Leukotoxin of Actinobacillus actinomycetemcomitans: Review of Its Significance and Transmission
Actinobacillus actinomycetemcomitans (Aa) has been implicated as the major periodontal pathogen of aggressive periodontitis due to its ability to produce leukotoxin that plays a role in the inhibition of human defense mechanisms and immune responses by its cytolytic activities on human neutrophils, macrophages, and T-lymphocytes. Various Aa strains from different clinical isolates are classified based on the levels of leukotoxin production. One of the underlying molecular mechanisms that result in the high levels of leukotoxin production is based on a 530-base pair (bp) deletion in the promoter region of the leukotoxin gene. Several studies have shown that the transmission of Aa from one site to another within the same mouth as well as interindividual transmission in the same family is possibly via saliva. We have conducted a pilot study to investigate its transmission in two Thai families. Subgingival plaque samples were collected from two aggressive periodontitis patients as well as their familial members, and the presence of highly leukotoxic strain of Aa in these samples was determined by polymerase chain reaction. Our study showed the absence of the highly leukotoxic strain of Aa within these two families, since the 530 bp deletion was not detected in all tested samples. However, because of a small sample size, the result could show only the trend of the absence of leukotoxic strain of Aa in Thai population. A large sample size is required for the further conclusion. Other interesting aspects of Aa have been proposed in this review as well.
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