Interaction Between Immune Cells and Bacteria Associated With Periodontitis

Rheumatoid Arthritis Clinical Trial

Official title:

Interaction Between Immune Cells and Bacteria Associated With Periodontitis

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03225950
• Other study ID #: H-16024734
• Status: Completed
• Start date: February 1, 2017
• Est. completion date: March 23, 2020

Study information

• Verified date: October 2018
• Source: University of Copenhagen
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

This study evaluates the interaction between host immune cells and bacteria associated with periodontitis. It comprises biological material from donors with and without periodontal disease. Specifically, we collect a spit and blood sample to conduct in vitro stimulations and measurements of selected parameters related to periodontitis to clarify obscure areas in the immunologic pathogenesis of this disease.

Description:

Periodontitis is a prevalent, multifactorial inflammatory disease characterized by the interaction between microorganisms organized in biofilms on tooth surfaces and host immune cells, leading to an inflammatory destruction of the tooth-supporting tissues and - if left untreated - eventually tooth loss. Periodontitis affects up to 50% of the population in the United States of America, and is classified in an aggressive and a chronic form depending on genetic factors, age of onset, speed and severity of attachment loss.

The onset of periodontitis is caused by an immunologic imbalance between host immune cells and residing microorganisms in subgingival pockets. The host immune cells are capable of enhancing both a protective and a destructive inflammatory response towards the microorganisms through the release of inflammatory mediators e.i. proinflammatory and antiinflammatory cytokines.

The role of antibodies in periodontitis is also unclear. Some studies show an excessive antibody level against bacteria associated with periodontitis e.g. Porphyromonas gingivalis (P.g.).

In general, this study contributes to a profound understanding of the host immune cells role in the onset and pathogenesis of periodontitis by comparing healthy versus diseased donors immunologic responses toward pathogene and apathogene microorganisms and their genetic background.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 90
• Est. completion date: March 23, 2020
• Est. primary completion date: October 12, 2018
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 19 Years to 60 Years

Eligibility

Inclusion criteria for chronic periodontitis donors:

• 50-60 years of age.

• Interproximal attachment loss at minimum 3 teeth besides molars and incisors.

• Clinical attachment loss at minimum 10 sites identified by bleeding and pus upon probing.

• Visible radiographic bone loss.

• Medically healthy donors.

Inclusion criteria for aggressive periodontitis donors:

• 19-40 years of age.

• Interproximal attachment loss at minimum 3 teeth besides molars and incisors.

• Clinical attachment loss at minimum 10 sites identified by bleeding and pus upon probing.

• Visible radiographic bone loss.

• Medically healthy donors.

Inclusion criteria for healthy donors: (age: 19-40 years; 50-60 years)

• No sign of inflammatory conditions or other general systemic diseases.

• Medically healthy donors.

Exclusion criteria for all groups:

• Pregnant and breastfeeding.

• Antibiotic treatment within 6 months.

• Suffer from periodontal manifestations caused by systemic diseases e.i. genetic diseases, haematologic anomalies or syndromes.

Related Conditions & MeSH terms

• Aggression
• Aggressive Periodontitis
• Chronic Periodontitis
• Dysbiosis
• Generalized Aggressive Periodontitis
• Generalized Chronic Periodontitis
• Immune System Diseases
• Immunologic Disease
• Inflammation
• Inflammation Gum
• Microbial Disease
• Periodontal Diseases
• Periodontal Pocket
• Periodontitis
• Rheumatoid Arthritis

Intervention

Other:
• In vitro stimulation of blood with periodontitis-associated- and control bacteria
Peripheral mononuclear blood cells are stimulated with periodontitis-associated- and control bacteria to measure the amount of positive cytokine-producing cells.

Diagnostic Test:
• Anti-CCP- and anti-P.g.-antibodies titers
Anitbody titers will be measured in saliva and serum samples.

Genetic:
• Analysis of selected single nucleotide polymorphisms (SNPs)
DNA obtained from saliva samples will be used to determine the genotype of the participants for selected SNPs.

Diagnostic Test:
• periodontitis-associated bacteria presence
Determination of the presence of periodontitis-associated bacteria e.i. Porphyromonas gingivalis in saliva and blood samples.

Locations

Country	Name	City	State
Denmark	Institute for Inflammation Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen University Hospital.	Copenhagen
Denmark	Section for Periodontology, Microbiology and Community Dentistry, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen	Copenhagen

Sponsors (2)

Lead Sponsor	Collaborator
University of Copenhagen	Copenhagen University Hospital, Denmark

Country where clinical trial is conducted

Denmark, 

References & Publications (14)

Armitage GC. Development of a classification system for periodontal diseases and conditions. Northwest Dent. 2000 Nov-Dec;79(6):31-5. — View Citation

Bartold PM, Van Dyke TE. Periodontitis: a host-mediated disruption of microbial homeostasis. Unlearning learned concepts. Periodontol 2000. 2013 Jun;62(1):203-17. doi: 10.1111/j.1600-0757.2012.00450.x. Review. — View Citation

Belstrøm D, Holmstrup P, Bardow A, Kokaras A, Fiehn NE, Paster BJ. Comparative analysis of bacterial profiles in unstimulated and stimulated saliva samples. J Oral Microbiol. 2016 Mar 16;8:30112. doi: 10.3402/jom.v8.30112. eCollection 2016. — View Citation

Belstrøm D, Paster BJ, Fiehn NE, Bardow A, Holmstrup P. Salivary bacterial fingerprints of established oral disease revealed by the Human Oral Microbe Identification using Next Generation Sequencing (HOMINGS) technique. J Oral Microbiol. 2016 Jan 14;8:30170. doi: 10.3402/jom.v8.30170. eCollection 2016. — View Citation

Berglundh T, Donati M. Aspects of adaptive host response in periodontitis. J Clin Periodontol. 2005;32 Suppl 6:87-107. Review. — View Citation

Damgaard C, Holmstrup P, Van Dyke TE, Nielsen CH. The complement system and its role in the pathogenesis of periodontitis: current concepts. J Periodontal Res. 2015 Jun;50(3):283-93. doi: 10.1111/jre.12209. Epub 2014 Jul 5. Review. — View Citation

Eke PI, Dye BA, Wei L, Slade GD, Thornton-Evans GO, Borgnakke WS, Taylor GW, Page RC, Beck JD, Genco RJ. Update on Prevalence of Periodontitis in Adults in the United States: NHANES 2009 to 2012. J Periodontol. 2015 May;86(5):611-22. doi: 10.1902/jop.2015.140520. Epub 2015 Feb 17. — View Citation

Fillatreau S. Cytokine-producing B cells as regulators of pathogenic and protective immune responses. Ann Rheum Dis. 2013 Apr;72 Suppl 2:ii80-4. doi: 10.1136/annrheumdis-2012-202253. Epub 2012 Dec 19. Review. — View Citation

Haffajee AD, Socransky SS, Patel MR, Song X. Microbial complexes in supragingival plaque. Oral Microbiol Immunol. 2008 Jun;23(3):196-205. doi: 10.1111/j.1399-302X.2007.00411.x. — View Citation

Kinane DF, Preshaw PM, Loos BG; Working Group 2 of Seventh European Workshop on Periodontology. Host-response: understanding the cellular and molecular mechanisms of host-microbial interactions--consensus of the Seventh European Workshop on Periodontology. J Clin Periodontol. 2011 Mar;38 Suppl 11:44-8. doi: 10.1111/j.1600-051X.2010.01682.x. — View Citation

Liu YC, Lerner UH, Teng YT. Cytokine responses against periodontal infection: protective and destructive roles. Periodontol 2000. 2010 Feb;52(1):163-206. doi: 10.1111/j.1600-0757.2009.00321.x. Review. — View Citation

Neely AL, Holford TR, Löe H, Anerud A, Boysen H. The natural history of periodontal disease in man. Risk factors for progression of attachment loss in individuals receiving no oral health care. J Periodontol. 2001 Aug;72(8):1006-15. — View Citation

Pussinen PJ, Jousilahti P, Alfthan G, Palosuo T, Asikainen S, Salomaa V. Antibodies to periodontal pathogens are associated with coronary heart disease. Arterioscler Thromb Vasc Biol. 2003 Jul 1;23(7):1250-4. Epub 2003 Apr 24. — View Citation

Pussinen PJ, Nyyssönen K, Alfthan G, Salonen R, Laukkanen JA, Salonen JT. Serum antibody levels to Actinobacillus actinomycetemcomitans predict the risk for coronary heart disease. Arterioscler Thromb Vasc Biol. 2005 Apr;25(4):833-8. Epub 2005 Feb 3. — View Citation

* Note: There are 14 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	periodontitis-associated- and control bacterial stimulation of host immune cells.	Identification and determination of the amount of cytokine-producing immune cells when stimulated with bacteria associated with periodontitis including pro- and antiinflammatory cytokines.; Genuses: Porphyromonas, Prevotella, Eikenella, Aggregatibacter, Actinomyces, Lactobacillus, Bifidobacterium, Rothia.	Aug. 2020
Primary	Anti-cyclic citrullinated peptides (anti-CCP) antibodies titers.	Determination of the prevalence of anti-CCP-positive periodontitis patients through measure of anti-CCP antibody titers in serum samples and correlation with the level of antibodies to P. gingivalis, and to the abundancy of the bacterium in saliva.	Aug. 2020
Primary	P. gingivalis presence and related antibodies.	Determination of P. gingivalis presence in saliva and serum samples through RT-qPCR and determination of the level of antibodies towards the bacterium using in-house Luminex-based technology.	Aug. 2020
Primary	Single nucleotide polymorphism (SNP) analysis.	Investigation of the potential association between periodontitis and selected polymorphisms in the PADI genes using multiplex bead-based SNP assays with the Luminex technology.	Aug. 2020
Secondary	Cytokine profile in saliva.	Determination of the cytokine profile in saliva samples from subject with periodontitis and healthy controls with Luminex based technology.	Aug. 2020
Secondary	Presence of other periodontal bacteria.	Determination of the presence of other periodontal bacteria through RT-qPCR assays.	Aug. 2020