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Identification of spirochetes related to Treponema pallidum in necrotizing ulcerative gingivitis and chronic periodontitis.
N Engl J Med. 1991 Aug 22; 325(8):539-43.NEJM

Abstract

BACKGROUND

Spirochetes are commonly associated with periodontal disease, but it is not known whether these treponemes are pathogenic or merely opportunistic. We sought to determine whether spirochetes present in periodontal disease share antigens thought to be unique to spirochetes that are known pathogens.

METHODS

We examined dental plaque from 24 healthy subjects, from ulcerative sites in 17 patients with ulcerative gingivitis, and from areas of involvement in 19 patients with chronic periodontitis, using an immunocyto-chemical technique with monoclonal antibodies against pathogen-specific determinants on 47-kd and 37-kd molecules from Treponema pallidum subspecies pallidum. Serum was tested against T. pallidum by immunoblotting and by serologic assays for syphilis.

RESULTS

Spirochetes with a pathogen-specific epitope on a 47-kd molecule were not found in plaque samples from any of the 24 healthy subjects, but they were identified in plaque samples from 11 of 17 patients with ulcerative gingivitis (P less than 0.001) and from 10 of 19 patients with periodontitis (P less than 0.01). Monoclonal antibodies directed against a 37-kd molecule reacted with spirochetes in plaque samples from 1 of 14 controls, from all 11 patients with gingivitis from whom samples could be obtained (P less than 0.001), and from 14 of 19 patients with periodontitis (P less than 0.001). Five of 18 normal subjects had IgG against 47-kd and 37-kd molecules, but none had IgG against 14-kd or 12-kd molecules from T. pallidum subspecies pallidum. Among 19 patients with ulcerative gingivitis, IgG was identified against 47-kd molecules in 15, against 37-kd molecules in 12, against 14-kd molecules in 4, and against 12-kd molecules in 15.

CONCLUSIONS

The spirochetes found in dental plaque from patients with ulcerative gingivitis or chronic periodontitis have antigens that are thought to be unique to pathogenic treponemes. This close antigenic relation suggests that T. pallidum or a closely related organism may be involved in the pathogenesis of periodontal disease.

Authors+Show Affiliations

Department of Pediatric Dentistry, School of Dentistry, Oregon Health Sciences University, Portland 97201-3097.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

1713299

Citation

Riviere, G R., et al. "Identification of Spirochetes Related to Treponema Pallidum in Necrotizing Ulcerative Gingivitis and Chronic Periodontitis." The New England Journal of Medicine, vol. 325, no. 8, 1991, pp. 539-43.
Riviere GR, Wagoner MA, Baker-Zander SA, et al. Identification of spirochetes related to Treponema pallidum in necrotizing ulcerative gingivitis and chronic periodontitis. N Engl J Med. 1991;325(8):539-43.
Riviere, G. R., Wagoner, M. A., Baker-Zander, S. A., Weisz, K. S., Adams, D. F., Simonson, L., & Lukehart, S. A. (1991). Identification of spirochetes related to Treponema pallidum in necrotizing ulcerative gingivitis and chronic periodontitis. The New England Journal of Medicine, 325(8), 539-43.
Riviere GR, et al. Identification of Spirochetes Related to Treponema Pallidum in Necrotizing Ulcerative Gingivitis and Chronic Periodontitis. N Engl J Med. 1991 Aug 22;325(8):539-43. PubMed PMID: 1713299.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Identification of spirochetes related to Treponema pallidum in necrotizing ulcerative gingivitis and chronic periodontitis. AU - Riviere,G R, AU - Wagoner,M A, AU - Baker-Zander,S A, AU - Weisz,K S, AU - Adams,D F, AU - Simonson,L, AU - Lukehart,S A, PY - 1991/8/22/pubmed PY - 1991/8/22/medline PY - 1991/8/22/entrez SP - 539 EP - 43 JF - The New England journal of medicine JO - N. Engl. J. Med. VL - 325 IS - 8 N2 - BACKGROUND: Spirochetes are commonly associated with periodontal disease, but it is not known whether these treponemes are pathogenic or merely opportunistic. We sought to determine whether spirochetes present in periodontal disease share antigens thought to be unique to spirochetes that are known pathogens. METHODS: We examined dental plaque from 24 healthy subjects, from ulcerative sites in 17 patients with ulcerative gingivitis, and from areas of involvement in 19 patients with chronic periodontitis, using an immunocyto-chemical technique with monoclonal antibodies against pathogen-specific determinants on 47-kd and 37-kd molecules from Treponema pallidum subspecies pallidum. Serum was tested against T. pallidum by immunoblotting and by serologic assays for syphilis. RESULTS: Spirochetes with a pathogen-specific epitope on a 47-kd molecule were not found in plaque samples from any of the 24 healthy subjects, but they were identified in plaque samples from 11 of 17 patients with ulcerative gingivitis (P less than 0.001) and from 10 of 19 patients with periodontitis (P less than 0.01). Monoclonal antibodies directed against a 37-kd molecule reacted with spirochetes in plaque samples from 1 of 14 controls, from all 11 patients with gingivitis from whom samples could be obtained (P less than 0.001), and from 14 of 19 patients with periodontitis (P less than 0.001). Five of 18 normal subjects had IgG against 47-kd and 37-kd molecules, but none had IgG against 14-kd or 12-kd molecules from T. pallidum subspecies pallidum. Among 19 patients with ulcerative gingivitis, IgG was identified against 47-kd molecules in 15, against 37-kd molecules in 12, against 14-kd molecules in 4, and against 12-kd molecules in 15. CONCLUSIONS: The spirochetes found in dental plaque from patients with ulcerative gingivitis or chronic periodontitis have antigens that are thought to be unique to pathogenic treponemes. This close antigenic relation suggests that T. pallidum or a closely related organism may be involved in the pathogenesis of periodontal disease. SN - 0028-4793 UR - https://www.unboundmedicine.com/medline/citation/1713299/Identification_of_spirochetes_related_to_Treponema_pallidum_in_necrotizing_ulcerative_gingivitis_and_chronic_periodontitis_ L2 - http://www.nejm.org/doi/full/10.1056/NEJM199108223250803?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -