Bacteria Host Response: Inflammatory and Immunology Fundamentals

Question 1

The inflammatory process involved in the
development of gingivitis and periodontitis is
influenced by the ___ ____ of the
individual.

Answer 1

immune response

Question 2

ongoing loss of clinical connective tissue attachment and alveolar and supporting bone

Answer 2

Periodontal Disease Activity

Question 3

Possible Causes for Decrease in Host Response 7.

Answer 3

1. Stress
2. Chemotherapy
3. Local Tissue Trauma
4. Uncontrolled diabetes
5. Leukemia
6. Steroids
7. AIDS

Question 4

Bacteria Host-Challenge:
Bacteria in biofilm:

Early bacteria are what kinds?
Bacteria left alone? Sub-G

Answer 4

• Cocci and gram +

- Gram - and complex spir

Question 5

Early Defense Mechanisms!
SupraG:
Gingival Crevice:
Gingival CT:

What do these contain

Answer 5

SupraG: Saliva contains antibacterial factors. Lysozyme, lactoferrine, lactoperoxidase, myeloperoxidase, sIgA

Gingival Crevice: GCF- Outward flow cleansing the sulcus (outward flow during inflammation) oral epithelium, PMN wall

Gingival CT: IgG, IgM

Question 6

Essentials of Immunity
Innate Immune System
Adaptive Immune System

What do each include

Answer 6

Innate Immune System:

• Things everyone has automatically
• Skin, stomach acid, complement
• Natural Killer cells

Adaptive Immune System

• Specific to antigens
• B cells
• T cells
• Antigen presenting cells
• Phagocytes

Question 7

B cells and T cells are the main mediators of the immune response. There are two types of each. Can you remember what they are?

Answer 7

B Cells

• Memory B Cells
• Plasma Cells

T Cells

• Helper T
• Cytotoxic T Cells

Question 8

3 Phases of the Inflammatory Process

Answer 8

1. Acute Transient Phase: characterized by local vasodilation and increased capillary permeability (histamine and prostaglandins); clinically we see gingival edema (swelling) and erythema (redness)
2. Delayed subacute phase:
   characterized by migration of
   PMNs and other phagocytic cells into the tissue
3. Chronic Phase
   characterized by TISSUE DESTRUCTION

Question 9

When tissue is damaged or infected, this group of hormones will create the reactions that cause pain, fever and inflammation, which sparks the healing process. Prostaglandins also stimulate the formation of a blood clot and the contraction of the blood vessel wall when your body is bleeding.

Answer 9

Prostaglandinds

Question 10

what are the 3 host cells that contribute to destruction

Answer 10

1. Cytokines
2. Prostaglandins
3. Matrix Metalloproteinases

Question 11

• Chemical controllers
• Produced by PMNs, macrophages, B cells,
  epithelial cells, gingival fibroblasts, and
  osteoblasts
• Recruit PMNs and macrophages to infection site
• Increase vascular permeability- allows better movement of immune cells and complement
  -Can initiate tissue destruction*****

Answer 11

CYTOKINES

Question 12

CAN INITIATE TISSUE DESTRUCTION! **

CYTOKINES OR PROSTAGLANDINS

Answer 12

CYTOKINES

Question 13

• Biochemical mediators derived from fatty
  acids
• Produced by PMNs and macrophages
• Increase dilation and permeability of blood
  vessels
  -***** Trigger osteoclasts

Answer 13

Prostaglandins

Question 14

• Biochemical mediators derived from fatty
  acids
• Produced by PMNs and macrophages
• Increase dilation and permeability of blood
  vessels

-***** Trigger osteoclasts

Answer 14

Prostaglandins

Question 15

• Family of enzymes produced by body cells
  that break down connective tissue
• Made by PMNs, macrophages, gingival
  fibroblasts, and junctional epithelium cells
• In health-> MMPs facilitate the normal
  turnover of the periodontal connective
  tissue matrix
• In disease -> overproduction of MMPs
  results in extensive collagen destruction

Answer 15

MMPs (Matrix Metalloproteinases)

Question 16

What 6 are commonly found in perio … hint lots are cytokines

Answer 16

cytokine IL-1, IL-6, IL-8, TNF-a,
Prostaglandin E-2
MMP Enzymes

Question 17

PMNs (Neutrophils)

1st on scene explain

Answer 17

PMN: Neutrophil= 1st line of defense. Hallmark of acute inflammation. First cell called into action at the site of inflammation. phagocytic infantry

Phagocytosis: Phagocyte engulfs/captures the antigen; once captured, invader is degraded by lysosomes

Chemotaxis: Movement of cells in the direction of a chemical attractant

PMN wall protects epithelium, PMns also in injured tissues

Question 18

neutrophil = “first line of defense,” “hallmark of acute inflammation;” first cell called into action at the site of inflammation; Phagocytic (infantry)

Answer 18

PMN

Question 19

movement of cells in the direction of a chemical attractant

Answer 19

Chemotaxis

Question 20

Depressed PMN function can lead to BIG problems. 7 Problems that are common

Answer 20

1. Localized aggressive periodontitis
2. Diabete Type I
3. Chediak- Higashi syndrome
4. Papillon-Lefevre Syndrom
5. Drug Induced agranulocytosis
6. Cyclic neutropenia
7. Leukemia

Question 21

• The other main phagocytic cell
• Monocyte (WBC) ->____
• Mostly in the inflamed CT, some continue
  into gingival crevice
• Release cytokines (Il-1 and TNF)

Answer 21

Macrophage

Question 22

*** (antibodies or
complement) bind to bacteria so that they
are more easily identified

Think Mission Impossible: At the embassy, they spray the target with a liquid that identifies him to the team

Answer 22

Opsonization:

Question 23

series of 20-30
plasma proteins that generate chemotactic
factors attracts PMNs, macrophages,
luekocytes; also directly kills and lyses
bacteria

Answer 23

Complement System

Question 24

Immune Response:

After __ days, inflammation will become chronic.

When __ and __ alone are not enough->

Activation of the “specific host response” or adaptive immune system; same reactions and cells seem in inflammatory level, but more cells involved

2 parts to immune reaction: humoral immunity and ____ immunity

Answer 24

7 days

PMN and Macrophages

cellular

Question 25

- B-cells (B-lymphocytes) are mediators - Humoral immune mechanisms are most effective against bacteria, such as those in perio

Answer 25

Humoral Immunity

Question 26

Humoral and ____ immunity occur almost at the same time; cells from one or the other will predominate during different stages of perio

Answer 26

cellular immunity

Question 27

- T-cells (T-lymphocytes) are mediators - T-cells “watch” the tissues (spies) - T-helper (CD4 receptors), - T-cytotoxic (CD8 receptors) - T-cells can cause bone loss (stimulate osteoclasts or produce IL-1) - Cytotoxic T-Cells (CD8 receptors) can directly kill virus-infected cells, cancer cells, parasites, and certain bacteria (poke holes) (natural killer cells play the same role in innate immunity) - Cellular immunity is most effective against fungi, viruses, cancer, foreign tissue

Answer 27

Cellular Immunity

Question 28

____ immunity is activated in severe gingiviits and periodontitis

Answer 28

humoral

Question 29

___ immunity is most effective against fungi, viruses, cancer and foreign tissue

Answer 29

cellular

Question 30

T-cells seen mostly in gingivitis or perio?

Answer 30

gingiviits