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What is the initial periapical immune response comprised of? Chronic?
Innate immunity with phagocytic leukocytes and cytokines
Adaptive immunity takes over when chronic
Where are APC dendritic cells found in pulp?
Where are the macrophage like cells found in pulp?
Centrally in pulp
Describe the presence of adaptive immunity components in the pulp?
Small number of T cells (BVs), B cells rare, plasma cell progeny are absent.
Earliest pulp response to bacteria includes infiltration of?
PMNs, neutrophils, monocytes, NK cells
mechanism is incapable of clearing the infection
Describe the second line defense of the immune response in the pulp?
purpose of immune response is to localize the infection within the confines of the root canal system and prevent it's travel to the whole body
How can teeth be vital and cause pain with periapical radiolucencies?
tissue destruction is indirect by soluble host-derived mediators
osteoclastogenesis is dependent on innate immune response which is first to occur
What cells comprise the mixed infiltrate of the immune response?
- 1. T
- 2. B
- 3. PMNs
- 4. Macro
- 5. DC
- 6. Plasma
- 7. NK
- 8. Eosinophils
- 9. Mast
Which cells are most numerous in immune response?
Lymphocytes or macrophages
What are the three types of DCs?
Describe levels of immunoglobulins with caries present?
IgG1>IgA1, IgM, IgA2
Describe levels of plasma cells during chronic lesions?
IgG (.7) IgA (.14) IgE (.1) IgM (.04)
What are the potentially destructive products of PMNs?
Elastase, cathepsin G, leukotriene B4
Name some diseases that have PMNs defects
Chronic granulomatous disease
Chediak Higashi syndrome
Leukocyte adhesion deficencies (LADs)
LAD-1: genetic defect of integrins affects transmigration
LAD-2: defect in sialyl Lewis X ligand affects rolling adhesion
What two drugs cause neutropenia?
Cyclophosphamide and methotrexate
What cytokine stimulates the anti-bacterial properties of mature neutrophils?
This biologic modifier is derived from yeast?
reduced bone destruction by 40% in periapical lesion
How do PMNs play a role in neurogenic inflammtion?
secrete Subst. P
Name some adaptive immunity diseases.
SCID (severe combined immunodef)
DiGeorge Syndrome (thymic aplasia)
selective IgA and IgG deficencies
SCID is defects in both?
Humoral and Cellular immunity
Which cytokine "primes" PMNs for elevated oxidative burst?
also IL-1 and TNF (prime for better phagocytosis)
Which two chemokines synergize to increase inflammatory responses?
IL-6 and PGE2: increase inflammatory response (IL-6 prim anti-inf)
IL-1 and PGE2: bone resorption
What chemokines comprise the osteoclast-actviating factor (OAF)?
IL-1beta (most activity) (stimulate RANKL)
Only 10-15% of resorptive action is due to what chemokine?
60% is by IL-1
IL-1beta is _____ times more potent than TNF in bone resorption.
What are autacoids?
Termed resolvins, produced by acetylated COX-2 from omega-3 fatty acids
Name anti-inf cytokines.
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