Peripheral Blood Leukocyte Abnormalities and Periodontal Disease: A Family Study

Abstract

R ecent reports indicate that young individuals with moderate to severe periodontitis frequently have chemotactically defective polymorphonuclear leukocytes and/or monocytes, and that both periodontitis and the leukocyte defects may be familial. We report studies of a 23‐year‐old Caucasian female and other members of her family with regard to periodontal status and leukocyte chemotaxis. The patient had molar‐incisor bone loss at age 15, which had become more generalized by age 17. At age 23, when the studies were done, she had advanced alveolar bone destruction necessitating periodontal therapy and extraction of several teeth. The capacity of her serum to generate a chemoattractant was normal but the chemotactic responsiveness of her polymorphonuclear neutrophilic leukocytes (PMNs) was only 6.3% normal. Except for periodontitis, the patient was healthy. One sister age 20 had moderately severe gingivitis and pockets of 5 and 6 mm around three molars; her PMNs and monocytes had normal chemotactic function, although her serum manifested a borderline defect in generating chemotactic activity. Another sister age 19 was free of gingivitis and periodontitis, although she had a history of chronic middle ear disease with onset at puberty and of sufficient severity to require surgical intervention. Her serum chemotactic activity was normal, although her PMNs were grossly defective with a chemotaxis value of 27.3% of normal. The mother was 47 years of age and had generalized moderately severe periodontitis of the adult type. She manifested both an intrinsic PMN chemotaxis defect and a serum defect. All family members tested had normal monocyte chemotaxis. Additional family history revealed that the father and maternal grandmother of the proband, as well as one maternal aunt and one maternal uncle, lost their teeth from “gum” disease at a young age. Leukocyte chemotaxis defects, either cellular or serum based, may be genetically transmitted and result in unusual susceptibility to periodontitis and other recurrent infections.