SUMMARY Porphyromonas gingivalis (Pg) expresses the enzyme peptidylarginine deiminase (PPAD), which has a strong preference for C-terminal arginines. Due to the combined activity of PPAD and Arg-specific gingipains, Pg on the cell surface is highly citrullinated. To investigate the contribution of PPAD to the interaction of Pg with primary human gingival fibroblasts (PHGF) and Pg-induced synthesis of prostaglandin E2 (PGE2), PHGF were infected with wild-type Pg ATCC 33277, an isogenic PPAD-knockout strain (Δppad) or a mutated strain (C351A) expressing an inactive enzyme in which the catalytic cysteine has been mutated to alanine (PPADC351A). Cells were infected in medium containing the mutants alone or in medium supplemented with purified, active PPAD. PHGF infection was assessed by colony-forming assay, microscopic analysis and flow cytometry. Expression of COX-2 and mPGES-1, key factors in the prostaglandin synthesis pathway, was examined by qRT-PCR, while PGE2 synthesis was evaluated by EIA. PHGF were infected more efficiently by wt-Pg than the Δppad strain, which correlated with strong induction of COX-2 and mPGES-1 expression by wt-Pg, but not by the PPAD activity-null mutant strains (ΔPPAD and C351A). The impaired ability of the ΔPPAD strain to adhere to and/or invade PHGF and both ΔPPAD and C351A to stimulate the PGE2-synthesis pathway was fully restored by the addition of purified PPAD. The latter effect was strongly inhibited by aspirin. Collectively, our results implicate PPAD activity, but not PPAD itself, as an important factor for gingival fibroblast infection and activation of PGE2 synthesis, the latter of which may strongly contribute to bone resorption and eventual tooth loss.

The pathogenesis of oral lichen planus (OLP) remains to be fully elucidated; however, certain psychoneurological factors may influence the onset and exacerbation of OLP. The aim of the present study is to evaluate the intensity of negative emotions in patients with OLP. A cross-sectional, questionnairebased study was performed. The sample consisted of 52 subjects, comprising 26 patients with OLP (OLP group) and 26 controls (CTRL group). The Depression Anxiety Stress Scale 21 (DASS-21) was used for psychometric evaluation. The patients were also asked about their attitude toward the disease, treatment, and interference of the disease on daily life. The mean level of depression was 12.54 ± 6.6 in the OLP group and 7.69 ± 5.22 in the CTRL group (P = 0.006). The mean level of anxiety was 11.15 ± 7.95 in the OLP group and 6.62 ± 4.86 in the CTRL group (P = 0.018). The mean stress levels were 8.69 ± 7.06 and 3.85 ± 3.18 in the OLP and CTRL groups, respectively (P = 0.003). Severe and very severe scores of depression and very severe scores of anxiety and stress were present in the OLP group, whereas these emotions were normal in the majority of controls. Depression, stress, and anxiety may be involved in the pathogenesis and course of OLP.

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Periodontitis is a highly prevalent disease caused by accumulation of a bacterial biofilm. Periodontal pathogens use a number of virulence strategies that are under intensive study to find optimal therapeutic approaches against bone loss.

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