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The Cytolethal Distending Toxin Induces Receptor Activator of NF-B Ligand Expression in Human Gingival Fibroblasts and Periodontal Ligament Cells

Divisions of Oral Microbiology,¹ Oral Cell Biology,² Periodontology, Department of Odontology, Umeå University, Umeå, Sweden,³ Division of Primary Oral Health Care, University of Southern California School of Dentistry, Los Angeles, California,⁴ Department of Preventive Dentistry and Periodontology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece⁵

Received 8 May 2004/ Returned for modification 20 July 2004/ Accepted 28 September 2004

Actinobacillus actinomycetemcomitans is associated with localized aggressive periodontitis, a disease characterized by rapid loss of the alveolar bone surrounding the teeth. Receptor activator of NF-B Ligand (RANKL) and osteoprotegerin (OPG) are two molecules that regulate osteoclast formation and bone resorption. RANKL induces osteoclast differentiation and activation, whereas OPG blocks this process by acting as a decoy receptor for RANKL. The purpose of this study was to investigate the effect of A. actinomycetemcomitans on the expression of RANKL and OPG in human gingival fibroblasts and periodontal ligament cells. RANKL mRNA expression was induced in both cell types challenged by A. actinomycetemcomitans extract, whereas OPG mRNA expression remained unaffected. Cell surface RANKL protein was also induced by A. actinomycetemcomitans, whereas there was no change in OPG protein secretion. A cytolethal distending toxin (Cdt) gene-knockout strain of A. actinomycetemcomitans did not induce RANKL expression, in contrast to its wild-type strain. Purified Cdt from Haemophilus ducreyi alone, or in combination with extract from the A. actinomycetemcomitans cdt mutant strain, induced RANKL expression. Pretreatment of A. actinomycetemcomitans wild-type extract with Cdt antiserum abolished RANKL expression. In conclusion, A. actinomycetemcomitans induces RANKL expression in periodontal connective tissue cells. Cdt is crucial for this induction and may therefore be involved in the pathological bone resorption during the process of localized aggressive periodontitis.

Editor: J. D. Clements

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