Terapêutica adjuvante na modulação da resposta imune no tratamento da doença periodontal: uma revisão de literatura / Adjuvant therapeutic in the modulation of the immune response in the treatment of periodontal disease: a literature review

Introdução: A Doença Periodontal tem caráter multifatorial, já que depende de condições microbiológicas, imunogenéticas e sistêmicas do hospedeiro. Representa inflamação crônica das estruturas de suporte e proteção dental. Desencadeia uma complexa estimulação imunológica, bem como a produção de citocinas inflamatórias, que mediam a destruição óssea e de tecido conjuntivo, provocando perda dental e complicações à distância. A compreensão da etiopatogênese, permitiu os conceitos de modulação, que referem-se às modificações dos aspectos danosos da resposta inflamatória. Objetivo: O presente artigo tem como objetivo realizar uma revisão dos estudos sobre as principais terapêuticas adjuvantes na modulação da resposta imune frente à doença periodontal. Revisão de Literatura: Foi realizada uma revisão da literatura, onde foram selecionados artigos científicos em inglês, publicados entre os anos 2005 a 2020, por meio das bases de dados PubMed e ScienceDirect. No decorrer das buscas, foram utilizadas as palavraschaves "Inflamation", "Periodontal Disease", "Subantimicrobial Dose of Doxycycline", "Periodontal Disease", "Host Response Modulation". Resultados e Conclusão: A literatura é bem promissora em relação à terapia de controle complementar da doença periodontal. Dessa forma, novas pesquisas nessa área podem trazer inúmeros beneficos aos pacientes, sendo, assim, um novo caminho para o contorno da resistência bacteriana(AU)

Introduction: Periodontal disease has a multifactorial character, depending on the host's microbiological, immunogenetic and systemic conditions. It represents chronic inflammation of dental support and protection structures. It triggers a complex immune stimulation, as well as the production of inflammatory cytokines, which mediate bone and connective tissue destruction, causing tooth loss and complications at a distance. The understanding of etiopathogenesis allowed the concepts of modulation, which refers to the modifications of the harmful aspects of the inflammatory response. This article has the escape of conducting a review of studies on the main mechanisms of modulation against periodontal disease. Objective: This article aims to rev iew the studies on the main modulation mechanisms in the face of periodontal disease. Literature Review: A literature review was carried out in which scientific articles were selected in English, published between 2005 and 2020, through the PubMed and ScienceDirect databases. During the searches, the keywords "Inflammation", "Periodontal Disease", "Subantimicrobial Dose of Doxycycline", "Periodontal Disease", "Host Response Modulation". Results and Conclusion: The literature is very promising with complementary control therapy for periodontal disease. Thus, new research in this area can bring countless benefits to patients, thus being a new way to bypass bacterial resistance(AU)

Estado periodontal y microbiota subgingival en mujeres preeclampticas / Periodontal status and subgingival microbiota in preeclamptic women

Objetivos: Describir el estado periodontal y la microbiota subgingival de mujeres gestantes con diagnostico de preeclampsia en el Hospital Universitario del Valle (HUV) de Cali-Colombia. Metodología: Participaron 81 mujeres con diagnóstico de preeclampsia, internadas en el Hospital Universitario del Valle, a quienes se les colectaron datos médicos y periodontales tales como profundidad al sondeo, nivel de inserción clínica, índice gingival y periodontal, con el fin de realizar el diagnóstico clínico periodontal teniendo en cuenta los parámetros de la Academia Americana de Periodoncia (AAP 1999); además se tomaron muestras microbiológicas subgingivales para cultivo e identificación de bacterias periodontopatógenas. Resultados: El 63 de la gestantes presentó preeclampsia leve y el 27.2 preeclampsia severa. Un 91.4 (n=74) de las pacientes presentó afección en el estado de salud periodontal dentro del cual el 59.3 (n=48) presentó un diagnóstico de periodontitis crónica y solo el 8.6 de las gestantes presentó un buen estado de salud periodontal. Los microorganismos periodontopáticos más frecuentes en las mujeres con preeclampsia fueron Fusobacterium ssp 80.2 (n=65), Porphyromonas gingivalis 59.3 (n = 48) y Prevotella intermedian/nigrescens 51.9 (n=42). Conclusiones: Se encontró que una alta proporción de las mujeres con preeclampsia tuvo afección en el estado periodontal con predominio de un diagnostico clínico de periodontitis crónica y presencia de una microbiota periodontopática. Solo un bajo porcentaje de las gestantes presentaron un estado de salud periodontal.

Objective: To describe periodontal status and subgingival microbiota composition among pre-eclamptic women institutionalized in the Hospital Universitario del Valle (HUV) – Cali- Colombia. Methods: Eighty one preeclamptic women were studied in the HUV after signing the inform consent and filling inclusion criteria. Selected patients were examined and their medical, dental, periodontal data recorded. Periodontal index used were pocket depth, clinical attachment loss six measurements by tooth in the whole dentition except third molars. Subgingival samples for bacterial culture were taken and Periodontal diagnosis made according to the American Academy of Periodontology (AAP) concensus report-1999. Results: Sixty three percent of women had slight pre-eclampsia and 27.2 severe preaclampsia. Ninety one percent women (n=74) had certain degree of gingival and periodontal afection. Fifty nine percent (n=48) had Chronic Periodontitis and only 8.6 preeclamptic women had oral health. More prevalent periodontal organisms among pre-eclamptic women were Fusobacterium ssp 80.2 (n=65), Porphyromonas gingivalis 59.3 (n = 48) and Prevotella intermedian/nigrescens 51.9 (n=42). Conclusions: More pre-eclamptic women had chronic periodontitis and also harbored in their subgingival microbiota important periodontophatic organisms. Treatment of periodontal disease before or during pregnancy might be important to reduce medical and systemic health complications.

Outcome of induced labour in pregnancies at 41 weeks gestation and over in Saudi Arabia

A retrospective, descriptive cohort study was conducted at King Faisal Military Hospital, Saudi Arabia, to compare pregnancy outcomes in patients induced with prostagl and in E2 from 41 weeks gestation. A total of 450 women whose antenatal care and delivery were conducted at the hospital during 1995-99 were studied. The main outcome measures used were caesarean section rate and perinatal morbidity and mortality. In otherwise normal pregnancies, the caesarean section rate was not significantly increased when induction of labour was carried out at 41 weeks gestation compared with >/=42 weeks. Although more perinatal complications occurred when induction was carried out at 42 weeks, the results were not statistically significant. A large prospective clinical trial is indicated

Trypanosoma cruzi antigens down-regulate T lymphocyte proliferation by muscarinic cholinergic receptor-dependent release of PGE2

Here we demonstrate that T. cruzi antigen molecule SAPA (shed acute phase antigen) with neuraminidase-trans sialidase activity triggers down-regulation of T lymphocyte proliferation by interacting with T lymphocyte muscarinic acetylcholine receptors (mAChR). SAPA attachment to mAChR from Lyt 2.2+ T cells resulted in synthesis of cyclic GMP (cGMP) and secretion of PGE2, an immunoregulator effector substance. These T suppressor cell signals were blunted by atropine and by indomethacin. Cell sorter analysis showed that the interaction of SAPA with purified T cells, affected the ratio of L3T4+/Lyt 2.2+ T cells increasing the percentage of Lyt 2.2+ T cells, effect that was inhibited by the mAChR antagonist, atropine. The interaction between SAPA and mAChR from Lyt 2.2+ T cells may result, therefore, in the down-regulation of the host immune response as consequence of T suppressor/cytotoxic cells activation and PGE2 release as they were observed. These results support the theory of an immunosuppressive state that contribute to the chronic course of Chagas'disease.