JP2 Genotype of Aggregatibacter actinomycetemcomitans in Caucasian Patients: A Presentation of Two Cases

Alexandra Stähli,Sigrun Eick,Anton Sculean

doi:10.3390/pathogens9030178

Abstract

Aggregatibacter actinomycetemcomitans is a key pathogen that has been associated with periodontal disease. Its most important virulence factor is a leukotoxin capable of inactivating immune cells. The JP2 genotype of Aggregatibacter actinomycetemcomitans shows enhanced leukotoxic activity and is mostly present in individuals of North and West African origin with severe periodontitis. In this paper, two cases of Caucasians diagnosed with the JP2 genotype are presented. A 50-year-old female patient had three approximal sites with ≥ 6 mm clinical attachment loss (CAL) and eight sites with probing depth (PD) ≥ 5 mm. Microbiological diagnostics revealed A. actinomycetemcomitans JP2 genotype, but not Porphyromonas gingivalis. This JP2 genotype was highly leukotoxic to monocytic cells. The second case was a 55-year-old female patient with CAL of > 5 mm at all molars and PD of up to 12 mm. A. actinomycetemcomitans JP2 was identified, but not P. gingivalis. Her husband originated from North-Africa. In him, no A. actinomycetemcomitans was detected, but their 17-year-old daughter was diagnosed with periodontitis and was found to be positive for the JP2 genotype. Both patients were successfully treated with adjunctive antibiotics and the JP2 genotype was eliminated. In summary, here, the microbiological diagnosis was key for the treatment with adjunctive antibiotics.

Highlights

Bacterial biofilm causes destruction of the periodontium in two ways: through direct action of bacteria and their products on the host-tissue and by activating the immune host response [1].Aggregatibacter actinomycetemcomitans is one of the key pathogens in the course of periodontal disease.A. actinomycetemcomitans has been strongly associated with localized aggressive periodontitis [2], its mere presence could not be used to distinguish between chronic (CP) and aggressive forms of periodontitis (AP) [3]
The patient was diagnosed with severe CP with three approximal sites with clinical attachment loss (CAL) ≥
We reported on two rare cases of A. actinomycetemcomitans JP2 genotype infection in Caucasians, highlighting the treatment sequences, the clinical outcomes, and the potential value of microbiological testing for the early detection of periodontal disease

Summary

Introduction

Bacterial biofilm causes destruction of the periodontium in two ways: through direct action of bacteria and their products on the host-tissue and by activating the immune host response [1].Aggregatibacter actinomycetemcomitans is one of the key pathogens in the course of periodontal disease.A. actinomycetemcomitans has been strongly associated with localized aggressive periodontitis [2], its mere presence could not be used to distinguish between chronic (CP) and aggressive forms of periodontitis (AP) [3]. Aggregatibacter actinomycetemcomitans is one of the key pathogens in the course of periodontal disease. In the Department of Periodontology, School of Dental Medicine, University of Bern, patients diagnosed with AP generally received antibiotics during nonsurgical periodontal therapy (i.e., hygienic phase). A. actinomycetemcomitans was higher in patients diagnosed with AP than in those diagnosed with. Especially surgical treatment, A. actinomycetemcomitans was less frequently detected in patients with AP than in those with CP [4]. A. actinomycetemcomitans possesses several virulence factors, that is, lipopolysaccharides that induce pro-inflammatory cytokines, a cytolethal distending toxin causing cell cycle arrest in T-cells, macrophages and epithelial cells, and a leukotoxin [5]. The leukotoxin produced by the bacterium is capable of killing or inactivating immune cells and of inducing the release of interleukin (IL)-1β [6]

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