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Periodontitis has been associated with other systemic diseases with underlying inflammation responsible for the shared link. This study evaluated longitudinal variation in peripheral T helper cells in periodontitis patients undergoing management over one year. Periodontal parameters and peripheral blood mononuclear cells (PBMCs) were collected from 54 periodontitis patients at baseline, 3-, 6- and 12-months post-treatment and 40 healthy controls. IFN-γ+ , IL-4+ , IL-17+ , Foxp3+ and their double positive expression was identified in CD4+ and TCRαβ+ cells using flow cytometry. PBMCs were incubated with P. gingivalis and IFN-γ, IL-4, IL-17 and IL-10 in cell-supernatant was measured by ELISA. Cells and cytokines were also assessed based on clinical response to treatment where good (<10% of sites), moderate (10-20%) and poor (>20%) treatment outcome (TxO) groups had probing depths of ≥5mm at study conclusion. IFN-γ+ cells were lower at baseline, 3- and 6-months compared to health, whereas Foxp3+ cells were increased at 12-months compared to all preceding timepoints and health. The good TxO group showed treatment-related variation in IFN-γ+ and Foxp3+ cells, whereas the poor TxO group did not. IFN-γ and IL-17 cytokine expression in cell-supernatants was significantly lower at baseline compared to health, and IFN-γ and IL-10 showed treatment-related decrease. This study suggests that IFN-γ+ and Foxp3+ cells may have a role in the systemic compartment in periodontitis. Periodontal management has local and systemic effects and thus, assessment and management of periodontitis should form an integral part of overall systemic health. |
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