Association between the interval of worksite dental check-ups and dental and medical expenditures: a single-site, 12-year follow-up study in Japan.

OBJECTIVES: The purpose of this study was to identify the effective intervals of worksite dental check-ups to reduce cumulative dental expenditures (CDEs) and cumulative medical expenditures (CMEs), based on 12 years of follow-up dental check-ups. SETTING, DESIGN AND PARTICIPANTS: A longitudinal study was conducted between 2002 and 2014 fiscal years. A total of 2691 full-time employees (2099 males and 592 females) aged 20-59 years in a manufacturing company in Japan were recruited. PRIMARY AND SECONDARY OUTCOME MEASURES: Based on the follow-up of 12-year dental check-ups, the interval of dental check-ups visits was classified into the following categories: 'Once per year' as the regular group, 'At least once per 2 years' as the subregular group and others as the irregular group. CDEs and CMEs per capita were examined by the three groups of dental check-ups interval after adjustment for sex, age, occupation and total CMEs at baseline. For sensitivity analysis, decayed teeth, missing teeth and Community Periodontal Index were added as adjustment factors. RESULTS: Compared with the irregular group, the pooled CDEs (including dental check-ups fee) per capita in the subregular group (OR 0.91, 95% CI 0.85 to 0.98) and regular group (OR 0.87, 95% CI 0.81 to 0.93) were significantly lower overall. The younger adults in the subregular group and younger-aged and middle-aged adults in the regular group had significantly lower CDEs. Sensitivity analysis confirmed these findings. CONCLUSIONS: Our findings suggest that regular and subregular worksite dental check-ups were related to reduction of CDEs. It is important to promote a yearly interval between dental check-ups.

[Association between periodontal pockets and health-related behaviors of workers].

OBJECTIVE: Periodontal disease is a chronic disease caused by bacterial infection, and frequently develops in adulthood. As the disease is closely related to lifestyle, it is important to clarify its relationship with health-related behaviors to provide effective health instructions targeting its prevention. In this study, we focused on periodontal pockets with advanced periodontal disease to clarify the health-related behaviors associated with the presence or absence of periodontal pockets. METHODS: The subjects were 3,142 employees (male: N=2,429, female: N=713; 42.4 ± 10.5 years, Range 20-59 years) of one company, which had provided all employees with an oral health program in 2002. Participants with a Community Periodontal Index code of ≤2 and ≥3 were classified as those without and with periodontal pockets, respectively. To clarify the health-related behaviors associated with the presence or absence of periodontal pockets, we conducted multivariate logistic regression analysis, with presence/absence of periodontal pockets as the dependent variable, and items of health-related behavior investigated in 2002 as independent variables, and calculated the odds ratios (OR) and 95% confidence intervals (95%CI) adjusted for sex, age group and occupation. RESULTS: The factor most strongly correlated with the presence of periodontal pockets was non-use of dental floss (OR=1.95 (95%CI: 1.57-2.41)), followed by smoking (OR=1.71 (95%CI: 1.44-2.03)), and tooth-brushing habits (≤once a day: OR=1.33 (95%CI: 1.10-1.61)). CONCLUSIONS: Our results suggest that, to promote oral health program at the worksite, it is important to provide health education and instructions to encourage the use of dental floss, a daily tooth-brushing habit, and smoking cessation.

Emulsified phosphatidylserine, simple and effective peptide carrier for induction of potent epitope-specific T cell responses.

BACKGROUND: To induce potent epitope-specific T cell immunity by a peptide-based vaccine, epitope peptides must be delivered efficiently to antigen-presenting cells (APCs) in vivo. Therefore, selecting an appropriate peptide carrier is crucial for the development of an effective peptide vaccine. In this study, we explored new peptide carriers which show enhancement in cytotoxic T lymphocyte (CTL) induction capability. METHODOLOGY/PRINCIPAL FINDINGS: Data from an epitope-specific in vivo CTL assay revealed that phosphatidylserine (PS) has a potent adjuvant effect among candidate materials tested. Further analyses showed that PS-conjugated antigens were preferentially and efficiently captured by professional APCs, in particular, by CD11c(+)CD11b(+)MHCII(+) conventional dendritic cells (cDCs) compared to multilamellar liposome-conjugates or unconjugated antigens. In addition, PS demonstrated the stimulatory capacity of peptide-specific helper T cells in vivo. CONCLUSIONS/SIGNIFICANCE: This work indicates that PS is the easily preparable efficient carrier with a simple structure that delivers antigen to professional APCs effectively and induce both helper and cytotoxic T cell responses in vivo. Therefore, PS is a promising novel adjuvant for T cell-inducing peptide vaccines.

Cross-protective peptide vaccine against influenza A viruses developed in HLA-A*2402 human immunity model.

BACKGROUND: The virus-specific cytotoxic T lymphocyte (CTL) induction is an important target for the development of a broadly protective human influenza vaccine, since most CTL epitopes are found on internal viral proteins and relatively conserved. In this study, the possibility of developing a strain/subtype-independent human influenza vaccine was explored by taking a bioinformatics approach to establish an immunogenic HLA-A24 restricted CTL epitope screening system in HLA-transgenic mice. METHODOLOGY/PRINCIPAL FINDINGS: HLA-A24 restricted CTL epitope peptides derived from internal proteins of the H5N1 highly pathogenic avian influenza A virus were predicted by CTL epitope peptide prediction programs. Of 35 predicted peptides, six peptides exhibited remarkable cytotoxic activity in vivo. More than half of the mice which were subcutaneously vaccinated with the three most immunogenic and highly conserved epitopes among three different influenza A virus subtypes (H1N1, H3N2 and H5N1) survived lethal influenza virus challenge during both effector and memory CTL phases. Furthermore, mice that were intranasally vaccinated with these peptides remained free of clinical signs after lethal virus challenge during the effector phase. CONCLUSIONS/SIGNIFICANCE: This CTL epitope peptide selection system can be used as an effective tool for the development of a cross-protective human influenza vaccine. Furthermore this vaccine strategy can be applicable to the development of all intracellular pathogens vaccines to induce epitope-specific CTL that effectively eliminate infected cells.

Peptides coupled to the surface of a kind of liposome protect infection of influenza viruses.

In our previous study, OVA conjugated on the surface of a liposome, we termed Oleoyl liposome, which consisted of dioleoyl phosphatidyl choline, dioleoyl phosphatidyl ethanolamine, dioleoyl phosphatidyl glycerol acid and cholesterol in a 4:3:7:2 molar ratio, induced OVA-specific IgG antibody production but not OVA-specific IgE antibody production that is detrimental to the host. Furthermore, OVA(257-264)-Oleoyl liposome elicited CTL responses in the presence of CpG and rejected E.G7 tumors in mice. In this study we tested whether a peptide-Oleoyl liposome conjugates are capable of inducing protection against viral growth. Subcutaneous inoculation of NP(366-374)-Oleoyl liposome with CpG inhibited growth of influenza viruses in lungs of mice. Thus, surface-linked liposomal peptide might serve as an effective vaccine without detrimental effects in the presence of immune potentiators.

Cost-benefit analysis of a worksite oral-health promotion program.

This study was conducted to examine whether oral-health promotion programs provided as an occupational health service for employees were cost-beneficial for employers. The subjects were composed of 357 male workers (20-59 yr of age) who participated in oral-health promotion programs conducted at their workplaces between 1992 and 1997. The design of this study was a quasi-experimental study design in which the three programs (light: 1 visit; medium: 2-4 visits; and heavy: 5-6 visits) were compared through cost-benefit analysis conducted from the viewpoint of the employers. The programs consisted of oral-health checkups by dentists and oral-health education, including that on the proper brushing method, by dental hygienists. The costs of the program included direct costs for the payment of oral-health-care staff and for teaching materials, and indirect costs for the time for employee participation in the program (20 min/employee per visit). The accumulated dental expenses for the seven years were used to calculate benefits, which were determined, based on the differences between 0 visits and each program. The benefit/cost ratios of the three programs were -2.45, 1.46, and 0.73, respectively. These results suggest that a worksite oral-health promotion program of medium frequency is cost-beneficial for employers.

Role of neuronal interferon-gamma in the development of myelopathy in rats infected with human T-cell leukemia virus type 1.

Human T-cell leukemia virus type 1 (HTLV-1) is the causative agent of not only adult T-cell leukemia but also HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Among the rat strains infected with HTLV-1, chronic progressive myelopathy, named HAM rat disease, occurs exclusively in WKAH rats. In the present study, we found that HTLV-1 infection induces interferon (IFN)-gamma production in the spinal cords of HAM-resistant strains but not in those of WKAH rats. Neurons were the major cells that produced IFN-gamma in HTLV-1-infected, HAM-resistant strains. Administration of IFN-gamma suppressed expression of pX, the gene critically involved in the onset of HAM rat disease, in an HTLV-1-immortalized rat T-cell line, indicating that IFN-gamma protects against the development of HAM rat disease. The inability of WKAH spinal cord neurons to produce IFN-gamma after infection appeared to stem from defects in signaling through the interleukin (IL)-12 receptor. Specifically, WKAH-derived spinal cord cells were unable to up-regulate the IL-12 receptor beta2 gene in response to IL-12 stimulation. We suggest that the failure of spinal cord neurons to produce IFN-gamma through the IL-12 pathway is involved in the development of HAM rat disease.