Department of Periodontology, School of Dentistry, Lille University Hospital, Lille, France.
Laboratory of Stress Immunity Pathogens, EA 7300, Faculty of Medicine, University of Lorraine, Vandoeuvre-lès-Nancy, France.
J Clin Periodontol. 2020 Sep;47(9):1064-1078. doi: 10.1111/jcpe.13339. Epub 2020 Jul 20.
The immune receptor triggering receptor expressed on myeloid cell-1 (TREM-1) is responsible for an amplification of the immuno-inflammatory response in inflammatory diseases. Its role in the aetiopathogenesis of periodontitis is underexplored. The aim of this case-control and before-after study was to determine the evolution of soluble form of TREM-1 (sTREM-1) concentrations after scaling and root planing (SRP), and its prognostic value and evaluate associated microbial, periodontal and psychosocial factors.
Gingival crevicular fluid was collected in two pathological sites (periodontal pocket depth (PPD) ≥ 5 mm) and one healthy site (PPD ≤ 3 mm) from thirty periodontitis patients (before/after SRP), and in one healthy site from thirty controls (patients without periodontal disease). Each patient filled-in stress/anxiety self-assessment questionnaires and provided a saliva sample. Diseased patients were followed for a total of 13-15 weeks in initial periodontal treatment. sTREM-1 and salivary cortisol levels were determined by ELISA and periodontopathogens by PCR.
Before SRP, higher crevicular sTREM-1 levels were positively associated with some increased clinical parameters (Plaque Index, tooth mobility, bleeding on probing, p < .05) and inversely with Aggregatibacter actinomycetemcomitans abundance (p = .03). No correlation with psychological factors nor cortisol was found with salivary sTREM-1 concentrations. After SRP, crevicular sTREM-1 levels decreased (p < .001) and were not linked to a PPD decrease but remained higher in pathological than in healthy sites (p < .001). Higher concentrations were also found out in unimproved sites (no change or increase in PPD) compared to improved ones (p = .02). Higher sTREM-1 levels were associated with Porphyromonas gingivalis, Treponema denticola and Campylobacter rectus in pathological sites after SRP (p < .05).
Crevicular sTREM-1 level decreased after SRP but did not appear to be a site outcome predictive factor of periodontal healing and remained an inflammatory parameter.
髓系细胞表达的触发受体-1（TREM-1）负责放大炎症性疾病中的免疫炎症反应。其在牙周炎发病机制中的作用尚未得到充分探索。本病例对照和前后对照研究的目的是确定牙周基础治疗（SRP）后可溶性 TREM-1（sTREM-1）浓度的变化及其预后价值，并评估相关的微生物、牙周和社会心理因素。
从 30 名牙周炎患者（SRP 前后）的两个病变部位（牙周袋深度（PPD）≥5mm）和一个健康部位（PPD≤3mm）采集龈沟液，从 30 名对照者（无牙周病患者）的一个健康部位采集龈沟液。每位患者填写压力/焦虑自评问卷，并提供唾液样本。在初始牙周治疗中，患病患者总共随访了 13-15 周。通过 ELISA 测定 sTREM-1 和唾液皮质醇水平，通过 PCR 测定牙周病原体。
在 SRP 之前，较高的龈沟液 sTREM-1 水平与某些增加的临床参数呈正相关（菌斑指数、牙齿松动度、探诊出血，p<.05），与伴放线放线杆菌丰度呈负相关（p=.03）。龈沟液 sTREM-1 浓度与心理因素或皮质醇均无相关性。SRP 后，龈沟液 sTREM-1 水平降低（p<.001），与 PPD 减少无关，但在病变部位仍高于健康部位（p<.001）。与改善部位（PPD 无变化或增加）相比，未改善部位（PPD 无改善或增加）的 sTREM-1 浓度也较高（p=.02）。SRP 后，病变部位 sTREM-1 水平较高与牙龈卟啉单胞菌、齿密螺旋体和直肠弯曲杆菌相关（p<.05）。
SRP 后龈沟液 sTREM-1 水平降低，但似乎不是牙周愈合的部位结局预测因子，仍是炎症参数。
