Microbial Challenge Host Immuno- inflammatory response Connective tissue and bone metabolism...
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Transcript of Microbial Challenge Host Immuno- inflammatory response Connective tissue and bone metabolism...
![Page 1: Microbial Challenge Host Immuno- inflammatory response Connective tissue and bone metabolism Clinical signs of disease initiation and progression Environmental.](https://reader035.fdocuments.us/reader035/viewer/2022081519/56649cf85503460f949c826e/html5/thumbnails/1.jpg)
Microbial Challenge
Host Immuno-inflammatory response
Connective tissue and bone metabolism
Clinical signs of disease initiation and progression
Environmental and acquired risk factors
Genetic risk factors
Page, Ann Periodontol 1998
Pathogenesis of Periodontitis
![Page 2: Microbial Challenge Host Immuno- inflammatory response Connective tissue and bone metabolism Clinical signs of disease initiation and progression Environmental.](https://reader035.fdocuments.us/reader035/viewer/2022081519/56649cf85503460f949c826e/html5/thumbnails/2.jpg)
Pathogenesis of Periodontitis
Microbial Challenge
Host Immuno-inflammatory response
Clinical signs of disease initiation and progression
Page, Ann Periodontol 1998
Bacteria attacking the body• Antigens• Lipopolysaccharides• Other virulence factors
![Page 3: Microbial Challenge Host Immuno- inflammatory response Connective tissue and bone metabolism Clinical signs of disease initiation and progression Environmental.](https://reader035.fdocuments.us/reader035/viewer/2022081519/56649cf85503460f949c826e/html5/thumbnails/3.jpg)
Pathogenesis of Periodontitis
Microbial Challenge
Host Immuno-inflammatory response
Clinical signs of disease initiation and progression
Page, Ann Periodontol 1998
Bacteria attacking the body• Antigens• Lipopolysaccharides• Other virulence factors
The body defense:• Antibodies• Neutrophils
![Page 4: Microbial Challenge Host Immuno- inflammatory response Connective tissue and bone metabolism Clinical signs of disease initiation and progression Environmental.](https://reader035.fdocuments.us/reader035/viewer/2022081519/56649cf85503460f949c826e/html5/thumbnails/4.jpg)
Microbial Challenge
Host Immuno-inflammatory response
Connective tissue and bone metabolism
Clinical signs of disease initiation and progression
Page, Ann Periodontol 1998
Inflammatory response releases:• Cytokines• Prostanoids• Matrix Metalloproteinases
Pathogenesis of Periodontitis
![Page 5: Microbial Challenge Host Immuno- inflammatory response Connective tissue and bone metabolism Clinical signs of disease initiation and progression Environmental.](https://reader035.fdocuments.us/reader035/viewer/2022081519/56649cf85503460f949c826e/html5/thumbnails/5.jpg)
In Patient A, who is NOT susceptible to periodontitis:
Microbial Challenge
Host Immuno-inflammatory response
Connective tissue and bone metabolism
Clinical signs of disease initiation and progression
Page, Ann Periodontol 1998
Tissue and bone repair/healing
![Page 6: Microbial Challenge Host Immuno- inflammatory response Connective tissue and bone metabolism Clinical signs of disease initiation and progression Environmental.](https://reader035.fdocuments.us/reader035/viewer/2022081519/56649cf85503460f949c826e/html5/thumbnails/6.jpg)
In Patient B, who is susceptible to periodontitis:
Microbial Challenge
Host Immuno-inflammatory response
Connective tissue and bone metabolism
Clinical signs of disease initiation and progression
Page, Ann Periodontol 1998
Tissue destruction and bone loss
![Page 7: Microbial Challenge Host Immuno- inflammatory response Connective tissue and bone metabolism Clinical signs of disease initiation and progression Environmental.](https://reader035.fdocuments.us/reader035/viewer/2022081519/56649cf85503460f949c826e/html5/thumbnails/7.jpg)
Microbial Challenge
Host Immuno-inflammatory response
Connective tissue and bone metabolism
Clinical signs of disease initiation and progression
Page, Ann Periodontol 1998
Deepening of periodontal pockets, furcation involvement, contaminated cementum…
In Patient B, who is susceptible to periodontitis:
![Page 8: Microbial Challenge Host Immuno- inflammatory response Connective tissue and bone metabolism Clinical signs of disease initiation and progression Environmental.](https://reader035.fdocuments.us/reader035/viewer/2022081519/56649cf85503460f949c826e/html5/thumbnails/8.jpg)
Microbial Challenge
Host Immuno-inflammatory response
Connective tissue and bone metabolism
Clinical signs of disease initiation and progression
Environmental and acquired risk factors
Genetic risk factors
Page, Ann Periodontol 1998
Pathogenesis of Periodontitis
![Page 9: Microbial Challenge Host Immuno- inflammatory response Connective tissue and bone metabolism Clinical signs of disease initiation and progression Environmental.](https://reader035.fdocuments.us/reader035/viewer/2022081519/56649cf85503460f949c826e/html5/thumbnails/9.jpg)
In periodontitis, what is actually occurring in a periodontal pocket…
![Page 10: Microbial Challenge Host Immuno- inflammatory response Connective tissue and bone metabolism Clinical signs of disease initiation and progression Environmental.](https://reader035.fdocuments.us/reader035/viewer/2022081519/56649cf85503460f949c826e/html5/thumbnails/10.jpg)
Periodontal Pathogens has invaded:
• Periodontal pocket• Cementum• Gingival tissue
In a patient susceptible to periodontitis, how does the body react?
![Page 11: Microbial Challenge Host Immuno- inflammatory response Connective tissue and bone metabolism Clinical signs of disease initiation and progression Environmental.](https://reader035.fdocuments.us/reader035/viewer/2022081519/56649cf85503460f949c826e/html5/thumbnails/11.jpg)
1. Epithelial Cells produce IL-8 and ICAM-1 in response to bacteria & antigens
IL-8/ICAM-1
![Page 12: Microbial Challenge Host Immuno- inflammatory response Connective tissue and bone metabolism Clinical signs of disease initiation and progression Environmental.](https://reader035.fdocuments.us/reader035/viewer/2022081519/56649cf85503460f949c826e/html5/thumbnails/12.jpg)
2. IL-8 and ICAM-1 are chemotactic signals for neutrophils, which are recruited to the sulcus
Neutrophils
Bacteria/Antigens
![Page 13: Microbial Challenge Host Immuno- inflammatory response Connective tissue and bone metabolism Clinical signs of disease initiation and progression Environmental.](https://reader035.fdocuments.us/reader035/viewer/2022081519/56649cf85503460f949c826e/html5/thumbnails/13.jpg)
3. Neutrophils control bacterial assault by phagocytosis but also secrete matrix metalloproteinases or collagenases (MMP-8) which results in collagen degradation
MMP-8
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4. Interaction of antigens with B cells lead to production of antibodies and complements, which contribute to phagocytosis
B-cell
Plasma Cell
T-cell
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5. In response to bacterial LPS, various cells produce IL-1, TNF-, and PGE2
Activated B-Cell
LPSMacrophage
Fibroblast
IL-1TNF-
PGE2
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Activated B-Cell
Macrophage
Fibroblast
IL-1TNF-
Osteoclast activation
PGE2
6. Production of IL-1, TNF-, and PGE2 leads to osteoclast activation, proliferation and differentiation
![Page 17: Microbial Challenge Host Immuno- inflammatory response Connective tissue and bone metabolism Clinical signs of disease initiation and progression Environmental.](https://reader035.fdocuments.us/reader035/viewer/2022081519/56649cf85503460f949c826e/html5/thumbnails/17.jpg)
Higher amounts of IL-1, TNF-, PGE2, MMPs
Disease Health
Lower amounts of IL-10, TGF-, IL-
1ra, TIMPs
Major Mediators
• Proinflammatory• Destructive
![Page 18: Microbial Challenge Host Immuno- inflammatory response Connective tissue and bone metabolism Clinical signs of disease initiation and progression Environmental.](https://reader035.fdocuments.us/reader035/viewer/2022081519/56649cf85503460f949c826e/html5/thumbnails/18.jpg)
Lower amounts of IL-1, TNF-, PGE2, MMPs
Disease Health
Higher amounts of IL-10, TGF-, IL-
1ra, TIMPs
• Anti-inflammatory• Protective