This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Currently about 15% of periodontitis patients fail conventional therapy and are deemed 'refractory'. This study examines the hypothesis that refractory periodontal disease is distinct from non-refractory periodontal disease and seeks means for prospectively identifying these patients.We will test the hypothesis that subjects with refractory disease can be distinguished from subjects with treatable periodontitis and with periodontal health, based on microbial profiles. This will identify those bacterial species that are useful for distinguishing between refractory and treatable periodontitis and identifying health.Second, we will test the hypothesis that subjects with refractory disease can be distinguished from those with treatable periodontitis, and with periodontal health, based upon antibody levels to periodontal bacteria and cytokine production by peripheral blood monocytes. This will identify key host markers.Third, we will develop a Human Oral Microbe Microarray (HOMM) for the detection of the 600 species found in the human oral cavity. The microbial samples used above will be re-analyzed using the essentially complete microbial coverage provided by this new microarray.Fourth, we will use the above combined data to differentiate refractory periodontitis from treatable periodontitis and health, and to identify refractory syndromes. Completion of this project will fill major gaps in our knowledge of the role of the total oral flora and of cytokines, chemokines, and their receptors, to better clarify the interaction between humans and their resident oral microorganisms.
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