AUTHOR=Leira Yago , Fragkiskos Dimitrios , Orlandi Marco , Suvan Jeanie , Nibali Luigi , Tonetti Maurizio S. , Belibasakis Georgios N. , Bostanci Nagihan , D'Aiuto Francesco 

TITLE=Severe Periodontitis and Biomarkers of Bacterial Burden. Results From a Case-Control and Intervention Clinical Trial

JOURNAL=Frontiers in Oral Health

VOLUME=2

YEAR=2021

URL=https://www.frontiersin.org/journals/oral-health/articles/10.3389/froh.2021.615579

DOI=10.3389/froh.2021.615579

ISSN=2673-4842

ABSTRACT=<p><bold>Background and aims:</bold> Periodontitis is an inflammatory-infectious disease. Identifying markers of systemic exposure of periodontitis might be of interest to study its interaction with other conditions. Soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) is upregulated during bacterial infections. Our aim was therefore to investigate whether periodontitis and its treatment are associated with bacterial endotoxin and sTREM-1.</p><p><bold>Methods:</bold> Fifty patients with severe periodontitis and 50 age-matched controls were included in a case-control study (all never smokers). A secondary analysis of a previously published intervention study was performed, in which included 69 patients with severe periodontitis were randomized to receive either intensive (IPT) or control periodontal therapy (CPT) and monitored over 6 months. Serum levels of bacterial endotoxin and sTREM-1 were determined at one time point (case-control study) and at baseline, 1 day, 1 and 6 months after periodontal treatment (intervention study).</p><p><bold>Results:</bold> Severe periodontitis was associated with elevated circulating endotoxin levels when cases (22.9 ± 2.2 EU/ml) were compared to controls (3.6 ± 0.5 EU/ml, <italic>p</italic> &lt; 0.001) and with sTREM-1 levels (1302.6 ± 47.8 vs. 870.6 ± 62.0 pg/ml, <italic>p</italic> &lt; 0.001). A positive correlation was observed between sTREM-1 and endotoxin levels (<italic>r</italic> = 0.4, <italic>p</italic> &lt; 0.001). At 6 months after treatment, IPT significantly decreased serum levels of sTREM-1 compared to CPT (adjusted mean difference of 500.2 pg/ml, 95% CI: 18.9–981.4; <italic>p</italic> = 0.042). No substantial differences were noted in endotoxin levels at any time point after treatment between groups.</p><p><bold>Conclusions:</bold> Severe periodontitis is linked to increased circulating endotoxin and sTREM-1 levels and following IPT a reduction in sTREM-1 levels is observed.</p>