Soluble Triggering Receptor Expressed on Myeloid Cells 1 (sTREM-1) in Gingival Crevicular Fluid: Association With Clinical and Microbiologic Parameters

• Localización: Journal of periodontology, ISSN 0022-3492, Nº. 1, 2014, págs. 204-210
• Idioma: inglés
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• Resumen

  • Background: Soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) belongs to the immunoglobulin superfamily and is involved in amplification of the inflammatory response to bacterial infection. This cross-sectional study aims to investigate the levels of sTREM-1 in gingival crevicular fluid (GCF) of individuals without periodontitis and with chronic periodontitis (CP) or generalized aggressive periodontitis (GAgP) and their association with the levels of key periodontal pathogens in subgingival plaque.

    Methods: GCF and subgingival plaque samples were obtained from healthy sites of participants without periodontitis (n = 20) and periodontitis sites of patients with CP (n = 22) and GAgP (n = 20). sTREM-1 levels in GCF were measured by enzyme-linked immunosorbent assay. Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, and Aggregatibacter actinomycetemcomitans levels in subgingival plaque were analyzed by quantitative real-time polymerase chain reaction.

    Results: sTREM-1 levels in GCF were higher in CP and GAgP than healthy sites by 3.6- and 4.4-fold, respectively, with no significant differences between the two forms of periodontitis. Moreover, sTREM-1 levels in GCF were positively correlated with site-specific clinical periodontal parameters and levels of P. gingivalis, T. denticola, and T. forsythia, but not A. actinomycetemcomitans, in subgingival plaque.

    Conclusion: Increased GCF levels of sTREM-1 at diseased sites and their positive correlation with clinical and microbiologic parameters strengthen the association of this inflammatory marker with periodontitis.

    Triggering receptor expressed on myeloid cells 1 (TREM-1), a receptor belonging to the immunoglobulin superfamily, is produced and released during the course of systemic infections,1 such as septic shock and pneumonia.2-7 To date, the role of TREM-1 in innate immunity is postulated to be regulation of the magnitude of the inflammatory response to bacterial challenge, eventually leading to enhanced proinflammatory cytokine production.8,9 Characteristically, during the course of systemic infection, TREM-1 is released from the membrane-bound form to its soluble form (sTREM-1). Because of this property, it serves as a biomarker of systemic inflammation in systemic sepsis,4,10 arthritis,7 pulmonary infection,3 pancreatitis,11 and inflammatory bowel disease.12 Periodontal disease entails the inflammatory destruction of the periodontal tissues, caused by the development of a subgingival biofilm. Most highly associated with the disease are the three red-complex species, namely, Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola,13 as well as Aggregatibacter actinomycetemcomitans,14 which is predominant in aggressive forms of the disease. Recent in vitro studies have shown that P. gingivalis can stimulate TREM-1 production in monocytes, promoting a shift from its cell-membrane bound form into sTREM-1, which is also accompanied by propagation of proinflammatory cytokine production.15,16 Interestingly, these effects can be abolished in the presence of doxycycline.17 Recent clinical studies indicate that levels of sTREM-1 in gingival crevicular fluid (GCF) are higher at sites with periodontitis than healthy ones18 and in saliva of patients with periodontitis versus without periodontitis.19 Nevertheless, it is not clear whether differences in sTREM-1 GCF levels exist among different forms of periodontitis or whether there is any association with the levels of periodontal pathogens in subgingival plaque.

    The hypothesis of this study is that GCF sTREM-1 levels are increased in periodontitis and positively correlate with clinical and microbiologic parameters. Therefore, the aim of the study is to investigate GCF sTREM-1 levels in individuals without periodontitis and with chronic periodontitis (CP) or generalized aggressive periodontitis (GAgP) and evaluate their association with levels of the P. gingivalis, T. forsythia, T. denticola, and A. actinomycetemcomitans in subgingival plaque.