Differential susceptibility to periodontitis in genetically selected Wistar rat lines that differ in their behavioral and endocrinological response to stressors

Microbiota-immune-brain interactions: A new vision in the understanding of periodontal health and disease

This review highlights the significance of interactions between the microbiota, immune system, nervous and hormonal systems, and the brain on periodontal health and disease. Microorganisms in the microbiota, immune cells, and neurons communicate via homeostatic nervous and hormonal systems, regulating vital body functions. By modulating pro-inflammatory and anti-inflammatory adaptive immune responses, these systems control the composition and number of microorganisms in the microbiota. The strength of these brain-controlled responses is genetically determined but is sensitive to early childhood stressors, which can permanently alter their responsiveness via epigenetic mechanisms, and to adult stressors, causing temporary changes. Clinical evidence and research with humans and animal models indicate that factors linked to severe periodontitis enhance the responsiveness of these homeostatic systems, leading to persistent hyperactivation. This weakens the immune defense against invasive symbiotic microorganisms (pathobionts) while strengthening the defense against non-invasive symbionts at the gingival margin. The result is an increased gingival tissue load of pathobionts, including Gram-negative bacteria, followed by an excessive innate immune response, which prevents infection but simultaneously destroys gingival and periodontal tissues. Thus, the balance between pro-inflammatory and anti-inflammatory adaptive immunity is crucial in controlling the microbiota, and the responsiveness of brain-controlled homeostatic systems determines periodontal health.

Evidence for a distinct neuro-immune signature in rats that develop behavioural disability after nerve injury

BACKGROUND

Chronic neuropathic pain is a neuro-immune disorder, characterised by allodynia, hyperalgesia and spontaneous pain, as well as debilitating affective-motivational disturbances (e.g., reduced social interactions, sleep-wake cycle disruption, anhedonia, and depression). The role of the immune system in altered sensation following nerve injury is well documented. However, its role in the development of affective-motivational disturbances remains largely unknown. Here, we aimed to characterise changes in the immune response at peripheral and spinal sites in a rat model of neuropathic pain and disability.

METHODS

Sixty-two rats underwent sciatic nerve chronic constriction injury (CCI) and were characterised as either Pain and disability, Pain and transient disability or Pain alone on the basis of sensory threshold testing and changes in post-CCI dominance behaviour in resident-intruder interactions. Nerve ultrastructure was assessed and the number of T lymphocytes and macrophages were quantified at the site of injury on day six post-CCI. ATF3 expression was quantified in the dorsal root ganglia (DRG). Using a multiplex assay, eight cytokines were quantified in the sciatic nerve, DRG and spinal cord.

RESULTS

All CCI rats displayed equal levels of mechanical allodynia, structural nerve damage, and reorganisation. All CCI rats had significant infiltration of macrophages and T lymphocytes to both the injury site and the DRG. Pain and disability rats had significantly greater numbers of T lymphocytes. CCI increased IL-6 and MCP-1 in the sciatic nerve. Examination of disability subgroups revealed increases in IL-6 and MCP-1 were restricted to Pain and disability rats. Conversely, CCI led to a decrease in IL-17, which was restricted to Pain and transient disability and Pain alone rats. CCI significantly increased IL-6 and MCP-1 in the DRG, with IL-6 restricted to Pain and disability rats. CCI rats had increased IL-1β, IL-6 and MCP-1 in the spinal cord. Amongst subgroups, only Pain and disability rats had increased IL-1β.

CONCLUSIONS

This study has defined individual differences in the immune response at peripheral and spinal sites following CCI in rats. These changes correlated with the degree of disability. Our data suggest that individual immune signatures play a significant role in the different behavioural trajectories following nerve injury, and in some cases may lead to persistent affective-motivational disturbances.

Inhibition of endogenous glucocorticoid synthesis aggravates lung injury triggered by septic shock in rats

The aim of this study was to determine the effects of previous administration of metyrapone (met) on the acute lung injury (ALI) induced by caecal ligation and puncture (CLP) and to explore met's relationship with endogenous glucocorticoids (GCs) as measured by inflammatory, oxidative and functional parameters. One hundred and thirty-five Wistar rats were divided into three main groups: Control (Naïve), Sham and CLP. The animals received pretreatment one hour before surgery. The Naïve group did not undergo any procedure or pretreatment. The Sham group only had the caecum exposed and was pretreated with saline. The CLP group was divided into three pretreatments: metyrapone (CLP met 50 mg/kg i.p.), dexamethasone (CLP dex 0.5 mg/kg i.p.) or saline (CLP sal equivalent volume of 0.9% NaCl). Analyses were performed after 6 and 24 h of sepsis. Previous administration of met significantly increased inflammatory cells, as well as myeloperoxidase (MPO) activity in the lung tissue and alveolar collapsed area, with consequent impairment of respiratory mechanics being observed compared to Sham and Naïve; CLP sal exhibited similar results to those of met. The met reduced corticosterone (CCT) levels and dramatically increased hydrogen peroxide (H2 O2 ) levels in the lung tissue compared to CLP sal. Our results suggest that previous administration of met may have contributed to increased pulmonary oxidative stress and increased mortality by mechanisms dependent of endogenous GC.

Maternal Deprivation of Lewis Rat Pups Increases the Severity of Experi-mental Periodontitis in Adulthood

Background and Objective:

Early life adverse events may influence susceptibility/resistance to chronic inflammatory diseases later in life by permanently dysregulating brain-controlled immune-regulatory systems. We have investigated the impact of infant-mother separation during early postnatal life on the severity of experimental periodontitis, as well as systemic stress and immune responses, in adulthood.

Material and Methods:

Pups of periodontitis resistant Lewis rats were separated from their mothers for 3 h daily during postnatal days 2-14 (termed maternal deprivation; MD), separated for 15 min daily during the same time period (termed handling; HD), or left undisturbed. As adults, their behaviour was tested in a novel stressful situation, and ligature-induced periodontitis applied for 21 days. Two h before sacrifice all rats were exposed to a gram-negative bacterial lipopolysaccharide (LPS) challenge to induce a robust immune and stress response.

Results:

Compared to undisturbed controls, MD rats developed significantly more periodontal bone loss as adults, whereas HD rats showed a tendency to less disease. MD and HD rats exhibited depression-like behaviour in a novel open field test, while MD rats showed higher glucocorticoid receptor (Gr) expression in the hippocampus, and HD rats had altered methylation of genes involved in the expression of hippocampal Gr. LPS provoked a significantly lower increase in circulating levels of the cytokine TGF-1β in MD and HD rats, but there were no significant differences in levels of the stress hormone corticosterone.

Conclusion:

Stressful environmental exposures in very early life may alter immune responses in a manner that influences susceptibility/resistance to periodontitis.

Does stress predispose to periodontal disease?

The relationship of a sound mind to the maintenance of a healthy body has been recognized throughout most of recorded history. The term 'stress' is used to describe adverse emotions or reactions to unpleasant experiences. Individuals with high levels of stress and poor coping skills experience twice as much periodontal disease as compared to those with minimal stress and good coping skills. Although stress may predispose an individual to more destruction from periodontitis, the presence of periodontal pathogens remains the essential aetiologic factor. This review presents a summary of stress, discussing how it can predispose an individual to periodontal disease.

CLINICAL RELEVANCE

Stress, which is a universal phenomenon, is implicated to have various systemic effects besides being a risk factor for periodontal disease. This article elucidates the relationship between psycho-social stress and destructive periodontal disease.

Dehydroepiandrosterone and metyrapone partially restore the adaptive humoral and cellular immune response in endotoxin immunosuppressed mice

Prior exposure to endotoxins renders the host temporarily refractory to subsequent endotoxin challenge (endotoxin tolerance). Clinically, this state has also been pointed out as the initial cause of the non-specific humoral and cellular immunosuppression described in these patients. We recently demonstrated the restoration of immune response with mifepristone (RU486), a receptor antagonist of glucocorticoids. Here we report the treatment with other modulators of glucocorticoids, i.e. dehydroepiandrosterone (DHEA), a hormone with anti-glucocorticoid properties, or metyrapone (MET) an inhibitor of corticosterone synthesis. These drugs were able to partially, but significantly, restore the humoral immune response in immunosuppressed mice. A significant recovery of proliferative responsiveness was also observed when splenocytes were obtained from DHEA- or MET-treated immunosuppressed mice. In addition, these treatments restored the hypersensitivity response in immunosuppressed mice. Finally, although neither DHEA nor MET improved the reduced CD4 lymphocyte count in spleen from immunosuppressed mice, both treatments promoted spleen architecture reorganization, partially restoring the distinct cellular components and their localization in the spleen. The results from this study indicate that DHEA and MET could play an important role in the restoration of both adaptive humoral and cellular immune response in LPS-immunosuppressed mice, reinforcing the concept of a central involvement of endogenous glucocorticoids on this phenomenon.

Chronic treatment with the glucocorticoid receptor antagonist RU486 inhibits diabetes-induced enhancement of experimental periodontitis

BACKGROUND AND OBJECTIVE

Chronic hypothalamic-pituitary-adrenal (HPA) axis hyperactivity and excessive glucocorticoid hormone release have been associated with diabetes, altered immune responses and increased susceptibility to periodontitis. In the present study we tested the impact of streptozotocin (STZ)-induced diabetes on ligature-induced periodontitis and the effect of subsequent treatment with the glucocorticoid receptor (GR) antagonist, RU486.

MATERIAL AND METHODS

A single dose of STZ [45 mg/kg, intraperitoneally (i.p.)] or vehicle was given 10 d before induction of ligature-induced periodontitis and implantation subcutaneously of a drug pellet containing the GR antagonist, RU486, or a placebo pellet. Periodontitis was assessed when the ligatures had been in place for 21 d. Two hours before decapitation all rats received gram-negative bacterial lipopolysaccharide (LPS) (150 μg/kg, i.p.) to induce a robust immune and stress response.

RESULTS

Compared with control rats, STZ-treated rats developed significantly more periodontal bone loss, and RU486 treatment of STZ -treated rats significantly inhibited this effect. STZ-treated rats also showed significantly higher levels of the HPA axis-derived hormone, corticosterone, as well as of the proinflammatory cytokine, tumor necrosis factor-alpha (TNF-α), but lower levels of the anti-inflammatory cytokines interleukin-10 (IL-10) and transforming growth factor-1beta (TGF-1β) after LPS stimulation. GR blockade had no statistically significant effects on these measurements in diabetic rats, but tended to enhance the levels of TNF-α and TGF-1β, and reduce the levels of IL-10 and blood glucose.

CONCLUSION

In diabetic subjects, excessive GR activation as a result of chronic high levels of glucocorticoid hormones may alter immune-system responses in a manner that may increase the susceptibility to periodontitis.

Chromogranin A: Novel biomarker between periodontal disease and psychosocial stress

CONTEXT

The psychosocial stress has long been regarded as a significant pre-disposing factor for periodontal disease. The association between the periodontal disease and the neuroendocrine hormones has been observed. Chromogranin A (CgA) is supposed to link the activity of the neuroendocrine system to local and systemic immune functions and to be related to periodontitis.

AIMS

The aim of this study was to determine the CgA levels in saliva and plasma in periodontal health and disease and to assess their potential relationship to periodontitis.

SETTINGS AND DESIGNS

In this case-control study, the association between periodontal disease and stress marker has been assessed.

MATERIALS AND METHODS

SIXTY SUBJECTS WERE CHOSEN FOR THIS STUDY: With case group comprising of 30 subjects with chronic periodontitis and control group comprising of 30 healthy subjects. Salivary and plasma CgA levels were determined by ELISA technique. Clinical parameters included were plaque index, papillary bleeding index and clinical attachment loss and probing depth. Correlation analysis was calculated by independent sample t-test.

RESULTS

Significantly higher CgA levels were found in saliva and plasma of patients with chronic periodontitis compared with healthy individuals (P < 0.05). No significant difference were observed between salivary and plasma CgA levels.

CONCLUSIONS

The elevated level CgA in the plasma and saliva of subjects with stress induced chronic periodontitis has yielded insights into biological plausible association between the psychosocial stress and chronic periodontitis. Thus, our results suggest that CgA is a useful biomarker for evaluating at least in part the etiopathogenesis of periodontitis.

Anti-inflammatory effect of the endocannabinoid anandamide in experimental periodontitis and stress in the rat

OBJECTIVE

Periodontitis is an infectious disease leading to inflammation and destruction of tissue surrounding and supporting the tooth. The progress of the inflammatory response depends on the host's immune system and risk factors such as stress. The aim of the present study was to investigate the role of the endocannabinoid anandamide (AEA) in experimental periodontitis with restraint stress, since the endocannabinoid system is known to modulate the hypothalamo-pituitary-adrenal axis as well as immune functions and has been found in human gingival tissues.

METHODS

Experimental periodontitis was induced by ligature around first inferior molars and immobilization stress for 2 h twice daily for 7 days in a rat model.

RESULTS

Corticosterone plasma levels, locomotor activity, adrenal gland weight and bone loss were increased in periodontitis and stress groups, and there was also less weight gain. The inflammatory parameters such as prostaglandin E(2) (radioimmunoassay), nitric oxide (radioconversion of (14)C-arginine), tumor necrosis factor (TNF)-α (ELISA) and interleukin (IL)-1β (Western blot) measured in the gingival tissue were significantly increased in the periodontitis groups compared to the control group. Local injection of AEA (10(-8)M, 30 µl) decreased corticosterone plasma levels and the content of the cytokines TNF-α and IL-1β in gingival tissue in periodontitis-stress groups. These AEA-induced inhibitions were mediated by CB(1) and CB(2) cannabinoid receptors since the injection of both antagonists together, AM251 (10(-6)M) and AM630 (10(-6)M) in 30 µl, prevented these effects.

CONCLUSION

The endocannabinoid AEA diminishes the inflammatory response in periodontitis even during a stressful situation.

Evidence that metyrapone in the presence of inflammation modulates cytokine mRNA expression

OBJECTIVE

Metyrapone (MT) has been used clinically to decrease glucocorticoid levels in human and animal studies. However, the potential effects of MT in the presence of inflammation are poorly understood. Thus, the aim of this study was to evaluate the effects of the administration of MT on the mRNA levels of pro-inflammatory cytokines in the presence of inflammation induced by the well-established model of ligature-induced periodontitis in rats.

MATERIAL AND METHODS

Sixty animals were randomly assigned into three experimental groups of 20 rats each: G1-control; G2-periodontal disease (PD) induced by cotton ligature; G3-PD associated with 3 daily doses of MT (50mg/kg/3×3h). After 30 days, all animals were killed by decapitation. Blood samples were taken and the concentrations of corticosterone and catecholamines measured. Marginal tissues around ligated and non-ligated teeth were harvested and gene expression was assessed by quantitative polymerase chain reaction technique (qPCR). Moreover, the area of interradicular bone loss (ABL) was histometrically determined.

RESULTS

Data analysis showed that: (i) ligature placement resulted in a significant ABL, as compared to non-ligated sites of G1 group; (ii) mRNA levels of all the pro-inflammatory factors assessed (INF-γ, TNF-α, IL-1β and IL-6) were increased in the PD group (G2) (p<0.05) when compared to G1; (iii) there were no significant differences in corticosterone and catecholamine plasmatic levels between the three groups; (iv) MT administration, in the presence of inflammation, induces an increased ABL and significantly increased mRNA levels of all pro-inflammatory cytokines analyzed (p<0.05).

CONCLUSION

Within the limits of this study, it can be concluded that MT in the presence of inflammation may modulate expression of pro-inflammatory cytokines, regardless of its effect on plasma corticosterone levels.

Effect of neonatal clomipramine in the pathogenesis of ligature-induced periodontitis in Lewis rats

OBJECTIVE

The aim of this study was to verify the association between an endogenous depression model and the development of ligature-induced periodontitis in rats.

MATERIAL AND METHODS

Nine male Lewis rats received 30 mg/kg clomipramine from neonatal day 8 to day 21 (depressed group), while 13 control Lewis rats were left untouched (control group). On day 150, ligatures were placed around the 2nd upper molars in both groups, i.e. the contralateral molar of the intra-group control. On day 190, the rats were killed and the maxillae were defleshed. The distance between the cemento-enamel junction and the alveolar bone crest was measured by a blinded examiner using standardized digital photographs.

RESULTS

The depressed rats showed hyperactivity in open field on day 142 and greater attempts to escape on day 143 compared to controls. The other behavioral data did not show statistically significant differences between the groups (Mann-Whitney, p>0.05). In teeth with ligature, mean alveolar bone loss varied from 0.51 to 0.60 and from 0.63 to 0.64 mm for tests and controls, respectively (t-test, p>0.05). In teeth without ligature, these values varied from 0.38 to 0.43 and 0.42 to 0.45 mm in the test and control groups, respectively (t-test, p>0.05).

CONCLUSION

Induced depression did not alter ligature-induced bone loss in Lewis rats.

Coping style and immunity in animals: making sense of individual variation

Predicting the individual vulnerability to immune mediated disease is one of the main challenges of modern biomedical research. However, the question of individual behavioral and physiological characteristics that might predict this vulnerability has been subject of research and debate for a long time. This paper will argue that animal models aimed at individual vulnerability should consider the biological function of variation in nature. An increasing number of studies show the ecological significance of variation within a species. Based on behavioral studies in several vertebrate species two coping style can be distinguished. Variation in coping style appears to play a role in the population dynamics and the evolutionary fitness of the species. Coping styles are reflected in a stable differentiation in the behavioral and physiological stress responsiveness over time and across situations. Based on the observations that the individual level of offensive aggressive behavior (i.e., the tendency to defend the home territory) is strongly related to the way animals react to various other environmental challenges, it is argued that the individual's level of offensiveness is an important indicator and component of a more trait-like behavioral and physiological response pattern (coping style) to environmental demands. The coping style of aggressive animals is principally aimed at a (pro)active prevention or manipulation of a stressor whereas the non-aggressive individuals tend to passively accept or react to it. Proactive coping is associated with high sympathetic reactivity to stressors whereas the more passive or reactive coping style generally has a higher HPA axis reactivity. In view of the immune modulating nature of these major neuroendocrine stress systems, one might expect that coping styles will be reflected in a differential vulnerability to immune mediated disease as well. Indeed, several studies have demonstrated such a relationship, indicating that the functional variation in coping style and related neuroendocrine stress reactivity, as it occurs in nature, might be a good standard for studies aimed at understanding individual vulnerability. This is in agreement with more recent views that also in humans stress reactivity may be the best predictor for the individual vulnerability to immune mediated diseases. This asks for a more fundamental and translational approach of individual disease vulnerability based on a common biological basis of individual differentiation in behavior and physiology in humans and animals.

Restraint stress enhances alveolar bone loss in an experimental rat model

BACKGROUND AND OBJECTIVE

The purpose of the present study was to examine the effects of restraint stress on periodontal breakdown resulting from Porphyromonas gingivalis-challenged periodontitis in rats.

MATERIAL AND METHODS

To examine the influence of restraint stress on periodontal breakdown, rats were orally challenged with the periodontal pathogen P. gingivalis. Twenty male, specific pathogen-free (SPF) 3-wk-old, Sprague-Dawley rats were divided into four groups: group A (controls), group B (exposed to restraint stress for 12 h/d for 22 d), group C (orally challenged with P. gingivalis), and group D (exposed to restraint stress for 12 h/d for 22 d and orally challenged with P. gingivalis). After 22 d, all animals were killed. The distance from the alveolar bone crest to the cemento-enamel junction was determined, concentrations of adrenocorticotropic hormone were measured as stress markers, and atrophy of the thymus and spleen were assessed. In addition, the furcation area of the maxillary molars was examined histologically, while gingival cytokine gene expression was assessed by mRNA using reverse transcription-polymerase chain reaction (RT-PCR).

RESULTS

In the restrained group, all stress markers were elevated, and the thymus and spleen were atrophied. Combined restraint stress and oral challenge with P. gingivalis resulted in significantly higher bone loss, and osteoclasts were observed. RT-PCR analysis revealed low cytokine gene expression in the restrained groups.

CONCLUSION

These results suggest that the presence of restraint stress significantly enhances the progression of P. gingivalis-challenged periodontitis in rats.

Enhanced susceptibility to periodontitis in an animal model of depression: reversed by chronic treatment with the anti-depressant tianeptine

OBJECTIVE

To test the hypothesis that the olfactory bulbectomy model of depression in rats could influence susceptibility to ligature-induced periodontitis, and that chronic treatment with the anti-depressant drug tianeptine could attenuate this effect.

MATERIAL AND METHODS

Tianeptine was given twice daily (10 mg/kg, i.p.) during the entire experiment, starting 29 days before induction of olfactory bulbectomy and periodontitis. Olfactory bulbectomized (OB) rats and sham-operated rats were given saline in a similar manner. Periodontal disease was assessed when the ligatures had been in place for 21 days. Two hours before decapitation, rats were injected with lipopolysaccharide (LPS;100 microg/kg, i.p.) to induce a robust immune and stress response.

RESULTS

Compared with sham-operated controls, OB rats developed significantly more periodontal bone loss, exhibited characteristic behavioural responses in a novel open field test, and showed a decreased expression of glucocorticoid receptors (GRs) in the hippocampus. LPS provoked a significantly larger increase in circulating levels of the stress hormone corticosterone and the cytokine transformation growth factor (TGF)-1beta but smaller tumour necrosis factor (TNF)-alpha levels. Tianeptine treatment of OB rats significantly inhibited peridodontal bone loss, normalized behavioural responses, enhanced TGF-1beta levels, and abolished TNF-alpha decrease, but did not attenuate the increased corticosterone response and the decreased hippocampal GR expression.

CONCLUSIONS

These experimental results are consistent with an emerging literature showing that life stress, anxiety, depression, pathological grief, and poor coping behaviour may dysregulate regulatory mechanisms within the brain involved in immune regulation, and thereby alter immune responses and influence the susceptibility/resistance to inflammatory disorders.

[Correlation between psychosocial factors and periodontal disease--a systematic review of the literature]

OBJECTIVES

This is a systematic review of the available empirical studies up to 2004 which deal with the question of the correlation between psychosocial factors/stress and gingival and periodontal disease.

METHOD

The three medical and psychological databases Medline, PsycInfo und Psyndex were searched systematically for relevant literature between 1946 and 2004.

RESULTS

34 empirical studies on humans (16 with and 18 without a control group) and ten empirical studies on animals are presented.

DISCUSSION

Despite serious methodological flaws in many studies, most (particularly the methodologically solid ones) indicated associations between a variety of psychosocial factors and periodontitis incidence and severity. The pathomechanisms between stress and periodontitis should therefore be the subject of further research.

Soluble beta-1,3/1,6-glucan from yeast inhibits experimental periodontal disease in Wistar rats

OBJECTIVE

We have investigated whether a purified immunomodulatory water soluble beta-1,3/1,6-glucan isolated from the cell wall of Bakers yeast, Saccharomyces cerevisiae, would influence the progression of ligature-induced periodontal disease, and to modulate accompanying cytokine and hypothalamic-pituitary-adrenal (HPA) axis responses to a lipopolysaccharide (LPS) challenge.

MATERIAL AND METHODS

beta-1,3/1,6-glucan (10 mg/kg/day) was given in the drinking water to Wistar rats during the entire experiment, starting 14 days before disease induction, while control rats were given tap water only. Periodontal disease was assessed when the ligatures had been in place for 35 days.

RESULTS

Orally administered soluble beta-1,3/1,6-glucan significantly reduced periodontal bone loss as measured on digital X-rays (p=0,026). Glucan-treated rats also showed a significantly enhanced plasma level of the HPA axis-driven hormone corticosterone (p=0.047), and of the cytokine transforming growth factor-1beta (p=0.032), as well as a tendency to enhanced IL-10 (p=0.106), induced by intra-peritoneally administered LPS.

CONCLUSION

Soluble beta-1,3/1,6-glucan administered by the oral route diminishes ligature-induced periodontal bone loss in this model. This effect may be attributable to the well documented ability of beta-1,3/1,6-glucan to stimulate macrophage phagocytosis and to skew the T helper (Th)1/Th2 balance towards Th1 and T regulatory responses. The HPA axis may play a significant role in beta-1,3/1,6-glucan induced immune modulation.

Chronic treatment with the glutamate receptor antagonist MK-801 alters periodontal disease susceptibility

OBJECTIVE

Previous experiments in rats suggest that hypothalamic-pituitary-adrenal (HPA) axis over-responsiveness, which leads to increased secretion of immunoregulatory glucocorticoid hormones, increases periodontal disease susceptibility, whereas HPA axis under-responsiveness is associated with increased resistance to the disease. The present study was designed to investigate whether MK-801 (dizocilipine malate), an antagonist of the glutamate receptor N-methyl-D-aspartate (NMDA) in the brain, which has been found to play an important role in the regulation of the HPA axis, would influence the outcome of experimental ligature-induced periodontal disease in a rat model.

METHODS

Experimental periodontal disease was induced in periodontal disease susceptible and HPA axis high-responding Fischer 344 rats 2 days before chronic treatment with MK-801(1 mg/kg intraperitoneally). The periodontal breakdown was assessed after the ligatures had been in place for 23 days. Following intraperitoneal Gram-negative bacterial lipopolysaccharide stimulation (Escherichia coli, 250 microg/kg), concentrations of glucocorticoid receptors (GRs) in the hippocampus, and levels of the cytokine tumour necrosis factor alpha (TNF-alpha), as well as the HPA axis-derived hormone corticosterone, were measured in serum.

RESULTS

Compared to vehicle-treated controls, MK-801-treated rats had significantly increased periodontal tissue destruction (p < 0.01). MK-801-treated rats also showed significantly increased expression of GRs in the hippocampus (p < 0.05), elevated levels of corticosterone (p < 0.001) and reduced levels of TNF-alpha (p < 0.01) in serum 2 h after lipopolysaccharide stimulation.

CONCLUSION

These findings may implicate glutamate receptor-dependent mechanisms in periodontal disease, and support the concept of a bidirectional immune-brain-immune regulatory network with importance for periodontal health and disease.

Chronic glycine treatment inhibits ligature-induced periodontal disease in Wistar rats

OBJECTIVE

Dysregulation of immune and stress responses plays a significant role for the development and progression of inflammatory diseases, including periodontal disease. The non-essential amino acid glycine modulates immune and central nervous system (CNS) responses, and has been shown to beneficially affect tissue destructive inflammatory conditions. The purpose of this study was to test the ability of orally administered glycine to influence periodontal disease progression, as well as immune and hypothalamic-pituitary-adrenal (HPA) responses following lipopolysaccharide stimulation.

METHODS

Glycine was supplied in the drinking water during the whole experiment to male Wistar rats, starting 3 days before the induction of experimental ligature-induced periodontal disease. Control rats were given tap water only. The periodontal breakdown was assessed after the ligatures had been in place for 34 days. Following intraperitonal lipopolysaccharide stimulation, concentrations of the proximal cytokines tumour necrosis factor-alpha (TNF-alpha) and interleukin-10, as well as the HPA axis-derived hormone corticosterone, were measured in blood serum.

RESULTS

Orally administered glycine significantly reduced periodontal bone loss as measured by digital X-rays (p = 0.007). Bone loss was negatively correlated with increased serum glycine, whereas no significant relationship was found with TNF-alpha, interleukin-10, or corticosterone.

CONCLUSION

Chronic ingestion of glycine supplied in the drinking water significantly reduced periodontal bone loss. No effect of glycine on immune and HPA-axis responses was revealed. Further studies are needed to clarify the mechanisms of action.

Apomorphine-susceptible rats and apomorphine-unsusceptible rats differ in the tyrosine hydroxylase-immunoreactive network in the nucleus accumbens core and shell

Individual variability in behavioural responses to stressors such as novelty and drugs of abuse is a well-known phenomenon in both animals and man. These individual differences are largely associated with differences in dopamine transmission in mesolimbic areas such as the nucleus accumbens. Apomorphine-susceptible (APO-SUS) rats and apomorphine-unsusceptible (APO-UNSUS) rats serve as a valid animal model for individual differences and these two types of rat differ in a number of behavioural, physiological, endocrinological and pharmacological parameters. In order to study the differences in the catecholaminergic network in the nucleus accumbens, possibly underlying at least some of the differences between the two types of rat, we quantified the extent of the tyrosine-hydroxylase immunoreactive (TH-IR) network and the number of TH-IR varicosities in subareas of the nucleus accumbens core and shell in naive rats. This study shows that the nucleus accumbens of APO-SUS rats has a more extensive fibre network and more varicosities than the nucleus accumbens of APO-UNSUS rats, and that the subarea of the shell contains more varicosities than the subarea of the core. These data provide a basis for further studying the structural and neurochemical properties of the nucleus accumbens contributing to individual differences in response to stressors such as novelty and drugs of abuse.

Reduced splenic natural killer cell activity in rats with a hyperreactive dopaminergic system

Interactions between the nervous system and the immune system have been recognized as important regulatory processes in determining the activity of the immune response. We have previously shown that rats, which differ in the reactivity of the dopaminergic system (APO-SUS and APO-UNSUS rats), also differ in experimental metastasis formation and in susceptibility to autoimmunity. APO-SUS rats have a high response to administration of apomorphine and can be characterized as hyperdopaminergic, whereas their APO-UNSUS counterparts show low susceptibility to apomorphine and have a hypodopaminergic phenotype. In this study we investigated whether the decreased experimental metastasis formation of APO-SUS rats compared to APO-UNSUS rats is associated with higher natural killer cell activity in APO-SUS rats. Surprisingly, splenic NK cell activity of hyperdopaminergic APO-SUS female as well as male rats is significantly lower than NK cell activity of their hypodopaminergic APO-UNSUS counterparts. The reduced splenic NK activity of female APO-SUS rats is associated with lower percentages of NK cells in the spleen cell population. In contrast, male APO-SUS and APO-UNSUS rats show similar numbers of NK cells in the spleen. There was no difference in plasma dopamine levels between APO-SUS and APO-UNSUS rats and i.p. treatment of rats with the dopaminergic agonist quinpirole did not alter NK cell activity. In conclusion, our data demonstrate that differences in the reactivity of the dopaminergic system are associated with differences in splenic NK cell activity. Moreover, our data demonstrate that in this model lower splenic NK cell activity is not related to increased experimental lung metastasis formation.

Oral treatment with SRP299 (killed Mycobacterium vaccae ) inhibits experimental periodontal disease in Wistar rats

OBJECTIVE

Mycobacterium vaccae injected subcutaneously was previously shown to prevent and treat ligature-induced periodontal disease (PD) in Wistar rats (Breivik & Rook 2000, 2002). Since mycobacteria are readily taken up via Peyer's patches in the intestine, we have now tested the ability of oral SRP299 (killed M. vaccae) to prevent ligature-enhanced PD in Wistar rats, and to modulate the accompanying cytokine and corticosterone responses.

MATERIAL AND METHODS

A single oral dose of SRP299 (1 mg) was given 14 days before the application of ligatures. PD was assessed when the ligatures had been in place for 56 days.

RESULTS

Oral SRP299 reduced bone loss (p = 0.036, X-ray; p = 0.061, histometry) and fibre loss, both on the ligatured (p = 0.0047) and control (p = 0.005) sides, and also reduced the level of TNF-alpha (p = 0.0137) and corticosterone (p = 0.048) induced by intraperitoneal endotoxin lipopolysaccharide (LPS).

CONCLUSIONS

SRP299 administered by the oral route diminishes ligature-induced bone and fibre loss in this model. This effect may be attributable to the known ability of SRP299 to evoke regulatory T cells, although the mechanism could not be investigated in this study. Treated rats also had less excitable hypothalamo-pituitary-adrenal (HPA) axes. HPA axis overactivity is a known risk factor in human PD. Trials of SRP299 in human PD are now justified.

Effect of variable moderate chronic stress on ligature-induced periodontal disease in Wistar rats

The aim of this investigation was to study the impact of stress on ligature-induced periodontal disease in rats by means of a variable moderate chronic stress model. Thirty male Wistar rats were randomly assigned to six groups. Control groups received only ligatures around the second maxillary molars, while experimental groups were exposed to stress in additional. Stress was imposed by means of flashing light, isolation, rat blood smelling, new environment exposure, immobilization in cold temperature and immobilization at room temperature. Stress was applied randomly, thereby diminishing adaptation of the animals to the model. The animals were killed after 29, 43, and 57 days. The distance between the cementum-enamel junction and the alveolar bone (CEJ-AB) was measured. Alveolar bone loss was statistically different between stressed and control animals, whereas differences were not observed between experimental periods. The mean CEJ-AB distance in animals exposed to stress was 154.50 microm smaller than the corresponding distance in the controls. It might be concluded that variable moderate chronic stress decreased alveolar bone loss in a ligature-induced periodontal disease model.

The effect of chronic emotional stress on the humoral immune response to Porphyromonas gingivalis in mice

Previous studies have shown that psychological stress plays a significant role in the outcome of infectious diseases, but data related to the effect of stress on periodontal infection is limited. The present study was designed to test the impact of emotional stress on the humoral immune response to the periodontal pathogen Porphyromonas gingivalis in a mouse model of local inflammation. Chambers constructed from titanium wire were implanted in the subcutaneous dorsolumbar region of mice. All mice were immunized with P. gingivalis followed by an intrachamber challenge with the bacteria. One group of mice was used as control, while the other two experienced experimental stress conditions (isolation/restraint stress). Stress-1 group was stressed during the immunization period, while Stress-2 group was stressed during the local challenge period. Chamber exudates and serum were collected and analyzed for levels of anti-P. gingivalis antibodies (IgG, IgG1 and IgG2a). The levels of serum antibodies to P. gingivalis were not different between the three tested groups, excluding increased levels of IgG2a in Stress-1 group at baseline. The levels of antibodies in the chamber exudates were significantly lower in the stressed groups at baseline, but higher at d 7. The IgG1 to IgG2a ratio was significantly higher in the control group compared with the two stressed groups. The findings of the present study suggest that chronic psychological stress had a marked impact on the localized response to P. gingivalis challenge. The lower IgG1/IgG2a ratio observed in the stress groups suggests elevated Th1 response during stress.

Social stress in laying hens: differential effect of stress on plasma dopamine concentrations and adrenal function in genetically selected chickens

Genetic selection for high or low group productivity and survivability (HGPS, LGPS) has created two phenotypically distinct chicken lines. Each line has unique characteristics in behavioral and physiological adaptability to multiple-bird cage system. The present study was designed to examine whether these differences reflect genetic variation in the control of plasma dopamine (DA) concentrations and adrenal function in response to social stress. Chickens from the HGPS and LGPS lines were randomly assigned to single- or 10-bird cages at 17 wk of age. The 10-bird cages were the same as those used in the development of the two lines. Differences in regulation of DA concentrations and adrenal function in response to different social environments were measured between the two lines when the study was conducted at 24 wk of age. In the 10-bird cages, the HGPS line had lower levels of DA (P < 0.05) and heavier adrenal glands (AG, P < 0.05) than those of the LGPS line, but concentrations of corticosterone (CORT) from the two lines were not significantly different. In the single-bird cages, DA levels in both lines were greater than in that of their siblings in the 10-bird cages, but a greater increase was found in the LGPS line (P < 0.01 and P < 0.05, 405% vs. 293%). Likewise, both lines had lower concentrations of CORT (P < 0.05) in the single- vs. 10-bird cages, but the AG were less heavy in the LGPS line but not in HGPS line in the single-bird cages (P < 0.05). The results indicated that the two strains reacted differently in terms of their stress hormone levels in the two different environments. These differences could contribute to the behavioral and physiological differences existing between the two lines.

Effects of hippocampal lesioning on experimental periodontitis in Wistar rats

The hippocampus, which is a brain structure involved in learning and memory processes, plays a key role in the feedback regulation of the hypothalamic-pituitary-adrenal (HPA) axis and autonomic sympathetic nervous system, and the subsequent secretion of immuno-modulatory hormones in response to pathogenic microorganisms. Dysregulation of these brain-neuroendocrine-immune regulatory networks, which act in concert to maintain homeostasis, is found to be of critical importance to the host defence against pathogens, as well as susceptibility to diseases, including periodontal disease. The present study was designed to determine the effects of hippocampal lesioning on the progression of periodontitis. Experimental ligature-induced periodontitis was induced in 16 Wistar rats, which were bilaterally lesioned in their hippocampal region with an aspiration technique that is well documented to impair learning and memory, as well as in 15 sham-operated control rats. The disease progression was evaluated radiographically and histometrically. The results revealed that the hippocampal lesioned rats developed significantly more destruction of the periodontium than did the sham-operated controls. This finding supports recent studies that indicate that inappropriate brain-neuroendocrine regulation of inflammatory responses to infectious agents may play an important role in disease susceptibility and progression.

Genetic susceptibility to chronic periodontal disease

Evidence suggests that there is a significant genetic component to susceptibility and resistance to chronic periodontal disease. Data from both clinical studies and studies using animal models are reviewed here. Also outlined are the genomic methods that are now available for identifying susceptibility and resistance loci.

Reduced tumor growth, experimental metastasis formation, and angiogenesis in rats with a hyperreactive dopaminergic system

Outgrowth of solid tumors requires blood supply to the tumor. Tumor angiogenesis is dependent on the interplay between tumor-derived angiogenic factors and stromal cells. Recently, it has been shown that the neurotransmitter dopamine is a potent inhibitor of VEGF-induced angiogenesis. Moreover, there is evidence that patients with schizophrenia have a hyperreactive dopaminergic system and are relatively protected from cancer. We hypothesized that hyperreactivity of the dopaminergic system is related to reduced angiogenesis and tumor development. Therefore, we investigated tumor growth and angiogenesis in two lines of Wistar rats with high (APO-SUS) or low (APO-UNSUS) dopaminergic reactivity. Subcutaneous implants of mammary adenocarcinoma cells (MADB106) in matrigel remained 35% smaller in APO-SUS rats than in APO-UNSUS rats (P<0.01). Moreover, APO-SUS rats developed less lung metastases after i.v. administration of MADB106 tumor cells. Furthermore, hemoglobin content (APO-SUS: 40.6+/-7.6; APO-UNSUS: 76.9+/-13 mg/dl, P<0.05) and expression of the endothelial determinant PECAM-1 in tumors from APO-SUS rats were reduced (APO-SUS: 37+/-18; APO-UNSUS 69+/-25 units, P<0.01), indicating that reduced angiogenesis is responsible for reduced tumor development in APO-SUS rats. These results suggest a novel link between dopaminergic reactivity, angiogenesis, and tumor development and may explain part of the individual differences in cancer progression.

Manipulations in maternal environment reverse periodontitis in genetically predisposed rats

The predisposition to develop periodontitis is partly genetically determined in humans as well as in animals. Here we demonstrate, however, that early manipulations in the maternal environment of an animal (rat) model of periodontitis can fully reverse the genetic predisposition to develop periodontitis at adult age.

Influence of restraint stress on ligature-induced periodontitis in rats

The influence of stress on periodontal breakdown in Wistar rats was analyzed during experimental periodontitis, induced by placing silk ligatures around the maxillary right second molar teeth. The rats were divided into three groups with 10 animals in each; the first group was exposed to restraint stress for 12 h d(-1) for a period of 4 wk; the second group was exposed to restraint stress for 2.5 h d(-1) for a period of 4 wk; the third group served as a control group. Ligation for 4 wk resulted in an accelerated periodontal degradation, whereas the restraint stress by itself had no significant effect. Combined stress and ligation resulted in a significantly higher attachment loss and alveolar bone resorption than either treatment alone, while no differences were seen between the two stress regimens. After 4 wk, a reduced body weight was found in both restrained groups of rats and a reduced weight of the thymus in the rats restrained for 12 h d(-1), while no changes were observed in the weight or composition of the suprarenal glands. We conclude that stress alone does not result in periodontal disease but may modulate the pathophysiological processes of already present periodontal inflammation, resulting in accelerated degradation of periodontal tissues.

The relationship of some negative events and psychological factors to periodontal disease in an adult Swedish population 50 to 80 years of age

BACKGROUND

Clinical observations and epidemiological studies suggest that experiences of negative life events, especially those manifested as depression, may contribute to an increased susceptibility to periodontal disease.

OBJECTIVE

In the present study, the prevalence of some negative life events and psychological factors and their relation to periodontal disease were investigated. The sample consisted of individuals 50-80 years of age from an extensive cross-sectional epidemiological study performed in 1993 in the city of Jönköping, Sweden.

METHOD

298 dentate individuals from the Jönköping study were randomly selected. Clinical and radiographic examinations included registration of the number of existing teeth, plaque index, gingival index, pocket depth, and alveolar bone loss. In addition, a questionnaire about socioeconomic status, life events, and psychological and stress-related factors was used.

RESULTS

The results revealed that, in addition to the well-documented periodontal disease risk factors such as increased age, oral hygiene status, and smoking, the loss of a spouse (being a widow or widower) and the personality trait of exercising extreme external control were also associated with severe periodontal disease.

CONCLUSION

The findings support recent studies suggesting that traumatic life events such as the loss of a spouse may increase the risk for periodontal disease. Above all, the present results indicate that an individual's ability to cope with stressful stimuli (coping behavior), as measured by the beliefs of locus of control of reinforcements may play a role in the progression of periodontal disease.

Postnatal glutamate-induced central nervous system lesions alter periodontal disease susceptibility in adult Wistar rats

BACKGROUND

Inability to mount a suitable brain-neuroendocrine response to bacterial or other antigenic challenges has been found to play an important rôle in infectious and inflammatory disease susceptibility and progression, including periodontal disease.

OBJECTIVE

The present study was designed to determine the effects of glutamate administration to new-born Wistar rats on the development and progression of naturally occurring and ligature-induced periodontal disease in the rats as adults. Postnatal glutamate administration is known to permanently damage neurones in the hypothalamic arcuate nucleus.

METHOD

New-born rats were treated 1x daily subcutaneously with 2 mg/g of monosodium-L-glutamate (MSG) for 5 days from day 3 to 6. Control animals were injected with similar amounts of saline. Experimental ligature-induced periodontal disease was induced in the rats at the age of 12 weeks at maxillary right 2nd molar teeth. The contralateral maxillary left 2nd molars served as control teeth, and for assessment of naturally occurring periodontal disease. Disease progression was evaluated histometrically.

RESULTS

The results revealed that the glutamate-lesioned rats developed significantly more periodontal tissue destruction compared to sham-lesioned control rats in both the ligated and non-ligated teeth.

CONCLUSIONS

This study supports our recent findings indicating that inappropriate brain-neuroendocrine-immune regulation may play a rôle in periodontal disease susceptibility and progression.