Defective neutrophil and monocyte motility in patients with early onset periodontitis

Abstract

Several studies have documented suppressed polymorphonuclear neutrophil (PMN) chemotaxis in most patients with juvenile periodontitis. In contrast, data regarding PMN chemotaxis in patients with rapidly progressive periodontitis are very limited, and monocyte (MN) chemotaxis and random migration of PMNs or MNs from these patients have not been studied previously. Accordingly, we examined cell motility of PMNs and MNs from 27 patients with rapidly progressive periodontitis, 5 patients with juvenile periodontitis, and 37 normal control subjects by using a microchamber technique and the synthetic peptide N-formylmethionyl-leucyl-phenylalanine (FMLP) as the chemoattractant. As a group, PMNs and MNs from patients with rapidly progressive periodontitis manifested significantly enhanced random migration relative to control cells (P less than 0.001), suppressed directed migration (chemotaxis) at FMLP doses of 10(-9) and 10(-8) M (P less than 0.05), and enhanced directed migration at a dose of 10(-6) M FMLP (P less than 0.01). In contrast, PMNs from patients with juvenile periodontitis exhibited normal random migration, and directed migration was significantly suppressed at all doses of FMLP tested (P less than 0.05). An abnormality of either PMN or MN motility was observed in 26 of 27 patients with rapidly progressive periodontitis. Enhanced random migration was seen in PMNs in 63%, MNs in 39%, and both cell types in 26% of the patients. Suppressed chemotaxis was seen in PMNs in 85%, in MNs in 74%, and in both cell types in 69% of the patients. The prevalence and magnitude of abnormalities in motility were somewhat lower in treated than in untreated patients. Thus, most, if not all, of this subgroup of patients with early onset, highly destructive periodontitis have abnormalities in PMN or MN motility, and these defects may differ from those seen in cells from patients with the juvenile form of the disease.

Histiocytosis X: an oral diagnostic problem

“…The only abnormality detected in the immunological investigation was some reduction in neutrophil chemotaxis. It has been shown that such functional defects may be associated with increased susceptibility to periodontal destruction in children and young adults and are a relatively constant finding in prepubertal, juvenile and some cases of rapidly progressive periodontitis in young adults (Page et al 1985).…”

Neutrophil chemotaxis in refractory cases of periodontitis

“…However, there is a group of cases which continue to show periodontal pocket formation and bone resorption despite all efforts at treatment by the periodontist and good oral hygiene practice by the patient. Increased attention is being given to this group of refractory or "downhill" cases (Page 1985) and the question is asked -How do these patients differ from those who are successfully treated and reqtiire only maintenance therapy thereafter?…”

“…Little specific information is available about these cases, some of which manifest progressive attachment loss while in others deterioration occurs in a "rapid and unrelenting manner regardless of the type or frequency of therapy applied" (Page 1985).…”

“…In recent years, studies of microbial etiology and host response in periodon-tal diseases have been most fruitful in finding new and significant information. Several investigators have focused attention on the polymorphonuclear neutrophilic leukocyte (Genco et al 1980, Murray & Patters 1980, Page et al 1985. Neutrophils serve a protective function by virtue of their abihty to phagocytize and kill organisms.…”

“…Defective chemotaxis of the polymorphonuclear neutrophils has been found to be a factor in such forms of periodontal disesse as localized juvenile periodontitis (LJP) and rapidly progressive periodontitis (Genco et al 1980, Page et al 1985). In the current study, we investigated the possibility that a defect in PMN chemotaxis might be a factor in refractory cases of periodontitis.…”