693
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Humoral responses to type I collagen after surgical curettage procedures employing bovine collagen implants P.
Hyder,
G, Singh and S.
Adarn
Department of Perfodo~tology, ~~f~ersi~ of Wales CMege of ~edi~~~a, Heath Park, Cardiff, Wales, UK Freeze-dried bovine type I coliagen was implanted into periodo~taily diseased sites of 11 patients in an effort to repair the affected site. Peripheral blood samples taken at 0, 6 and 12 wk were assayed for antibody to human and bovine collagen using an enzyme-linked immunosorbent assay and compared with samples from 9 control subjects. Antibody fevets to both human and bovine collagen, which were present at significantly higher levels in the patients
at 0 wk than in the control subjects (P < 0.01 for human and bovine), were significantly lower at 6 wk than at zero time (P < 0.05 and P < 0.01 for human and bovine collagens, respectively). At 12 wk pot-impiantatjon, the antibody levei to human collagen stilt remained signjfj~ntly tower (P < 0.05) than zero time levels but not in respect of the antibody to bovine collagen. Keywords: Collages, dental surgery, antibodies Received 20 August 1991; revised 10 November 1991; accepted 23 January 1992
A number of approaches have been suggested to obtain new attachment after periodontal therapy, These have proposed either modifying the root surface to enhance and encourage its repopulation with fibroblasts*-~ or protecting the root from gingival tissues with an implanted membrane to enable its repopulation with cells arising from the periodontal ligament5, i.e. guided tissue regeneration (GTR). Various materials have been proposed for use in GTR procedures, such as polytetrafl uorethylene (PTFE)**‘, millipore filters’, polyactic acid membrane@and collagen”. Collagen is of particular interest, since it is a resorbable extracellular biopolymer, not requiring a re-entry procedure for its removal. In periodontal disease, both cellular and humoral immunity to human type I collagen have been demonstratedl’* *’ as well as a cellular response to native and denatured type I collagenl’. Cellular and humoral immune responses have also been shown in other diseases where collagen destruction is a characteristic of the disease such as, for example, in rheumatoid arthritis13s 14. In view of these immunological responses to collagen in periodontal disease, our investigation was undertaken to examine the humoral immune response to collagen of patients implanted with bovine type I collagen used in the surgical treatment of periodontal disease. Correspondence
to Dr S. Adam.
MATERIALS AND METHODS Patients All 11 patients (8 women, age range 34-42, 3 men, age range 39-50) were attending the Dental Hospital (Heath Park, Cardiff, South Wales, UK) for the treatment of moderate to severe periodontal disease. Their selection for the trial was based upon the loss of 5 mm or more connective tissue attachment at contralateral sites involving l-3 teeth and radiological evidence of 25% or more interproximal bone loss at the same sites. They were not suffering from a disease involving collagen (other than periodontal disease] and none was receiving systemic medication. One of the contralateral sites was treated with a bovine collagen sponge (Geistlich Pharmaceutical Company, Switzerland] implant for GTR. The control site underwent surgical curettage with no implant. No systemic antibiotics were administered. Samples of peripheral blood were obtained before treatment (zero time) end at 8 and 12 wk after placing the collagen in situ. The samples were assayed for collagen antibodies. Peripheral blood was obtained from a further nine subjects to act as controls with an indexZ50f
_
Humoral responses to type I collagen after surgical curettage procedures employing bovine collagen implants P.
Hyder,
G, Singh and S.
Adarn
Department of Perfodo~tology, ~~f~ersi~ of Wales CMege of ~edi~~~a, Heath Park, Cardiff, Wales, UK Freeze-dried bovine type I coliagen was implanted into periodo~taily diseased sites of 11 patients in an effort to repair the affected site. Peripheral blood samples taken at 0, 6 and 12 wk were assayed for antibody to human and bovine collagen using an enzyme-linked immunosorbent assay and compared with samples from 9 control subjects. Antibody fevets to both human and bovine collagen, which were present at significantly higher levels in the patients
at 0 wk than in the control subjects (P < 0.01 for human and bovine), were significantly lower at 6 wk than at zero time (P < 0.05 and P < 0.01 for human and bovine collagens, respectively). At 12 wk pot-impiantatjon, the antibody levei to human collagen stilt remained signjfj~ntly tower (P < 0.05) than zero time levels but not in respect of the antibody to bovine collagen. Keywords: Collages, dental surgery, antibodies Received 20 August 1991; revised 10 November 1991; accepted 23 January 1992
A number of approaches have been suggested to obtain new attachment after periodontal therapy, These have proposed either modifying the root surface to enhance and encourage its repopulation with fibroblasts*-~ or protecting the root from gingival tissues with an implanted membrane to enable its repopulation with cells arising from the periodontal ligament5, i.e. guided tissue regeneration (GTR). Various materials have been proposed for use in GTR procedures, such as polytetrafl uorethylene (PTFE)**‘, millipore filters’, polyactic acid membrane@and collagen”. Collagen is of particular interest, since it is a resorbable extracellular biopolymer, not requiring a re-entry procedure for its removal. In periodontal disease, both cellular and humoral immunity to human type I collagen have been demonstratedl’* *’ as well as a cellular response to native and denatured type I collagenl’. Cellular and humoral immune responses have also been shown in other diseases where collagen destruction is a characteristic of the disease such as, for example, in rheumatoid arthritis13s 14. In view of these immunological responses to collagen in periodontal disease, our investigation was undertaken to examine the humoral immune response to collagen of patients implanted with bovine type I collagen used in the surgical treatment of periodontal disease. Correspondence
to Dr S. Adam.
MATERIALS AND METHODS Patients All 11 patients (8 women, age range 34-42, 3 men, age range 39-50) were attending the Dental Hospital (Heath Park, Cardiff, South Wales, UK) for the treatment of moderate to severe periodontal disease. Their selection for the trial was based upon the loss of 5 mm or more connective tissue attachment at contralateral sites involving l-3 teeth and radiological evidence of 25% or more interproximal bone loss at the same sites. They were not suffering from a disease involving collagen (other than periodontal disease] and none was receiving systemic medication. One of the contralateral sites was treated with a bovine collagen sponge (Geistlich Pharmaceutical Company, Switzerland] implant for GTR. The control site underwent surgical curettage with no implant. No systemic antibiotics were administered. Samples of peripheral blood were obtained before treatment (zero time) end at 8 and 12 wk after placing the collagen in situ. The samples were assayed for collagen antibodies. Peripheral blood was obtained from a further nine subjects to act as controls with an indexZ50f
