of total CFU recovered) (CFU %) revealed the presence of P. intermedia (ANUP1, 41.7 CFU %; ANUP2, 14.8 CFU %), Fusobacterium nucleatum (ANUP1, 3.6 CFU %; ANUP2, 48.1 CFU %), and Veillonella spp. (ANUP1, 18.2 CFU %; ANUP2, 18.5 CFU %). Spirochetes were also observed in cytocentrifuged, Gram-stained plaque from both ANUP patients. The predominant Gram-positive bacterial species recovered from both NUG1 and NUG2 was Streptococcus morbillorum.
Insights
Necrotizing ulcerative gingivo-periodontitis (ANUP) in two Egyptian brothers showed impaired polymorphonuclear leukocyte (PMN) function against specific bacteria. This suggests a potential link between PMN dysfunction and ANUP pathogenesis.
Area of Science:
- Oral Medicine
- Immunology
- Microbiology
Background:
- Necrotizing ulcerative gingivo-periodontitis (ANUP) is a severe oral condition.
- Understanding the immune and microbial factors in ANUP pathogenesis is crucial.
Purpose of the Study:
- To investigate the pathogenesis of ANUP in two pediatric patients from Egypt.
- To assess polymorphonuclear leukocyte (PMN) function and subgingival microflora in ANUP.
Main Methods:
- Assessed PMN phagocytosis and killing function against Prevotella intermedia, Peptostreptococcus micros, Campylobacter rectus, and Porphyromonas gingivalis using a fluorochrome microassay.
- Analyzed subgingival microflora composition (CFU %) in ANUP patients.
- Compared patient PMN function to healthy control subjects.
Main Results:
- ANUP patients exhibited significantly reduced PMN phagocytosis and killing of Campylobacter rectus and Prevotella intermedia compared to controls (P < 0.05).
- Subgingival microflora analysis revealed high proportions of Prevotella intermedia, Fusobacterium nucleatum, and Veillonella spp.
- Spirochetes and Streptococcus morbillorum were also identified in the plaque samples.
Conclusions:
- Impaired PMN phagocytosis and killing function against specific bacteria may contribute to ANUP pathogenesis.
- The identified bacterial species are potential contributors to the disease in these patients.