Evaluation of "soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), interleukin-1ß, and matrix metalloproteinase-8" as a short panel of salivary biomarkers in patients with and without stage III/IV periodontitis and type 2 diabetes mellitus.

BACKGROUND AND AIM: Periodontitis involves a dynamic disease process, demanding the identification of biomarkers to diagnose the current state of disease activity. Therefore this study assessed the potential of "sTREM-1, IL-1ß, and MMP-8" as a short panel of biomarkers of host biological process indicating the inflammatory burden in periodontium and thereby serving as a panel of diagnostic markers in periodontal disease. METHODS: Sixty eight patients were recruited and allotted into four groups comprising of subjects with clinically healthy gingiva and Stage III/IV Periodontitis with and without type 2 diabetes with HbA1c levels in the range of 6.5-7.9%. Periodontal parameters were measured and full mouth radiographic assessment was done. Whole saliva (unstimulated) samples were collected from all patients and estimation of the levels of markers was done employing ELISA. RESULTS: All the three biomarkers were noted to be the lowest in group I (sTREM-1: 75.63 ± 13.77; IL-1ß: 15.67 ± 3.39; MMP-8: 85.83 ± 22.32) and highest in group IV (sTREM-1: 138.83 ± 14.89; IL-1ß: 39.19 ± 7.20; MMP-8: 201.15 ± 50.32) with statistically significant difference. The difference observed between groups II and III for all the biomarkers assessed were statistically insignificant. The clinical parameters and HbA1c levels had positive correlation with the levels of biomarkers which was statistically significant. CONCLUSION: This study unveils the potential of the short panel of biomarkers ("sTREM-1, IL-1ß, and MMP-8") to be used as diagnostic and possible prognostic markers for Periodontitis. It further corroborates the role of type 2 diabetes mellitus in amplifying the diverse processes that result in periodontal destruction.

An emphasis of T-cell subsets as regulators of periodontal health and disease.

BACKGROUND: The pathogenesis of complex diseases like periodontitis is moderated by the balance in immune inflammatory responses. T-lymphocytes are immune cells that descend from the bone marrow. Furthermore, they develop in the thymus playing an indispensable role in adaptive immune responses. The periodontal microenvironment allows differentiation of various groups of T-lymphocytes such as CD4+ (Th1/Th2/Th17/Treg/Tfh/Th9/T22), CD8+ cells, gamma-delta (γd) T cells, or memory cells based on the current regional cytokine milieu to secrete distinct cytokines and other molecules required for resolution of inflammation or result in progression of the disease based on interactions among various cells. AIM: The dynamism of T-lymphocytes in the immunopathogenesis of periodontal diseases resulting in tissue destruction is established but the mechanisms of immunoregulation that underpins periodontal disease progression are cumbersome. This review aims to understand the distinct types of T cells and their effector functions with their portrayal in periodontal disease. RELEVANCE FOR PATIENTS: This review gives valuable insights on the possibility of predicting periodontal disease progression, on the management and its prognosis by evaluating specific cytokines of destructive T-cell phenotype, and on the future perspectives of therapeutic modalities including ways of modulating host immune and inflammatory responses to establish periodontal homeostasis and areas of research.