Pál Fejérdy

Salivary Defense Proteins: Their Network and Role in Innate and Acquired Oral Immunity

There are numerous defense proteins present in the saliva. Although some of these molecules are present in rather low concentrations, their effects are additive and/or synergistic, resulting in an efficient molecular defense network of the oral cavity. Moreover, local concentrations of these proteins near the mucosal surfaces (mucosal transudate), periodontal sulcus (gingival crevicular fluid) and oral wounds and ulcers (transudate) may be much greater, and in many cases reinforced by immune and/or inflammatory reactions of the oral mucosa. Some defense proteins, like salivary immunoglobulins and salivary chaperokine HSP70/HSPAs (70 kDa heat shock proteins), are involved in both innate and acquired immunity. Cationic peptides and other defense proteins like lysozyme, bactericidal/permeability increasing protein (BPI), BPI-like proteins, PLUNC (palate lung and nasal epithelial clone) proteins, salivary amylase, cystatins, prolin-rich proteins, mucins, peroxidases, statherin and others are primarily responsible for innate immunity. In this paper, this complex system and function of the salivary defense proteins will be reviewed.

Salivary genomics, transcriptomics and proteomics: The emerging concept of the oral ecosystem and their use in the early diagnosis of cancer and other diseases

There is an increasingly growing interest world-wide for the genomics, transcriptomics and proteomics of saliva and the oral cavity, since they provide a non-invasive source of unprecedently rich genetic information. The complexity of oral systems biology goes much beyond the human genome, transcriptome and proteome revealed by oral mucosal cells, gingival crevicular fluid, and saliva, and includes the complexity of the oral microbiota, the symbiotic assembly of bacterial, fungal and other microbial flora in the oral cavity. In our review we summarize the recent information on oral genomics, transcriptomics and proteomics, of both human and microbial origin. We also give an introduction and practical advice on sample collection, handling and storage for analysis. Finally, we show the usefulness of salivary and oral genomics in early diagnosis of cancer, as well as in uncovering other systemic diseases, infections and oral disorders. We close the review by highlighting a number of possible exploratory pathways in this emerging, hot research field.

Caries prevalence and tooth loss in Hungarian adult population: results of a national survey

BackgroundOral health is basicly important for the well-being of people. Thus, it is strongly suggested to organize epidemiological surveys in order to gain representative data on oral condition of the given population. The purpose of the cross-sectional study was to determine the results on tooth loss and caries prevalence of Hungarian adults in different age groups.MethodsAltogether 4606 persons (2923 women, 1683 men) participated in the study who were classified into different age groups: 19 [less than or equal to], 20–24, 35–44, 45–64, 65–74, [greater than or equal to]75 year olds. Probands were selected randomly from the population attending the compulsory lung screening examinations. The participants were examined by calibrated dentists, according to the WHO (1997) criteria. In order to produce representative data, the chosen localities for these examinations covered the capital, the largest towns, the villages, and case weights were used for the statistical evaluation.ResultsThe mean values of DMF-T were found between 11.79±5.68 and 21.90±7.61 These values were significantly higher in women compared to men (p < 0.05). In all age groups the values of M were the highest. Except for the women in the groups of 35–44 and 45–64 year olds, these values showed an increasing tendency both in women and men by age (from 5.50±6.49, and 4.70±4.08 to 21.52±9.07 and 18.41±8.89 respectively). The values of D components reached the highest values in 45–64 year olds (4.54±2.12 and 4.22±2.81, by gender, respectively), then in the older age groups there was a high reduction in these values (in 65–74 year olds: 2.72±1.88 and 1.36±2.48; in 75 or more than 75 year olds: 1.05±1.41 and 1.03±1.76 by gender, respectively). The ratio of D and F values was the highest in the age group of 65–74 year olds (2.12), the lowest ratio could be calculated in 20–34 year olds (0.65).Data showed some decrease in caries experience in 35–44 years of age between 2000 and 2004. The prevalence of persons with 21 or more teeth had been increased from 65.6% to 73.1%. This positive tendency has not been occured in prevalence of edentulousness in this age group: the prevalence of edentulous persons changed from 1.4 to 1.9%. In 65–74 year olds the level of edentulousness became lower, from 25.9 to 14.8% and the prevalence of persons with 21 or more teeth is higher (22.6%) than it was in 2000 (13.0%).ConclusionPresent data from Hungary show some slight decrease in caries experience between 35–44 years of age, although this positive tendency has not been occured in prevalence of edentulousness in this age group. A positive tendency could be experienced in the group of 65–74 year olds in edentulousness and in number of teeth, but further efforts are needed to reach a better situation.

Dental Status and Oral Health of Patients with Epilepsy: An Epidemiologic Study

Summary:  Purpose: We performed a dental survey of epilepsy patients to examine their oral health by statistical means and to provide a guide for the dental treatment of these patients.

Periodontal health of an adult population in Hungary: findings of a national survey.

OBJECTIVES To estimate the levels of periodontal health conditions of Hungarian adults. MATERIAL AND METHODS Periodontal data on 4153 adults in 304 survey locations from all Hungarian regions were analysed. The Community Periodontal Index (CPI) was used to report the occurrence of probing pocket depth, calculus, and gingival inflammation. Age, gender, socioeconomic and health status, oral hygiene and lifestyle habits, dental office attendance, level of education, and fixed partial denture (FPD) treatment were evaluated for their association with periodontal conditions. CPI score as an outcome was dichotomized using an accepted threshold as low (<3) and high (3, 4) for multiple logistic regression modelling. RESULTS CPI2 was the most prevalent score in all age groups. CPI scores were also strongly associated with the independent variables. Approximately 66% of subjects visited a dentist only in the case of an emergency. Lack of periodontal aspects of restorative care was demonstrated by the result of CPI0 among 16% of non-FPD wearers compared with only 9% of individuals treated with FPD. CONCLUSION The present survey indicates that oral hygiene standards and periodontal health conditions need improvement in Hungary. Effective intervention programme for the prevention and control of periodontal disease are recommended at a national level.

Potential immunological functions of salivary Hsp70 in mucosal and periodontal defense mechanisms

Abstract.Molecular chaperones were considered to be intracellular, but there is increasing evidence demonstrating their cytoprotective and immune modulator properties outside the cell. The major extracellular chaperone (Hsp70) was also found in saliva, indicating a possible effect of Hsp70 on mucosal surfaces. Here we summarize the immune-modulatory role of the 70-kDa stress protein family, with special attention on the potential impact of salivary Hsp70 on oral defense mechanisms. There are three major facets of Hsp70-induced immune activation: 1) the appearance of Hsp70 on the surface of certain tumor cells or virally infected cells, leading to their phagocytosis and subsequent lysis; 2) the role of extracellular uncomplexed Hsp70 as a danger signal, leading to the secretion of proinflammatory cytokines from antigen-presenting cells and T lymphocytes and of nitric oxide from macrophages as well as to complement activation; 3) receptor-mediated uptake of peptide-loaded Hsp70 to antigen-presenting cells and cross-presentation of the Hsp70-peptide complex as an antigen to cytotoxic T cells and natural killer lymphocytes. The immune-activating effect of salivary Hsp70 may also be highly important in oral defense, especially in areas where molecular and cellular participants of the immune response appear on the surface of the oral cavity (i.e. several lesions of the mucosa and the periodontal tissues).

Molecular Mechanisms of Taste Recognition: Considerations about the Role of Saliva

The gustatory system plays a critical role in determining food preferences and food intake, in addition to nutritive, energy and electrolyte balance. Fine tuning of the gustatory system is also crucial in this respect. The exact mechanisms that fine tune taste sensitivity are as of yet poorly defined, but it is clear that various effects of saliva on taste recognition are also involved. Specifically those metabolic polypeptides present in the saliva that were classically considered to be gut and appetite hormones (i.e., leptin, ghrelin, insulin, neuropeptide Y, peptide YY) were considered to play a pivotal role. Besides these, data clearly indicate the major role of several other salivary proteins, such as salivary carbonic anhydrase (gustin), proline-rich proteins, cystatins, alpha-amylases, histatins, salivary albumin and mucins. Other proteins like glucagon-like peptide-1, salivary immunoglobulin-A, zinc-α-2-glycoprotein, salivary lactoperoxidase, salivary prolactin-inducible protein and salivary molecular chaperone HSP70/HSPAs were also expected to play an important role. Furthermore, factors including salivary flow rate, buffer capacity and ionic composition of saliva should also be considered. In this paper, the current state of research related to the above and the overall emerging field of taste-related salivary research alongside basic principles of taste perception is reviewed.

Distortional effect of beam-hardening artefacts on microCT: a simulation study based on an in vitro caries model

OBJECTIVE The aim of this study was to assess quantitatively the degrading effect of artefacts caused by beam hardening on the microscopic computerized tomography (microCT) measurements of an in vitro caries model. STUDY DESIGN A simulation-based method was described, with which the degrading effect of microCT artefacts on certain parameters of the observed structure could be determined. Simulations were carried out with polychromatic and monochromatic X-ray source, and a linearization method with a second-order polynomial fit algorithm was used in specific cases to correct the beam hardening artefact. The virtual test object was a half-crown of a tooth with an artificial caries lesion. RESULTS For simulation with monochromatic X-ray source, the relative error of lesion depth and thickness measurements of the remineralized layer was found to be 1%-2%. For polychromatic X-ray source, and omitting beam hardening correction, the relative error exceeded 6%. After appropriate beam-hardening correction, the relative error of the measurement could be reduced to 1%-2%. CONCLUSION With the adjustment simulated in this study, microCT having polychromatic X-ray source resulted in the same level of error as with monochromatic source if the linearization method to correct the beam hardening was used. The presented simulation-based method is a useful way to determine artefact-caused distortions for other studies testing objects with different material and geometry.

The role of molecular chaperones (HSPAs/HSP70s) in oral health and oral inflammatory diseases: A review

Heat shock proteins of the 70kDa family (HSPAs/HSP70s) are major molecular chaperones and cytokines of most cells and microbes, extracellular and interstitial fluids, blood, synovial fluids and secretory body fluids like saliva. The induction of human HSPAs plays an important role at cellular level under most stress conditions; whereas microbial HSPAs improve microbial tolerance to environmental changes, and improve virulence and resistance against antimicrobial peptides. Extracellular HSPAs reveal cytoprotective properties and are involved in numerous physiological and pathological events, including modulation of cytokine release and immunity. Accordingly, HSPAs play a role in the maintenance of pulpal health, and the repair of injured dental hard tissues. HSPAs also play a role in stress adaptation of periodontal tissues, and in the maintenance of periodontal and mucosal health including defense against microbes, prevention of mucosal allergic reactions, and facilitation of healing of ulcers and wounds. Despite their advantageous effects maintaining health of several oral tissues, HSPAs are likely to play a role in the disadvantageous amplification of pulpal inflammatory response to bacteria, and in the formation of several periapical inflammatory lesions. HSPAs may also induce gingivitis under certain conditions, and play a role in the progression of periodontal bone defects. HSPAs may also play a role in atopic-type allergic reactions, autoimmune disorders, and haptenation in certain cases. Based on the above data, it can be assumed that HSPAs play an important role in oral defense under healthy conditions; however, their role is somewhat “Janus-faced” under pathological conditions.

Attitude toward death : Does it influence dental fear?

Abstract:  The possible influence of fear of death and attitude toward death were studied related to dental anxiety in Hungarian elementary and secondary school subjects (n= 277; 114 males, 163 females; age between 8 and 18 years). Dental fear and anxiety scores were DAS: 10.8 ± 3.6; DFS: 40.6 ± 15.6; STAI‐S: 38.0 ± 11.0; STAI‐T: 40.3 ± 10.0. Lesters Attitude Toward Death Scale scores were 6.3 ± 1.3. Girls scored higher on DAS, STAI‐S, and STAI‐T scales (P≤ 0.05). Age influenced STAI‐S, STAI‐T, and Lesters Scale scores (P≤ 0.05). Lesters Scale scores influenced the expectations of the subjects about the dental fear of their surrounding people (parents, brother, sister, friends) (P≤ 0.05). A percentage of 7.22 of the subjects indicated a rather strong connection between dental fear and fear of death. These subjects had significantly higher dental fear and anxiety scores as compared to others (P≤ 0.01). Death‐related content was found in 4.3% of drawings and in 10.5% of free associations (couplings) related to teeth (in 12.6% either in drawings or in couplings). The appearance of death‐related content was higher with higher age, and higher expected dental fear of surrounding people (P≤ 0.01). Our data indicate a detectable influence of fear of death on dental fear, especially in subjects with higher dental fear scores.