RESUMEN
AIM: To assess the distribution of elevated antibody titres to multiple periodontal bacteria, including established/putative pathogens and health-related species, by selected demographic, behavioural, and oral- and general health-related characteristics. METHODS: Data from 8153 >or=40-year-old participants from the third National Health and Nutrition Examination Survey were used, including 1588 edentulous individuals. We used checkerboard immunoblotting to assess serum IgG levels to 19 periodontal species. Thresholds for elevated antibody responses were defined for each species using the 90th percentile titre in periodontal healthy participants, using two alternative definitions of periodontitis. RESULTS: Edentulous individuals showed lower antibody responses than dentate participants, notably for titres to "red complex" species and Actinobacillus actinomycetemcomitans. Elevated titres to Porphyromonas gingivalis were twice as prevalent in participants with periodontitis than in periodontal healthy individuals. Non-Hispanic blacks and Mexican-Americans were more likely to display elevated titres for P. gingivalis compared with non-Hispanic whites (22.9%versus 19.4%versus 9.5%). Current smokers were significantly less likely to exhibit high titres to multiple bacteria than never smokers. CONCLUSION: Demographic, behavioural, and oral- and general health-related characteristics were strong determinants of systemic antibody responses to periodontal bacteria in a nationally representative sample of US adults.
Asunto(s)
Anticuerpos Antibacterianos/sangre , Boca Edéntula/microbiología , Boca/microbiología , Periodontitis/inmunología , Periodontitis/microbiología , Adulto , Negro o Afroamericano , Factores de Edad , Anciano , Aggregatibacter actinomycetemcomitans/inmunología , Estudios de Casos y Controles , Escolaridad , Femenino , Humanos , Inmunoglobulina G/sangre , Modelos Logísticos , Masculino , Americanos Mexicanos , Persona de Mediana Edad , Periodontitis/sangre , Periodontitis/etnología , Porphyromonas gingivalis/inmunología , Fumar , Estados UnidosRESUMEN
BACKGROUND: Assessment of periodontal conditions in epidemiologic studies usually requires a clinical examination, which is resource-intensive. We investigated the ability of serum immunoglobulin G (IgG) antibodies to periodontal bacteria to reflect clinical periodontal status. METHODS: We used checkerboard immunoblotting to assess serum IgG levels to 19 species, including established/putative periodontal pathogens and non-pathogenic bacteria, in 5,747 dentate adults aged > or = 40 years who participated in the third National Health and Nutrition Examination Survey between 1988 and 1994. Three earlier described alternative definitions of periodontitis were used, based on specific combinations of probing depth and attachment level values. Optimized elevated titer thresholds and corresponding sensitivities and specificities were calculated for each definition. Titers significantly associated with periodontitis were identified in univariable and multivariable logistic regression models. Parsimonious models were subsequently developed using age, gender, race/ethnicity, education, smoking, and diagnosed diabetes. RESULTS: In unadjusted models, high titers to Porphyromonas gingivalis were most strongly associated with periodontitis across all definitions (odds ratio, 2.07 to 2.74; P <0.05). In parsimonious models including demographic data, smoking, and diagnosed diabetes, high P. gingivalis titers were consistently associated with periodontitis, whereas high Eubacterium nodatum titers were associated with periodontal health in two of three definitions. Receiver operating characteristic curves for the parsimonious multivariable models showed that the area under the curve ranged between 0.72 and 0.78. CONCLUSIONS: Serum IgG titers to selected periodontal species, combined with demographic and behavioral characteristics, resulted in a moderately accurate classification of periodontal status in epidemiologic studies. The external validity of these findings must be examined further.
Asunto(s)
Anticuerpos Antibacterianos/sangre , Periodontitis/diagnóstico , Periodontitis/inmunología , Actinomyces/inmunología , Adulto , Anciano , Aggregatibacter actinomycetemcomitans/inmunología , Bacteroides/inmunología , Campylobacter rectus/inmunología , Femenino , Humanos , Inmunoglobulina G/inmunología , Modelos Logísticos , Masculino , Persona de Mediana Edad , Periodontitis/sangre , Periodontitis/microbiología , Porphyromonas gingivalis/inmunología , Prevotella intermedia/inmunología , Curva ROC , Sensibilidad y Especificidad , Treponema denticola/inmunologíaRESUMEN
BACKGROUND: We revisited the postulate that localized aggressive periodontitis (LAP) patients have robust serum antibody (ab) responses to periodontal pathogens while patients with generalized aggressive periodontitis (GAP) show weak responses. We also studied ab responses in localized chronic (LCP) and generalized chronic periodontitis (GCP). METHODS: Fifty-seven patients (14-74 years, 25% male, 70% Hispanic, 26% African American) were studied (15 LAP, 19 GAP, 11 LCP, 12 GCP patients). Three plaque samples/subject were analysed with respect to 15 species, and serum immunoglobulin G (IgG) responses to the same bacteria were determined. Ab responses were expressed as log-transformed titres, and "infection ratios", i.e., log-transformed ratios of ab titre over the subject-based mean bacterial load for the homologous species. RESULTS: The results failed to corroborate the postulate that LAG patients have robust responses to infecting agents while GAP subjects exhibit weak responses. This held true for ab to "red complex", "orange complex", and health-associated species, and for both titres and infection ratios. Similarly, no differences were found between ab titres or infection ratios in chronic and aggressive periodontitis, or their extent-based subdivisions. CONCLUSIONS: A distinction between the two principal categories of the current periodontitis classification cannot be established by the study of infection patterns.