Impact of IL-1 genotype and smoking status on the prognosis of osseointegrated implants

Aim: This study evaluated the impact of the IL-1 genotype and smoking status on the prognosis and development of complications of osseointegrated implants. Material and methods: The clinical charts of 180 consecutively admitted patients were analyzed with respect to the occurrence of biological complications in conjunction with oral implants. Biologic complications were defined as clinical conditions with suppuration from the peri-implant sulcus, development of a fistula or peri-implantitis with radiologic bone loss. All patients had received one or more ITI® dental implants, which had been in function for at least 8 (range: 8-15) years. This patient population had received 292 implants. From these, 51 implants in 34 patients showed late (infectious) biologic complications, and 241 implants had survived without any biologic complications at all. Results: Of the 180 patients, 53 were smokers, who were subdivided in a series of classes according to their intensity of smoking and 127 were never smokers. Sixty-four of 180 (36%) patients tested positive for the IL-1 genotype polymorphism. This prevalence corresponds to previous reports for the prevalence of European descent populations. The results for the non-smoking group indicated no significant correlation between implant complications and a positive IL-1 genotype. However, there was a clear association for heavy smokers between a positive IL-1 genotype and implant complications. 6 of 12 or half of the heavy smokers and IL-1 genotype-positive patients had either an implant failure, i.e. loss of implant, or a biologic complication during the follow-up period. Conclusions: These findings have led to the conclusion that there is a synergistic effect between a positive IL-1 genotype and smoking that puts dental implants at a significantly higher risk of developing biologic complications during function.link_to_subscribed_fulltex

Expression of single-chain antibody against RgpA protease of Porphyromonas gingivalis in Lactobacillus.

AIMS: The monoclonal antibody 61BG1.3, recognizing the RgpA protease, has been reported to confer protection against recolonization by the periodontal pathogen Porphyromonas gingivalis in humans. The aim of this study was to express a functional scFv derived from the monoclonal antibody 61BG1.3 on the surface of Lactobacillus paracasei for potential use in the prevention or treatment of periodontal diseases. METHODS AND RESULTS: The scFv was fused to an E-tag and cloned in the Escherischia coli/Lactobacillus shuttle vector pLP501, which mediates surface expression of the scFv. FACS analysis using an anti-E-tag antibody revealed that the scFv was expressed on the surface of the transformed lactobacilli and binding of the scFv to RgpA was shown by ELISA. Lact. paracasei expressing the scFv against RgpA was able to agglutinate P. gingivalis whereas the Lact. paracasei expressing an irrelevant scFv fragment did not. Scanning electron microscopy demonstrated efficient binding of the lactobacilli expressing the scFv anti-RgpA to P. gingivalis. CONCLUSIONS: We have expressed a functional scFv antibody directed against the RgpA protease of P. gingivalis in Lactobacillus. SIGNIFICANCE AND IMPACT OF THE STUDY: These results suggest a potential of Lactobacillus expressing scFvs against P. gingivalis to be used to combat periodontal disease

IL-1RN gene polymorphism is associated with peri-implantitis

Objectives: Interleukin (IL)-1 alpha, IL-1 beta and their natural specific inhibitor IL-1 receptor antagonist (IL-1ra) play a key role in the regulation of the inflammatory response in periodontal tissues. Polymorphisms in the IL-1 gene cluster have been associated with severe adult periodontitis. We aimed to investigate the IL-1 gene cluster polymorphisms in patients with peri-implantitis. Material and methods: The study included 120 North Caucasian individuals. A total of 71 patients (mean age 68 years, 76% smokers) demonstrating peri-implantitis at one or more implants as evidenced by bleeding and/or pus on probing and bone loss amounting to > 3 threads on Branemark implants and 49 controls (mean age 66 years, 45% smokers) with clinical healthy mucosa and no bone loss around the implants were recruited for the study. The titanium implants, ad modum Branemark, had been in function for at least 2 years. Mouthwash samples were collected and used for genotyping of the bi-allelic polymorphisms IL-1A(-889), IL-1B(+3953), IL-1B(-511) and a variable number of tandem repeat IL-1RN gene polymorphisms using PCR technique. Results: Significant differences were found in the carriage rate of allele 2 in the IL-1RN gene between peri-implantitis patients and controls (56.5% vs. 33.3%, respectively; odds ratios (OR) 2.6; 95% confidence interval (CI) 1.2-5.6; P=0.015). Logistic regression analysis taking smoking, gender and age into account confirmed the association between the IL-1RN allele 2 carriers and peri-implantitis (OR 3; 95% CI 1.2-7.6; P=0.02). Conclusions: Our results provide evidence that IL-1RN gene polymorphism is associated with peri-implantitis and may represent a risk factor for this disease

Repeat bacterial challenge in a subcutaneous chamber model results in augmented tumour necrosis factor-α and interferon-γ response, and suppression of interleukin-10

The present study compared the effect of a single or a repeat challenge with the Gram-negative pathogen Porphyromonas gingivalis on the local inflammatory response within subcutaneous chamber model in mice. Subcutaneous chambers were implanted 2 weeks prior to the final challenge. The repeat-challenge (REP) group received two intrachamber bacterial injections 14 days apart, while the single-injection group (SIN) received only a single bacterial challenge. Injection of saline was used as the control. The cellular contents of the chamber exudates were used for differential cell counts, and the supernatants were analysed for tumour necrosis factor-α (TNF-α), interferon-γ (IFN-γ), and interleukin (IL)-10 levels. Immunoglobulin G1 (IgG1) and IgG2a levels to P. gingivalis in the exudates were also determined. The results showed that the leucocyte counts increased significantly post-challenge, and the REP group showed the highest number of lymphocytes and neutrophils. Both P. gingivalis-challenged groups exhibited significant increase in TNF-α and IL-10 levels at day 1 post-challenge. TNF-α levels in the chamber exudate were threefold higher in the REP group compared with the SIN group on day 1 post-challenge (P < 0·05). In contrast, IL-10 levels were significantly lower in the REP group 1 day post-challenge compared with the SIN group. The REP group had significantly higher levels of IFN-γ at baseline, and this difference remained significant 1 day post-challenge. Analysis of antibody levels to P. gingivalis showed that while the control and the SIN groups had no anti-P. gingivalis IgG in the chamber exudate during the 7-day study period, the REP group showed high anti-P. gingivalis IgG levels. In addition, the titres of IgG2a were fivefold higher than the IgG1 titres. The results showed that a repeat local challenge with P. gingivalis augmented the proinflammatory cytokines TNF-α and IFN-γ, while inhibiting the accumulation of the anti-inflammatory cytokine IL-10. This shift towards a T helper 1 (Th1)-dominant response was reflected in the relatively high anti-P. gingivalis IgG2a titres in the local inflammatory environment 7 days post-challenge