immunology and pathogenesis

Question 1

what causes periodontal disease

Answer 1

bacterial pathogens and the host immune response

Question 2

t/f. acute inflammation causes vascular permeability

Answer 2

true. it then results in redness, edema, and increased GCF flow

Question 3

bacterial species that invade periodontal soft tissue

Answer 3

P gingivalis and Aa

Question 4

effects of bacterial metabolic waste products

Answer 4

ammonia, indole compounds, FA, hydrogen sulfide

Question 5

damaging bacterial enzymes

Answer 5

leukotoxins (Aa) and gingipains (proteases from Pg)

Question 6

immunostimulatory molecules

Answer 6

LPS (G-), lipoteichoic acid (G+), gingipains, formylpeptides (stim. leukocyte chemotaxis)

Question 7

what does LPS do

Answer 7

complement activation, pmn activation, macrophage activation, B-cell mitogen activity, pyrogenicity, stim bone resorption, stim prostaglandin synthesis, induction of TNF-alpha

Question 8

host defense of gingivitis

Answer 8

acute inflammation (also seen in an abscess)

Question 9

host defense of periodontitis

Answer 9

chronic inflammation (also seen in Tb)

Question 10

after Tx, there is typically an increase or decrease in protease levels?

Answer 10

decrease

Question 11

what do proteinase inhibitors do and what are 2 examples

Answer 11

inhibit degradation of matrix proteins

alpha-2 macroglobulin, alpha-1 antitrypsin

Question 12

what do MMPs do

Answer 12

degrade ECM (ex. PMN collagenase)

Question 13

are there higher or lower concentrations of MMPs in inflamed gingiva

Answer 13

higher

Question 14

what do IL-1beta and TNF-alpha do

Answer 14

proinflammatory cytokines that stimulate bone resorption and inhibit bone formation

Question 15

what does IL-8 do

Answer 15

chemotactic activity

Question 16

PGE2

Answer 16

prostaglandin that induces vasodilaiton and cytokine and MMP production

Question 17

t/f. pmns are only in GCF in disease states

Answer 17

false. health and disease

Question 18

primary and secondary granules found in periodontitis lesions

Answer 18

elastase - primary, lactoferrin - secondary

Question 19

osteoclast activating cytokines

Answer 19

IL-1beta, 6, 11, 17, PGE2, TNF-alpha

Question 20

RANKL:OPG ratio

Answer 20

RANKL (osteroclast activationg) higher and OPG (ostoblast activating) lower in periodontitis

Question 21

innate immunity defense in periodontitis

Answer 21

biofilm, gingival crevice, mechanical barrier

Question 22

acquired immunity

Answer 22

acute and chronic inflammatory process

Question 23

how does GCF provide innate immunity

Answer 23

carries antibodies, lactoferrin, lysozyme

Question 24

4 steps the innate immune sys takes to provide a defense mechanism

Answer 24

oral mucosa makes antimicrobial peptides
oral epithelium produce pro inflammatory cytokines (IL-1B and TNF-alpha, IL-8)
GCF flows to the site of injury
phagocytic function of PMNs and macrophages

Question 25

what do TLRs do for immuntiy

Answer 25

recognize MAMPs and signal cells to make cytokines, chemokines, antimicrobial peptides, NO and eicosanoids
responds to ox LDL

Question 26

in chronic periodontitis, describe the relative amount of plasma cells to Blymphocytes to T lymphocytes

Answer 26

plasma cells > B lymphocytes > T lymphocytes

Question 27

Th1 cytokines involved in chronic periodontitis

Answer 27

IL-2, IFN gamma, TNF alpha

Question 28

Th2 cytokines involved in chronic periodontits

Answer 28

IL-4, 5, 6, 10, 13

Question 29

t/f. in chronic periodontitis, IgG2

Answer 29

true. IgG2 is predominant in aggressive periodontitis annd recognizes LPS

Question 30

t/f. Th2>Th1 in chronic periodontitis

Answer 30

true. plasma cells are the most predominant and active secretory cells in advanced periodontitis

Question 31

an advanced periodontitis lesion is characteristic of what stage in periodontitis

Answer 31

4

Question 32

what happens in advanced periodontits

Answer 32

plasma cells dominat the ct, PMNs dominate the JE, apical migration of the JE = attachment loss