Affiliation:
1. Department of Cytokine Biology, Forsyth Dental Center, 140 The Fenway, Boston, Massachusetts
2. Department of Basic Sciences, University of Texas at Houston, Dental Branch, Houston, Texas
Abstract
Periapical inflammatory responses occur as a consequence of bacterial infection of the dental pulp, as a result of caries, trauma, or iatrogenic insult. Periapical inflammation stimulates the formation of granulomas and cysts, with the destruction of bone. These inflammatory responses are complex and consist of diverse elements. Immediate-type responses-including vasodilatation, increased vascular permeability, and leukocyte extravasation-are mediated by endogenous mediators, including prostanoids, kinins, and neuropeptides. Non-specific immune responses-including polymorphonuclear leukocyte and monocyte migration and activation, and cytokine production-are elicited in response to bacteria and their products. Interleukin-1 and prostaglandins in particular have been implicated as central mediators of periapical bone resorption. Chronic periapical inflammation further involves specific T- and B-cell-mediated anti-bacterial responses, and activates a network of regulatory cytokines which are produced by Th 1- and Th2-type T-lymphocytes. Various naturally occurring and genetically engineered models of immunodeficiency are beginning to help elucidate those components of the immune system which protect the pulpal/periapical complex. Both specific and non-specific responses interface with and are regulated by the neural system. The modulation of these responses by immune response modifiers, cytokine antagonists, and other novel therapeutic agents is discussed. As an experimental model, periapical inflammation has many advantages which permit it to be used in studies of microbial ecology and pathogenesis, host response, neuroimmunology, and bone resorption and regeneration.
Subject
General Dentistry,Otorhinolaryngology
Cited by
292 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献