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Moghaddasi M, Ghassemi M, Shekari Yazdi M, Habibi SAH, Mohebi N, Goodarzi A. The first case report of Haim Munk disease with neurological manifestations and literature review. Clin Case Rep 2021; 9:e04802. [PMID: 34603725 PMCID: PMC8473953 DOI: 10.1002/ccr3.4802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 08/17/2021] [Accepted: 08/25/2021] [Indexed: 11/10/2022] Open
Abstract
HMS can have neurologic MS like manifestations. It is urgent to do more research and report probable unknown associations of HMS for its better management.
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Affiliation(s)
- Mehdi Moghaddasi
- Department of NeurologyRasool Akram Medical ComplexIran University of Medial Sciences (IUMS)TehranIran
| | - Mohammadreza Ghassemi
- Department of DermatologyRasool Akram Medical ComplexIran University of Medical Sciences (IUMS)TehranIran
| | - Mohammad Shekari Yazdi
- Department of DermatologyRasool Akram Medical ComplexIran University of Medical Sciences (IUMS)TehranIran
| | - Seyed Amir Hasan Habibi
- Department of NeurologyRasool Akram Medical ComplexIran University of Medial Sciences (IUMS)TehranIran
| | - Nafiseh Mohebi
- Department of NeurologyRasool Akram Medical ComplexIran University of Medial Sciences (IUMS)TehranIran
| | - Azadeh Goodarzi
- Department of DermatologyRasool Akram Medical ComplexIran University of Medical Sciences (IUMS)TehranIran
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Peacock ME, Arce RM, Cutler CW. Periodontal and other oral manifestations of immunodeficiency diseases. Oral Dis 2017; 23:866-888. [PMID: 27630012 PMCID: PMC5352551 DOI: 10.1111/odi.12584] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 08/31/2016] [Accepted: 09/08/2016] [Indexed: 12/14/2022]
Abstract
The list of immunodeficiency diseases grows each year as novel disorders are discovered, classified, and sometimes reclassified due to our ever-increasing knowledge of immune system function. Although the number of patients with secondary immunodeficiencies (SIDs) greatly exceeds those with primary immunodeficiencies (PIDs), the prevalence of both appears to be on the rise probably because of scientific breakthroughs that facilitate earlier and more accurate diagnosis. Primary immunodeficiencies in adults are not as rare as once thought. Globally, the main causes of secondary immunodeficiency are HIV infection and nutritional insufficiencies. Persons with acquired immune disorders such as AIDS caused by the human immunodeficiency virus (HIV) are now living long and fulfilling lives as a result of highly active antiretroviral therapy (HAART). Irrespective of whether the patient's immune-deficient state is a consequence of a genetic defect or is secondary in nature, dental and medical practitioners must be aware of the constant potential for infections and/or expressions of autoimmunity in these individuals. The purpose of this review was to study the most common conditions resulting from primary and secondary immunodeficiency states, how they are classified, and the detrimental manifestations of these disorders on the periodontal and oral tissues.
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Affiliation(s)
- Mark E Peacock
- Associate Professor, Departments of Periodontics, Oral Biology
| | - Roger M. Arce
- Assistant Professor, Departments of Periodontics, Oral Biology
| | - Christopher W Cutler
- Professor, Departments of Periodontics, Oral Biology; Chair, Department of Periodontics, Associate Dean for Research, The Dental College of Georgia at Augusta University
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Dababneh RH, Jebrin SE, Khouri AT, Bissada NF. Papillon-Lefèvre or Haim-Munk Syndrome? Report on Two Sisters in a Consanguineous Family. Clin Adv Periodontics 2015; 5:192-200. [DOI: 10.1902/cap.2014.130089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 01/28/2014] [Indexed: 11/13/2022]
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4
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Matarese G, Isola G, Anastasi G, Cutroneo G, Cordasco G, Favaloro A, Vita G, Vermiglio G, Milardi D, Zizzari V, Tetè S, Perillo L. Transforming Growth Factor Beta 1 and Vascular Endothelial Growth Factor Levels in the Pathogenesis of Periodontal Disease. EUR J INFLAMM 2013. [DOI: 10.1177/1721727x1301100217] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- G. Matarese
- Department of Specialized Surgery, School of Dentistry, University of Messina, Messina, Italy
| | - G. Isola
- Department of Specialized Surgery, School of Dentistry, University of Messina, Messina, Italy
- Department of Orthodontic and Gnathology - Masticatory Function, School of Orthodontics, University of Turin, Turin, Italy
| | - G.P. Anastasi
- Department of Biomedical Sciences and of Morphological and Functional Images, University of Messina, Messina, Italy
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Messina, Italy
| | - G. Cutroneo
- Department of Biomedical Sciences and of Morphological and Functional Images, University of Messina, Messina, Italy
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Messina, Italy
| | - G. Cordasco
- Department of Specialized Surgery, School of Dentistry, University of Messina, Messina, Italy
| | - A. Favaloro
- Department of Biomedical Sciences and of Morphological and Functional Images, University of Messina, Messina, Italy
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Messina, Italy
| | - G. Vita
- Unit of Tissue Typing, Department of Pathology and Experimental Microbiology, University of Messina, Messina, Italy
| | - G. Vermiglio
- Department of Biomedical Sciences and of Morphological and Functional Images, University of Messina, Messina, Italy
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Messina, Italy
| | - D. Milardi
- Department of Biomedical Sciences and of Morphological and Functional Images, University of Messina, Messina, Italy
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Messina, Italy
| | - V.L. Zizzari
- Department of Medicine and Ageing Sciences, University “G. d'Annunzio”, Chieti, Italy
| | - S. Tetè
- Department of Oral Science, Nano and Biotechnology, University “G. d'Annunzio”, Chieti, Italy
| | - L. Perillo
- Department of Dentistry, Orthodontics and Surgery, Second University of Naples, Italy
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5
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Abstract
The progress of molecular genetics helps clinicians to prove or exclude a suspected diagnosis for a vast and yet increasing number of genodermatoses. This leads to precise genetic counselling, prenatal diagnosis and preimplantation genetic haplotyping for many inherited skin conditions. It is also helpful in such occasions as phenocopy, late onset and incomplete penetrance, uniparental disomy, mitochondrial inheritance and pigmentary mosaicism. Molecular methods of two genodermatoses are explained in detail, i.e. genodermatoses with skin fragility and neurofibromatosis type 1.
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Affiliation(s)
- Vesarat Wessagowit
- Molecular Genetics Laboratory, The Institute of Dermatology, Bangkok, Thailand.
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6
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Pahwa P, Lamba AK, Faraz F, Tandon S. Haim-Munk syndrome. J Indian Soc Periodontol 2011; 14:201-3. [PMID: 21760678 PMCID: PMC3100867 DOI: 10.4103/0972-124x.75919] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2010] [Accepted: 10/05/2010] [Indexed: 11/04/2022] Open
Abstract
Haim-Munk syndrome is an extremely rare autosomal recessive disorder of keratinization characterized clinically by palmoplantar hyperkeratosis, severe early onset periodontitis, onychogryphosis, pes planus, arachnodactyly, and acro-osteolysis. Recently, germline mutations in the lysosomal protease cathepsin C gene have been identified as the underlying genetic defect in Haim-Munk syndrome and in the clinically related disorders, such as Papillon-Lefèvre syndrome and prepubertal periodontitis. The periodontal disease associated with these syndromes is particularly aggressive and unresponsive to traditional periodontal therapies. As a result, most patients become edentulous by 15 years of age. This case report describes a patient with the cardinal features of Haim-Munk syndrome.
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Affiliation(s)
- Priyanka Pahwa
- Department of Periodontics and Oral Implantology, Maulana Azad Institute of Dental Sciences, University of Delhi, Government of National Capital Territory of Delhi, India
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Dalgic B, Bukulmez A, Sari S. Pyogenic liver abscess and peritonitis due to Rhizopus oryzae in a child with Papillon-Lefevre syndrome. Eur J Pediatr 2011; 170:803-5. [PMID: 21165748 DOI: 10.1007/s00431-010-1368-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Accepted: 11/24/2010] [Indexed: 11/26/2022]
Abstract
Papillon-Lefevre syndrome (PLS) is an autosomal recessive disease that is characterized by symmetric palmoplantar keratodermatitis and severe periodontal destruction. Mutations in the cathepsin C gene (CTSC) have recently been detected in PLS. Immune dysregulation, due to a mutation in CTSC, increases the risk of pyogenic infections in PLS patients. A child with PLS is presented here with liver abscesses and peritonitis caused by Rhizopus oryzae. His liver abscess and peritonitis were cured with amphotericin B without surgical care. This is the first case in the literature liver abscess due to Rhizopus oryzae in a child with PLS.
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Affiliation(s)
- Buket Dalgic
- Department of Pediatric Gastroenterology, Faculty of Medicine, Gazi University, Besevler, 06500, Ankara, Turkey
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9
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Rai R, Thiagarajan S, Mohandas S, Natarajan K, Shanmuga Sekar C, Ramalingam S. Haim Munk syndrome and Papillon Lefevre syndrome - allelic mutations in cathepsin C with variation in phenotype. Int J Dermatol 2010; 49:541-3. [DOI: 10.1111/j.1365-4632.2010.04300.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Janjua SA, Iftikhar N, Hussain I, Khachemoune A. Dermatologic, periodontal, and skeletal manifestations of Haim-Munk syndrome in two siblings. J Am Acad Dermatol 2008; 58:339-44. [DOI: 10.1016/j.jaad.2007.08.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2007] [Revised: 08/07/2007] [Accepted: 08/09/2007] [Indexed: 10/22/2022]
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11
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Babel N, Cherepnev G, Babel D, Tropmann A, Hammer M, Volk HD, Reinke P. Analysis of Tumor Necrosis Factor-α, Transforming Growth Factor-β, Interleukin-10, IL-6, and Interferon-γ Gene Polymorphisms in Patients With Chronic Periodontitis. J Periodontol 2006; 77:1978-83. [PMID: 17209781 DOI: 10.1902/jop.2006.050315] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Cytokine gene polymorphisms may have an impact on the susceptibility to and progression of chronic periodontitis. In this study, we analyzed the -1082 interleukin-10 (IL-10), -308 tumor necrosis factor-alpha (TNF-alpha), transforming growth factor-beta 1 (TGF-beta1) (codons 10 and 25), -174IL-6, and +874 interferon-gamma (IFN-gamma) gene single-nucleotide polymorphisms in a cohort of patients with chronic periodontal disease. METHODS The diagnosis was made on the basis of standardized clinical and radiographic criteria. A total of 122 adult patients with chronic periodontitis and 114 unrelated, ethnically and age-matched white control subjects were genotyped by a polymerase chain reaction-sequence-specific primer. RESULTS The number of individuals carrying the -174IL-6 CC genotype was significantly higher in the group of patients than in the control group (odds ratio [OR] = 1.896; 95% confidence interval [CI] = 1.106 to 3.250; P = 0.0283). The TGF-beta1 (codon 25) GG (Arg(25)/Arg(25)) genotype was detected more frequently in control subjects than in periodontitis patients (OR = 0.459; 95% CI = 0.230 to 0.920; P = 0.0421). CONCLUSION The -174IL-6 and TGF-beta1 (codon 25) single-nucleotide polymorphisms are associated with susceptibility to chronic periodontitis in the population studied.
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Affiliation(s)
- Nina Babel
- Interdisciplinary Transplant Research Laboratory, Department of Nephrology and Internal Intensive Care, Charité University Medicine, Berlin, Germany.
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12
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Kinane DF, Peterson M, Stathopoulou PG. Environmental and other modifying factors of the periodontal diseases. Periodontol 2000 2006; 40:107-19. [PMID: 16398688 DOI: 10.1111/j.1600-0757.2005.00136.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Denis F Kinane
- University of Louisville School of Dentistry, Kentucky, USA
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13
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Micali G, Nasca MR, Innocenzi D, Frasin LA, Radi O, Parma P, Camerino G, Schwartz RA. Association of palmoplantar keratoderma, cutaneous squamous cell carcinoma, dental anomalies, and hypogenitalism in four siblings with 46,XX karyotype: A new syndrome. J Am Acad Dermatol 2005; 53:S234-9. [PMID: 16227098 DOI: 10.1016/j.jaad.2005.02.033] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2004] [Revised: 12/17/2004] [Accepted: 02/10/2005] [Indexed: 11/18/2022]
Abstract
The association of palmoplantar keratoderma (PPK) with the development of cutaneous squamous cell carcinomas (SCCs), dental anomalies, severe hypogenitalism with hypospadias, abnormal development of gonads with ambiguous external genitalia, gynecomastia, altered plasma sex hormones levels, and hypertriglyceridemia has not, to our knowledge, been reported previously. We describe it in 4 brothers with 46,XX karyotype, whereas the 5 sisters of their consanguineous parents were unaffected. This family may represent a new syndrome. The PPK was of the classical nonepidermolytic histologic type. The proband also had a laryngeal carcinoma diagnosed in his early forties and nodular testicular hyperplasia of Leydig cells.
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14
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Loos BG, John RP, Laine ML. Identification of genetic risk factors for periodontitis and possible mechanisms of action. J Clin Periodontol 2005; 32 Suppl 6:159-79. [PMID: 16128836 DOI: 10.1111/j.1600-051x.2005.00806.x] [Citation(s) in RCA: 208] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AIM To review the literature for genetic risk factors associated with periodontitis. METHODS Computerized search of the literature in English using key words: Periodontitis; Genes; Mutation; Polymorphism; Risk. RESULTS AND CONCLUSIONS Mutations in the cathepsin C gene (CTSC) have been identified as causal for the Papillon-Lefèvre syndrome (PLS), which includes prepubertal periodontitis (PP). Some CTSC mutations are causal for PP without PLS. No relationship has been demonstrated between CTSC mutations and other forms of periodontitis. Genetic polymorphisms in a candidate gene approach have been explored as risk factors for periodontitis. There is limited evidence that some polymorphisms in the genes encoding interleukins (IL)-1, Fc gamma receptors (Fc gammaR), IL-10 and the vitamin D receptor, may be associated with periodontitis in certain ethnic groups. However relatively large variations in carriage rates of the Rare (R)-alleles among studies on any polymorphism were observed. The available studies appear under-powered and do not adequately take into account other pertinent risk factors for periodontitis. Future studies should include larger cohorts, should clearly define phenotypes and should adequately control for other risk factors. In addition to the candidate gene approach, alternative strategies need to be considered to elucidate the gene variations, which confer risk for periodontitis.
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Affiliation(s)
- Bruno G Loos
- Department of Periodontology, Acadcemic Center for Dentistry Amsterdam (ACTA), University of Amsterdam, The Netherlands.
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15
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Affiliation(s)
- Denis F Kinane
- University of Louisville School of Dentistry, Louisville, Kentucky, USA
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16
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Ullbro C, Kinnby B, Lindberg P, Matsson L. Tissue plasminogen activator (t-PA) and placental plasminogen activator inhibitor (PAI-2) in gingival crevicular fluid from patients with Papillon-Lefevre syndrome. J Clin Periodontol 2004; 31:708-12. [PMID: 15312091 DOI: 10.1111/j.1600-051x.2004.00551.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Numerous patients with Papillon-Lefèvre syndrome (PLS) express a severe periodontal inflammation that results in premature loss of deciduous and permanent teeth. The plasminogen activating (PA) system is involved in physiological and pathological processes including epithelial healing, extracellular proteolysis and local inflammatory reactions. The aim of the study was to explore a possible role of the PA system in patients with PLS. MATERIAL AND METHODS Samples of gingival crevicular fluid (GCF) were collected from areas with gingival infection in 20 patients with PLS and in 20 healthy controls. The concentration of tissue plasminogen activator (t-PA) and inhibitor (PAI-2) was measured with ELISA. RESULTS The median level of PAI-2 was significantly higher (p < 0.01) in PLS patients than in the controls, while the median value of t-PA did not differ between the groups. No difference in t-PA or PAI-2 levels was found regarding age, gender or presence of active periodontal disease. CONCLUSION The findings indicate an atypical activity of the PA system with a disturbed epithelial function in PLS patients, suggesting that the periodontal destruction seen in patients with PLS is secondary to a hereditary defect in the defense system.
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Affiliation(s)
- Christer Ullbro
- Department of Dentistry, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
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17
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Abstract
Children and adolescents are subject to several periodontal diseases. Although there is a much lower prevalence of destructive periodontal diseases in children than in adults, children can develop severe forms of periodontitis. In some cases, this destructive disease is a manifestation of a known underlying systemic disease. In other young patients, the underlying cause for increased susceptibility and early onset of disease is unknown. These diseases are often familial, suggesting a genetic predisposition for aggressive disease. Current modalities for managing periodontal diseases of children and adolescents may include antibiotic therapy in combination with non-surgical and/or surgical therapy. Since early diagnosis ensures the greatest chance for successful treatment, it is important that children receive a periodontal examination as part of their routine dental visits.
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18
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Kinane DF, Hart TC. Genes and gene polymorphisms associated with periodontal disease. ACTA ACUST UNITED AC 2003; 14:430-49. [PMID: 14656898 DOI: 10.1177/154411130301400605] [Citation(s) in RCA: 218] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The scientific literature during the last ten years has seen an exponential increase in the number of reports claiming links for genetic polymorphisms with a variety of medical diseases, particularly chronic immune and inflammatory conditions. Recently, periodontal research has contributed to this growth area. This new research has coincided with an increased understanding of the genome which, in turn, has permitted the functional interrelationships of gene products with each other and with environmental agents to be understood. As a result of this knowledge explosion, it is evident that there is a genetic basis for most diseases, including periodontitis. This realization has fostered the idea that if we can understand the genetic basis of diseases, genetic tests to assess disease risk and to develop etiology-based treatments will soon be reality. Consequently, there has been great interest in identifying allelic variants of genes that can be used to assess disease risk for periodontal diseases. Reports of genetic polymorphisms associated with periodontal disease are increasing, but the limitations of such studies are not widely appreciated. While there have been dramatic successes in the identification of mutations responsible for rare genetic conditions, few genetic polymorphisms reported for complex genetic diseases have been demonstrated to be clinically valid, and fewer have been shown to have clinical utility. Although geneticists warn clinicians on the over-enthusiastic use and interpretation of their studies, there continues to be a disparity between the geneticists and the clinicians in the emphasis placed on genes and genetic polymorphism associations. This review critically reviews genetic associations claimed for periodontal disease. It reveals that, despite major advances in the awareness of genetic risk factors for periodontal disease (with the exception of periodontitis associated with certain monogenetic conditions), we are still some way from determining the genetic basis of both aggressive and chronic periodontitis. We have, however, gained considerable insight into the hereditary pattern for aggressive periodontitis. Related to our understanding that it is autosomal-dominant with reduced penetrance comes a major clinically relevant insight into the risk assessment and screening for this disease, in that we appreciate that parents, offspring, and siblings of patients affected with aggressive periodontitis have a 50% risk of this disease also. Nevertheless, we must exercise caution and proper scientific method in the pursuit of clinically valid and useful genetic diagnostic tests for chronic and aggressive periodontitis. We must plan our research using plausible biological arguments and carefully avoid the numerous bias and misinterpretation pitfalls inherent in researching genetic associations with disease.
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Affiliation(s)
- D F Kinane
- University of Louisville School of Dentistry, Louisville, KY 40292, USA.
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Deas DE, Mackey SA, McDonnell HT. Systemic disease and periodontitis: manifestations of neutrophil dysfunction. Periodontol 2000 2003; 32:82-104. [PMID: 12756035 DOI: 10.1046/j.0906-6713.2003.03207.x] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- David E Deas
- Director of Clinical Periodontics US Air Force Periodontics Residency Wilford Hall Medical Center, Lackland Air Force Base, San Antonio, Texas, USA
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20
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Loesche WJ, Grossman NS. Periodontal disease as a specific, albeit chronic, infection: diagnosis and treatment. Clin Microbiol Rev 2001; 14:727-52, table of contents. [PMID: 11585783 PMCID: PMC89001 DOI: 10.1128/cmr.14.4.727-752.2001] [Citation(s) in RCA: 274] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Periodontal disease is perhaps the most common chronic infection in adults. Evidence has been accumulating for the past 30 years which indicates that almost all forms of periodontal disease are chronic but specific bacterial infections due to the overgrowth in the dental plaque of a finite number of mostly anaerobic species such as Porphyromonas gingivalis, Bacteroides forsythus, and Treponema denticola. The success of traditional debridement procedures and/or antimicrobial agents in improving periodontal health can be associated with the reduction in levels of these anaerobes in the dental plaque. These findings suggest that patients and clinicians have a choice in the treatment of this overgrowth, either a debridement and surgery approach or a debridement and antimicrobial treatment approach. However, the antimicrobial approach, while supported by a wealth of scientific evidence, goes contrary to centuries of dental teaching that states that periodontal disease results from a "dirty mouth." If periodontal disease is demonstrated to be a risk factor for cardiovascular disease and stroke, it will be a modifiable risk factor since periodontal disease can be prevented and treated. Since the antimicrobial approach may be as effective as a surgical approach in the restoration and maintenance of a periodontally healthy dentition, this would give a cardiac or stroke patient and his or her physician a choice in the implementation of treatment seeking to improve the patient's periodontal condition so as to reduce and/or delay future cardiovascular events.
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Affiliation(s)
- W J Loesche
- Department of Microbiology and Immunology, School of Medicine, University of Michigan, Ann Arbor, Michigan 48109, USA.
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Affiliation(s)
- P Hodge
- University of Glasgow Dental Hospital and School, Glasgow, Scotland, United Kingdom
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22
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Abstract
Systemic diseases affecting the host response as primary immunodeficiencies or secondary defects caused by lack of nutrients or changes in the local tissues are very often accompanied by early-onset prepubertal periodontitis. Local treatment in combination with systemic antibiotics may in milder forms improve the situation, but in many cases the success is questionable and premature loss of teeth occurs. Since the genetic basis of many of the diseases has been identified, future developments permit the correction of at least some of these defects by gene therapy.
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Affiliation(s)
- J Meyle
- Department of Periodontology, Zentrum für Zahn-, Mund und Kieferheilkunde, Universität Giessen, Giessen, Germany
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23
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Abstract
OBJECTIVES Papillon-Lefèvre syndrome (PLS) is a rare disease associated with prepubertal periodontitis. Our previous studies demonstrated that three unrelated patients with PLS showed the similar antigen-specific immune responses to Actinobacillus actinomycetemcomitans. The initiation of antigen-specific immune responses was involved with human leukocyte antigens (HLA) on antigen-presenting cells. The aim of this study was to examine HLA haplotypes in the three patients with PLS. SUBJECTS AND METHODS The three PLS patients, their mothers and the father of one patient participated in this study. HLA class I and class II antigens were determined serologically and DNA typing for DRB1 and DQB1 was performed using the restriction fragment length polymorphism-polymerase chain reaction method. RESULTS The distribution of serologic HLA haplotypes, in two of three patients, was found to be quite similar. The DNA typing revealed that DRB1*0406, DRB1*08032, DQB1*0302, DQB1*06011 genotypes were shared in the two patients. The probability of sharing these four DNA types in unrelated individuals was nearly 1:40,000 in the Japanese population. CONCLUSION Our results suggest that HLA antigen may be included as a possible host factor in the pathogenesis of PLS and that a genetically controlled immune response may account for an increased susceptibility to periodontal infection.
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Affiliation(s)
- H Nitta
- Department of Periodontology, Faculty of Dentistry, Tokyo Medical and Dental University, Tokyo, Japan.
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24
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Hart TC, Hart PS, Michalec MD, Zhang Y, Firatli E, Van Dyke TE, Stabholz A, Zlotogorski A, Shapira L, Soskolne WA, Zlorogorski A. Haim-Munk syndrome and Papillon-Lefèvre syndrome are allelic mutations in cathepsin C. J Med Genet 2000; 37:88-94. [PMID: 10662807 PMCID: PMC1734521 DOI: 10.1136/jmg.37.2.88] [Citation(s) in RCA: 165] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Of the many palmoplantar keratoderma (PPK) conditions, only Papillon-Lefèvre syndrome (PLS) and Haim-Munk syndrome (HMS) are associated with premature periodontal destruction. Although both PLS and HMS share the cardinal features of PPK and severe periodontitis, a number of additional findings are reported in HMS including arachnodactyly, acro-osteolysis, atrophic changes of the nails, and a radiographic deformity of the fingers. While PLS cases have been identified throughout the world, HMS has only been described among descendants of a religious isolate originally from Cochin, India. Parental consanguinity is a characteristic of many cases of both conditions. Although autosomal recessive transmission of PLS is evident, a more "complex" autosomal recessive pattern of inheritance with phenotypic influences from a closely linked modifying locus has been hypothesised for HMS. Recently, mutations of the cathepsin C gene have been identified as the underlying genetic defect in PLS. To determine if a cathepsin C mutation is also responsible for HMS, we sequenced the gene in affected and unaffected subjects from the Cochin isolate in which both the PLS and HMS phenotypes appear. Here we report identification of a mutation of cathepsin C (exon 6, 2127A--> G) that changes a highly conserved amino acid in the cathepsin C peptide. This mutation segregates with HMS in four nuclear families. Additionally, the existence of a shared common haplotype for genetic loci flanking the cathepsin C gene suggests that affected subjects descended from the Cochin isolate are homozygous for a mutation inherited "identical by descent" from a common ancestor. This finding supports simple autosomal recessive inheritance for HMS in these families. We also report a mutation of the same exon 6 CTSC codon (2126C-->T) in a Turkish family with classical PLS. These findings provide evidence that PLS and HMS are allelic variants of cathepsin C gene mutations.
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Affiliation(s)
- T C Hart
- University of Pittsburgh, School of Dental Medicine, Department of Oral Medicine/Pathology, 628 Salk Hall, 3501 Terrace Street, Pittsburgh, PA 15261, USA.
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25
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Abstract
Microbial dental plaque is the initiator of periodontal disease but whether it affects a particular subject, what form the disease takes, and how it progresses, are all dependent on the host defenses to this challenge. Systemic factors modify all forms periodontitis principally through their effects on the normal immune and inflammatory defenses. Some good examples of this effect exist such as when there is a reduction in number or function of polymorphonuclear leukocytes (PMNs) that may result in an increased rate and severity of periodontal destruction. Many other systemic factors are much less clear cut and are difficult to causally link to periodontitis. In many cases the literature is insufficient to make definite statements on links between systemic factors and periodontitis. It is also at times difficult to be precise regarding the causative agent in systemic exposures such as smoking and even prescribed drug therapy. The possible role of systemic diseases and systemic exposures in initiating or modifying the progress of periodontal disease is clearly a complex issue. It is however generally agreed that several conditions may give rise to an increased prevalence, incidence, or severity of gingivitis and periodontitis. The categorization of the systemic modifying factors causing periodontitis and the evidence to support the role of these factors are the focus of this review. An attempt has been made to consider the conditions under broad headings, but it will be clear that many conditions fall within more than one category and that for several conditions only case reports exist whereas in other areas an extensive literature is present.
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Affiliation(s)
- D F Kinane
- Glasgow Dental Hospital and School, Department of Adult Dental Care, Scotland
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26
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Affiliation(s)
- A J Clark
- Department of Endocrinology, St. Bartholomew's London, United Kingdom.
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