EFFECT OF DEFENSINS ON SUSCEPTIBILITY TO INFECTION AT THE MUCOSAL SURFACE

Periodontal diseases are among the most common diseases of the oral cavity. Periodontal disease is the major cause of tooth loss in adults, and recently there has been increasing interest in the relationship of periodontal disease to important systemic diseases, such as cardiovascular disease and complications in pregnancy. Despite the importance of infection and colonization by bacteria and yeast in periodontal and candidal infections, the immune status of the host and the effectiveness of the host response are key determinants of disease susceptibility. The regulation of β-defensins by various mediators and their expression in oral tissues, salivary glands, and secretions suggest that β-defensins are in a prime position to defend epithelial cells and mucosa from infection and respond to inflammation in the periodontium. The complexity of multiple regulatory pathways involved in β-defensin expression and their physicochemical properties and structures supports their pluripotential functions. β-Defensin expression also appears to be regulated during inflammation in vivo. Unlike the results of in vitro studies demonstrating upregulation by inflammatory stimulants, such upregulation does not always occur in vivo. Understanding the basis for differential expression of β-defensins in the oral cavity will assist us in defining individuals at risk for periodontal diseases and Candida infections.