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The broad
objectives of this proposal are to examine the hypothesis of
that human herpesviruses enhance the pathogenesis of
periodontal disease. This hypothesis is based on the following
observations. First, specific herpesviruses display tissue
tropism in white blood cells during latency that allows them
to enter areas of inflammation and contribute to the tissue
destruction that occurs during periodontitis. Second, human
herpesviruses are opportunistic pathogens that periodically
reactivate. The intermittent pattern of reactivation and
tissue breakdown is concordant with the relapsing-remitting
course of periodontitis. Third, human herpesviruses can alter
cytokine and chemokine production and dysregulate immune
responses, leading to overgrowth of pathogenic bacteria. Based
on these observations, this proposal focuses on the detection
of human herpesvirus DNA and mRNA in periodontitis sites and
tissue, as well as the biological interactions of
herpesviruses with putative bacterial pathogens and cytokines.
In Aim 1 we will determine the ability of human herpesviruses
to enhance the pathogenesis of periodontal disease. This will
be tested using three approaches: (i) a cross-sectional human
study to determine the relationship of periodontal disease
severity and the presence of HHVs at individual disease sites.
Molecular procedures will be used to identify and quantify the
prevalence of all eight HHVs in the oral cavity of this
patient population. (ii) since HHVs remain latent in
leukocytes that are attracted to periodontitis sites by
inflammation, we will correlate the prevalence of HHVs within
WBCs with periodontal inflammation and using a prospective,
longitudinal study, we will also determine whether HHVs can be
eliminated from diseased sites following mechanical therapy;
and (iii) the in vivo significance of cytomegalovirus
infection will be assessed using the rat model of
periodontitis, including studies of antiviral agents and
immunesuppression to alter the disease process. In Aim 2 we
will characterize the bacterial and host defense mechanisms
regulated by herpesvirus infection. These studies will be
performed by: (i) analyzing attachment and invasion of P.
gingivalis into CMV infected cells using gingival fibroblasts
and oral epithelial cells as a models of viral lytic and
latent infection, (ii) determining whether latently infected
epithelial cells support CMV reactivation following challenge
with putative periodontal pathogens, endotoxin, bacterial
metabolites and byproducts, and (iii) elucidating the effects
of viral and cellular IL-10 on the phagocytosis activities of
macrophages. One of the greatest challenges in periodontology
concerns the events that induce conversion from gingivitis to
periodontitis or from stable to disease-active periodontitis.
The proposed studies will clarify the pathogenic significance
of herpesvirus infections in the development of periodontitis
through comprehensive research involving human, animal and in
vitro studies. As a result, novel approaches to the treatment
of periodontitis and refractory periodontitis may be
developed. |