Transcriptomics will help in the treatment of periodontitis
The susceptibility of men to toothache is genetically confirmed
Copper News from Columbia University: Gene Expression Signature Reveals New Way to Classify Gum DiseaseResearchers from the Medical Center at Columbia University (USA) have proposed a new approach to the classification of periodontitis, based not on clinical manifestations and symptoms, as is now customary, but on the genetic characteristics of the affected tissues.
They were able to identify two clusters of patients that differ sharply from each other in these signs, and in one of them there were more men with a severe course of the disease. The first classification system of this kind, the authors are sure, will allow for earlier diagnosis and more individualized therapy of periodontitis. The work was published in the Journal of Dental Research (Kebschull et al., Gingival Tissue Transcriptomes Identify Distinct Periodontitis Phenotypes).
Periodontitis is an inflammation of the periodontium (connective tissue between the root of the tooth and the alveolar process of the jaw), accompanied by destruction of the ligamentous apparatus of the tooth, resorption of the surrounding bone tissue, formation of cysts. Most often, periodontitis develops with dental caries due to infection of the periodontal through the root canal.
According to the accepted classification based on the difference in clinical symptoms, acute and chronic periodontitis are distinguished. However, as the lead author of the work, Professor Panos N. Papapanou, noted, such a division is often very conditional: "Many patients with pronounced, acute symptoms respond well to treatment, while others with much less severe manifestations, despite therapy, continue to dissolve bone tissue. As a result, we cannot say with complete certainty whether periodontitis is acute or chronic until really serious, irreparable disorders manifest themselves."
Papapanu and his colleagues, in search of a more unambiguous classification system for the disease, conducted a cross-genome analysis of gene expression in 241 samples of gingival tissue involved in the pathological process, taken from 120 patients with acute or chronic periodontitis. Patients of both sexes, whose age ranged from 11 to 76 years, were generally healthy and did not smoke.
As a result, based on the genetic characteristics of the tissues, all patients were divided into two different clusters that did not coincide with the accepted symptomatic classification. Differences in gene expression profiles were found to be associated with increased cell proliferation for cluster 1, and with activation of lymphocytes and such a sign of cellular stress as the reaction of non–folded proteins (UPR) for cluster 2.
It was found that in patients from both groups, regardless of age, there are significant differences in phenotypic signs, in particular, in the composition of the oral microflora. Thus, among the patients from cluster 2 there were more male representatives, they more often had a shift of the oral microbiome towards pathogenic microorganisms, and the symptoms of the disease were more pronounced than in patients from cluster 1, which confirms the previously made observation about the greater susceptibility of men compared with women to severe periodontitis.
"Our results suggest that molecular profiling of gingival tissue can become the basis for the development of an alternative system of classification of periodontitis based on the pathobiology of the disease, which adequately correlates with the clinical manifestations of the disease," Papapanu said. The new system, he believes, will give huge advantages in early diagnosis and the choice of a personalized strategy for periodontitis therapy.
The next goal of Papapanu and his colleagues is to investigate the possibility of predicting the outcome of the disease using a new classification system, as well as the search for easily detectable biomarkers characteristic of the two identified clusters, since conducting a full-genome tissue analysis in each case of periodontitis is unrealistic.
Portal "Eternal youth" http://vechnayamolodost.ru25.03.2014