Evaluation of Microcirculation, Cytokine Profile, and Local Antioxidant Protection Indices in Periodontal Health, and Stage II, Stage III Periodontitis.

Artem Eldzharov,Adelina Gatsalova,Dmitry Nemeryuk,Dzerassa Kabaloeva,Elena Ivanova,Florence Carrouel,Aida Goncharenko,Denis Bourgeois,Igor Kostritskiy

doi:10.3390/jcm10061262

Abstract

Periodontitis, initiated by the subgingival biofilm and modified by the individual’s inflammatory/immune response, has been associated with vascular dysfunction. To analyze microcirculation indices in periodontal tissues and determine the activity of the enzymatic component of antioxidant defense and humoral immunity factors, a single-blind non-invasive clinical trial was realized. Forty subjects, aged from 30 to 65 years, with moderate to severe chronic periodontitis (chronic generalized periodontitis, CGP) vs. 40 subjects as periodontally healthy were recruited. Information such as capillary diameter, capillary blood flow velocity, concentration of pro- and anti-inflammatory cytokines in serum, vascular endothelial growth factor, and enzymatic component of antioxidant protection were taken. The revealed microcirculatory dysfunctions in patients with CGP clearly demonstrate the progressive disorder of periodontal tissue perfusion and oxygenation, the presence of increased vascular permeability and functional failure of the microvascular system in the lesion. Cytokine profile of CGP patients’ blood serum demonstrated a significant increase of interleukin (IL)-1β, IL-6, tumor necrosis factor α (TNF-α), IL-4 levels as well as statistically significant decrease of IL-1ra, IL-10 concentration. Participants with CGP demonstrated a dominant superiority of IgM and IgG levels. In conclusion, these results contribute to a better understanding of potential correlation between microvascular changes and local and systemic markers of inflammation.

Highlights

IntroductionPeriodontitis is an infectious-inflammatory disease, which is initiated by the subgingival biofilm and modified by the individual’s inflammatory/immune response [1,2]
Periodontitis is an infectious-inflammatory disease, which is initiated by the subgingival biofilm and modified by the individual’s inflammatory/immune response [1,2].Resulting from loss of balance between the commensal microbiome and the host response, the pathogenesis of periodontal diseases is mediated by the inflammatory response to bacteria in the dental biofilm [3]
Inflammation is associated with pathological angiogenesis and a high number of newly formed blood vessels that can be quantified as micro-vessel density (MVD) [8]

Summary

Introduction

Periodontitis is an infectious-inflammatory disease, which is initiated by the subgingival biofilm and modified by the individual’s inflammatory/immune response [1,2]. Resulting from loss of balance between the commensal microbiome and the host response, the pathogenesis of periodontal diseases is mediated by the inflammatory response to bacteria in the dental biofilm [3]. Accumulation of infiltrates within the connective tissue led to collagen degradation or fibrotic reaction by stimulating the effects of inflammatory mediators of the connective tissue [4,5,6,7]. Angiogenesis together with inflammatory infiltrate are associated with the evolution of gingival inflammatory processes [9]. Periodontitis is accompanied by the proliferation of small blood vessels in the gingival lamina propria

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