In Vivo Assay of Crevicular Leukocyte Migration: Its Development and Potential Applications

Abstract

Defects in neutrophil or polymorphonuclear leukocyte (PMNL) Chemotaxis have been observed in a number of clinical conditions, including Down's syndrome and insulindependent diabetes mellitus (IDDM), which tend to be associated with severe forms of periodontal disease. In addition, impaired PMNL Chemotaxis is frequently detected in individuals with localized juvenile periodontitis (LJP). The ability to monitor PMNL function in vivo at the gingival sulcus should therefore be useful as a diagnostic test. In this regard, we developed a technique which measures the response of PMNLs to a chemotactic agent, e.g., casein and N‐formylmethionylleucylphenylalanine (N‐FMLP) placed directly into gingival crevices. The development of the technique and its relationship to in vitro assays of Chemotaxis are discussed, and data obtained from tests of the assay on control and streptozotocin‐induced diabetic rats and human subjects with various periodontal diseases and IDDM are presented. As compared with healthy subjects and control animals, atypical (double peak) and reduced crevicular PMNL response patterns were observed during oral and systemic diseases. This suggests that the in vivo assay with appropriate modifications can be used diagnostically to assess PMNL migratory dysfunction and to identify individuals who may be susceptible to severe forms of periodontal disease.

Gingival crevicular fluid levels of protease‐activated receptors type 1 and type 2 in diabetic patients with periodontitis

“…It is known that neutrophils, which also express PAR 2 in gingival crevicular fluid of patients with chronic periodontitis , show compromised chemotactic activity and release of lysosomal enzymes in diabetics. . Thus, as neutrophils are hypofunctional in diabetics , and are presented in lower quantities at their periodontal pockets , one might speculate that PR3 had insufficient concentration in this environment and therefore lower activation of PAR 2 may occur.…”

Periodontal disease and diabetes mellitus

“…The exact mechanism, which predisposes these individuals to infections, is not known, but several aspects of immunity may play a role. Reduced polymorphonuclear leukocyte (PMN) chemotaxis, phagocytosis, and an impaired antioxidant killing of bacteria have been implicated [28,29]. Thickening of the vascular basement membranes may reduce tissue nutrition and inhibit the migration of PMNs.…”

The effect of periodontal treatment on glycemic control in patients with type 2 diabetes mellitus

“…The prevalence of periodontal disease among individuals with inadequately controlled type 2 DM is generally higher than that of people free of the systemic disorder (Ueta et al 1993, Quintiliani & Maderazo 1995, Sholssman et al 1990). Specifically, the diabetic state impairs the gingival fibroblast’s synthesis of collagen and glycosaminoglycan, enhances crevicular fluid collagenolytic activity, results in the loss of periodontal fibers, loss of the alveolar supporting bone, loosening and ultimate exfoliation of the teeth (Iacono et al 1985).…”