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Background: Localized aggressive periodontitis (LAgP) is an infectious periodontal disease which generally affects young people. Recent data suggest the involvement of different bacterial species in different populations. The causative bacterial species in Israel has never been identified despite a high prevalence of LAgP in this population. The objectives of this study were to characterize the bacterial microbiota of periodontal pockets within an Israeli LAgP population who were also clinically assessed., Methods: Twenty-one LAgP patients (test) and 12 chronic periodontitis patients (control) were examined. Bacterial samples were collected from periodontal pockets and analysed by both culture and polymerase chain reaction techniques. Mann-Whitney U test and chi-square test were used to compare results between the groups., Results: Higher levels of Parvimonas micra (>10(6) ), Aggregatibacter actinomycetemcomitans (>10(5) ), Fusobacterium nucleatum/F. periodonticum (>10(6) ), and Tannerella forsythia (levels of 10(5) to 10(6) bacteria) were detected in the LAgP group compared to the control (p < 0.05), while levels of Porphyromonas gingivalis and Prevotella intermedia were higher in the CP group., Conclusions: The characteristic periodontal bacterial flora of LAgP patients in Israel is mainly comprised of P. micra, A. actinomycetemcomitans, F. nucleatum/F. periodonticum and T. forsythia. Similar population based studies of each population will improve the quality of treatment of LAgP when individual sampling is not possible., (© 2014 Australian Dental Association.)

The history of the North African Jewish community is ancient and complicated with a number of immigration waves and persecutions dramatically affecting its population size. A decade-long process in Israel of clinical-molecular screening of North African Jews with incurable autosomal recessive blindness led to the identification of a homozygous splicing mutation (c.95-2A > T; IVS2-2A > T) in RPE65, the gene encoding the isomerase that catalyzes a key step in the retinoid-visual cycle, in patients from 10 unrelated families. A total of 33 patients (four now deceased) had the severe childhood blindness known as Leber congenital amaurosis (LCA), making it the most common cause of retinal degeneration in this population. Haplotype analysis in seven of the patients revealed a shared homozygous region, indicating a population-specific founder mutation. The age of the RPE65 founder mutation was estimated to have emerged 100-230 (mean, 153) generations ago, suggesting it originated before the establishment of the Jewish community in North Africa. Individuals with this RPE65 mutation were characterized with retinal studies to determine if they were candidates for gene replacement, the recent and only therapy to date for this otherwise incurable blindness. The step from molecular anthropological studies to application of genetic medicine was then taken, and a representative of this patient subgroup was treated with subretinal rAAV2-RPE65 gene therapy. An increase in vision was present in the treated area as early as 15 days after the intervention. This process of genetically analyzing affected isolated populations as a screen for gene-based therapy suggests a new paradigm for disease diagnosis and treatment.

The frequencies of various indications for enucleations have changed during the past decades. Knowledge of these trends may aid us in assessing the efficacy of early diagnostic techniques and improved modes of treatment. This study was designed to evaluate the indications for enucleations and their changes during a period of thirty years in a major Israeli medical center. We present a retrospective review of 463 enucleations performed between 1960 and 1989 at the Hadassah University Hospital, Jerusalem, Israel, and analyze the changes in the indications for enucleations. In our study, fewer enucleations were performed in the last two decades: 105 in the 1970's and 111 in the 1980's, as opposed to 247 in the 1960's. The incidence of enucleations due to glaucoma and to traumatic complications decreased significantly, from 22.3% in the 1960's to 7.7% glaucoma-related enucleations in the 1970's and 1980's, and 7.2% trauma-associated enucleations in the 1980's as opposed to 11.3% in the 1960's, reflecting improved medical management of these conditions. No significant change was noted in the frequency of enucleations due to inflammation, congenital disease or retinal detachment, nor in the number of malignant melanoma-related enucleations. The number of enucleations due to retinoblastoma rose in our study between 1960 and 1989.

The Moroccan Jewish community living in Israel shows a relatively large genetic distance from other North African Jewish communities. In this work the polymorphism of HLA class I and class II determinants, as defined by serology and oligotyping, is analyzed in 113 healthy unrelated Jews of Moroccan stock. The class I antigens HLA-A1, -B44, and -Cw7 showed the highest frequency, while the most prevalent class II variants were DRB1*0701 and *1104, DQA1*0501, and DQB1*0201 and *0301. HLA A1-B13-DR7, A2-B51-DR10, and A1-B44-DR13 were the most typical three-locus haplotypes. Although the antigen frequency distribution of the Moroccan Jews falls within the Caucasian diversity range, this community has a unique pattern in terms of antigen, gene, and haplotype frequencies. Thus, in the Moroccan Jews DRB1*1305, an allele believed to be the result of a recombination event between DRB1*1301-1302 and DRB1*1101, is represented to a much larger extent than in all the other population groups studied at the 11th IHWS. This allele may therefore be a typical Jewish variant. A particular finding was the high frequencies of HLA-B13, B52, and DR10, alleles common among some Oriental populations. The answer to this enigmatic phenomenon probably must be sought in the tortuous history of this community.

HLA proteins are genetically determined, and account in part for individual immune response. Several studies have been performed seeking an association between HLA antigens and various forms of periodontitis with no conclusive results. The aim of the present study was to determine the frequency of HLA antigens of patients suffering from the localized (LJP) and the generalized (SGP) forms of early-onset periodontitis (EOP). Twenty-six EOP patients from the same ethnic group were studied in comparison to 113 race-matched controls. The EOP group included 11 LJP and 15 SGP patients. HLA-A9 and B15 antigens were found to be significantly elevated in the patient group. These differences were found to be due to the high frequency of A9 and B15 antigens in the SGP patients, with the LJP patient group showing no significant difference from the control group. The results are in agreement with previous studies in which A9 and B15 were found to be associated with EOP. However, previous studies did not differentiate between the localized and the generalized form of EOP. These results support the hypothesis that the generalized and the localized forms of EOP are under different genetic control.

Dental research has emphasized the importance of understanding the epidemiology and etiology of periodontal disease, the second most prevalent dental pathology. The World Health Organization includes periodontal health prevalence, according to the Community Periodontal Index of Treatment Needs (CPITN), in its Global Oral Data Bank. Recent immigrants to Israel from Ethiopia offer a unique and important opportunity for investigation. Seventy adults aged 35-45 years were examined. Dividing the dentition into six sextants (according to CPITN), on average, two sextants were found to be healthy and only 1.18 sextants revealed shallow or deep pockets. These results demonstrate a relatively healthy periodontal status, as compared both to Israeli adults and data from the WHO Data Bank. Periodontal health has traditionally been related to regular dental visits (professional teeth cleaning) and home oral hygiene maintenance (toothbrushing and flossing). This population of immigrants had never visited dentists or hygienists nor used toothbrushes or dental floss. The periodontal health of this population is therefore of particular interest.

The present study describes the prevalence of alveolar bone loss (ABL) in children in relation to caries, contact and space loss. In addition, the microbial composition of the subgingival plaque of 20 sites, from 5 children, is presented. Bite-wing radiographs from 500 children were examined. ABL was evident in: 99 sites from 60 children; > 1 site in 27 children; the maxilla only in 34 children; the mandible only in 17 children; both arches in 9 children; 37 sites with no caries; 4.9 percent of all sites with proximal caries; 15.8 percent of all sites with contact loss; and 20.5 percent of all sites with mesial drift. Anaerobic bacteria were cultured from all 20 sites. No significant differences in the percentages of colony forming units of Actinobacillus actinomycetemcomitans and black pigmented Bacteroides were found among sites with/without bone loss, with/without caries or probing depths smaller/equal or larger than 2.5 mm.

Adults (35-45 yr old) and children (5 and 12 yr old) recently arrived in Israel from rural areas in Ethiopia were examined. Caries levels were low: e.g. DMFT = 0.31 among 12-yr-olds, and 1.27 amongst adults. The 5-yr-olds were 86.8% caries-free, while 12-yr-olds were 81.8% and adults 54% caries-free respectively. According to interview data, the diet in Ethiopia had been based on local agricultural products and was almost sugar-free. The mean total count of salivary bacteria, as determined on blood agar, was 3.4 x 10(8); mean count of Streptococcus viridans, on mitis salivarius, was 6.7 x 10(7); and mean count of S. mutans, as determined on mitis salivarius with bacitracin, was 1.7 x 10(7). These levels were all high and were not significantly different from a control group of 20 Israelis. The mean number of lactobacilli, on Rogosa agar, was 2.75 x 10(4), which was significantly higher than among the controls (3.6 x 10(3). Salivary pH levels were generally similar between the Ethiopian group and the controls. Salivary flow was significantly higher for the Ethiopians (1.93 ml/min) than for controls (1.16 ml/min). Low levels of caries in this population can be attributed to an almost sugar-free diet and high salivary flow, but not to the composition of oral microflora.

The prevalence of dental caries and periodontal treatment needs in an institutionalized Down syndrome (DS) population was examined as well as the relationship between caries prevalence, salivary pH and salivary levels of Streptococcus mutans. Twelve patients with DS, aged 20 to 48, were compared with two similar age and gender control groups: healthy, and non-Down institutionalized mentally retarded patients. The pH levels did not differ significantly among the three groups. As to periodontal needs expressed by the CPITN, the institutionalized groups had the highest needs compared with the healthy group. Down adults, who were cariesfree, had significantly lower S. mutans counts compared with the patients with caries. In addition, the cariesfree patients with DS had much lower CPITN scores compared with the patients with caries.

The prevalence of dental caries and periodontal treatment needs in an institutionalized population with Down syndrome was examined and the relationship between caries prevalence, salivary pH, and salivary levels of Streptococcus mutans was studied. Thirty-two children with Down syndrome, aged 8 to 13, were compared with two control groups of similar age ranges: healthy children and non-Down mentally retarded (MR) children living in the same institution as the Down syndrome population. The gender ratio mixtures in each group also matched the study sample. Caries experience as indicated by decayed, missing, and filled surfaces (DMF-S) showed significantly lower mean scores for the Down syndrome group compared with both control groups. A similar pattern was found when evaluating the mean numbers of decayed surfaces. Streptococcus mutans counts, expressed as number of colony-forming units on mitis salivarius agar plates among the Down syndrome group, were the lowest, although not statistically significant compared with the counts of the healthy children. Both groups had bacterial counts which were significantly lower than those of the MR group. Significant differences between the two institutionalized groups and the healthy group were recorded for the salivary pH levels. The periodontal treatment needs as evaluated by the Community Periodontal Index of Treatment Needs showed significant difference between the MR group versus both the healthy population and the Down syndrome group. On the whole, 84% of the Down syndrome children were cariesfree.

Two hundred and ten members belonging to two consecutive generations of 41 atopic families (healthy and affected by clinical atopic manifestations) were investigated for basal immunoglobulin E (IgE) levels and clinical picture. The results show overall increased IgE levels, above standard values in the whole population studied, and a significant correlation between clinical atopy and high IgE levels in the children of the group. Within these families recessive inheritance of abnormally high IgE levels suggests that their high IgE levels are due to a genetically transmitted defect in IgE suppression.

A synthetic copolymer of amino acids, copolymer 1 (Cop 1), proved to be very effective in suppressing experimental autoimmune encephalomyelitis (EAE), an animal model for multiple sclerosis (MS). It is 1 of a series of synthetic amino acid copolymers which simulate the basic protein constituent of the myelin sheath and the autoantigen responsible for induction of EAE. It cannot induce EAE but it does suppress it in a variety of animals. The immunological cross-reaction between Cop 1 and the basic protein is the basis for this suppressive activity. In view of the resemblance between EAE and MS, clinical trials with Cop 1 in MS were started. The first preliminary clinical trial was at this hospital and involved 4 patients with severe MS. A double-blind, randomized placebo-controlled pilot trial was carried on for 2 years in 50 patients with the exacerbating-remitting form of MS but with a Kurtzke Disability Status Scale rating of no more than 6. There were statistically significant differences in the number of patients with exacerbations in the placebo group, 23, as compared to only 16 in the Cop 1-treated group. As to exacerbations per patient, the 2-year averages were 2.7 and 0.6, respectively. Side-effects of Cop 1 were minimal. These results suggest that Cop 1 may be beneficial when given early in the exacerbating-remitting form of MS. Further trials, necessary to establish its efficacy in MS, are being run at the Albert Einstein College of Medicine in NY.

Investigation of 98 members (healthy and affected) belonging to 17 hay-fever families, for clinical picture, total and specific IgE and HLA A, B, C and DR is presented. There was no significant correlation between hay-fever, total or specific IgE and a certain HLA antigen or haplotype. There was, however, an association between hay-fever and same haplotype within 4 of the 17 families.