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Vályi P, Wirth R, Minárovits J, Strang O, Maróti G, Kovács KL. The oral microbiome of a family including Papillon-Lefèvre-syndrome patients and clinically healthy members. BMC Oral Health 2024; 24:158. [PMID: 38297252 PMCID: PMC10832247 DOI: 10.1186/s12903-024-03856-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 01/03/2024] [Indexed: 02/02/2024] Open
Abstract
AIMS The oral microbiota composition of patients diagnosed with Papillon-Lefèvre-syndrome and treated for several years were compared to those existing in the oral cavity of the clinically healthy family members and a cohort of patients having various stages of chronic periodontitis. MATERIALS AND METHODS A family with two sisters affected with severe periodontitis and with the typical skin symptoms of Papillon-Lefèvre-syndrome, and symptomless parents and third sibling were investigated. The Patients received periodontal treatment for several years and their oral microbiome was analysed by amplicon sequencing. Data were evaluated by microbial cluster analysis. RESULTS The microbiome of the patients with Papillon-Lefèvre-syndrome was predominated with Aggregatibacter actinomycetemcomitans and associated oral periodontopathogens. Although the clinically healthy family members showed no oral disorder, their microbiome resembled that of subjects having mild periodontitis. CONCLUSIONS Predominance of A. actinomycetemcomitans in the subgingival microbiome of patients with Papillon-Lefèvre-syndrome suggests that specific treatment strategies directed against this pathobiont may improve the oral health status of the affected individuals. TRIAL REGISTRATION The study was conducted in accordance with the Declaration of Helsinki and the ethical permission has been issued by the Human Investigation Review Board of the University of Szeged, Albert Szent-Györgyi Clinical Centre (Permission No. 63/2017-SZTE). September 19, 2017. https://u-szeged.hu/klinikaikutatas/rkeb-altal-jovahagyott/rkeb-2017 .
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Affiliation(s)
- Péter Vályi
- Department of Oral Diagnostics, Faculty of Dentistry, Semmelweis University, Szentkirályi u 47, Budapest, H1085, Hungary.
| | - Roland Wirth
- Department of Biotechnology, University of Szeged, Közép fasor 52, Szeged, H6726, Hungary
- Institute of Plant Biology, Biological Research Center, Temesvári krt 62, Szeged, H6726, Hungary
| | - János Minárovits
- Department of Oral Biology and Experimental Dental Research, Faculty of Dentistry, University of Szeged, Tisza L. krt 64, Szeged, H6720, Hungary
| | - Orsolya Strang
- Department of Biotechnology, University of Szeged, Közép fasor 52, Szeged, H6726, Hungary
| | - Gergely Maróti
- Department of Biotechnology, University of Szeged, Közép fasor 52, Szeged, H6726, Hungary
- Institute of Plant Biology, Biological Research Center, Temesvári krt 62, Szeged, H6726, Hungary
| | - Kornél L Kovács
- Department of Biotechnology, University of Szeged, Közép fasor 52, Szeged, H6726, Hungary
- Institute of Biophysics, Biological Research Center, Temesvári krt 62, Szeged, H6726, Hungary
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Richter GM, Wagner G, Reichenmiller K, Staufenbiel I, Martins O, Löscher BS, Holtgrewe M, Jepsen S, Dommisch H, Schaefer AS. Exome Sequencing of 5 Families with Severe Early-Onset Periodontitis. J Dent Res 2021; 101:151-157. [PMID: 34515563 PMCID: PMC8807999 DOI: 10.1177/00220345211029266] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Periodontitis is characterized by alveolar bone loss leading to tooth loss. A small proportion of patients develop severe periodontitis at the juvenile or adolescent age without exposure to the main risk factors of the disease. It is considered that these cases carry rare variants with large causal effects, but the specific variants are largely unknown. In this study, we performed exome sequencing of 5 families with children who developed stage IV, grade C, periodontitis between 3 and 18 y of age. In 1 family, we found compound heterozygous variants in the gene CTSC (p.R272H, p.G139R), 1 of which was previously identified in a family with prepubertal periodontitis. Subsequent targeted resequencing of the CTSC gene in 24 patients <25 y of age (stage IV, grade C) identified the known mutation p.I453V (odds ratio = 4.06, 95% CI = 1.6 to 10.3, P = 0.001), which was previously reported to increase the risk for adolescent periodontitis. An affected sibling of another family carried a homozygous deleterious mutation in the gene TUT7 (p.R560Q, CADD score >30 [Combined Annotation Dependent Depletion]), which is implicated in regulation of interleukin 6 expression. Two other affected siblings shared heterozygous deleterious mutations in the interacting genes PADI1 and FLG (both CADD = 36), which contribute to the integrity of the environment-tissue barrier interface. Additionally, we found predicted deleterious mutations in the periodontitis risk genes ABCA1, GLT6D1, and SIGLEC5. We conclude that the CTSC variants p.R272H and p.I453V have different expressivity and diagnostic relevance for prepubertal and adolescent periodontitis, respectively. We propose additional causal variants for early-onset periodontitis, which also locate within genes that carry known susceptibility variants for common forms. However, the genetic architecture of juvenile periodontitis is complex and differs among the affected siblings of the sequenced families.
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Affiliation(s)
- G M Richter
- Department of Periodontology and Synoptic Dentistry, Institute for Dental and Craniofacial Sciences, Charité-University Medicine Berlin, Berlin, Germany
| | - G Wagner
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | | | - I Staufenbiel
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Hannover Medical School, Hannover, Germany
| | - O Martins
- Institute of Periodontology, Department of Dentistry, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - B S Löscher
- Institute of Clinical Molecular Biology, Christian-Albrechts-University Kiel and University Hospital Schleswig-Holstein, Kiel, Germany
| | - M Holtgrewe
- Core Unit Bioinformatics-CUBI, Berlin Institute of Health, Charité-University Medicine Berlin, Berlin, Germany
| | - S Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | - H Dommisch
- Department of Periodontology and Synoptic Dentistry, Institute for Dental and Craniofacial Sciences, Charité-University Medicine Berlin, Berlin, Germany
| | - A S Schaefer
- Department of Periodontology and Synoptic Dentistry, Institute for Dental and Craniofacial Sciences, Charité-University Medicine Berlin, Berlin, Germany
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3
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Molitor A, Prud'homme T, Miao Z, Conrad S, Bloch-Zupan A, Pichot A, Hanauer A, Isidor B, Bahram S, Carapito R. Exome sequencing identifies a novel missense variant in CTSC causing nonsyndromic aggressive periodontitis. J Hum Genet 2019; 64:689-694. [PMID: 31068678 DOI: 10.1038/s10038-019-0615-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 04/12/2019] [Accepted: 04/21/2019] [Indexed: 11/09/2022]
Abstract
Cathepsin C (CatC) is a cysteine protease involved in a variety of immune and inflammatory pathways such as activation of cytotoxicity of various immune cells. Homozygous or compound heterozygous variants in the CatC coding gene CTSC cause different conditions that have in common severe periodontitis. Periodontitis may occur as part of Papillon-Lefèvre syndrome (PLS; OMIM#245000) or Haim-Munk syndrome (HMS; OMIM#245010), or may present as an isolated finding named aggressive periodontitis (AP1; OMIM#170650). AP1 generally affects young children and results in destruction of the periodontal support of the primary dentition. In the present study we report exome sequencing of a three generation consanguineous Turkish family with a recessive form of early-onset AP1. We identified a novel homozygous missense variant in exon 2 of CTSC (NM_148170, c.G302C, p.Trp101Ser) predicted to disrupt protein structure and to be disease causing. This is the first described CTSC variant specific to the nonsyndromic AP1 form. Given the broad phenotypic spectrum associated with CTSC variants, reporting this novel variant gives new insights on genotype/phenotype correlations and might improve diagnosis of patients with early-onset AP1.
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Affiliation(s)
- Anne Molitor
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), LabEx TRANSPLANTEX, Université de Strasbourg, 4 rue Kirschleger, 67085, Strasbourg, France
| | - Tony Prud'homme
- Département d'Odontologie Pédiatrique, UFR Odontologie, Université de Nantes, Nantes, France.,Unité d'Investigation Clinique Odontologie (UIC), CSERD Nantes, CHU de Nantes, France.,INSERM, UMR 1246, MethodS in Patients-centered outcomes and HEalth ResEarch, Nantes, France
| | - Zhichao Miao
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus, Hinxton, Cambridge, CD10 1SD, UK.,Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, CB10 1SA, UK
| | - Solène Conrad
- Service de Génétique Médicale, Hôpital Hôtel-Dieu, CHU de Nantes, Nantes, France
| | - Agnès Bloch-Zupan
- Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France.,Pôle de Médecine et Chirurgie Bucco-Dentaires, Centre de Référence des Manifestations Odontologiques des Maladies Rares, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,Institut de Génétique et de Biologie Moléculaire and Cellulaire, CNRS UMR7104, INSERM U964, Centre Européen de Recherche en Biologie et en Médecine, Université de Strasbourg, Illkirch, France
| | - Angélique Pichot
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), LabEx TRANSPLANTEX, Université de Strasbourg, 4 rue Kirschleger, 67085, Strasbourg, France
| | - Antoine Hanauer
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), LabEx TRANSPLANTEX, Université de Strasbourg, 4 rue Kirschleger, 67085, Strasbourg, France
| | - Bertrand Isidor
- Service de Génétique Médicale, Hôpital Hôtel-Dieu, CHU de Nantes, Nantes, France
| | - Seiamak Bahram
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), LabEx TRANSPLANTEX, Université de Strasbourg, 4 rue Kirschleger, 67085, Strasbourg, France. .,Service d'Immunologie Biologique, Plateau Technique de Biologie, Pôle de Biologie, Nouvel Hôpital Civil, 1 place de l'Hôpital, 67091, Strasbourg, France.
| | - Raphael Carapito
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), LabEx TRANSPLANTEX, Université de Strasbourg, 4 rue Kirschleger, 67085, Strasbourg, France. .,Service d'Immunologie Biologique, Plateau Technique de Biologie, Pôle de Biologie, Nouvel Hôpital Civil, 1 place de l'Hôpital, 67091, Strasbourg, France.
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4
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Ebersole JL, Lambert J, Bush H, Huja PE, Basu A. Serum Nutrient Levels and Aging Effects on Periodontitis. Nutrients 2018; 10:E1986. [PMID: 30558282 PMCID: PMC6316450 DOI: 10.3390/nu10121986] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 12/06/2018] [Accepted: 12/12/2018] [Indexed: 12/12/2022] Open
Abstract
Periodontal disease damages tissues as a result of dysregulated host responses against the chronic bacterial biofilm insult and approximately 50% of US adults >30 years old exhibit periodontitis. The association of five blood nutrients and periodontitis were evaluated due to our previous findings regarding a potential protective effect for these nutrients in periodontal disease derived from the US population sampled as part of the National Health and Nutrition Examination Survey (1999⁻2004). Data from over 15,000 subjects was analyzed for blood levels of cis-β-carotene, β-cryptoxanthin, folate, vitamin D, and vitamin E, linked with analysis of the presence and severity of periodontitis. Moderate/severe disease patients had lower cis-β-carotene levels across all racial/ethnic groups and these decreased levels in moderate/severe periodontitis were exacerbated with age. β-cryptoxanthin demonstrated lower levels in severe disease patients across the entire age range in all racial/ethnic groups. Folate differences were evident across the various age groups with consistently lower levels in periodontitis patients >30 years and most pronounced in females. Lower levels of vitamin D were consistently noted across the entire age range of patients with a greater difference seen in females with periodontitis. Finally, an analytical approach to identify interactions among these nutrients related to age and periodontitis showed interactions of vitamin D in females, and folate with race in the population. These findings suggest that improving specific nutrient intake leading to elevated blood levels of a combination of these protective factors may provide a novel strategy to affect the significant increase in periodontitis that occurs with aging.
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Affiliation(s)
- Jeffrey L Ebersole
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, 1001 Shadow Lane, B221, MS 7425, Las Vegas, NV 89106, USA.
| | - Joshua Lambert
- College of Nursing, University of Cincinnati; Cincinnati, OH 45221, USA.
| | - Heather Bush
- Department of Biostatistics, College of Public Health, University of Kentucky; Lexington, KY 40536, USA.
| | - Pinar Emecen Huja
- Department of Periodontics, School of Dentistry, Medical University of South Carolina; Charleston, SC 29425, USA.
| | - Arpita Basu
- Department of Kinesiology and Nutrition Sciences, School of Allied Health Sciences, University of Nevada Las Vegas, Las Vegas, NV 89106, USA.
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5
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Ebersole JL, Orraca L, Kensler TB, Gonzalez-Martinez J, Maldonado E, Gonzalez OA. Periodontal disease susceptible matrilines in the Cayo Santiago Macaca mulatta macaques. J Periodontal Res 2018; 54:134-142. [PMID: 30277577 DOI: 10.1111/jre.12610] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 07/19/2018] [Accepted: 08/14/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE AND BACKGROUND The expression of periodontitis, including age of onset, extent, and severity is considered to represent an interaction of the individual's oral microbiome and host response to the microbial challenge that is modified by both genetics and environmental factors. The aim of this study was to determine the distribution of periodontitis in a population of nonhuman primates, to document features of familial distribution that could reflect heritability and transmission of microbes with enhanced virulence. MATERIAL AND METHODS This report presents our findings from evaluation of periodontal disease bone defects in skulls from 569 animals (5-31 years of age) derived from the skeletons of the rhesus monkeys (Macaca mulatta) of Cayo Santiago derived from eight matrilines over 6-9 generations. The distance from the base of alveolar bone to the cemento-enamel junction on 1st /2nd premolars and 1st /2nd molars from all four quadrants was evaluated as a measure of periodontal disease. Additionally, we documented the presence of periodontitis in 79 living descendants within these matrilines. RESULTS The results demonstrated an increased extent and severity of periodontitis with aging across all matrilines. Extensive heterogeneity in disease expression was observed among the animals and this was linked to specific periodontitis susceptible matrilines. Moreover, we identified some matrilines in which the members appeared to show some resistance to more severe disease, even with aging. CONCLUSION Linking these disease variations to multigenerational matriarchal family units supported familial susceptibility of periodontitis. This familial disease relationship was reinforced by the distribution of naturally-occurring periodontitis in the living descendants.
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Affiliation(s)
- Jeffrey L Ebersole
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, Nevada
| | - Luis Orraca
- School of Dental Medicine, University of Puerto Rico, San Juan, Puerto Rico
| | - Terry B Kensler
- Laboratory of Primate Morphology, University of Puerto Rico, San Juan, Puerto Rico
| | | | - Elisabeth Maldonado
- Laboratory of Primate Morphology, University of Puerto Rico, San Juan, Puerto Rico
| | - Octavio A Gonzalez
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, Kentucky.,Division of Periodontology, College of Dentistry, University of Kentucky, Lexington, Kentucky
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6
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Xia X, Cheng L, Zhang S, Wang L, Hu J. The role of natural antimicrobial peptides during infection and chronic inflammation. Antonie van Leeuwenhoek 2017; 111:5-26. [PMID: 28856473 DOI: 10.1007/s10482-017-0929-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 08/15/2017] [Indexed: 01/12/2023]
Abstract
Natural antimicrobial peptides (AMPs), a family of small polypeptides that are produced by constitutive or inducible expression in organisms, are integral components of the host innate immune system. In addition to their broad-spectrum antibacterial activity, natural AMPs also have many biological activities against fungi, viruses and parasites. Natural AMPs exert multiple immunomodulatory roles that may predominate under physiological conditions where they lose their microbicidal properties in serum and tissue environments. Increased drug resistance among microorganisms is occurring far more quickly than the discovery of new antibiotics. Natural AMPs have shown promise as 'next generation antibiotics' due to their broad-spectrum curative effects, low toxicity, the fact that they are not residual in animals, and the low rates of resistance exhibited by many pathogens. Many types of synthetic AMPs are currently being tested in clinical trials for the prevention and treatment of various diseases such as chemotherapy-associated infections, diabetic foot ulcers, catheter-related infections, and other conditions. Here, we provide an overview of the types and functions of natural AMPs and their role in combating microorganisms and different infectious and inflammatory diseases.
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Affiliation(s)
- Xiaojing Xia
- College of Animal Science and Veterinary Medicine, Henan Institute of Science and Technology, No. 90, Hualan Street, Xinxiang, 453003, People's Republic of China
| | - Likun Cheng
- Shandong Binzhou Animal Science and Veterinary Medicine Academy, Binzhou, 256600, People's Republic of China
| | - Shouping Zhang
- College of Animal Science and Veterinary Medicine, Henan Institute of Science and Technology, No. 90, Hualan Street, Xinxiang, 453003, People's Republic of China
| | - Lei Wang
- College of Animal Science and Veterinary Medicine, Henan Institute of Science and Technology, No. 90, Hualan Street, Xinxiang, 453003, People's Republic of China
| | - Jianhe Hu
- College of Animal Science and Veterinary Medicine, Henan Institute of Science and Technology, No. 90, Hualan Street, Xinxiang, 453003, People's Republic of China.
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7
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Chu Y, Guo Y, Walls AF, Zhou X. The regulatory role of Dipeptidyl peptidase I on the activation of immune granulocytes. Cell Biol Int 2017; 41:1093-1102. [DOI: 10.1002/cbin.10815] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 06/28/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Yi Chu
- The School of Pharmaceutical Engineering and Life Science; Changzhou University; Jiangsu 213164 China
| | - Yaming Guo
- The School of Pharmaceutical Engineering and Life Science; Changzhou University; Jiangsu 213164 China
| | - Andrew F. Walls
- The School of Pharmaceutical Engineering and Life Science; Changzhou University; Jiangsu 213164 China
- The School of Medicine; The University of Southampton; Southampton SO16 6YD UK
| | - Xiaoying Zhou
- The School of Pharmaceutical Engineering and Life Science; Changzhou University; Jiangsu 213164 China
- The School of Medicine; The University of Southampton; Southampton SO16 6YD UK
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8
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Noack B, Görgens H, Hoffmann T, Fanghänel J, Kocher T, Eickholz P, Schackert HK. Novel Mutations in the Cathepsin C Gene in Patients with Pre-pubertal Aggressive Periodontitis and Papillon-Lefèvre Syndrome. J Dent Res 2016; 83:368-70. [PMID: 15111626 DOI: 10.1177/154405910408300503] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Aggressive periodontitis (AP) in pre-pubertal children is often associated with genetic disorders like Papillon-Lefèvre syndrome (PLS). PLS is caused by mutations in the cathepsin C ( CTSC) gene. We report a novel CTSC mutation (c.566-572del) in an otherwise healthy AP child and two novel compound heterozygous mutations (c.947T>G, c.1268G>C) in a PLS patient. We conclude that at least a subset of pre-pubertal AP is due to CTSC mutations and therefore may be an allelic variant of PLS.
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9
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Tekin B, Yucelten D, Beleggia F, Sarig O, Sprecher E. Papillon-Lefèvre syndrome: report of six patients and identification of a novel mutation. Int J Dermatol 2016; 55:898-902. [DOI: 10.1111/ijd.13297] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 12/03/2015] [Accepted: 12/28/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Burak Tekin
- Department of Dermatology; Marmara University School of Medicine; Istanbul Turkey
| | - Deniz Yucelten
- Department of Dermatology; Marmara University School of Medicine; Istanbul Turkey
| | - Filippo Beleggia
- Institute of Human Genetics; University of Cologne; Cologne Germany
| | - Ofer Sarig
- Department of Dermatology; Tel Aviv Sourasky Medical Center; Tel Aviv University; Tel Aviv Israel
| | - Eli Sprecher
- Department of Dermatology; Tel Aviv Sourasky Medical Center; Tel Aviv University; Tel Aviv Israel
- Department of Human Molecular Genetics & Biochemistry; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
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10
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Abstract
A paradigm shift several decades ago elucidated that aggressive periodontitis (AgP) was not a degenerative disorder but a rapid progressive form of plaque-induced inflammatory periodontal disease. Ensuing years of research have led to linkage analysis identification of specific genetic defects responsible for AgP in some families and to the finding that subgingival detection of A. actinomycet-emcomitans JP2 clone is a predictive factor for disease onset and progression. However, rather disappointingly, these ‘proven’ risk factors are only detected in a small subset of AgP cases. Recent advances are leading to a new paradigm shift, with the realization that genetically-driven dysbiotic changes in the subgingival microbiota may predispose to a cascade of events leading to the rapid periodontal tissue destruction seen in AgP. This review tries to dissect the existing literature on the host response-microbial axis of AgP and to propose possible pathogenic pathways in line with current theories.
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Affiliation(s)
- Luigi Nibali
- a Periodontology Unit and Department of Clinical Research; UCL Eastman Dental Institute ; London , UK
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11
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Soliman H, Eldeen HG, Mustafa MI. A novel nonsense mutation in cathepsin C gene in an Egyptian patient presenting with Papillon–Lefèvre syndrome. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2015. [DOI: 10.1016/j.ejmhg.2015.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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12
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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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13
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Alkhiary YM, Jelani M, Almramhi MM, Mohamoud HSA, Al-Rehaili R, Al-Zahrani HS, Serafi R, Yang H, Al-Aama JY. Whole-exome sequencing reveals a recurrent mutation in the cathepsin C gene that causes Papillon-Lefevre syndrome in a Saudi family. Saudi J Biol Sci 2015; 23:571-6. [PMID: 27579005 PMCID: PMC4992098 DOI: 10.1016/j.sjbs.2015.06.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Revised: 05/27/2015] [Accepted: 06/10/2015] [Indexed: 11/24/2022] Open
Abstract
Papillon-Lefevre syndrome (PALS) is a rare, autosomal recessive disorder characterized by periodontitis and hyperkeratosis over the palms and soles. Mutations in the cathepsin C gene (CTSC) have been recognized as the cause of PALS since the late 1990s. More than 75 mutations in CTSC have been identified, and phenotypic variability between different mutations has been described. Next generation sequencing is widely used for efficient molecular diagnostics in various clinical practices. Here we investigated a large consanguineous Saudi family with four affected and four unaffected individuals. All of the affected individuals suffered from hyperkeratosis over the palms and soles and had anomalies of both primary and secondary dentition. For molecular diagnostics, we combined whole-exome sequencing and genome-wide homozygosity mapping procedures, and identified a recurrent homozygous missense mutation (c.899G>A; p.Gly300Asp) in exon 7 of CTSC. Validation of all eight family members by Sanger sequencing confirmed co-segregation of the pathogenic variant (c.899G>A) with the disease phenotype. This is the first report of whole-exome sequencing performed for molecular diagnosis of PALS in Saudi Arabia. Our findings provide further insights into the genotype-phenotype correlation of CTSC pathogenicity in PALS.
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Affiliation(s)
- Yaser Mohammad Alkhiary
- Oral and Maxillofacial Prosthodontics Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Musharraf Jelani
- Princess Al-Jawhara Albrahim Center of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia; Medical Genetics and Molecular Biology Unit, Biochemistry Department, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Mona Mohammad Almramhi
- Princess Al-Jawhara Albrahim Center of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hussein Sheikh Ali Mohamoud
- Princess Al-Jawhara Albrahim Center of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia; Human Genetics Research Centre, Division of Biomedical Sciences (BMS), St. George's University of London (SGUL), London SW17 0RE, United Kingdom
| | - Rayan Al-Rehaili
- Oral and Maxillofacial Prosthodontics Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hams Saeed Al-Zahrani
- Princess Al-Jawhara Albrahim Center of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rehab Serafi
- Department of Dermatology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Huanming Yang
- Oral and Maxillofacial Prosthodontics Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Genetic Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Jumana Yousuf Al-Aama
- Princess Al-Jawhara Albrahim Center of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia; BGI-Shenzhen, Shenzhen 518083, China
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Wang X, Liu Y, Liu Y, Dong G, Kenney EB, Liu Q, Ma Z, Wang Q. Long-term change of disease behavior in Papillon-Lefèvre syndrome: Seven years follow-up. Eur J Med Genet 2015; 58:184-7. [DOI: 10.1016/j.ejmg.2014.12.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 12/04/2014] [Indexed: 10/24/2022]
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Gonzalez OA, Orraca L, Kensler TB, Gonzalez-Martinez J, Maldonado E, Ebersole JL. Familial periodontal disease in the Cayo Santiago rhesus macaques. Am J Primatol 2015; 78:143-51. [PMID: 25708960 DOI: 10.1002/ajp.22376] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 12/08/2014] [Accepted: 12/13/2014] [Indexed: 11/06/2022]
Abstract
Substantial ongoing research continues to explore the contribution of genetics and environment to the onset, extent and severity of periodontal disease(s). Existing evidence supports that periodontal disease appears to have an increased prevalence in family units with a member having aggressive periodontitis. We have been using the nonhuman primate as a model of periodontal disease for over 25 years with these species demonstrating naturally occurring periodontal disease that increases with age. This report details our findings from evaluation of periodontal disease in skulls from 97 animals (5-31 years of age) derived from the skeletons of the rhesus monkeys (Macaca mulatta) on Cayo Santiago. Periodontal disease was evaluated by determining the distance from the base of the alveolar bone defect to the cemento-enamel junction on 1st/2nd premolars and 1st/2nd molars from all four quadrants. The results demonstrated an increasing extent and severity of periodontitis with aging across the population of animals beyond only compensatory eruption. Importantly, irrespective of age, extensive heterogeneity in disease expression was observed among the animals. Linking these variations to multi-generational matriarchal family units supported familial susceptibility of periodontitis. As the current generations of animals that are descendants from these matrilines are alive, studies can be conducted to explore an array of underlying factors that could account for susceptibility or resistance to periodontal disease.
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Affiliation(s)
- Octavio A Gonzalez
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, Kentucky
| | - Luis Orraca
- School of Dental Medicine, University of Puerto Rico, San Juan, Puerto Rico
| | - Terry B Kensler
- Laboratory of Primate Morphology, University of Puerto Rico, San Juan, Puerto Rico
| | | | - Elizabeth Maldonado
- Laboratory of Primate Morphology, University of Puerto Rico, San Juan, Puerto Rico
| | - Jeffrey L Ebersole
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, Kentucky
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Nagy N, Vályi P, Csoma Z, Sulák A, Tripolszki K, Farkas K, Paschali E, Papp F, Tóth L, Fábos B, Kemény L, Nagy K, Széll M. CTSC and Papillon-Lefèvre syndrome: detection of recurrent mutations in Hungarian patients, a review of published variants and database update. Mol Genet Genomic Med 2014; 2:217-28. [PMID: 24936511 PMCID: PMC4049362 DOI: 10.1002/mgg3.61] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 12/04/2013] [Accepted: 12/05/2013] [Indexed: 11/20/2022] Open
Abstract
Papillon-Lefèvre syndrome (PLS; OMIM 245000) is an autosomal recessive condition characterized by palmoplantar hyperkeratosis and periodontitis. In 1997, the gene locus for PLS was mapped to 11q14-21, and in 1999, variants in the cathepsin C gene (CTSC) were identified as causing PLS. To date, a total of 75 different disease-causing mutations have been published for the CTSC gene. A summary of recurrent mutations identified in Hungarian patients and a review of published mutations is presented in this update. Comparison of clinical features in affected families with the same mutation strongly confirm that identical mutations of the CTSC gene can give rise to multiple different phenotypes, making genotype-phenotype correlations difficult. Variable expression of the phenotype associated with the same CTSC mutation may reflect the influence of other genetic and/or environmental factors. Most mutations are missense (53%), nonsense (23%), or frameshift (17%); however, in-frame deletions, one splicing variant, and one 5' untranslated region (UTR) mutation have also been reported. The majority of the mutations are located in exons 5-7, which encodes the heavy chain of the cathepsin C protein, suggesting that tetramerization is important for cathepsin C enzymatic activity. All the data reviewed here have been submitted to the CTSC base, a mutation registry for PLS at http://bioinf.uta.fi/CTSCbase/.
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Affiliation(s)
- Nikoletta Nagy
- Department of Medical Genetics, University of SzegedSzeged, Hungary
- Department of Dermatology and Allergology, University of SzegedSzeged, Hungary
- Dermatological Research Group of the Hungarian Academy of Sciences, University of SzegedSzeged, Hungary
| | - Péter Vályi
- Department of Periodontology, University of SzegedSzeged, Hungary
| | - Zsanett Csoma
- Department of Dermatology and Allergology, University of SzegedSzeged, Hungary
| | - Adrienn Sulák
- Department of Medical Genetics, University of SzegedSzeged, Hungary
| | | | - Katalin Farkas
- Dermatological Research Group of the Hungarian Academy of Sciences, University of SzegedSzeged, Hungary
| | - Ekaterine Paschali
- Department of Dermatology and Allergology, University of SzegedSzeged, Hungary
| | - Ferenc Papp
- Department of Pediatrics, University of SzegedSzeged, Hungary
| | - Lola Tóth
- Department of Medical Genetics, University of SzegedSzeged, Hungary
| | - Beáta Fábos
- Mór Kaposi Teaching HospitalKaposvár, Hungary
| | - Lajos Kemény
- Department of Dermatology and Allergology, University of SzegedSzeged, Hungary
- Dermatological Research Group of the Hungarian Academy of Sciences, University of SzegedSzeged, Hungary
| | - Katalin Nagy
- Department of Periodontology, University of SzegedSzeged, Hungary
| | - Márta Széll
- Department of Medical Genetics, University of SzegedSzeged, Hungary
- Dermatological Research Group of the Hungarian Academy of Sciences, University of SzegedSzeged, Hungary
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Vieira AR, Albandar JM. Role of genetic factors in the pathogenesis of aggressive periodontitis. Periodontol 2000 2014; 65:92-106. [DOI: 10.1111/prd.12021] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2012] [Indexed: 12/14/2022]
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18
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Wang WF, Shi J, Chen SJ, Niu YM, Zeng XT. Interleukin-1α -899 (+4845) C→T polymorphism is not associated with aggressive periodontitis susceptibility: A meta-analysis based on 19 case-control studies. Biomed Rep 2014; 2:378-383. [PMID: 24748978 PMCID: PMC3990208 DOI: 10.3892/br.2014.240] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Accepted: 01/01/2014] [Indexed: 12/12/2022] Open
Abstract
A number of published studies investigated the association between interleukin-1α (IL-1α) −899 (+4845) C→T polymorphism and susceptibility to aggressive periodontitis (AgP). However, the results from different studies are controversial. This study was conducted to further investigate the association between IL-1α −899 (+4845) C→T polymorphism and AgP using a meta-analysis. A search was conducted through PubMed up to May 1, 2013 and a total of 19 relevant case-control studies were identified. The results of this meta-analysis demonstrated that IL-1α −899 (+4845) C→T polymorphism is not associated with susceptibility to AgP under allele T vs. C [odds ratio (OR)=1.00, 95% confidence interval (CI): 0.88–1.14, P=0.98; I2=28.86%] or allele A vs. C comparison (OR=0.99, 95% CI: 0.85–1.14, P=0.85; I2=33.66%). The subgroup analyses based on ethnicity, source of controls and Hardy-Weinberg equilibrium (HWE) also revealed no such association. There existed a weak publication bias (Egger’s test P=0.02). In conclusion, based on the currently available evidence, there is no association between IL-1α −899 (+4845) C→T polymorphism and susceptibility to AgP.
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Affiliation(s)
- Wan-Fen Wang
- Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, P.R. China
| | - Jun Shi
- Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, P.R. China
| | - Shao-Juan Chen
- Department of Stomatology, Shiyan Maternal and Child Health Hospital, Hubei University of Medicine, Shiyan, Hubei, P.R. China
| | - Yu-Ming Niu
- Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, P.R. China ; Center for Evidence-based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, P.R. China
| | - Xian-Tao Zeng
- Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, P.R. China ; Center for Evidence-based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, P.R. China
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Brogden KA, Johnson GK, Vincent SD, Abbasi T, Vali S. Oral inflammation, a role for antimicrobial peptide modulation of cytokine and chemokine responses. Expert Rev Anti Infect Ther 2014; 11:1097-113. [DOI: 10.1586/14787210.2013.836059] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
Genetic factors play an important etiologic role in destructive periodontal diseases. There have been reports that sex chromosomes, especially disorders associated with the X chromosome, affect periodontal health. Although numerous X-linked diseases have been reported to be associated with various periodontal diseases, the association of gingivitis and/or periodontitis with these genetic syndromes should be considered tenuous and raises the question of whether the periodontal manifestation truly arises from an underlying X-linked genetic etiology. A brief overview of genetics in relation to sex chromosomes and putative X-linked genetic periodontal diseases is given.
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21
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Ebersole JL, Dawson DR, Morford LA, Peyyala R, Miller CS, Gonzaléz OA. Periodontal disease immunology: 'double indemnity' in protecting the host. Periodontol 2000 2013; 62:163-202. [PMID: 23574466 PMCID: PMC4131201 DOI: 10.1111/prd.12005] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
During the last two to three decades our understanding of the immunobiology of periodontal disease has increased exponentially, both with respect to the microbial agents triggering the disease process and the molecular mechanisms of the host engagement maintaining homeostasis or leading to collateral tissue damage. These foundational scientific findings have laid the groundwork for translating cell phenotype, receptor engagement, intracellular signaling pathways and effector functions into a 'picture' of the periodontium as the host responds to the 'danger signals' of the microbial ecology to maintain homeostasis or succumb to a disease process. These findings implicate the chronicity of the local response in attempting to manage the microbial challenge, creating a 'Double Indemnity' in some patients that does not 'insure' health for the periodontium. As importantly, in reflecting the title of this volume of Periodontology 2000, this review attempts to inform the community of how the science of periodontal immunology gestated, how continual probing of the biology of the disease has led to an evolution in our knowledge base and how more recent studies in the postgenomic era are revolutionizing our understanding of disease initiation, progression and resolution. Thus, there has been substantial progress in our understanding of the molecular mechanisms of host-bacteria interactions that result in the clinical presentation and outcomes of destructive periodontitis. The science has embarked from observations of variations in responses related to disease expression with a focus for utilization of the responses in diagnosis and therapeutic outcomes, to current investigations using cutting-edge fundamental biological processes to attempt to model the initiation and progression of soft- and hard-tissue destruction of the periodontium. As importantly, the next era in the immunobiology of periodontal disease will need to engage more sophisticated experimental designs for clinical studies to enable robust translation of basic biologic processes that are in action early in the transition from health to disease, those which stimulate microenvironmental changes that select for a more pathogenic microbial ecology and those that represent a rebalancing of the complex host responses and a resolution of inflammatory tissue destruction.
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Sharma A, Kaur G, Sharma A. Papillon-Lefevre syndrome: A case report of 2 affected siblings. J Indian Soc Periodontol 2013; 17:373-7. [PMID: 24049340 PMCID: PMC3768190 DOI: 10.4103/0972-124x.115643] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Accepted: 04/16/2013] [Indexed: 11/24/2022] Open
Abstract
Papillon-Lefèvre syndrome (PLS) is a very rare syndrome of autosomal recessive inheritance characterized by palmar-plantar hyperkeratosis and early onset periodontitis, leading to premature loss of both primary and permanent dentitions. Various etiopathogenic factors are associated with the syndrome, but a recent report has suggested that the condition is linked to x mutations of the cathepsin C gene. The purpose of this report is to describe two cases of PLS in the same family who presented to the Department of Dentistry of Dr. R. P. Government Medical College at Tanda, Kangra (Himachal Pradesh) with a chief complaint of mobility and rapid loss of teeth. Hyperkeratosis of palms and soles was present. On intraoral examination, there was severe gingival inflammation, abscess formation, and deep periodontal pockets with mobility of teeth. Histopathological examination of the specimen taken from the thickened skin was reported to be consistent with PLS. The dental treatment comprised oral prophylaxis, scaling and root planning, antibiotic therapy, instructions on oral hygiene, restorations, extraction of hopelessly affected teeth, and prosthetic rehabilitation.
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Affiliation(s)
- Anupriya Sharma
- Department of Dentistry, Dr. R. P. Government Medical College, Kangra at Tanda, Himachal Pradesh, India
| | - Gurpreet Kaur
- Department of Periodontics, National Dental College, Derabassi, Punjab, India
| | - Ashish Sharma
- Department of Medicine, Dr. R. P. Government Medical College, Kangra at Tanda, Himachal Pradesh, India
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Romero-Quintana JG, Frías-Castro LO, Arámbula-Meraz E, Aguilar-Medina M, Dueñas-Arias JE, Melchor-Soto JD, Romero-Navarro JG, Ramos-Payán R. Identification of novel mutation in cathepsin C gene causing Papillon-Lefèvre Syndrome in Mexican patients. BMC MEDICAL GENETICS 2013; 14:7. [PMID: 23311634 PMCID: PMC3563609 DOI: 10.1186/1471-2350-14-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 01/08/2013] [Indexed: 11/15/2022]
Abstract
BACKGROUND Papillon-Lefèvre Syndrome (PLS) is a type IV genodermatosis caused by mutations in cathepsin C (CTSC), with a worldwide prevalence of 1-4 cases per million in the general population. In México, the prevalence of this syndrome is unknown, and there are few case reports. The diagnosis of twenty patients in the state of Sinaloa highlights the need to characterize this syndrome in Mexicans. METHODS To understand the basis of PLS in Mexicans, the gene expression, enzymatic activity and mutational analysis of CTSC were assayed in nine PLS patients and their relatives. Frequencies of CTSC gene polymorphisms and HLA alleles were determined in these patients, their relatives, and the population. RESULTS Patients showed normal CTSC gene expression, but a deep reduction (up to 85%) in enzymatic activity in comparison to unrelated healthy individuals. A novel loss-of-function mutation, c.203 T > G (p.Leu68Arg), was found in all patients, and some carried the polymorphism c.458C > T (p.Thr153Ile). Allelic frequencies in patients, relatives and controls were 88.89%, 38.24% and 0.25% for G (c.203 T > G); and 11.11%, 8.82% and 9.00% for T (c.458C > T). HLA-DRB1*11 was found significantly more frequent (P = 0.0071) in patients than controls (33.33% vs. 7.32%), with an estimated relative risk of 6.33. CONCLUSIONS The novel loss-of function mutation of CTSC gene (c.203 T > G) found in patients correlated with their diminished enzymatic activity, and HLA-DRB1*11 was found to be associated with PLS. The study of more PLS patients may give more insights into the etiology of the disease as well as its prevalence in México.
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Affiliation(s)
- José G Romero-Quintana
- Faculty of Biological and Chemical Sciences, Doctoral Program in Biotechnology and Master Program in Biomedical Sciences, Autonomous University of Sinaloa, Culiacán, Sinaloa, 80010, México
| | - Luis O Frías-Castro
- Dermatology, Pediatric Hospital of Sinaloa, Culiacán, Sinaloa, 80200, México
| | - Eliakym Arámbula-Meraz
- Faculty of Biological and Chemical Sciences, Doctoral Program in Biotechnology and Master Program in Biomedical Sciences, Autonomous University of Sinaloa, Culiacán, Sinaloa, 80010, México
| | - Maribel Aguilar-Medina
- Faculty of Biological and Chemical Sciences, Doctoral Program in Biotechnology and Master Program in Biomedical Sciences, Autonomous University of Sinaloa, Culiacán, Sinaloa, 80010, México
| | | | - Jesús D Melchor-Soto
- Odontopediatry divisions, Pediatric Hospital of Sinaloa, Culiacán, Sinaloa, 80200, México
| | - José G Romero-Navarro
- Faculty of Biological and Chemical Sciences, Doctoral Program in Biotechnology and Master Program in Biomedical Sciences, Autonomous University of Sinaloa, Culiacán, Sinaloa, 80010, México
| | - Rosalío Ramos-Payán
- Faculty of Biological and Chemical Sciences, Doctoral Program in Biotechnology and Master Program in Biomedical Sciences, Autonomous University of Sinaloa, Culiacán, Sinaloa, 80010, México
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Abstract
The goal of periodontal therapy has always been regeneration of the lost tissues. However, conventional periodontal therapy has not always been successful in achieving regeneration, especially when it is part of a syndrome. This case report involves a 13-year old male patient with the chief complaint of mobile teeth for over 3 months. His dental history revealed early loss of primary dentition, around 3–4 years of age and that he noticed mobility of permanent incisors and molars at 9–10 years. Keratotic skin lesions on the palms and soles were present since the age of 3 years. Full mouth intra-oral periapical radiographs showed extensive bone loss upto apical thirds of the teeth and an orthopantamograph showed “floating in air” appearance. Further, a lateral cephalogram was taken to rule out any calcifications of the duramater. The case was provisionally diagnosed to be Papillon Lefévre syndrome. A conventional polymerase chain reaction assay was also done to assess the virulence genes in aggressive periodontitis. Though the management of PLS involves the regular phases of periodontal therapy, namely, etiotropic, surgical, restorative and maintenance phases, the complete esthetic and functional rehabilitation also involves other specialities especially prosthodontic and dermatologic and later an implantologist. After appropriate periodontal and prosthodontic management, the patient has been followed up for over a year and is maintaining in a stable condition.
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Kosem R, Debeljak M, Repic Lampret B, Kansky A, Battelino T, Trebuak Podkrajek K. Cathepsin C Gene 5'-Untranslated Region Mutation in Papillon-Lefèvre Syndrome. Dermatology 2012; 225:193-203. [DOI: 10.1159/000342509] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Accepted: 08/13/2012] [Indexed: 11/19/2022] Open
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Powell V, Din FM, Acharya A, Torres-Urquidy MH. Broader Considerations of Medical and Dental Data Integration. HEALTH INFORMATICS 2012. [PMCID: PMC7177026 DOI: 10.1007/978-1-4471-2185-5_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Valerie Powell
- Robert Morris University, Moon Township,, Moon Township, 15108-1189 USA
| | - Franklin M. Din
- Medical Informatics Center of Excellence, Camp Hill, 25403 USA
| | - Amit Acharya
- MCRF/BIRC, Marshfield, WI, USA, Marshfield, 54449 Wisconsin USA
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Abstract
Papillon-Lefevre Syndrome (PLS) is a very rare autosomal recessive disorder characterized by palmoplantar hyperkeratosis and severe early onset periodontitis, affecting the primary and permanent dentition. The syndrome was first described by Papillon and Lefevre in 1924. Genetic, immunologic, and microbiologic factors are suggested as responsible for the initiation and progression of the disease. A point mutation of cathepsin C gene has recently been detected in PLS. A multidisciplinary approach is important for management .The prognosis has improved with the early recognition of the syndrome, effective professional supervision, and home care.
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28
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Sadik CD, Noack B, Schacher B, Pfeilschifter J, Mühl H, Eickholz P. Cytokine production by leukocytes of Papillon-Lefèvre syndrome patients in whole blood cultures. Clin Oral Investig 2011; 16:591-7. [PMID: 21380503 DOI: 10.1007/s00784-011-0532-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2010] [Accepted: 02/18/2011] [Indexed: 12/18/2022]
Abstract
Papillon-Lefèvre syndrome (PLS) is characterised by aggressively progressive periodontitis combined with palmo-plantar hyperkeratosis. It is caused by "loss of function" mutations in the cathepsin C gene. The hypothesis behind this study is that PLS patients' polymorphonuclear leukocytes (PMNs) produce more proinflammatory cytokines to compensate for their reduced capacity to neutralize leukotoxin and to eliminate Aggregatibacter actinomycetemcomitans. Production of more interleukin (IL)-8 would result in the attraction of more PMNs. The aim of this study was to evaluate the cytokine profile in PLS patients' blood cultures. Blood was sampled from eight PLS patients (one female) from six families (antiinfective therapy completed: six; edentulous: two) with confirmed cathepsin C mutations and deficient enzyme activity. Nine healthy males served as controls. Whole blood cultures were stimulated with highly pure lipopolysaccharide (LPS) from Escherichia coli R515 and IL-1β plus tumor necrosis factor (TNF)-α. Thereafter, release of IL-1β (stimulation: LPS and LPS plus adenosine triphosphate), IL-6, IL-8, interferon-inducible protein (IP)-10, and interferon (IFN)-γ (stimulation: LPS, IL-1β/TNFα) were detected by ELISA. Medians of cytokine release were, with the exception of IP-10, slightly higher for PLS than for controls' cultures. None of these differences reached statistical significance. Increased production of IL-1β, IL-6, IL-8, IP-10, or IFNγ as a significant means to compensate for diminished activity and stability of polymorphonuclear leukocyte-derived proteases could not be confirmed in this study. Cytokine profiles in blood cultures may not be used to identify PLS patients.
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Affiliation(s)
- Christian D Sadik
- Institute of General Pharmacology and Toxicology, Center for Pharmacology, Johann Wolfgang Goethe-University Frankfurt am Main, Frankfurt am Main, Germany
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Rapp GE, Pineda-Trujillo N, McQuillin A, Tonetti M. Genetic power of a brazilian three-generation family with generalized aggressive periodontitis. II. Braz Dent J 2011; 22:68-73. [DOI: 10.1590/s0103-64402011000100012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The genetic power of a Brazilian three-generation family with generalized aggressive periodontitis (GAgP) has been reported. The empirical logarithms of the odds (LOD) score thresholds for genetic linkage analysis of complex diseases proposed by Haines rely on confirmation from independent datasets. This study estimated the power of another large Brazilian family with GAgP for future linkage analysis. The three-generation family was seen at the Dental School of the Federal University of Bahia. Following the previously described methodology, full-mouth periodontal probing at 6 sites/tooth was performed in all 19 family members. Six out of 12 siblings were affected with GAgP. All affected family members were non-smokers and did not present diabetes or any other systemic condition or consanguinity. A parametric simulation (?=0) was performed on 100 replicates using the statistical software SLINK for linkage analysis. There was maximum expected LOD scores of 3.75 and 3.45 at penetrance rate F=0.98, and both studied phenocopy rates P=0.0 and P=0.02, respectively. The power of the study increased with the increase of the adopted penetrance rates in both studied phenocopy rates. The studied Brazilian three-generation family showed statistical power for future genetic linkage analysis of candidate genes to GAgP.
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Pallos D, Acevedo AC, Mestrinho HD, Cordeiro I, Hart TC. Novel cathepsin C mutation in a Brazilian family with Papillon-Lefèvre syndrome: case report and mutation update. JOURNAL OF DENTISTRY FOR CHILDREN (CHICAGO, ILL.) 2010; 77:36-41. [PMID: 20359428 PMCID: PMC4617240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
PURPOSE Papilion-Lefèvre syndrome (PLS) is a rare autosomal recessive disorder that involves palmoplantar keratosis (PK) and severe aggressive periodontitis. Cathepsin C (CTSC) gene mutations are etiologic for PLS, with more than 60 different mutations reported in different ethnic groups worldwide. The purpose of this study was to report a novel cathepsin C mutation in a Brazilian patient. METHODS A 4-year-old boy presented with aggressive periodontitis, recession, missing teeth, and hyperkeratosis of the palms of hands and soles. Peripheral blood samples were obtained from family members for genomic DNA isolation. The coding region and exon/intron boundaries of the CTSC gene were amplified and sequenced. RESULTS The patient had a PLS phenotype, which included PK and early-onset severe periodontitis. Sequence analysis showed a novel CTSC mutation (c.267-268del) present in the homozygous state. CONCLUSION This report described a novel mutation in a family with Brazilian Papillon-Lefèvre syndrome and presented a review of all cathepsin C (65) mutations reported to date.
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Affiliation(s)
- Debora Pallos
- Department of Periodontics, University of Taubaté, São Paulo, Brazil.
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Hart TC, Hart PS. Genetic studies of craniofacial anomalies: clinical implications and applications. Orthod Craniofac Res 2009; 12:212-20. [PMID: 19627523 DOI: 10.1111/j.1601-6343.2009.01455.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The objective of the study was to overview the role of genetic research in fostering translational studies of craniofacial diseases of dental interest. Background information is presented to illustrate influences affecting genetic research studies of Mendelian diseases. Genetic studies of amelogenesis imperfecta, dentinogenesis imperfecta, hereditary gingival fibromatosis and Papillon Lefèvre syndrome are reviewed. Findings are presented to illustrate how translational applications of clinical and basic research may improve clinical care. Clinical and basic science research has identified specific genes and mutations etiologically responsible for amelogenesis imperfecta, dentinogenesis imperfecta, hereditary gingival fibromatosis and Papillon Lefèvre syndrome. These findings are enabling researchers to understand how specific genetic alterations perturb normal growth and development of dental tissues. Identification of the genetic basis of these conditions is enabling clinicians and researchers to more fully understand the etiology and clinical consequences of these diseases of dental importance. Findings from genetic studies of dental diseases provide a basis for diagnostic genetic testing and development of therapeutic intervention strategies directed at the underlying disease etiology. These studies are advancing our understanding of the development of dental tissues in health and disease. The dental community must consider how to incorporate these developments into effective disease prevention paradigms to facilitate the diagnosis and treatment of individuals with genetic diseases.
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Affiliation(s)
- T C Hart
- Human Craniofacial Genetics Section, Skeletal and Craniofacial Diseases Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD 20892, USA.
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Kurban M, Wajid M, Shimomura Y, Bahhady R, Kibbi AG, Christiano AM. Evidence for a founder mutation in the cathepsin C gene in three families with Papillon-Lefèvre syndrome. Dermatology 2009; 219:289-94. [PMID: 19816003 DOI: 10.1159/000245341] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2009] [Accepted: 04/21/2009] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Papillon-Lefèvre syndrome (PLS; OMIM 245000) is a rare autosomal recessive disorder. Clinically, PLS is characterized by hyperkeratosis involving the palms, soles, elbows and knees which is followed later on by periodontitis, destruction of alveolar bone and loss of primary and permanent teeth. The condition is caused by mutations in the cathepsin C (CTSC) gene. METHODS We analyzed the DNA of members from 3 consanguineous families for mutations in the CTSC gene by direct sequencing analysis. We then performed haplotype analysis. RESULTS We identified an identical recurrent missense mutation, R272P, in all 3 families. Microsatellite marker analysis around the CTSC gene revealed the same haplotype on the mutation-carrying allele in all 3 families. CONCLUSION The presence of this common mutation in families from 2 different geographical areas provides evidence for a founder effect for CTSC mutations in PLS.
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Affiliation(s)
- Mazen Kurban
- Department of Dermatology, Columbia University, New York, N.Y., USA
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de Carvalho FM, Tinoco EMB, Govil M, Marazita ML, Vieira AR. Aggressive periodontitis is likely influenced by a few small effect genes. J Clin Periodontol 2009; 36:468-73. [PMID: 19453571 DOI: 10.1111/j.1600-051x.2009.01410.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM To evaluate the inheritance mode of aggressive periodontitis in a collection of families with a similar geographic origin. MATERIALS AND METHODS Segregation analysis was performed in pedigree data from 74 families by the use of the SEGREG program of SAGE v.5.4.2. Homogeneous no transmission, homogeneous Mendelian transmission, homogeneous general transmission, semi-general transmission and heterogeneous general transmission models were tested assuming the prevalence of aggressive periodontitis as 1% and no deviations from Hardy-Weinberg equilibrium. The parameters of the model were estimated by the method of maximum likelihood, which provides the overall ln (likelihood), -2ln and the AIC (Akaike's score) for each model. The likelihood ratio test (LRT) was used to compare each model against a fully general model (p>0.05). RESULTS The most parsimonious mode of inheritance was the semi-general transmission model that allows the heterozygote transmission probability to vary. CONCLUSION This result provides strong support for the hypothesis that genetic factors play a role in aggressive periodontitis and that a few loci, each with relatively small effects, contribute to aggressive periodontitis, with or without interaction with environmental factors.
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Affiliation(s)
- Flavia M de Carvalho
- Department of Periodontology, Rio de Janeiro State University, Rio de Janeiro, Brazil
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Yacoub A, Hattab F. Oral and Dermatologic Findings in Two siblings with Papillon-Lefevre Syndrome: Review of the Literature. Qatar Med J 2008. [DOI: 10.5339/qmj.2008.2.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Papillon-Lefevre syndrome (PLS), first described in 1924, is a rare autosomal recessive disorder characterized by early onset palmoplanter hyperkeratosis and severe generalized destructive periodontitis leading to premature loss of both primary and permanent dentitions. PLS usually manifest itself between the ages of six months to four years, coinciding with the eruption of primary teeth. The proband becomes completely edentulous by the age of 15.
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Affiliation(s)
- A.A. Yacoub
- *Dental Department, Hamad Medical Corporation
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Noack B, Görgens H, Hempel U, Fanghänel J, Hoffmann T, Ziegler A, Schackert H. Cathepsin C Gene Variants in Aggressive Periodontitis. J Dent Res 2008; 87:958-63. [DOI: 10.1177/154405910808701017] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Cathepsin C ( CTSC) mutations are known to cause Papillon-Lefèvre syndrome. The aim of this study was to examine the association of CTSC genotype with susceptibility to non-syndromic aggressive periodontitis. The CTSC gene was analyzed in 110 persons with generalized aggressive periodontitis in comparison with 78 control individuals, after identifying different variants in a cohort of 100 persons. Five out of 19 discovered variants were included in this association study, representing 5 single-nucleotide polymorphism groups in tight linkage disequilibrium. The relevance of genotypes on enzyme function was examined. The carrier frequency of the missense variant p.I453V was significantly increased in persons with disease compared with healthy control individuals (17.3% vs. 6.4%, p < 0.05). CTSC activity in leukocytes from individuals harboring this variant was significantly reduced (119.8 ΔOD/min*105 cells, 95% confidence interval 17.4–174.9, p = 0.018). No influence of promoter variants was found on mRNA expression. The results support the hypothesis that CTSC gene variants contribute to increased susceptibility in generalized aggressive periodontitis.
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Affiliation(s)
- B. Noack
- Department of Conservative Dentistry,
- Department of Surgical Research, and
- Institute of Physiological Chemistry, Dresden University of Technology, Medical Faculty, Fetscherstrasse 74, 01307, Dresden, Germany
- Department of Periodontology, Ernst Moritz Arndt University, Greifswald, Germany; and
- Institute of Medical Biometry and Statistics, University at Lübeck, Germany
| | - H. Görgens
- Department of Conservative Dentistry,
- Department of Surgical Research, and
- Institute of Physiological Chemistry, Dresden University of Technology, Medical Faculty, Fetscherstrasse 74, 01307, Dresden, Germany
- Department of Periodontology, Ernst Moritz Arndt University, Greifswald, Germany; and
- Institute of Medical Biometry and Statistics, University at Lübeck, Germany
| | - U. Hempel
- Department of Conservative Dentistry,
- Department of Surgical Research, and
- Institute of Physiological Chemistry, Dresden University of Technology, Medical Faculty, Fetscherstrasse 74, 01307, Dresden, Germany
- Department of Periodontology, Ernst Moritz Arndt University, Greifswald, Germany; and
- Institute of Medical Biometry and Statistics, University at Lübeck, Germany
| | - J. Fanghänel
- Department of Conservative Dentistry,
- Department of Surgical Research, and
- Institute of Physiological Chemistry, Dresden University of Technology, Medical Faculty, Fetscherstrasse 74, 01307, Dresden, Germany
- Department of Periodontology, Ernst Moritz Arndt University, Greifswald, Germany; and
- Institute of Medical Biometry and Statistics, University at Lübeck, Germany
| | - Th. Hoffmann
- Department of Conservative Dentistry,
- Department of Surgical Research, and
- Institute of Physiological Chemistry, Dresden University of Technology, Medical Faculty, Fetscherstrasse 74, 01307, Dresden, Germany
- Department of Periodontology, Ernst Moritz Arndt University, Greifswald, Germany; and
- Institute of Medical Biometry and Statistics, University at Lübeck, Germany
| | - A. Ziegler
- Department of Conservative Dentistry,
- Department of Surgical Research, and
- Institute of Physiological Chemistry, Dresden University of Technology, Medical Faculty, Fetscherstrasse 74, 01307, Dresden, Germany
- Department of Periodontology, Ernst Moritz Arndt University, Greifswald, Germany; and
- Institute of Medical Biometry and Statistics, University at Lübeck, Germany
| | - H.K. Schackert
- Department of Conservative Dentistry,
- Department of Surgical Research, and
- Institute of Physiological Chemistry, Dresden University of Technology, Medical Faculty, Fetscherstrasse 74, 01307, Dresden, Germany
- Department of Periodontology, Ernst Moritz Arndt University, Greifswald, Germany; and
- Institute of Medical Biometry and Statistics, University at Lübeck, Germany
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Polymorphisms in the interleukin-1 (IL1) gene cluster are not associated with aggressive periodontitis in a large Caucasian population. Genomics 2008; 92:309-15. [PMID: 18723088 DOI: 10.1016/j.ygeno.2008.07.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2008] [Revised: 06/23/2008] [Accepted: 07/15/2008] [Indexed: 11/24/2022]
Abstract
Polymorphisms in the interleukin-1 (IL1) gene have been suggested to influence transcription of IL1A (interleukin-1alpha) and IL1B (interleukin-1beta) and thereby the pathophysiology of periodontitis. This case-control association study on 415 northern European Caucasian patients with aggressive periodontitis (AgP) and 874 healthy controls was conducted to examine 10 single-nucleotide polymorphisms (SNPs) in the genes of the IL1 cluster for association with IL1A, IL1B, CKAP2L (cytoskeleton-associated protein 2-like), and IL1RN (IL-1 receptor antagonist). The results do not support an association between variants in the IL1 gene cluster and AgP. This case-control study had at least 95% power to detect genuine associations with variants carrying relative risks of at least 1.5 for heterozygous carriers and 2.25 for homozygous carriers. Previous reports of an association between IL1 promoter SNPs and periodontitis might reflect subpopulation effects and have to be interpreted with care.
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Noack B, Görgens H, Schacher B, Puklo M, Eickholz P, Hoffmann T, Schackert HK. Functional Cathepsin C mutations cause different Papillon-Lefèvre syndrome phenotypes. J Clin Periodontol 2008; 35:311-6. [PMID: 18294227 DOI: 10.1111/j.1600-051x.2008.01201.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM The autosomal-recessive Papillon-Lefèvre syndrome (PLS) is characterized by severe aggressive periodontitis, combined with palmoplantar hyperkeratosis, and is caused by mutations in the Cathepsin C (CTSC) gene. This study aimed to identify CTSC mutations in different PLS phenotypes, including atypical forms and isolated pre-pubertal aggressive periodontitis (PAP). MATERIAL AND METHODS Thirteen families with different phenotypes were analysed by direct sequencing of the entire coding region and the regulatory regions of CTSC. The function of novel mutations was tested with enzyme activity measurements. RESULTS In 11 of 13 families, 12 different pathogenic CTSC mutations were found in 10 typical PLS patients, three atypical cases and one PAP patient. Out of four novel mutations, three result in protein truncation and are thus considered to be pathogenic. The homozygous c.854C>T nucleotide exchange (p.P285L) was associated with an almost complete loss of enzyme activity. The observed phenotypic heterogeneity could not be associated with specific genotypes. CONCLUSIONS The phenotypic variability of the PLS associated with an identical genetic background may reflect the influence of additional genetic or environmental factors on disease characteristics. CTSC mutation analyses should be considered for differential diagnosis in all children suffering from severe aggressive periodontitis.
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Affiliation(s)
- Barbara Noack
- Department of Conservative Dentistry, University Hospital Carl Gustav Carus, TU Dresden, Germany.
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Affiliation(s)
- Thomas C Hart
- Clinical Research Core, Section on Dental and Craniofacial Genetics, National Institute of Dental and Craniofacial Research, Bethesda, MD, USA
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Yang Y, Bai X, Liu H, Li L, Cao C, Ge L. Novel mutations of cathepsin C gene in two Chinese patients with Papillon-Lefèvre syndrome. J Dent Res 2007; 86:735-8. [PMID: 17652201 DOI: 10.1177/154405910708600809] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Papillon-Lefèvre syndrome (PLS) is an inherited human disease characterized by early-onset periodontitis and palmoplantar hyperkeratosis. Mutations of the lysosomal protease cathepsin C (CTSC) gene have been shown to be the genetic cause of Papillon-Lefèvre syndrome. There are several case reports in China, while there has been no study on the genetic analysis of PLS. We studied two Chinese patients carrying Papillon-Lefèvre syndrome and showing premature tooth loss and palmoplantar hyperkeratosis. Mutation screening and sequence analysis of the CTSC gene revealed a compound heterozygous mutation (c.415 G>A and c.778 T>C) in one patient, and two novel compound heterozygous mutations (c.851G>A and c.112delCCTG) in the other patient. Our novel discovery indicates that the phenotypes observed in these two patients are due to the CTSC gene mutation.
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Affiliation(s)
- Y Yang
- Department of Pedodontics, Peking University, Beijing, People's Republic of China
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Affiliation(s)
- Hiromasa Yoshie
- Division of Periodontology, Department of Oral Biological Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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Ullbro C, El-Samadi S, Boumah C, Al-Yousef N, Wakil S, Twetman S, Alfadley A, Thestrup-Pedersen K, Meyer B. Phenotypic variation and allelic heterogeneity in young patients with Papillon-Lefèvre syndrome. Acta Derm Venereol 2006; 86:3-7. [PMID: 16585980 DOI: 10.1080/00015550510011619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Papillon-Lefèvre syndrome is an autosomal recessive disorder characterized by palmoplantar hyperkeratosis and aggressive periodontitis. The aim of the study was to identify underlying cathepsin C mutations in 39 subjects with Papillon-Lefèvre syndrome and to explore any phenotypic associations. Genotyping and mutation analyses were performed using standard molecular techniques, and dermatological and oral characteristics were assessed with a semiquantitative clinical score. Three genotypes were present at microsatellite marker D11S1780 and two underlying mutations were identified. The most common genotype (183/183) was associated with an 815G --> C mutation in exon 6 resulting in an arginine to proline change at amino acid 272 (R272P). Patients with the 173/173 genotype revealed an exon 7 G300D mutation resulting in a glycine to aspartic acid change at amino acid 300. The mutation in a family with 189/189 genotype remained unknown. A significant difference in hyperkeratosis of the feet was found between the patients with mutations G300D and R272P ( p < 0.05), but not regarding hands or periodontal condition. Young girls displayed significantly less palmoplantar hyperkeratosis ( p < 0.05) than young boys. In conclusion, considerable phenotypic heterogeneity was observed within the two cardinal mutations and in the 189/189 genotype.
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Affiliation(s)
- Christer Ullbro
- Department of Dentistry, King Faisal Specialist Hospital, Research Centre, Riyadh, Saudi Arabia.
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Wani AA, Devkar N, Patole MS, Shouche YS. Description of two new cathepsin C gene mutations in patients with Papillon-Lefèvre syndrome. J Periodontol 2006; 77:233-7. [PMID: 16460249 DOI: 10.1902/jop.2006.050124] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Papillon-Lefèvre syndrome (PLS) is a rare autosomal disorder characterized by severe periodontitis and palmar plantar hyperkeratosis (PPK). PLS is caused by mutations in the cathepsin C (CTSC) gene. Dipeptidyl peptidase I (DPPI) encoded by the CTSC locus removes dipeptides from the amino terminus of the protein substrate and mainly plays an important role in immune and inflammatory processes. Several mutations have been reported in this gene in patients with PLS. This study reports two novel deletion mutation of the CTSC gene in two Indian families with PLS. METHODS Peripheral blood samples were obtained for genomic DNA isolation from individuals belonging to two Indian families. Exon-specific intronic primers were used to amplify DNA from all individuals, and the PCR products were subsequently sequenced to detect the mutations. Heteroduplex analysis (HDA) was used to confirm heterozygosity and to determine the presence of mutations in control individuals. RESULTS All patients from both families had a classic PLS phenotype, which included PPK and severe periodontitis. Sequence analysis of the CTSC gene revealed two novel deletion mutations, one (1213-1215delCAT) in exon 7 and the other (629-630delGA) in exon 4 of the CTSC gene. For both mutations, the patients were homozygous, whereas the parents were heterozygous. CONCLUSIONS This study reports two novel deletion mutations in two Indian families with PLS. One of the mutations introduces a premature stop codon, thereby producing a truncated protein. In the other case, the mutation observed leads to the loss of a highly conserved histidine molecule that is present in the active site of the enzyme. In both cases, mutations may result in a conformation change, causing loss of the enzymatic activity.
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Affiliation(s)
- Aijaz Ahmad Wani
- Molecular Biology Unit, National Center for Cell Science, Pune, Maharashtra, and Jodhpur Dental College General Hospital, Jodhpur, Rajasthan, India
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Cagli NA, Hakki SS, Dursun R, Toy H, Gokalp A, Ryu OH, Hart PS, Hart TC. Clinical, genetic, and biochemical findings in two siblings with Papillon-Lefèvre Syndrome. J Periodontol 2006; 76:2322-9. [PMID: 16332247 DOI: 10.1902/jop.2005.76.12.2322] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Papillon-Lefèvre Syndrome (PLS) is an autosomal recessive disease characterized by palmoplantar hyperkeratosis and severe periodontitis affecting both primary and secondary dentitions. Cathepsin C (CTSC) gene mutations are etiologic for PLS. The resultant loss of CTSC function is responsible for the severe periodontal destruction seen clinically. METHODS A 4-year-old female (case 1) and her 10-year-old sister (case 2) presented with palmoplantar skin lesions, tooth mobility, and advanced periodontitis. Based on clinical findings, the cases were diagnosed with PLS. Mutational screening of the CTSC gene was conducted for the cases, and their clinically unaffected parents and brother. Biochemical analysis was performed for CTSC, cathepsin G (CTSG), and elastase activity in neutrophils for all members of the nuclear family. The initial treatment included oral hygiene instruction, scaling and root planing, and systemic amoxicillin-metronidazole therapy. RESULTS CTSC mutational screening identified a c.415G>A transition mutation. In the homozygous state, this mutation was associated with an almost complete loss of activity of CTSC, CTSG, and elastase. Although monthly visits, including scaling, polishing, and 0.2% chlorhexidine digluconate irrigation were performed to stabilize the periodontal condition, case 1 lost all her primary teeth. In case 2, some of the permanent teeth could be maintained. CONCLUSIONS This report describes two siblings with a cathepsin C gene mutation that is associated with the inactivity of cathepsin C and several neutrophil serine proteases. The failure of patients to respond to periodontal treatment is discussed in the context of these biological findings.
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Affiliation(s)
- N Arzu Cagli
- Department of Periodontology, Faculty of Dentistry, Selcuk University, Konya, Turkey
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Affiliation(s)
- Harvey A Schenkein
- Department of Peridontics, Virginia Commonwealth University-VCU/MCV, Richmond, Virginia, USA
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45
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Affiliation(s)
- Shogo Takashiba
- Department of Pathophysiology-Peridontal Science, Okayama University, Japan
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Abstract
Papillon-Lefévre syndrome (PLS) is characterized by severe periodontal disease extending to destruction of the alveolar bone surrounding deciduous teeth and palmoplantar hyperkeratosis of the skin. Increased susceptibility to infection has been reported among individuals with the cathepsin C (CTSC) gene mutation. This article reports a 7-year-old Japanese girl who presented with deciduous tooth mobility and was diagnosed as having PLS. Radiographic examination revealed loosening of deciduous incisors and the right second molar of the maxilla, and destruction of the alveolar bone around the residual deciduous dentition. However, there was no destruction of the alveolar bone around the permanent molars. The patient did not show the typical signs of CTSC polymorphism, which almost always negatively impacts certain activating enzymes. With respect to immune function, analysis of the patient's leukocytes indicated that H(2)O(2), chemotactic and phagocytotic functions were within the normal range. However, the special precautions normally applied to prevent infections in PLS patients undergoing dental treatment were taken.
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Affiliation(s)
- Atsushi Ikeshima
- Department of Radiology, Nihon University School of Dentistry at Matsudo, Chiba, Japan.
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Hattab FN, Amin WM. Papillon-Lefèvre syndrome with albinism: A review of the literature and report of 2 brothers. ACTA ACUST UNITED AC 2005; 100:709-16. [PMID: 16301152 DOI: 10.1016/j.tripleo.2004.08.030] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2004] [Revised: 06/23/2004] [Accepted: 08/27/2004] [Indexed: 10/23/2022]
Abstract
BACKGROUND Papillon-Lefèvre syndrome (PLS) is a very rare autosomal recessive disorder characterized by palmoplantar hyperkeratosis and severe early onset of destructive periodontitis leading to premature loss of both primary and permanent dentitions. The etiopathogenesis of the condition suggests that there is a genetic basis for susceptibility to specific virulent pathogens. Variation in the clinical presentation of PLS has recently been observed. OBJECTIVE The objective was to present the first report, which describes the concurrence of PLS and albinism. The etiology, pathology, and management of the condition were reviewed and genetic analysis was performed. SUBJECTS AND CLINICAL PRESENTATION: The probands are Jordanian brothers aged 13 and 20 years on their initial presentation. The parents were second cousins and not affected. The patients exhibited the typical clinical features of PLS with type 1 oculocutaneous albinism (OCA1). They also had increased susceptibility to infection manifested in recurrent tonsillitis, respiratory tract infection, pyoderma, onychogryphosis, and other pathosis. Skin biopsy demonstrated hyperkeratosis, focal parakeratosis, hypergranulosis, and acanthosis. Ectopic calcification of the dura was noticed in one of the probands. Hematological parameters tested were within the normal limits. The probands were tested for mutations in the causative genes of PLS and OCA1, cathepsin C (CTSC), and tyrosinase, respectively. Independent mutations (c.318-1G>A and c.817G>C/p.W272C) were identified in CTSC and tyrosinase, respectively. The probands were homozygous and their sister who had only PLS was homozygous for the same (CTSC) mutation but heterozygous for tyrosinase gene. CONCLUSION We hope that this report of coinheritance PLS and albinism will initiate further investigations to disclose other possible variations that may enhance our knowledge on gene mutations of this intriguing syndrome.
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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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Matheson S, Larjava H, Häkkinen L. Distinctive localization and function for lumican, fibromodulin and decorin to regulate collagen fibril organization in periodontal tissues. J Periodontal Res 2005; 40:312-24. [PMID: 15966909 DOI: 10.1111/j.1600-0765.2005.00800.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Small leucine-rich proteoglycans (SLRPs) decorin, biglycan, fibromodulin and lumican are secreted extracellular matrix molecules that associate with fibrillar collagens and regulate collagen fibrillogenesis. Collagens are the major extracellular matrix components of periodontal connective tissues where they provide mechanical attachment of the tooth to the bone and gingiva and mediate signals that regulate cell functions, including remodeling of the periodontal ligament and bone. Structural organization of collagen may also be important for the defense against periodontal disease, because in certain conditions abnormal collagen fibrils associate with increased susceptibility to periodontal disease. OBJECTIVES The purpose of this study was to find out the role of SLRPs to regulate collagen fibril and fibril bundle formation in periodontal tissues. METHODS The localization of SLRPs in human and mouse periodontal tissues was studied using immunohistochemical methods. To assess the function of SLRPs we studied periodontal tissues of mice harboring targeted deletions of decorin, fibromodulin or lumican genes and lumican and fibromodulin double knockout mice using histological and electronmicroscopical methods. RESULTS The SLRPs were coexpressed in human and mouse gingival and periodontal ligament connective tissues where they colocalized with collagen fibril bundles. Teeth in the knockout animals were fully erupted and showed normal gross morphology. Targeted deletion of decorin, fibromodulin, lumican or both lumican and fibromodulin resulted in abnormal collagen fibril and fibril bundle morphology that was most evident in the periodontal ligament. Each of the gene deletions resulted in a unique fibril and fibril bundle phenotype. CONCLUSIONS These findings indicate that decorin, fibromodulin and lumican coordinately regulate the fibrillar and suprafibrillar organization of collagen in the periodontal ligament.
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Affiliation(s)
- S Matheson
- Department of Oral Biological and Medical Sciences, Laboratory of Periodontal Biology, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
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Lux CJ, Kugel B, Komposch G, Pohl S, Eickholz P. Orthodontic Treatment in a Patient With Papillon-Lefèvre Syndrome. J Periodontol 2005; 76:642-50. [PMID: 15857107 DOI: 10.1902/jop.2005.76.4.642] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Report of a combined periodontal and orthodontic treatment in a patient with Papillon-Lefevre Syndrome (PLS). METHODS A patient with PLS was treated orthodontically 26 months after the start of a combined mechanical and antibiotic therapy. Clinical periodontal parameters were obtained 26 (t1), 60 (t2), and 79 (t3) months after anti-infective therapy. The deepest site of each tooth was sampled for microbiological analysis at 26 and 60 months. Periodontal maintenance therapy was provided every 6 weeks. After a stable periodontal situation was achieved, orthodontic treatment, consisting of space opening for the upper canines with a multibracket appliance and coil springs, was carried out. In the lower jaw, crowding was resolved by an orthodontic mesialization of the canines. RESULTS Twenty-six months (t1) after the beginning of the combined mechanical and antibiotic therapy, 6% of the sites exhibited 4 mm probing depth (PD) with bleeding on probing (BOP) or PD > or =5 mm. Sixty months (t2) after therapy the number of sites with 4 mm PD with BOP or PD > or =5 mm had increased to 17%, and 79 months after therapy (t3) 13% of all sites were similarly affected. From 26 to 60 months, a slight mean clinical attachment level (CAL) gain was observed, whereas the mean PD increased. From 60 to 79 months, there was a mean PD reduction. However, a significant mean attachment loss was also noted. After 26 months (t1), RNA probes failed to detect A. actinomycetemcomitans, P. gingivalis, or T. forsythensis from any site. Thirty-four months later (t2), subgingival recolonization was observed. A. actinomycetemcomitans was detected by RNA probes at three sites. At 26 and 60 months (t1, t2), trypticase-soy with serum, bacitracin, and vancomycin (TSBV) culture failed to detect A. actinomycetemcomitans at any of the sampled sites. Eighty-two months after the beginning of therapy (t4), none of the applied methods could detect A. actinomycetemcomitans from the pooled samples from the deepest pockets of each quadrant or the oral mucosa. In the present case, concomitant orthodontic treatment with a fixed appliance could be performed without further pronounced periodontal deterioration. Space for eruption of the canines and premolars was created, in addition to an alignment of the teeth. CONCLUSION After a successful combined mechanical and antibiotic periodontal therapy of the PLS periodontitis, moderate orthodontic tooth movements may be possible within a complex interdisciplinary treatment regimen.
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