Antibodies could predict perio treatment success

Dentists may be able to gauge a patient's likely response to periodontal treatments by identifying the level of antibodies present in their mouth, an American study has suggested.

Research carried out at the University of Michigan's School of Dentistry has reported that HtpG antibodies, generated in response to the Porphyromonas gingivalis pathogen, present in much lower amounts in individuals with periodontal disease. Higher concentrations were identified in those with good oral health.

Antibodies are typically elevated in people with active gum disease.

"What has been seen in periodontal disease over the last 30 to 40 years is that patients with periodontal disease have higher levels of antibodies to the bacteria associated with periodontal disease, but...those antibodies aren't usually protective," said Dennis Lopatin, principal investigator and senior associate dean of the School of Dentistry.

"It's like being vaccinated against the wrong strain of the flu. The healthy patient makes high levels of the antibodies but to the right part of the bug."

The team discovered that not only were HtpG antibodies present in higher amounts in patients with good oral health, those patients also responded better to periodontal treatment.

"We're in a position now where we have a potential tool that gives insight as to how the patient will respond to treatment," Lopatin said. "In the United States we spend $8 billion to $12 billion a year caring for people with serious periodontal disease.

"From a public health standpoint, it's very important to identify those people who not only need therapy but will actually respond to a specific type of therapy."

Over time, this method could lead to early interventional therapy to prevent periodontal disease from advancing, or as an even more effective means of prevention.

The antibody also has potential as a vaccine candidate, suggested Charles Shelburne, assistant research scientist at the U-M School of Dentistry.

The poor immune response identified among patients with periodontal disease supports the idea that oral health plays a significant role in influencing systemic health.

"We want to understand how unique this mechanism is in other types of chronic infections," Lopatin explained. "We'd like to think it's not a mechanism unique to just this pathogen, if it is a more common mechanism, it makes it even more interesting."