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Volume 27 , Issue 2
March/April 2007
Page 105

Editorial: Annual Award for Clinical Research in Periodontology

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PMID: 17514881

The 2006 Annual Award for Clinical Research in Periodontology was presented to Kim A. Boggess, MD; Devin Moss; Phoebus Madianos, PD; Amy P. Murtha, MD; James Beck, PhD; and Steven Offenbacher, DDS, PhD at the 92nd Annual Meeting of the American Academy of Peri-odontology (AAP), which was held from September 16 to 19, 2006, in San Diego, California. Their report, ¡°Fetal Immune Response to Oral Pathogens and Risk of Preterm Birth,¡± was published in the September 2005 issue of the American Journal of Obstetrics and Gynecology.

This annual single cash award honors an outstanding published scientific manuscript with direct clinical relevance and application to the practice of periodontics. The manuscript must have appeared in peer-reviewed scientific literature within the prior calendar year. The entries are judged by the Research Committee of the AAP, and the award is supported by Quintessence Publishing Company, Inc, publisher of The International Journal of Periodontics & Restorative Dentistry.

The aim of this year¡¯s winning study was to determine the relationship between fetal inflammatory and immune responses to oral pathogens and risk for preterm birth. Six hundred forty umbilical cord blood specimens were prospectively collected. Cord serum levels of C-reactive protein, interleukin (IL)-1beta, IL-6, tumor necrosis factor (TNF)-alpha, prostaglandin E2 (PGE2), and 8-isoprostane were determined by enzyme-linked immunosorbent assay and categorized as high (> median) or low (¡Ü median). Presence of fetal immunoglobulin M (IgM) antibody against oral pathogens was determined by checkerboard immuno-blot assay; detection of one or more oral pathogen¨Cspecific antibodies resulted in a categor-ization of positive. Preterm birth was defined as spontaneous delivery at less than 35 weeks. Chi-square analysis was used to determine association between cord serum mediator or IgM category and preterm birth. Odds ratios (OR) for preterm birth were calculated, stratified by mediator and IgM category. Of 640 births, 48 (7.5%) delivered preterm. Preterm birth rates were higher if cord serum levels were categorized as high versus low for 8-isoprostane or TNF-alpha (23% vs 5%, P < .001 and 10% vs 4%, P < .01, respectively). Preterm birth rates were also higher if the specimens were categorized as IgM positive versus negative (10.6% vs 5.8%, P = .04). The joint effects of fetal IgM seropositivity; detect-able C-reactive protein; or high 8-isoprostane, PGE2, or TNF-alpha resulted in significantly increased risk for preterm birth. This study showed that fetal exposure to oral pathogens evidenced by an IgM response is associated with preterm birth, and the risk for preterm birth is greatest among fetuses that also demonstrate an inflammatory response.

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