Immunohistological study of neuronal markers in inflamed gingiva obtained from children with Down's syndrome

Abstract

The histological appearance of the gingiva in children with Down's syndrome (DS) was studied with special reference to inflammatory involvement and innervation. A dense infiltration of inflammatory cells was seen in the propria of most of the DS patients, including a few polymorphonuclear leucocytes. A hyperplasia of the epithelium was also found. The innervation of the gingiva was studied using immunohistochemistry. Nerve fibers as well as nerve bundles immunoreactive to neurofilament (NF) were seen in the propria, while occasionally intraepithelial NF fibers were observed. Calcitonin gene-related peptide (CGRP)-immunoreactive fibers and fiber bundles were also visualized, but they were less abundant than NF fibers. The density of NF and CGRP fibers and fiber bundles was estimated by semiquantitative evaluation. A higher density of NF and CGRP immunoreactive structures was observed in the propria of DS patients compared to the control subjects, while no obvious alteration was seen in their distribution in the propria. In addition, sparsely distributed fibers immunoreactive to peptide histidine isoleucine amide (PHI) and vasoactive intestinal polypeptide (VIP) fibers as well as neuropeptide Y (NPY) and tyrosine hydroxylase (TH) were seen, mainly surrounding blood vessels. A few substance P (SP) fibers were also found, mostly close to the epithelium. No obvious differences of these sparsely distributed fibers were seen in the DS patients compared to controls. Thus, a profound inflammatory involvement of the gingiva of DS patients is seen concomitant with a hyperinnervation of the presumed sensory component of the gingival innervation. In contrast, no alterations were seen in the density of neuronal markers related to autonomic nerve fibers. The sensory hyperinnervation observed is probably not specifically related to DS, but may be due to a sprouting of afferent nerves induced by the inflammatory reaction. However, factors released from the sensory afferents could contribute to the gingival inflammation seen in DS.

Vagal innervation is required for the formation of tertiary lymphoid tissue in colitis

“…One of the requirements for neuronal stromal cell interaction is close association between neuronal fibers and stromal cells. It has been shown in other tissues that inflammation can lead to nerve fiber sprouting [22][23][24]. Intriguingly, we show that there is sparse neuronal innervation of the healthy mucosa, which dramatically increases as a result of inflammation.…”

Periodontal management of an adolescent with Down's syndrome – a case report

“…inappropriate regulation of enzymes and T cell immunodeficiency [8] together with the functional defects of polymorphonuclear leucocytes and monocytes already highlighted [9]. These factors, together with the possibility of differences in collagen biosynthesis, abnormal capillary morphology [8] and hyperinnervation of the gingivae [10], may contribute to the rapid periodontal destruction observed in these patients.…”

Identification of autonomic neuronal chains innervating gingiva and lip

“…It is also well documented that the parasympathetic fibers contain VIP, which is released at their termination (Fahrenkrug et al, 1978;Lundberg, 1981). The presence of VIP fibers was demonstrated in human and rat gingiva and lip (Luthman et al, 1988;Barr-Agholme et al, 1991). These data suggest that VIP fibers not only innervate vessels in the gingiva and vessels and glands in the lip, but it may also influence T-cells.…”