ORAL INFECTION AND INFLAMMATION IN TRANSPLANT PATIENTS

移植患者的口腔感染和炎症

• 批准号: 7377365
• 负责人: Anna I Dongari-Bagtzoglou
• 金额: $ 8.38万
• 依托单位: UNIVERSITY OF CONNECTICUT SCH OF MED/DNT
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-04-01 至 2007-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7377365
• 关键词: ORAL; INFECTION; INFLAMMATION; TRANSPLANT; PATIENTS

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Chronic periodontitis and oral candidiasis are the most frequent opportunistic oral infections associated with immunosuppression caused by disease or treatment. These oral infections are frequently asymptomatic and therefore can remain undiagnosed and untreated. Solid organ transplant recipients represent a growing population of chronically immunosuppressed patients whose oral health status has been largely uncharacterized. Because recent studies have shown that chronic oral infection can trigger low grade systemic inflammation which may contribute to vascular disease and because chronic graft vasculitis can lead to transplant rejection, studies characterizing the oral and systemic inflammatory status in this patient population are urgently needed. Serum interleukin-6 (IL-6) and C-reactive protein (CRP) are well established, sensitive markers of systemic inflammation which have been shown to be elevated in chronic periodontitis patients and are also good diagnostic indicators for transplant rejection. In this proposal we hypothesize that in transplant patients with Candida stomatitis or chronic periodontitis, chronic elevation of serum IL-6 may directly or indirectly (via induction of CRP) be associated with chronic graft allograft failure. To begin to explore a potential relationship between chronic oral opportunistic infection and chronic transplant rejection we propose to a) study the prevalence of oral candidiasis and chronic periodontitis in their patients population; b) collect preliminary data on a possible association between the presence of these oral opportunistic infections and a history of chronic rejection; and c) determine the levels of IL-6 and CRP in the serum of transplant patients and study their relationship with i) the presence of oral infection; and ii) the levels of oral mucosal IL-6 expression in situ. The pilot work proposed herein will provide the framework for the design of a larger scale prospective clinical study which will conclusively address the role of oral opportunistic infections in systemic inflammation and chronic transplant rejection in this special needs patient population.

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子弹和调查员（PI）可能已经从其他NIH来源获得了主要资金，因此可以在其他清晰的条目中代表。列出的机构适用于该中心，这不一定是调查员的机构。慢性牙周炎和口腔念珠菌病是与疾病或治疗引起的免疫抑制相关的最常见的机会性口腔感染。这些口腔感染通常是无症状的，因此可能保持未诊断和未经治疗。固体器官移植受者代表了越来越多的慢性免疫抑制患者，其口腔健康状况在很大程度上没有表征。因为最近的研究表明，慢性口腔感染会引发低年级的全身性炎症，这可能导致血管疾病，并且由于慢性移植血管炎会导致移植抑制，因此迫切需要该患者口服和全身性炎症状态的研究。血清白介素6（IL-6）和C反应蛋白（CRP）是完善的全身性炎症敏感标志物，已显示在慢性牙周炎患者中升高，也是移植抑制的良好诊断指标。在该提案中，我们假设在念珠菌口腔炎或慢性牙周炎的移植患者中，血清IL-6的慢性升高可能直接或间接地（通过CRP诱导）与慢性移植同种异体移植衰竭有关。 为了开始探索慢性口腔机会感染与慢性移植排斥反应之间的潜在关系，我们建议a）研究患者人群中口腔念珠菌病和慢性牙周炎的患病率； b）收集有关这些口腔机会感染的存在与慢性排斥史之间可能关联的初步数据； c）确定移植患者血清中IL-6和CRP的水平，并研究其与i）口腔感染的关系； ii）原位口服粘膜IL-6表达的水平。本文提出的试点工作将为设计大规模的前瞻性临床研究提供框架，该研究将最终解决口腔机会感染在全身性炎症和慢性移植抑制中在这种特殊需求患者人群中的作用。