Understanding & Detecting Diseases or Cancers Before They're Apparent

Research being conducted in Dr. Yvonne Kapila's laboratory may one day lead to developing new tools to diagnose and treat periodontal disease and perhaps cancer as well.

An associate professor in the Department of Periodontics and Oral Medicine, Kapila is researching how the extracellular matrix regulates the life and death of cells in conditions such as inflammation, which is encountered in periodontal disease, and during the process of cancer progression in oral squamous cell carcinoma.

Why the matrix?

As the name implies, the matrix is the all important "mother" or center of life for cells. Whether the matrix is broken down because of a bacterial assault (as in periodontal disease), or whether it is altered by repair or a cancer process, dictates whether cells in this environment live, die, or get sick.

So the state of the matrix is critical in determining whether cells and tissues are healthy or beginning their demise.

Trying to Predict, Not React

Although there is a normal turnover of matrix, keeping its formation and breakdown in fine balance is critical. By examining the status of the matrix, scientists get a mirror that reflects the relative state of health of the resident cells and tissues.

How is that information of help?

"The tools we in the oral health care profession are using and have been using for some time to detect and measure the progression of periodontal disease, such as radiographs and clinical measurements, only tell us what has already happened," Kapila said. "What we are interested in knowing is how we can use these microscopic substances around cells in the matrix that have broken down to tell us that disease is about to occur before the actual onset of clinically perceptible bone loss or attachment loss in an oral or clinical setting."

One of the research projects Kapila leads is investigating if matrix and cell death (apoptotic) fragments or biomarkers could be used to predict the likelihood of periodontal disease before it occurs.

The presence of high levels of matrix fragments or apoptotic proteins sampled around the teeth of patients suggest that the matrix is breaking down and cells are dying. Cells that have no firm ground on which to sit and survive simply shrivel up and die, in essence, causing the tissue to die. A stable matrix is essential to maintaining the life and health of cells. A broken down matrix and its fragments signals inflammation and an impending onset of clinical disease progression or bone and attachment loss.

Fibronectin fragments that Kapila and members of her research team are studying are usually found in inflammatory fluids associated with diseases such as periodontitis or arthritis. Several grants from the National Institutes of Health are funding her research team to try to better understand the signaling cues induced by the fibronectin fragments that cause cells to die or undergo apoptosis.