Irwandi Rizky A, Kuswandani Sandra O, Harden Simon, Marletta Debora, D'Aiuto Francesco
Periodontology Unit, Eastman Dental Institute, University College London, London, United Kingdom.
Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia.
J Leukoc Biol. 2022 May;111(5):1069-1096. doi: 10.1002/JLB.5RU1021-524R. Epub 2022 Feb 24.
Inflammation is a key driver of common noncommunicable diseases. Among common triggers of inflammation, chronic gingival inflammation (periodontitis) triggers a consistent humoral host inflammatory response, but little is known on its impact on circulating inflammatory cell profiles. We aimed to systematically appraise all the evidence linking periodontitis and its treatment to circulating inflammatory cell profiles. From 6 databases, 157 studies were eligible for qualitative synthesis and 29 studies for meta-analysis. Our meta-analysis showed that participants with periodontitis exhibited a significant mean increase in circulating CD4 , CD4 CD45RO , IFNγ-expressing CD4 and CD8 T cells, CD19 CD27 and CD5 B cells, CD14 CD16 monocytes, and CD16 neutrophils but decrease in CD8 T and CD14 CD16 monocytes. Our qualitative synthesis revealed that peripheral blood neutrophils of patients with periodontitis consistently showed elevated production of reactive oxygen species (ROS) when compared with those of healthy controls. Some evidence suggested that the treatment of periodontitis reversed the exaggerated ROS production, but limited and inconclusive data were found on several circulating inflammatory cell profiling. We conclude that periodontitis and its treatment are associated with minor but consistent alterations in circulating inflammatory cell profiles. These changes could represent key mechanisms explaining the association of periodontitis with other comorbidities such as cardiovascular disease, diabetes, and rheumatoid arthritis.
炎症是常见非传染性疾病的关键驱动因素。在常见的炎症触发因素中，慢性牙龈炎症（牙周炎）会引发持续的体液性宿主炎症反应，但关于其对循环炎症细胞谱的影响却知之甚少。我们旨在系统评估所有将牙周炎及其治疗与循环炎症细胞谱联系起来的证据。从6个数据库中，有157项研究符合定性综合分析的条件，29项研究符合荟萃分析的条件。我们的荟萃分析表明，患有牙周炎的参与者循环中的CD4、CD4 CD45RO、表达IFNγ的CD4和CD8 T细胞、CD19 CD27和CD5 B细胞、CD14 CD16单核细胞以及CD16中性粒细胞的平均水平显著升高，但CD8 T细胞和CD14 CD16单核细胞水平降低。我们的定性综合分析显示，与健康对照者相比，牙周炎患者外周血中性粒细胞产生活性氧（ROS）的水平持续升高。一些证据表明，牙周炎的治疗可逆转ROS产生的过度现象，但在几种循环炎症细胞谱方面发现的数据有限且尚无定论。我们得出结论，牙周炎及其治疗与循环炎症细胞谱的微小但一致的变化有关。这些变化可能代表了解释牙周炎与其他合并症（如心血管疾病、糖尿病和类风湿性关节炎）之间关联的关键机制。
