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Blood Group Substances As Differentiation Markers in Human

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Blood Group Substances As Differentiation Markers in Human B. Steffensen*, D. E. Lopatin, Blood group substances as R. G. Caffesse and C. T. Hanks Departments of Periodontics, Oral Biology, andUniversity Oral Pathology, of Michigan, School Ann ofArbor, Dentistry. Michigan, differentiation markers in human USA dento-g i ng ival e pi t heI i um Steffensen, B.. Lopatin, D. E., Caffesse, R. G.,Hanks, C. 7: Bloodgroup substances as differentiation markers in human dento-gingival epithelium. Journal of Perio- donral Research 1987: 22: 451-455. The level of cellular differentiation of human oral, sulcular, and junctional epithe- lium was compared by immunohistochemical analysis of cell membrane-associated blood group-specific carbohydrates. Identification of the blood group A-specific carbohydrate and its two immediate precursor substances, type 2 chain H and N-acetyllactosamine. was accomplished by an indirect immunofluorescence tech- nique. Murine monoclonal antibodies reacting specifically with the antigenic determinants of the blood group substances were used as markers. The blood group A substance, indicating the highest level of cellular differentiation, was demonstrated on the cells in the upper layers of the oral epithelium. In the sulcular epithelium, the A substance was present on a few cells only, while type 2 chain H was observed frequently. This indicates an intermediate differentiation level of sulcular epithelium. The type 2 chain H precursor, N-acetyllactosamine, the indicator of the lowest level of cell differentiation among the tested substances, was the only blood group substance detected on the junctional epithelial cells and on the basal cells of the sulcular and oral epithelium. Based upon previous studies of cell renewal and differentiation in oral epithelium, the present results indicate that the variations in distribution of the different blood group substances correspond with the regional rates of cell division and the levels of cellular differentiation. The findings also suggest that the cells in the junctional epithelium differentiate to a level similar to that of basal cells in the oral epithelium. Accepted for publication April 23, 1987 reestablishment of structure and func- Introduction data are available on the level of cellular tion of the junctional epithelium is not differentiation of the different epithelial The epithelium of the human dento-gin- yet fully understood (13). components of the dento-gingival area gival region has been divided into oral, Blood group-specific carbohydrate in humans (21). Results from studies in sulcular, and junctional epithelium (1, substances have been detected on epi- mice indicate, however, that the 2). The differences in structural and thelial cell membranes as well as on junctional epithelium is less differentiat- functional characteristics of these ep- erythrocytes (14). It has been demon- ed than sulcular or oral epithelium (8, ithelia, such as tissue permeability (3), strated, biochemically, that the speci- 22). variation in ultrastructure (4), rate of ficity of the blood group substances is The aim of the present investigation cellular division (5), and degree of kerat- determined by variations in the struc- was to compare the level of cellular dif- inization (6). have been attributed to ture of the terminal sugar residues on ferentiation between human oral, sulcu- embryogenic development, tissue inter- the carbohydrate chains (1 5, 16). Analy- lar, and junctional epithelium by immu- action and the special environment in sis of epithelial blood group substances nohistochemical identification of three the dento-gingival area (7, 8). The has been shown to be useful in studies well-defined epithelial blood group sub- junctional epithelium retains specific of cell differentiation of normal oral epi- stances. qualities which are clearly distinct from thelium (17, 18) and in conditions of the sulcular and oral gingival epithe- premalignancy, malignancy, and wound lium. However, after surgical removal, healing (19, 20). Current data indicate Material and methods a new junctional epithelium can regen- that the synthesis and elongation of the Tlssue samples erate from the oral epithelium (2, 9-12). blood group-specific carbohydrates are Twenty-one biopsies of marginal gin- The nature of the processes leading to correlated to the differentiation and ma- giva were obtained from 14 patients turity of epithelial cells (17, 18, 20). during periodontal surgery (1 6 speci- *Present address: Department of Peri- Thus, with increasing differentiation, mens) or in combination with tooth ex- odontics, University of Texas Health Science the epithelial cells express more de- traction (5 specimens). Blood typing Center. San Antonio, Texas. U.S.A. veloped carbohydrates. Very few similar showed that 11 patients had blood type 452 Stej’ensen et al. Mouse Similar procedures for tissue processing Carbohydrate monoclonal have previously been shown to enable Antigen structure antibodies clear detection of epithelial blood group GalNAcal substances (1 7, 18). 1-3 \ “AH16” A 3 or Type 1 or 2 determinant Gal191 --4GlcNAcl --R Antibodies and conjugates chain f2 L-FucuI The epithelial blood group substances were identified by an indirect immuno- “BE2” fluorescent staining technique. Murine H L-Fucal--2Gal/II-4GlcNAcl --R Type 2 chain- monoclonal antibodies reacting with determinant specific carbohydrates specific for the complete blood group A substance (AH16) (24) “ 1B2” and the immediate precursor sub- N-acctyllactosamine Gal/?I-dGlcNAc--R Type 2 chain- stances, type 2 chain H (BE2) (25) or specific N-acetyllactosamine (1 B2) (25) were ap- Gal =Galactose. plied to the sections as the primary anti- GI = Glucose. bodies. The chemical composition of the FUC= FUCOSC. carbohydrate determinants for these AC= Acetyl. blood group substances is shown in Fig. GIcNAc = N-acet yl-D-glucosamine. 1. (The murine monoclonal antibodies Fig. 1. The chemical composition of the carbohydrate chains specific for the blood group were obtained as a gift from Dr. S.I. substances A, type 2 chain H, and N-acetyllactosamine. Hakomori, Fred Hutchinson Cancer Research Center, Seattle, WA). The sec- 0 and 3 patients had blood type A. Bi- and 5 specimens were fixed in Bouin’s ondary antibodies were goat anti-mouse opsies from patients with these blood fixative (23). Following fixation, the immunoglobulins (IgA + IgG + IgM, types were selected because previous specimens, which included tooth sub- heavy and light chain-specific) conju- studies have demonstrated the blood stance, were placed in a buffered 0.5 gated with fluorescein isothiocyanate group substances type 2 chain H and mol/l EDTA solution (pH 7.1) for decal- (FITC) for immunofluorescence visual- N-acetyllactosamine in epithelium from cification of the hard tissues. All speci- ization (Cappel Scientific Div., Mal- individuals with blood type 0 and, in mens were embedded in parafin and vern, PA). addition, the blood group A substance cut at 4-5 microns-thick sections. The in persons with blood type A (20). sections were deparafinized with xylene The patients were appraised of the and hydrated in graded ethanol and Staining procedure study and informed consents were ob- phosphate buffered saline at pH 7.4 The tissue sections were incubated in tained consistent with the policies of (PBS) before the staining procedure. a humidity chamber with the primary The University of Michigan and the NIH. Tissue processing Sixteen specimens were fixed in a 4% neutral buffered formaldehyde solution, lium Fig. 2. Schematic drawing of a gingival tissue section illustrating the oral, sulcular, and junctional epithelium. The circles represent the areas in the subepithelial connective tis- Fig. 3. Oral epithelium from a patient having blood type A ( x 250). A: Immunofluorescence sue where the inflammatory cell infiltrate was staining of the blood group A substance using murine monoclonal antibodies. B: Hematoxylin- evaluated. eosin staining of the section shown in A. Blood group substances in gingiva 453 nous cells was determined in each area. After examination and photography in the IF microscope, the sections were re- stained with hematoxylin-eosin (HE), permitting comparison of the IF stain- ing reaction with the normal histology. Degree of inflammation The degree of inflammation was deter- mined from the HE-stained sections. In each section, the total number of in- flammatory cells was counted (field size = 1.3 mm2 at 400 x ) in the connec- tive tissue located immediately beneath a) the oral epithelium, b) the sulcular epithelium, corresponding to the region where keratinization disappeared, and c) the junctional epithelium at the mid- point between the most coronal colla- gen fiber attachment and the most api- cal part of the sulcular epithelium. These cell counts were related to the IF staining patterns (Fig. 2). Control reactions Control reactions included a) staining with FITC-conjugated goat anti-mouse antibodies alone, b) substitution of PBS in place of the murine monoclonal anti- bodies, and c) application of the hybri- doma cell culture media in place of the cultured hybridoma supernatant fluid containing antibody. Results Blood group A substance The blood group A substance was found on single cells or groups of cells in the upper spinous cell layers in the oral epi- thelium (Fig. 3). Only single scattered cells in the most superficial cell layers Fig. 4. Gingival epithelium from a patient having blood type 0 ( x 250). Immunofluorescent of the sulcular epithelium showed pres- staining of the blood group substance typc 2 chain H using murine monoclonal antibodies in ence of the A substance. No substance (A) oral epithelium and (C) sulcular epithelium. B and C: Hematoxylin-eosin staining of the A was detected in the junctional epithe- sections shown in A and C. lium. npe 2 chain H substance murine monoclonal antibodies at a di- In the ortho-keratinized oral epithe- lution of 1 :5 for 24 h at 4°C. After three Evaiuatlon Of reaction lium, the type 2 chain H substance was rinses with PBS, each for 5 min, a 1:lO Evaluation of the stained sections was demonstrated on cells in all spinous cell dilution of the secondary goat anti- performed with a Leitz epifluorescence layers (Fig.
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