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• W2070472364 abstract "Periodontal diseases result in the destruction of tooth supporting tissues eventually leading, if untreated, to tooth loss. The most common form, chronic adult periodontitis (AP), is prevalent in humans after the fourth decade of life. It has recently been reported that 77% of adults in the USA had at least one site with periodontal attachment loss of 2 mm or more, and that, on average, 6 sites were affected. It is now well established that bacteria play a central role in the initiation and progression of these inflammatory diseases. Because of the complexity of the oral flora (about 200 taxa have been found in periodontal pockets), precise information about the etiologic bacteria is difficult to ascertain. However, the role of specific groups of microorganisms, including Gram-negative anaerobic bacteria, in the pathogenesis of periodontial diseases has been increasingly appreciated in recent years, so that these are nowadays considered polymicrobial, mixed, infections. Studies of the predominant cultivable microbiota have revealed that black-pigmented Bacteroides spp (BPB) are frequently associated with active destructive periodontal lesions of AP, together with Wolinella recta, Fusobacterium nucleatum, Eubacterium spp., and Bacteroides forsythus , to name a few. Actinobacillus actinomycetemcomitans , an aerotolerant, capnophilic Gram-negative species, has quite specifically been implicated in the etiology of the juvenile and localized form of periodontitis. The taxonomy or oral Bacteroides spp has undergone substantial change in the last decade. Eight species of oral black-pigmented Bacteroides and 11 species of nonpigmented oral Bacteroides are now recognized. It is customary to distinguish asaccharolytic from saccharolytic species within the group of black-pigmented Bacteroides . Of the saccharolytic species 5 are isolated from the oral cavity of man or animals : B. melaninogenicus, B. denticola, B. loescheii, B. intermedius and B. macacae , and 2 are extra-oral : B. corporis and B. levii . Recently, it has been proposed to reclassify the three asaccharolytic black-pigmented Bacteroides spp, B. gingivalis, B. endodontalis and B. asaccharolyticus , to the new genus Porphyromonas . All three organisms have been associated with human diseases : B. gingivalis in periodontal diseases; B. endodontalis in dental root canal infections; and B. asaccharolyticus in pelvic and bite wound infections, and endometritis. The primary habitat of B. gingivalis is the dento-gingival area; B. endodontalis is seldom found in the gingival sulcus, and B. asaccharolyticus is almost never found in the oral cavity. Thus, it appears that each of these species occupies a unique ecological niche in the human body. A recent experiment resulted in the successful implantation of a rifampicin-resistant B. gingivalis into the periodontal microbiota of the macaque monkey. An increase in the systemic level of antibody to the microorganism and a burst of bone loss were observed, indicating that the emergence of B. gingivalis in the subgingival microflora is capable of inducing periodontitis. Most of the oral BPBs are not infectious for mice or guinea pigs when injected as pure cultures. However, virulent strains of B. gingivalis have been reported which caused abcesses or were invasive upon subcutaneous injection. Yet it is not clear whether B. gingivalis strains recovered from active destructive periodontal lesions are always infectious or invasive in animal models. The periodontopathic potential of BPBs, in particular of B. gingivalis , is documented mostly by studies of the factors which may contribute to the virulence of these bacteria. It must be noted that no exotoxin has been described in this species. Factors important for colonization, in terms of adherence, include fimbriae and extra-cellular vesicules. The fimbriae of B. gingivalis were originally thought to confer hemagglutinating activity, but it has recently been shown that a hemagglutinating adhesin was distinct from fimbrillin although the subunits of both have similar molecular weight. Other possible adhesins include binding sites for lectins and fibrinogen. Outgrowths of the outer membrane freed as extracellular vesicules promote homotypic as well as heterotypic bacterial aggregation, attachment to the tooth surface, and hemagglutination, and also exhibit proteolytic activity. Factors with potential for tissues destructions are mostly associated with enzymatic activities. B. gingivalis can produce trypsin-like and other proteases active on protein substrates, such as gelatin, casein, fibrin, fibrinogen. A true collagenase has been reported in addition to nonspecific proteases active on collagen. Volatile sulfur compounds released in copious amounts by B. gingivalis have been shown to increase the permeability of the oral mucosa and reduce collagen and noncollagenous protein synthesis. The LPS of B. gingivalis is atypical : it contains very low heptose and KDO levels and shows little endotoxic activity. It is thought to function as an immunomodulator rather than as a virulence factor. Factors important in the inactivation of host defense systems include IgG and IgA proteases, and C3 and C5 proteases that may allow B. gingivalis to evade phagocytosis and may locally paralyse the immune response. Inactivation or degradation of plasma proteinase inhibitors such as alpha-1-antitrypsin, alpha-2-macroglobulin, haptoglobin and hemopexin may lead to exacerbation of the inflammatory process. The ability of B. gingivalis to suppress polymorphonuclear neutrophil adherence and chemotaxis may also contribute significantly to its pathogenicity. In conclusion, a variety of structures and molecules, including numerous proteolytic enzymes associated with tissue destruction or likely to paralyse the host's defenses against the infection make up the virulent arsenal at the disposal of B. gingivalis . However, it is important to note that most of these activities have been shown only in vitro , and it has yet to be demonstrated whether these occur in vivo . Indeed, it is intriguing that adult periodontitis, a chronic inflammatory condition, results in bone loss around infected teeth of just a few mm over decades. Fulminating destruction of the tooth-supporting tissues would be expected instead, considering the bacterial load associated with this infection and the virulence potential of the major segments of the representative microbiota. Host-parasite interactions which occur in periodontal diseases still need vigorous pursuit of full knowledge." @default.
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• W2070472364 date "1990-12-01" @default.
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• W2070472364 title "Les Bacteroides de la cavite buccale. Pathogénicité et facteurs de virulence" @default.
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