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Treatment outcome for IDDM patients in relation to glutamic acid decarboxylase autoantibodies and serum IgG to periodontal pathogens

Sims, Tom J.; Lernmark, Åke LU ; Smith, Todd; Page, Roy C. and Persson, G. Rutger (2001) In Journal of Clinical Periodontology 28(6). p.550-557
Abstract

Background: Patients with insulin-dependent diabetes mellitus (IDDM) have elevated risk for periodontitis (PD) relative to subjects without diabetes. Whether refractory PD in IDDM patients is related to autoimmunity as indicated by serum glutamic acid decarboxylase autoantibody GAD Ab levels or to host bacterial immunity as reflected by serum antibody titers to periodontal pathogens is unknown. Aims: To determine if non-surgical periodontal treatment outcome differs between GAD Ab-seropositive and -seronegative IDDM patients by assessing the following parameters: (1) pretreatment serum levels of GAD Ab, (2) pretreatment serum IgG titers to key periodontal pathogens, and (3) changes in periodontal pocket probing depth (PDC) after... (More)

Background: Patients with insulin-dependent diabetes mellitus (IDDM) have elevated risk for periodontitis (PD) relative to subjects without diabetes. Whether refractory PD in IDDM patients is related to autoimmunity as indicated by serum glutamic acid decarboxylase autoantibody GAD Ab levels or to host bacterial immunity as reflected by serum antibody titers to periodontal pathogens is unknown. Aims: To determine if non-surgical periodontal treatment outcome differs between GAD Ab-seropositive and -seronegative IDDM patients by assessing the following parameters: (1) pretreatment serum levels of GAD Ab, (2) pretreatment serum IgG titers to key periodontal pathogens, and (3) changes in periodontal pocket probing depth (PDC) after treatment. Methods: Before and two months after periodontal treatment of 11 GAD Abseronegative and 7 -seropositive subjects, PDC was assessed and serum GAD Ab and IgG to Porphyromonas gingivalis (Pg), Bacteroides forsythus (Bf), and Actinobacillus actinomycetemcomitans (Aa) were studied using established radioligand precipitation and enzyme-linked immunosorbent assays, respectively. Results: The PDC decrease was significantly better for GAD Ab-seronegative subjects than for seropositive subjects (median 1.4 mm±0.5 s.d. versus 0.5 mm±0.3 s.d., p<0.03, Mann-Whitney). GAD Ab levels and PDC were positively correlated (r=+0.71, p<0.05) for sero-positive subjects but were neutral (r=-0.07) for seronegative subjects. Serum IgG to Pg and GAD Ab levels were positively associated (r2=0.42) in seropositive subjects. Logistic regression analysis confirmed that GAD Ab status was the primary discriminator for PDC (p<0.04). Conclusion: Detection of elevated GAD Ab levels in combination with elevated IgG titers to Pg before treatment is indicative of IDDM patients with refractory PD.

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published
keywords
Actinobacillus actinomycetemcomitans, Bacteroides forsythus, Diabetes mellitus, ELISA, Glutamic acid decarboxylase, Periodontitis, Porphyromonas gingivalis
in
Journal of Clinical Periodontology
volume
28
issue
6
pages
8 pages
publisher
Wiley-Blackwell
external identifiers
  • scopus:0035374647
ISSN
0303-6979
language
English
LU publication?
no
id
996eac90-375b-4993-aee6-7da7f2ecace5
date added to LUP
2017-09-07 09:15:47
date last changed
2018-05-29 11:38:19
@article{996eac90-375b-4993-aee6-7da7f2ecace5,
  abstract     = {<p>Background: Patients with insulin-dependent diabetes mellitus (IDDM) have elevated risk for periodontitis (PD) relative to subjects without diabetes. Whether refractory PD in IDDM patients is related to autoimmunity as indicated by serum glutamic acid decarboxylase autoantibody GAD Ab levels or to host bacterial immunity as reflected by serum antibody titers to periodontal pathogens is unknown. Aims: To determine if non-surgical periodontal treatment outcome differs between GAD Ab-seropositive and -seronegative IDDM patients by assessing the following parameters: (1) pretreatment serum levels of GAD Ab, (2) pretreatment serum IgG titers to key periodontal pathogens, and (3) changes in periodontal pocket probing depth (PDC) after treatment. Methods: Before and two months after periodontal treatment of 11 GAD Abseronegative and 7 -seropositive subjects, PDC was assessed and serum GAD Ab and IgG to Porphyromonas gingivalis (Pg), Bacteroides forsythus (Bf), and Actinobacillus actinomycetemcomitans (Aa) were studied using established radioligand precipitation and enzyme-linked immunosorbent assays, respectively. Results: The PDC decrease was significantly better for GAD Ab-seronegative subjects than for seropositive subjects (median 1.4 mm±0.5 s.d. versus 0.5 mm±0.3 s.d., p&lt;0.03, Mann-Whitney). GAD Ab levels and PDC were positively correlated (r=+0.71, p&lt;0.05) for sero-positive subjects but were neutral (r=-0.07) for seronegative subjects. Serum IgG to Pg and GAD Ab levels were positively associated (r<sup>2</sup>=0.42) in seropositive subjects. Logistic regression analysis confirmed that GAD Ab status was the primary discriminator for PDC (p&lt;0.04). Conclusion: Detection of elevated GAD Ab levels in combination with elevated IgG titers to Pg before treatment is indicative of IDDM patients with refractory PD.</p>},
  author       = {Sims, Tom J. and Lernmark, Åke and Smith, Todd and Page, Roy C. and Persson, G. Rutger},
  issn         = {0303-6979},
  keyword      = {Actinobacillus actinomycetemcomitans,Bacteroides forsythus,Diabetes mellitus,ELISA,Glutamic acid decarboxylase,Periodontitis,Porphyromonas gingivalis},
  language     = {eng},
  number       = {6},
  pages        = {550--557},
  publisher    = {Wiley-Blackwell},
  series       = {Journal of Clinical Periodontology},
  title        = {Treatment outcome for IDDM patients in relation to glutamic acid decarboxylase autoantibodies and serum IgG to periodontal pathogens},
  volume       = {28},
  year         = {2001},
}