Host Modulation Therapy Terms - Perio Chapter 29 Study Set

What is host modulation therapy?

manipulating or modifying a patient's host response to a bacterial challenge

•

the exact functions of host modulation therapy

targets the inflammation, NOT the microbes

• manages the inflammation, not the disease itself

• there is no concern of microbes becoming resistant to drugs

• TEST QUESTION - EXPLAIN

T/F: Host modulation therapy is a replacement to nonsurgical periodontal therapy,

FALSE

• promising as an ADJUNCT to nonsurgical and surgical therapy, but not a replacement

How is host modulation therapy used to treat osteoporosis?

through modulation of the host response to minimize bone loss

• antiresorptive agents: estradiol and bisphosphonates reduce bone resorption

• bone forming agents: teriparatide stimulates bone formation

what is Antiresorptive agents

Estradiol and bisphosphonates reduce bone

what is bone forming agents

Teriparatide stimulates bone formation

how was treating Osteoporosis considered host modulation therapy?

because we are not treating the disease (loss of bone density and mass), we are modifying the normal bone remodeling process to offset the disease

true or false additional drugs are being researched for promising future tx options as host modulation in periodontitis

true

how is Doxycycline in sub-antibacterial dose is host modulation in perio

○ inhibits collagenase -- stops breakdown of collagen

Doxycycline amount

(20mg vs typical dose of 50-100mg)

how is Modified tetracyclines a host modulation in perio

Lack any antibacterial effect but still disrupt

which host modulation therapy is currenlty approved from the treatment of periodontitis

only Periostat (low dose doxycycline)

How could NSAIDS be used in host modulation therapy in periodontitis? (like the benfit of them)

• they reduce the function of osteoclasts

• inhibits PGE2 (prostaglandin)

inhibiting PGE2 (prostaglandin) means

decreasing inflammation

why arent nsaids used as a host modulation therapy in perio

• not used at this time due to other side effects (GI mainly

How could Statins be used in host modulation therapy in periodontitis?

early research suggests reduced systemic inflammation

examples of statins

• atorvastatin and simvastatin

How could Omega 3 fatty acids/spms be used in host modulation therapy in periodontitis?

ongoing trials pointing to resolve/ reduce inflammation

spm stands for

Specialized Pro Resolution Mediators

an example of dietary supplements

○ Omega 3 fatty acids and probitiotics

Which biochemical mediators are produced by the host immune cells in response to microbial invasion?

Pro-inflammatory mediators

• IL-1

• IL-6

• PGE2

• TNFa

• MMPs

Which biochemical mediators play a key role in limiting the tissue-damaging side effects of the pro-inflammatory response?

Anti-inflammatory mediators

• IL-4

• IL-10

• IL-1ra

• TIMPS

How could anti-cytokines be used in host modulation for periodontitis?

blocks receptors for TNFa/anti-RANKL agent

what is anti-cytokines currenly be used to do

treat inflammatory autoimmune disorders (rheumatism, IBS)

what is currnely going on with anticytokines

larger clinical trials are still need to evaluate effectiveness in treating periodontitis

How could probiotics be used in host modulation for periodontitis?

• helps maintain symbiosis in bacterial colonies

what is a promising fututre therapy

Host modulation in periodontitis

What is currently the ONLY approved use of host modulation therapy?

sub-antibacterial dosing of doxycycline

What are the 4 different ways host modulation therapy can be used?

• can be used to:

enhance host's protective response

modify the overall inflammatory response

suppress the effect of specific pro-inflammatory mediators

block the breakdown of collagen or block bone resorption