http://jdr.sagepub.com Immunologic Reactions and Periodontal Inflammation
Stephan E. Mergenhagen, Thomas R. Tempel and Ralph Snyderman J DENT RES 1970; 49; 256 DOI: 10.1177/00220345700490020901 The online version of this article can be found at: http://jdr.sagepub.com
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Immunologic Reactions and Periodontal Inflammation
STEPHAN E. MERGENHAGEN, THOMAS R. TEMPEL,* and RALPH SNYDERMAN Immunology Section, Laboratory of Microbiology, National Institute of Dental Research, National Institutes of Health, Bethesda, Maryland 20014
Plasma Cells During the past decade information has accumulated establishing therole of antigenantibody complexes as pathogenic agents in both acute and chronic inflammatory reactions.4-5 At present, research is oriented toward understanding the biochemical mediators of inflammation that are sequelae of the immune response. Immunobiologists have tried to relate biologic activity that results in tissue damage to the well-established fact that endotoxins are potent antigens andmay give rise to some as yet ill-defined forms of hypersensitivity phenomena.
There is abundant evidence that bacteria man.8 Since these cells are part of the associated with dental plaque are the pri- lymphoreticular system involved in the promary etiologic factor in periodontal inflam- duction of immunoglobulins, it is reasonable mation.1-3 Bacteria isolated from dental to conclude that localimmune responses plaque have been shown to produce many occur in the gingival tissues. The most likely tissue-damaging products.' Probably most result of plasma cell accumulation is the important from the standpoint of immuno- release of antibodies against antigenic comlogic injury to oral tissues are the potent ponents of bacteria in the gingival sulcus or bacterial antigens that could add tothe de- col. Support for this idea comes from findvelopment of periodontal inflammation. ings that a plasma cell infiltration can be Prominent among these antigens are the experimentally produced in rabbits by reso-called endotoxins or lipopolysaccharides peated exposure of the gingival epithelium from oral gram-negative bacteria. Bacterial to a protein antigen.9 In rabbits whose ginendotoxins arederived from the outer mem- gival sulci were treated with egg albumin, brane of the complex cell wall of gram- the gingival tissue showed chronic inflammanegative bacteria and are macromolecular tion with numerous plasma cells, and the structures containing polysaccharide, phos- serums contained anti-egg albumin antibodies. In correlate studies, Berglund, Rizzo, pholipid, and small quantities ofprotein. and Mergenhagen'0 showed that shortly
after the regional lymph node showed specific antibodies to intramucosally injected endotoxin, a heavy infiltrate of lymphocytes and plasma cells appeared at the injection site. It was also shown that specific antibody to endotoxin was being elaborated by certain of those cells in this local inflammatory response. These examples show that antigenspenetrating the gingival epithelium can stimulate the regional lymph nodes or other lymphoid tissues or both to produce immunocytes that may accumulate at the local tissue site (gingival tissue) (Fig 1). Once mature plasma cells appear in the gingival tissues, they may elaborate specific antibodies that form antigen-antibody complexes. On interaction with the antigen, the antibody is altered and may...