INTRODUCTION

Immunity and immunopathology are proverbial two edges of double-

edged sword. The common periodontal diseases found in humans are
gingivitis and periodontitis. These are inflammatory responses in the
periodontal tissues induced by microorganisms in dental plaque, which
contribute to tissue destruction, bone loss, and eventually tooth loss. The
immune system is a network designed for the homeostasis of large
molecules (oligomers) and cells based on specific recognition processes.
Recognition of the structural features of an oligomer by receptors on
immune cells is an important component of the specificity of the immune
system.
Few terms and definitions commonly used in any description of
immunology are,
An antigen (Ag) is defined as a substance, usually protein in nature,
which when introduced into the tissues stimulates antibody production.
Hapten is a non-protein substance which has no antigenic properties,
but on combining with a protein can form a new antigen capable of
forming antibodies.
An antibody (Ab) is a protein substance produced as a result of
antigenic stimulation. Circulating antibodies are immunoglobulins (Igs) of
which there are 5 classes: IgG, IgA, IgM, IgE and IgD.
An antigen may induce specifically sensitised cells having the capacity
to recognise, react and neutralise the injurious agent or organisms.
The antigen may combine with antibody to form antigen-antibody
complex. The reaction of Ag with Ab in vitro may be primary or secondary
phenomena; the secondary reaction induces a number of processes. In
vivo, the AgAb reaction may cause tissue damage.

TYPES OF IMMUNITY
Broadly speaking, immunity or body defense mechanism is divided into 2
types, each with humoral and cellular components:
Natural or innate immunity is non-specific and is considered as the first
line of defense without antigenic specificity. It has 2 major components:
a) Humoral: comprised by complement.
b) Cellular: consists of neutrophils, macrophages, and natural killer (NK)
cells.
Innate immune responses may adapt with exposure to the same pathogen
but subside once the threat has been eliminated. An example of innate
immunity is phagocytic cells (i.e., monocytes, macrophages, neutrophils),
which possess a number of inherently antimicrobial peptides and proteins
that kill many different pathogens rather than one specific pathogen.
Specific or adaptive immunity is specific and is characterised by
antigenic specificity. It too has 2 main components:
a) Humoral: consisting of antibodies formed by B cells.
b) Cellular: mediated by T cells.
The various components of both types of immunity are interdependent
and interlinked for their functions. The specific immune responses will in-
crease after exposure to a pathogen and usually maintain higher levels for
years. Lymphocytes (e.g., T cells, B cells) are important in the
fundamental form of specific adaptive immunity referred to as the specific
immune response. The ability of T cells and B cells to recognize specific
oligomeric structures on a pathogen and generate progeny that also
recognize the structure enables the immune system to respond more
rapidly and effectively when reexposed to that same pathogen.
INFLAMMATION
Inflammation is an observable alteration in tissues associated with
changes in vascular permeability and dilation, often with the infiltration of
leukocytes into affected tissues.
Inflammation is defined as the local response of living mammalian tissues
to injury due to any agent. It is a body defense reaction in order to
eliminate or limit the spread of injurious agent, followed by removal of the
necrosed cells and tissues.
The agents causing inflammation may be as under:
1. Infective agents like bacteria, viruses and their toxins, fungi, parasites.
2. Immunological agents like cell-mediated and antigen-antibody
reactions.
3. Physical agents like heat, cold, radiation, mechanical trauma.
4. Chemical agents like organic and inorganic poisons. 5. Inert materials
such as foreign bodies.

Thus, inflammation is distinct from infectionwhile inflammation is

a protective response by the body to variety of etiologic agents
(infectious or non-infectious), while infection is invasion into the
body by harmful microbes and their resultant ill-effects by toxins.
Inflammation involves 2 basic processes with some overlapping, viz.
early inflammatory response and later followed by healing
SIGNS OF INFLAMMATION
The Roman writer Celsus in 1st century A.D. named the famous 4 cardinal
signs of inflammation as:
rubor (redness);
tumor (swelling);
calor (heat); and
dolor (pain)
To these, fifth sign functio laesa (loss of function) was later added by
Virchow. The word inflammation means burning.

Typically, inflammation can progress through three stages:

immediate, acute, and chronic.
Leukocytes, the white blood cells, control all three stages of
inflammation.
Leukocytes originate in the bone marrow and exit from the blood by
trarrsenolothelial 'migration under normal conditions, accounting for
the resident leukocytes or nonelicited leukocytes) found in tissues.
Among the most important resident leukocytes are mast cells,
peripheral dendritic cells, and monocyte derivatives such as dermal
dendrocytes (histiocytes). These resident leukocytes transmit
information that initiates the processes of immediate inflammation.
Immediate inflammation is followed within minutes by a short-lived
period (up to several hours) of acute inflammation that is
characterized by an influx of neutrophils to the area after they exit
the blood. If the problem is not resolved, acute inflammation gives
way to a potentially unending period of chronic inflammation
dominated by the migration of lymphocytes and macrophages to
the local tissues. The leukocytes recruited into tissues in acute and
chronic inflammation are termed inflammatory leukocytes.