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牙龈疾病（牙周炎）中涉及的口腔细菌和免疫系统问题

2026年10月23日 更新者：National Institute of Dental and Craniofacial Research (NIDCR)

免疫功能障碍患者的口腔微生物和免疫学特征

Background:

- Gum disease is a condition in which the tissue around the tooth root becomes swollen and infected. This condition can cause tooth loss if it is not treated. Who gets gum disease and how bad it will be depends on (1) the different bacteria in the mouth and (2) how the immune system of an individual handles these bacteria. Researchers want to look at the oral bacteria and genetic immune problems of different people to learn how these affect gum disease and other conditions of the mouth.

Objectives:

- To study how immune system problems may lead to problems in the mouth, including gum disease.

Eligibility:

  • Children and adults at least 7 years of age who have genetic problems with their immune system.
  • Healthy adults that have periodontal disease
  • Health adults that do not have periodontal disease

Design:

  • This study will involve a screening visit and a study visit.
  • Participants will be screened with a medical history, blood work and a full oral and dental exam, including dental x-rays and photos.
  • The study visit will involve collection of blood, urine, and other samples, including saliva, plaque, and gum swabs. Any abnormal tissue will sampled for a biopsy. Additional oral and dental exams will be performed. Participants will also answer questions about any current medical or dental problems.

研究概览

地位

招聘中

条件

详细说明

This is a cross sectional/natural history protocol designed to investigate the clinical,

microbiologic, and immunologic consequences of genetic immune defects in the oral cavity. The hypothesis is that genetic immune defects will lead to alterations in the local immune response and microbial colonization and ultimately predispose to susceptibility to oral infections and inflammatory conditions.

In the cross-sectional phase the following individuals will be enrolled, evaluated and screened for presence and severity of periodontitis, presence of a genetic defects and sampled for studies in oral immunity and microbiome: 1) individuals diagnosed with genetic immune defects 2) individuals with severe periodontitis of suspected genetic etiology and their family members 3) healthy volunteers. Subjects identified with a genetic immune defect and with presence of oral disease (primarily periodontitis) may enter the natural history phase of the study to be clinically followed at the National Institutes of Health (NIH) over time. This protocol aims to determine whether specific genetic immune defects will predispose to oral disease (primarily periodontitis) and to better understand consequences of immune deficiency on the oral immune response and microbiome.

Primary Objectives

  1. Investigate the degree, scope, etiology and natural history of oral manifestations in patients with genetic immune defects.
  2. Characterize the immune response in the oral cavity of patients with genetic immune defects.
  3. Characterize the microbiome in the oral cavity of patients with genetic immune defects.

Secondary Objectives

  1. Assay development/validation for the study of tissue immunity and microbiome characterization
  2. Establishment of normative values for immune mediators and microbial elements at the oral cavity

Study Population (s)

The study population will include:

  1. Subjects with genetic immune defects
  2. Subjects with severe periodontitis of suspected genetic etiology and their family members
  3. Healthy volunteers (with/without periodontal disease)

Design

This is a cross-sectional/natural history study for the evaluation of clinical, immunologic, and microbiologic oral manifestations (primarily periodontitis) in patients diagnosed with genetic immune defects or those with severe periodontitis of suspected genetic etiology and healthy volunteer subjects.

Cross Sectional Phase: Three groups of subjects will be enrolled in the cross-sectional phase of the study 1) individuals diagnosed with genetic immune defects 2) individuals with severe periodontitis of suspected genetic etiology and their family members that include parents or siblings 3) healthy volunteers (with/without periodontal disease). All groups will be evaluated for oral disease (periodontitis) may be and sampled for oral immunity, systemic immunity and microbiome characterization. Individuals with severe periodontitis in the presence/absence of a genetic defect may be offered the option of receiving standard of care inflammatory control periodontal treatment at NIH without travel compensation, following the cross-sectional portion of the study. Family members (parents or siblings) of individuals with periodontal disease of suspected genetic may be asked to participate in this study. During the course of genetic testing, family members may be enrolled in the cross sectional phase of the study for phenotyping and genetic testing.

Natural History Phase: Subjects identified with a genetic defect with the presence of oral disease may enroll in the natural history phase of the study to be followed clinically over time.

Primary Outcome Measures

  1. Clinical intraoral characterization (i.e., presence and severity of periodontitis).
  2. Characterize the immune response in the oral cavity of patients with genetic immune defects
  3. Characterize the microbiome in the oral cavity of patients with genetic immune defects

Secondary Outcome Measures

  1. Assay development/validation for the study of tissue immunity and microbiome characterization
  2. Establishment of normative values for immune mediators and microbial elements at the oral cavity

Exploratory Outcome Measures

Initial data from this study may generate new hypotheses for investigation as part of this study.

研究类型

观察性的

注册 (估计的)

700

联系人和位置

本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。

学习联系方式

研究联系人备份

学习地点

  • 美国
    • Maryland
      • Bethesda、Maryland、美国、20892
        • 招聘中
        • National Institutes of Health Clinical Center
        • 接触：
          • For more information at the NIH Clinical Center contact Office of Patient Recruitment (OPR)
          • 电话号码：TTY dial 711 800-411-1222
          • 邮箱：ccopr@nih.gov

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

7年 至 100年 (孩子、成人、年长者)

接受健康志愿者

是的

有资格学习的性别

全部

取样方法

非概率样本

研究人群

This is a cross sectional/natural history protocol designed to investigate the clinical, microbiologic, and immunologic consequences of genetic immune defects in the oral cavity. Three cohorts will be enrolled 1) subjects with genetic immune defects 2) subjects with severe periodontitis of suspected genetic etiology and their family members 3) healthy volunteers (with/without periodontal disease). The study involves detailed oral clinical and radiographic evaluations, standard laboratory testing and research sampling of blood and oral samples. All evaluations are performed at the NIH Clinical Center.

描述

  • INCLUSION CRITERIA:

Subjects with Genetic Immune Defects:

Patients with a known genetic immune defect will be eligible for screening inclusion under this protocol.

  • Diagnosed with a genetic immune defect

  • Willing to allow genetic testing

    • 7 years old

Subjects with Severe Periodontitis of Suspected Genetic Etiology:

  • History of severe periodontitis prior to age <30

  • Willing to allow genetic testing

    ->=7 years old

  • In good general health

Family members of Subjects with Severe Periodontitis of Suspected Genetic Etiology:

-Willing to allow genetic testing

->=7 years old

Healthy Volunteer Subjects (with/without periodontitis):

  • In good general health

    ->=18 years old

  • Willing to allow genetic testing

  • Have a minimum of 20 natural teeth

Inclusion Criteria for Natural History phase, all subjects:

  • Diagnosis of genetic immune defect
  • Presence of oral manifestation (primarily periodontitis)

Criteria for standard of care treatment:

  • Active untreated disease (visible signs of tissue inflammation including erythema/edema, generalized bleeding upon probing)
  • Periodontal disease defined as bone loss of >=5mm as measured on periodontal exam.

EXCLUSION CRITERIA:

All Subjects:

  • History of Hepatitis B or C
  • History of HIV
  • Prior radiation therapy to the head or neck
  • Have an active malignancy except localized basal or squamous cell carcinoma of the skin
  • Have been treated with systemic chemotherapeutics or radiation therapy within 5 years of screening
  • Pregnant or lactating
  • If participation in the protocol would not be safe or in the subject s best interest in the opinion of either the PI or the primary medical team.

Additional Exclusions for Healthy Volunteers:

  • Diagnosis of diabetes and/or HbA1C level >6%

  • More than 3 hospitalizations in the last 3years

  • Have an autoimmune disorder such as Lupus, Rheumatoid arthritis, etc.

  • In the 3 months before study enrollment, have used any of the following:

    • Systemic (intravenous, intramuscular, or oral) antibiotics
    • Oral, intravenous, intramuscular, intranasal, or inhaled corticosteroids or other immunosuppressants (e.g., cyclosporine)
    • Cytokine therapy
    • Methotrexate or immunosuppressive chemotherapeutic agents
    • Large doses of commercial probiotics (>=10^8 colony-forming units or organisms per day); includes tablets, capsules, lozenges, chewing gum, or powders in which a probiotic is a primary component; ordinary dietary components such as fermented beverages/milks, yogurts, and foods do not apply

  • Have used tobacco products (including e-cigarettes) within 1 year of screening

  • Unwillingness to consent to oral biopsy

  • NIH employees working in the Oral Immunity and Inflammation Unit and members of the Clinical Research Core Team will not be eligible for enrollment.

Additional Exclusions for Standard of Care Treatment at NIH:

  • Mild/moderate non-active disease (absence of active inflammatory lesions)
  • Subjects with urgent/complex restorative needs (ex. severe active carious lesions/fractured dentition)
  • Subjects in need for advanced prosthetic needs (including implants and restorations)

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

  • 观测模型：CASE_CONTROL
  • 时间观点：CROSS_SECTIONAL

队列和干预

团体/队列
Healthy Volunteers

Healthy volunteers (with/without periodontal disease)
Immune deficient patients

Subjects with known genetic immune deficiency
Subjects with severe periodontitis of suspected genetic etiology and their family

Subjects with severe periodontitis of suspected genetic etiology and their family members

研究衡量的是什么？

主要结果指标

结果测量
措施说明
大体时间
3. Characterize the microbiome in the oral cavity of patients with genetic immune defects
大体时间：25 years

The primary clinical endpoints of the study are severity and types of oral disease: specifically for periodontal disease, mean PD, mean CAL, proportion of sites with PD >5 mm, and proportion of subjects with BOP, proportion of patient with other inflammatory conditions or infections of the oral cavity by immune disorder.Characterization of the oral microbiome in patients with monogenic immune defects. Immunologic endpoints: types and levels of immune mediators in the saliva, GCF, oral tissues, and/or blood.
25 years
2. Characterize the immune response in the oral cavity of patients with genetic immune defects
大体时间：25 years

The primary clinical endpoints of the study are severity and types of oral disease: specifically for periodontal disease, mean PD, mean CAL, proportion of sites with PD >5 mm, and proportion of subjects with BOP, proportion of patient with other inflammatory conditions or infections of the oral cavity by immune disorder.Characterization of the oral microbiome in patients with monogenic immune defects. Immunologic endpoints: types and levels of immune mediators in the saliva, GCF, oral tissues, and/or blood.
25 years
1. Clinical intraoral characterization (i.e., presence and severity of periodontitis).
大体时间：25 years

The primary clinical endpoints of the study are severity and types of oral disease: specifically for periodontal disease, mean PD, mean CAL, proportion of sites with PD >5 mm, and proportion of subjects with BOP, proportion of patient with other inflammatory conditions or infections of the oral cavity by immune disorder.Characterization of the oral microbiome in patients with monogenic immune defects. Immunologic endpoints: types and levels of immune mediators in the saliva, GCF, oral tissues, and/or blood.
25 years

次要结果测量

结果测量
措施说明
大体时间
2. Establishment of normative values for immune mediators and microbial elements at the oral cavity
大体时间：25 years

Validate methodologies for measuring levels of immune mediators in oral fluids - Establish normative values of immune mediators in oral fluids and tissues - Assay development; Develop new methodologies to study pathways of the immune response in the oral cavity - Assay development: Develop new methodologies to study the microbiome in the oral cavity
25 years
1. Assay development/validation for the study of tissue immunity and microbiome characterization
大体时间：25 years

Validate methodologies for measuring levels of immune mediators in oral fluids - Establish normative values of immune mediators in oral fluids and tissues - Assay development; Develop new methodologies to study pathways of the immune response in the oral cavity - Assay development: Develop new methodologies to study the microbiome in the oral cavity
25 years

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

National Institute of Dental and Craniofacial Research (NIDCR)

调查人员

  • 首席研究员：Niki M Moutsopoulos, D.D.S.、National Institute of Dental and Craniofacial Research (NIDCR)

出版物和有用的链接

负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。

一般刊物

有用的网址

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2012年10月5日

研究注册日期

首次提交

2012年3月30日

首先提交符合 QC 标准的

2012年3月30日

首次发布 (估计的)

2012年4月2日

研究记录更新

最后更新发布 (实际的)

2026年10月26日

上次提交的符合 QC 标准的更新

2026年10月23日

最后验证

2026年10月9日

更多信息

与本研究相关的术语

关键字

其他相关的 MeSH 术语

其他研究编号

  • 120100
  • 12-D-0100

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)？

未定

药物和器械信息、研究文件

研究美国 FDA 监管的药品

不

研究美国 FDA 监管的设备产品

不

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