 n
collaboration with the University of Texas Health Sciences
Center at San Antonio and The Forsyth Institute in Boston,
Ebersole is attacking the problem from another direction,
too. He is studying samples from pregnant baboons.
"Baboons
were chosen for several reasons," Ebersole says. "They
develop periodontal disease similar to humans, they are a
tough animal, the mother/child bond is stronger than with
many other primates, and there is an available colony of
about 3,500 baboons at the National Primate Research
Center in San Antonio."
Ebersole and
his collaborator, Lakshmyya Kesavalu, a veterinary
researcher at UK's Center for Oral Health Research, are
studying the effects of periodontal disease on pre-term
birth in the animals.
Research
began in July 2002, with samples from a group of 37
baboons. Ebersole will be making three or four trips to
San Antonio each year during this project to collect
clinical, microbiological and blood samples. The blood
samples will then be brought to UK for study. Ebersole
expects the study to be completed in 2007.
 bersole's
UK colleague John Novak, professor and associate director
of the Center for Oral Health Research, is the principal
investigator at UK for a $7 million study, a
human-subjects counterpart to the work Ebersole is doing
with baboons. In this first-ever national, multi-center
study, Novak and his team will examine pregnant women who
already have periodontal disease in a project being funded
by the National Institute of Dental and Craniofacial
Research.
 |
|
Jeffrey Ebersole (left) and John Novak in are
investigating the link between periodontal disease in
expectant mothers and low birthweight of their babies.
|
The
University of Minnesota is leading this study, with
research partners at UK, the University of Mississippi and
Columbia University. Each university is recruiting 200
patients into the study. Half of the mothers will be
treated for periodontal disease during their second
trimester and the other half treated after giving birth.
At UK, the
research is being done in collaboration with the
Department of Obstetrics and Gynecology's High-Risk
Maternal Fetal Medicine Clinic. James Ferguson, department
chair of obstetrics and gynecology, is a co-investigator
on the study. It is the first large, federally funded
study to be done as part of the new
Delta Dental Plan of Kentucky Clinical Research Center
located in the College of Dentistry.
"This is
primarily an intervention study," says Novak. "We will be
treating periodontal disease as an infection, then seeing
what effect that has on the delivery of the child relative
to the adverse outcomes that are associated with pre-term
delivery." He says the primary question is, "Does the
mother deliver prematurely?" The secondary question is,
"What impact does it have on the baby?"
The
researchers began recruiting patients in March 2003 for
the study, which will take two to three years to complete.
"What we really don't understand is what types of oral
infection are associated with pre-term birth," says Novak.
"Is every woman who has an infection in her mouth, who has
plaque in her mouth, liable to deliver her baby pre-term?
Well, we know this isn't true. Most women deliver
normally. So we are also very interested in the types of
infections that make up their dental plaque and the types
of bacteria that are colonizing their mouth."
Novak is
targeting seven or eight bacteria, the same ones
implicated in many other problems. Interestingly, one of
the oral bacterial species may be associated with early
fetal loss in horses, a condition called Mare Reproductive
Loss Syndrome. Novak and Ebersole are also planning
collaborative studies with the College of Agriculture's
Department of Veterinary Science to look at the potential
contribution of oral infections to fetal deaths in horses.
"Veterinarians have identified a specific organism in the
horse that is very closely related to an oral organism in
humans," Novak says. "They don't know how this organism
gets from the horse's mouth to the fetus and may create
this problem, but they have already isolated the organism
from the fetal membranes."
Novak says
this organism, a member of the bacterial family
Actinobacillius, is closely related to an organism in
humans that causes severe periodontal disease in young
people. "It appears that similar biologic processes may be
occurring in some pregnant mares," he says.
Ebersole
reiterates that the overall goal in his study and Novak's
is to identify if there is a link between periodontal
disease and pre-term, low-birthweight infants and, if so,
how strong this link is. The next step, he says, is to
intervene in that process to lower the risk of pre-term
birth. "Eventually we hope to have this treated as a
public health measure so that every expectant mother
receives dental care as part of her prenatal care," he
says.
The Delta
Dental Plan of Kentucky Clinical Research Center was
created in October 2002 with a $750,000 endowment from
Delta Dental, an amount matched by the Kentucky Research
Challenge Trust Fund. The center will combine the
expertise of medical and dental researchers with research
groups around the country, and will serve as a focal point
for interdisciplinary research.
The
University of Louisville received a similar gift, boosting
Delta Dental's investment in oral health research in
Kentucky to $1.5 million. At UK, the center will be the
clinical arm of the Center for Oral Health Research, which
Jeffrey Ebersole directs.
"The
establishment of these centers immediately gives us a
greater opportunity to develop and implement collaborative
clinical and translational research with investigators in
Kentucky, across the country and around the world,"
Ebersole says. |
