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Clinical and microbiological effects of egg yolk antibody against Porphyromonas gingivalis as an adjunct in the treatment of moderate to severe chronic periodontitis: a randomized placebo-controlled clinical trial

  • Xu, Yan (Department of Periodontology, Stomatologic Hospital and College, Anhui Medical University) ;
  • Selerio-Poely, Tshepiso (Department of Periodontology, Stomatologic Hospital and College, Anhui Medical University) ;
  • Ye, Xingru (Department of Periodontology, Stomatologic Hospital and College, Anhui Medical University)
  • Received : 2018.01.11
  • Accepted : 2018.02.13
  • Published : 2018.02.28

Abstract

Purpose: To evaluate the clinical and microbiological effects of the local use of egg yolk immunoglobulin against Porphyromonas gingivalis (anti-P.g. IgY) as an adjunct to scaling and root planing (SRP) in the treatment of moderate to severe chronic periodontitis. Methods: This was a randomized, placebo-controlled, double-blind trial involving 60 systematically healthy patients with moderate to severe chronic periodontitis. Subjects (n=20/group) were randomly assigned to receive SRP combined with subgingival irrigation of anti-P.g. IgY and anti-P.g. IgY mouthwash, subgingival irrigation of 0.2% chlorhexidine and 0.2% chlorhexidine mouthwash, or subgingival irrigation of placebo and placebo mouthwash for 4 weeks. Probing pocket depth, clinical attachment level, bleeding on probing, and the plaque index were evaluated at baseline and at 4 weeks. Subgingival plaque, gingival crevicular fluid, and saliva were simultaneously collected for microbiological analysis. Results: Our results showed that anti-P.g. IgY mouthwash was as effective as chlorhexidine at improving clinical parameters over a 4-week period. All the groups showed a significant reduction in levels of P.g. at 4 weeks. No significant difference was observed in the test group when compared to placebo regarding the reduction in the levels of P.g. Anti-P.g. IgY significantly suppressed the numbers of red complex bacteria (RCB) in subgingival plaque and saliva in comparison with placebo. No adverse effects were reported in any of the subjects. Conclusions: Within the limitations of the study, the present investigation showed that passive immunization with anti-P.g. IgY may prove to be effective in the treatment of chronic periodontitis due to its ability to improve clinical parameters and to reduce RCB. No significant differences were found between the anti-P.g. IgY and placebo groups in the reduction of P.g.

Keywords

References

  1. Sanz M, van Winkelhoff AJ. Periodontal infections: understanding the complexity--consensus of the Seventh European Workshop on Periodontology. J Clin Periodontol 2011;38 Suppl 11:3-6. https://doi.org/10.1111/j.1600-051X.2010.01681.x
  2. Corbet EF, Leung WK. Epidemiology of periodontitis in the Asia and Oceania regions. Periodontol 2000 2011;56:25-64. https://doi.org/10.1111/j.1600-0757.2010.00362.x
  3. Dye BA. Global periodontal disease epidemiology. Periodontol 2000 2012;58:10-25. https://doi.org/10.1111/j.1600-0757.2011.00413.x
  4. Grenier D, Mayrand D. Periodontitis as an ecological imbalance. In: Kuramitsu HK, Ellen RP, editors. Oral bacterial ecology: the molecular basis. Wymondham: Horizon Scientific; 2000. p.275-310.
  5. Slots J, Ting M. Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis in human periodontal disease: occurrence and treatment. Periodontol 2000 1999;20:82-121. https://doi.org/10.1111/j.1600-0757.1999.tb00159.x
  6. Holt SC, Kesavalu L, Walker S, Genco CA. Virulence factors of Porphyromonas gingivalis. Periodontol 2000 1999;20:168-238. https://doi.org/10.1111/j.1600-0757.1999.tb00162.x
  7. Bostanci N, Belibasakis GN. Porphyromonas gingivalis: an invasive and evasive opportunistic oral pathogen. FEMS Microbiol Lett 2012;333:1-9. https://doi.org/10.1111/j.1574-6968.2012.02579.x
  8. Slots J, Ting M. Systemic antibiotics in the treatment of periodontal disease. Periodontol 2000 2002;28:106-76. https://doi.org/10.1034/j.1600-0757.2002.280106.x
  9. Handal T, Caugant DA, Olsen I. Antibiotic resistance in bacteria isolated from subgingival plaque in a Norwegian population with refractory marginal periodontitis. Antimicrob Agents Chemother 2003;47:1443-6. https://doi.org/10.1128/AAC.47.4.1443-1446.2003
  10. James P, Worthington HV, Parnell C, Harding M, Lamont T, Cheung A, et al. Chlorhexidine mouthrinse as an adjunctive treatment for gingival health. Cochrane Database Syst Rev 2017;3:CD008676.
  11. Klemperer PF. Ueber naturliche immunitat und ihre verwerthung fur die immunisirungstherapie. Arch Exp Pathol Pharmakol 1893;31:356-82. https://doi.org/10.1007/BF01832882
  12. Schade R, Hlinak A. Egg yolk antibodies, state of the art and future prospects. ALTEX 1996;13:5-9.
  13. Xu FX, Xu YP, Jin LJ, Liu H, Wang LH, You JS, et al. Effectiveness of egg yolk immunoglobulin (IgY) against periodontal disease-causing Fusobacterium nucleatum. J Appl Microbiol 2012;113:983-91. https://doi.org/10.1111/j.1365-2672.2012.05396.x
  14. Yokoyama K, Sugano N, Rahman AK, Oshikawa M, Ito K. Activity of anti-Porphyromonas gingivalis egg yolk antibody against gingipains in vitro. Oral Microbiol Immunol 2007;22:352-5. https://doi.org/10.1111/j.1399-302X.2007.00358.x
  15. Nilsson E, Larsson A, Olesen HV, Wejaker PE, Kollberg H. Good effect of IgY against Pseudomonas aeruginosa infections in cystic fibrosis patients. Pediatr Pulmonol 2008;43:892-9. https://doi.org/10.1002/ppul.20875
  16. Suzuki H, Nomura S, Masaoka T, Goshima H, Kamata N, Kodama Y, et al. Effect of dietary anti Helicobacter pylori-urease immunoglobulin Y on Helicobacter pylori infection. Aliment Pharmacol Ther 2004;20 Suppl 1:185-92. https://doi.org/10.1111/j.1365-2036.2004.02027.x
  17. Wilhelmson M, Carlander D, Kreuger A, Kollberg H, Larsson A. Oral treatment with yolk antibodies for the prevention of C. albicans infections in chemotherapy treated children. A feasibility study. Food Agric Immunol 2005;16:41-5. https://doi.org/10.1080/09540100400003543
  18. Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann Periodontol 1999;4:1-6. https://doi.org/10.1902/annals.1999.4.1.1
  19. World Medical Association General Assembly. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. J Int Bioethique 2004;15:124-9. https://doi.org/10.3917/jib.151.0124
  20. Loe H. The gingival index, the plaque index and the retention index systems. J Periodontol 1967;38:610-6. https://doi.org/10.1902/jop.1967.38.6_part2.610
  21. Schade R, Calzado EG, Sarmiento R, Chacana PA, Porankiewicz-Asplund J, Terzolo HR. Chicken egg yolk antibodies (IgY-technology): a review of progress in production and use in research and human and veterinary medicine. Altern Lab Anim 2005;33:129-54.
  22. Sugano N. Adjunctive effects of anti-porphyromonas gingivalis egg yolk antibody with scaling and root planing: a randomized, placebo-controlled clinical trial. J Periodontol 2009;80:1901-3. https://doi.org/10.1902/jop.2009.0911004
  23. Yokoyama K, Sugano N, Shimada T, Shofiqur RA, Ibrahim ES, Isoda R, et al. Effects of egg yolk antibody against Porphyromonas gingivalis gingipains in periodontitis patients. J Oral Sci 2007;49:201-6. https://doi.org/10.2334/josnusd.49.201
  24. Plessas A. Nonsurgical periodontal treatment: review of the evidence. Oral Health Dent Manag 2014;13:71-80.
  25. Muller HP, Hartmann J, Flores-de-Jacoby L. Clinical alterations in relation to the morphological composition of the subgingival microflora following scaling and root planing. J Clin Periodontol 1986;13:825-32. https://doi.org/10.1111/j.1600-051X.1986.tb02237.x
  26. Xu Y, Li X, Jin L, Zhen Y, Lu Y, Li S, et al. Application of chicken egg yolk immunoglobulins in the control of terrestrial and aquatic animal diseases: a review. Biotechnol Adv 2011;29:860-8. https://doi.org/10.1016/j.biotechadv.2011.07.003
  27. Hanes PJ, Purvis JP. Local anti-infective therapy: pharmacological agents. A systematic review. Ann Periodontol 2003;8:79-98. https://doi.org/10.1902/annals.2003.8.1.79
  28. Socransky SS, Haffajee AD, Teles R, Wennstrom JL, Lindhe J, Bogren A, et al. Effect of periodontal therapy on the subgingival microbiota over a 2-year monitoring period. I. Overall effect and kinetics of change. J Clin Periodontol 2013;40:771-80. https://doi.org/10.1111/jcpe.12117
  29. Shiloah J, Patters MR. Repopulation of periodontal pockets by microbial pathogens in the absence of supportive therapy. J Periodontol 1996;67:130-9. https://doi.org/10.1902/jop.1996.67.2.130
  30. Petersilka GJ, Ehmke B, Flemmig TF. Antimicrobial effects of mechanical debridement. Periodontol 2000 2002;28:56-71. https://doi.org/10.1034/j.1600-0757.2002.280103.x
  31. Greenstein G. Periodontal response to mechanical non-surgical therapy: a review. J Periodontol 1992;63:118-30. https://doi.org/10.1902/jop.1992.63.2.118
  32. Socransky SS, Haffajee AD, Cugini MA, Smith C, Kent RL Jr. Microbial complexes in subgingival plaque. J Clin Periodontol 1998;25:134-44. https://doi.org/10.1111/j.1600-051X.1998.tb02419.x
  33. Hajishengallis G, Lamont RJ. Beyond the red complex and into more complexity: the polymicrobial synergy and dysbiosis (PSD) model of periodontal disease etiology. Mol Oral Microbiol 2012;27:409-19. https://doi.org/10.1111/j.2041-1014.2012.00663.x
  34. Adair JG. The Hawthorne effect: a reconsideration of the methodological artifact. J Appl Psychol 1984;69:334-45. https://doi.org/10.1037/0021-9010.69.2.334
  35. Coleman MA, inventor; Ovimmune, Inc., assignee. Oral administration of chicken yolk immunoglobulins to lower somatic cell count in the milk of lactating ruminants. United States patent US 5,585,098. 1996 Dec 17.

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