Heterogeneity of systemic inflammatory responses to periodontal therapy.
OBJECTIVE
We investigated the effect of comprehensive periodontal therapy on the levels of multiple systemic inflammatory biomarkers.


METHODS
Thirty patients with severe periodontitis received comprehensive periodontal therapy within a 6-week period. Blood samples were obtained at: 1-week pre-therapy (T1), therapy initiation (T2), treatment completion (T3), and 4 weeks thereafter (T4). We assessed the plasma concentrations of 19 biomarkers using multiplex assays, and serum IgG antibodies to periodontal bacteria using checkerboard immunoblotting. At T2 and T4, dental plaque samples were analysed using checkerboard hybridizations.


RESULTS
At T3, PAI-1, sE-selectin, sVCAM-1, MMP-9, myeloperoxidase, and a composite summary inflammatory score (SIS) were significantly reduced. However, only sE-selectin, sICAM, and serum amyloid P sustained a reduction at T4. Responses were highly variable: analyses of SIS slopes between baseline and T4 showed that approximately 1/3 and 1/4 of the patients experienced a marked reduction and a pronounced increase in systemic inflammation, respectively, while the remainder were seemingly unchanged. Changes in inflammatory markers correlated poorly with clinical, microbiological and serological markers of periodontitis.


CONCLUSIONS
Periodontal therapy resulted in an overall reduction of systemic inflammation, but the responses were inconsistent across subjects and largely not sustainable. The determinants of this substantial heterogeneity need to be explored further.
Division of Periodontics, Section of Oral and Diagnostic Sciences, Columbia University College of Dental Medicine, New York, NY 10032, USA.
Jan H
JH
Behle
Michael H
MH
Sedaghatfar
Ryan T
RT
Demmer
Dana L
DL
Wolf
Romanita
R
Celenti
Moritz
M
Kebschull
Paul B
PB
Belusko
Miriam
M
Herrera-Abreu
Evanthia
E
Lalla
Panos N
PN
Papapanou
D052242:Adiponectin / Q000097:blood; D000293:Adolescent; D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000097:blood / Q000601:surgery / Q000628:therapy; D000907:Antibodies, Bacterial / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000097:blood*; D003773:Dental Plaque / Q000382:microbiology; D012534:Dental Scaling; D019040:E-Selectin / Q000097:blood; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood*; D018836:Inflammation Mediators / Q000097:blood*; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D007378:Interleukins / Q000097:blood; D016014:Linear Models; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood; D008875:Middle Aged; D009910:Oral Hygiene / Q000193:education; D010518:Periodontitis / Q000097:blood* / Q000601:surgery / Q000628:therapy*; D009195:Peroxidase / Q000097:blood; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D011446:Prospective Studies; D000683:Serum Amyloid P-Component / Q000032:analysis; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood; D055815:Young Adult
D052242:Adiponectin; D000907:Antibodies, Bacterial; D019040:E-Selectin; D018836:Inflammation Mediators; D007378:Interleukins; D017395:Plasminogen Activator Inhibitor 1; D000683:Serum Amyloid P-Component; D014409:Tumor Necrosis Factor-alpha; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein; D009195:Peroxidase; D020780:Matrix Metalloproteinase 9