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조기발병형 치주염의 임상적 및 면역유전학적 연구
Clinical and Immunogenetic Study on the Early - Onset Periodontitis
김준홍(Jun Hong Kim),김성조(Sung Jo Kim),최점일(Jeom Il Choi)
UCI I410-ECN-0102-2009-510-005572517
* 발행 기관의 요청으로 이용이 불가한 자료입니다.

542 periodontal patients having early-onset periodontitis(EOP) have been reclassified into a more homogeneous phenotypic subsets by newly revised radiographic criteria. Representative patients of each EOP subform have been examined of serum IgG subclass antibodies against periodontopathic bacteria, Porphyromonas gingivalis(Pg) 381 and of genetic markers for IgG allotypes to clarify the relationship between these parameters and phenotype expression of each subform. The early-onset periodontitis could be reclassified by the radiographic parameters combining the mean interproximal alveolar bone loss(BL) and the radiographic ratio(between 1st molars and the adjacent teeth: Ratio) with statistical significance(p<0.001 by MA- NOVA). Moreover these EOP subforms could clearly be delineated from adult periodontitis. Of subform I and II(localized-type EOP) patients with minimal mean bone loss(BL<5.0), patients demonstrating disease activities in localized areas(RatioD1.5) showed the elevated responses in all the IgG subclasses against Pg compared with those of patients without disease activity(Ratio 41.5). There were gradual increase in the IgG2 and IgG4 titers against Pg as the disease developed into the generalized forms suggesting the possible role of these antibodies in modulating the phenotype expression. The genetic marker study for IgG allotype revealed that mean IgG2 and IgG4 subclass titers were significantly higher(p<0.01, p(0.05, respectively) in patients who were positive for G2m(n). This indicated that IgG subclass responsiveness against the bacterial antigens are under the immnuogenetic control. The observed frequencies of G2m(n) were significantly higher(p(0.05) in subfrom IV patients who had the characteristic features of classical rapidly progressing periodontitis indicating the possible genetic predisposition in these patients.

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