Adjunctive Systemic Use of Beta-Glucan in the Nonsurgical Treatment of Chronic Periodontitis

Abstract

Periodontal lesions in chronic periodontitis are associated with a subgingival microbiota predominated by gram-negative anaerobic rods, spirochetes and other motile microorganisms (Tanner et al., 1979). Chronic periodontitis is a complex process itself involving periodontal microorganisms, immune system and host factors. One reason for the augmented colonization of these periodontopathogens is believed to be related with a weak specific T helper 1-mediated immunity (Bartova et al., 2000; Breivik & Thrane, 2001; Wassenar et al., 1998) and, the immune response in patients with periodontal lesions may be inclined towards a strong T helper 2-mediated immunity. Immune functions can be enhanced by activating macrophages and establishing Th1 dominance (Inoue et al., 2002; Lee et al., 2002). The use of certain immunomodulating agents may stimulate immune response and activate macrophages and neutrophils. Beta-glucan (┚-glucan), a polysaccharide extracted from cell walls of Saccharomyces cerevisiae, has been found to have immunomodulatory effects in animals and humans (Babineau et al., 1994; Bleicher & Mackin, 1995; Chan et al., 2009; Engstad, 1994; Engstad et al., 2002). It increases resistance to bacterial infections and cancer cells while stimulating wound healing (Brown & Gordon, 2001; Chan et al., 2009; Yun et al., 2003). Numerous studies have shown that ┚-glucan is a stimulator activating phagocytosis, respiratory burst, and the production of cytokines and chemokines in macrophages (Kankkunen et al., 2010; Sherwood et al., 1987, Williams & Di Luzio, 1980). Recently, the possibility of subcutaneous injections of ┚-glucan being able to modulate allergic sensitisation has been demonstrated in children (Sarinho et al., 2009). The authors proposed a new therapeutic strategy in allergic diseases as ┚-glucan possesses a beneficial action in restoring T helper 2 function (Sarinho et al., 2009). Furthermore, besides its antibacterial effects, antiviral and antifungal properties of ┚-glucan have been put forward (Bedirli et al., 2003; Di Luzio et al., 1980; Jung et al., 2004; Kenyon, 1983; Kernodle et al., 1998; Leblanc et al., 2006; Nicoletti et al., 1992; Tzianabos, 2000). The protective effect of ┚-glucan has been established to Staphylococcus aureus (Di Luzio & Williams, 1978), Escherichia coli, Listeria monocytogenes, Mycobacterium leprae, Candida albicans (Williams et al., 1978), Pneumocytis carinii, Leishmania donovani and Influenza virus (Jung et al., 2004).