Class II major histocompatibility complex (MHC) antigen-presenting cells are associated with the early phase of the immune response. We have studied the distribution of class II-expressing cells in developing, healthy and carious human teeth to clarify, when human pulp acquires an immunologic defense potential and how this reacts to dental caries. Antigen-expressing cells were identified immunohistochemically with the following monoclonal antibodies: HLA-DR - for dendritic cells and CD68 - for macrophages. In the pulp of unerupted developing teeth, HLA-DR-positive cells were distributed mainly in and around the odontoblast layer. A few CD68 positive cells were located more coronary around the blood vessels. In erupted teeth, HLA-DR-positive cells were located, for the most part, just beneath the odontoblast layer. CD68 positive cells were also located coronary, mainly around the blood vessels. Superficial caries lesions caused an aggregation of HLA-DR-positive cells and macrophages in the dental pulp corresponding to the lesion. These findings showed that: (1) human teeth are already equipped with an immunological defense potential prior to eruption; (2) in the initial stage of caries infection, an immuno-response mediated by class-II-expressing cells is initiated in human dental pulp (Fig. 8, Ref. 33).
Defense reactions of the dental pulp involve a variety of biological reactions, in which the immune system plays a very important role. The class II major histocompatibility complex (MHC) molecule expressing cells, termed dendritic cells and lymphocytes in human dental pulp are highly sensitive to exogenous antigenic stimuli. Their drastic changes in number and localization are induced by dental caries. This study investigated the responses of the immune system in two different clinical conditions: shallow and deep cavities. Cells were identified immunohistochemically by using the following monoclonal antibodies: HLA-DR, CD45RO and CD20. Initial pulpal
response was characterized by a localized accumulation of HLA-DR antibody-positive cells in the pulp tissue beneath the dentinal tubules communicating with the caries lesion. In the pulp of progressed caries, a large number of HLA-DR-positive cells was observed with a marked increase of other kinds of immunocompetent cells. This might indicate the occurrence of antigen presentation locally in the pulp tissue, which is very important for the immune response. Results obtained in this study demonstrated that dental pulps respond to the progression of the carious lesion and cellular and humoral
immune responses occur in the pulp tissue.
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