Abstract The relationship between periodontitis and the pathogenesis of other inflammatory diseases, such as diabetes, rheumatoid arthritis and obesity has been an important topic of study in recent decades. The Th17 pathway plays a significant role in how local inflammation can influence systemic inflammation in the absence of systemic pathology. Objective: To determine Th17 biased-cells in systemically healthy patients in the presence of generalized chronic periodontitis. Methodology: A total of 28 patients were recruited without systemic inflammatory pathology, which was determined by clinical history, the Health Assessment Questionnaire (HAQ) and rheumatoid factor detection. Of these patients, 13 were diagnosed as healthy/gingivitis (H/G) and 15 as generalized chronic periodontitis (GCP). Th17 (CD4+CD161+) cells and Th17IL23R+ (CD4+CD161+IL-23R+) cells were quantified by flow cytometry, based on the total cells and on the lymphocyte region, termed the “enriched population” (50,000 events for each). Results: The percentages of Th17 cells of the H/G and periodontitis groups were similar on total cells and enriched population (19 vs 21.8; p=4.134 and 19.6 vs 21.8; p=0.55). However, Th17IL23R+ cells differ significantly between periodontally healthy patients and generalized chronic periodontitis patients in both total cell (0.22% vs 0.65%; p=0.0004) and enriched populations (0.2% vs 0.75%; p=0.0266). Conclusions: GCP patients (otherwise systemically healthy) were characterized by increased Th17-proinflammatory cell phenotype positive for the IL-23 receptor in peripheral blood. The proportion of Th17 cells that are negative for the IL-23 receptor in the peripheral blood of systemically healthy patients seemed to be unaffected by the presence or absence of chronic periodontitis.

Dental caries is an infectious disease which still constitutes a public health concern. It begins at an early age and is caused mainly Streptococcus mutans (S. mutans). The aim of this study was to characterize the salivary humor immune response to S. mutans proteins in patients with caries, with history of caries and without caries, in order to determine which S. mutans proteins participate in the immunological response in subjects with different caries experience. Saliva was collected by spontaneous salivation for 5 minutes from 60 subjects aged 18 to 30 years, classified according to their caries experience as: without caries (Group I), with active caries (Group II) and with history of caries (Group III). The antigens derived from S. mutans by sonication were recognized by salivary IgA and IgG by Western Blot. The results showed that all the individuals studied recognized S. mutans proteins with molecular weights in the range of 8 to 191 kDa, with similar recognition profiles for salivary IgA and IgG. Subjects without caries recognized the 29 kDa protein, also known as S. mutans Antigen A, via salivary IgA, differing from patients with caries and history of caries, who recognized it via IgG. The protective response against S. mutans is mediated by IgA. To conclude, a differential response to the 29 kDa protein between study individuals may be indicative of resistance to dental caries and may have a protective role in the induction of IgA antibodies against dental caries, as found in the group without caries, in contrast to subjects with active caries and history of caries.

La caries dental es una enfermedad infecciosa que continua siendo un problema de salud publica, inicia a temprana edad y es causada principalmente por Streptococcus mutans (S. mutans). El objetivo de este estudio fue caracterizar la respuesta inmune humoral salival, ante las proteinas de S. mutans, en pacientes con caries, historia de caries e individuos libres de caries, para asi establecer que proteinas de S. mutans participan en la respuesta inmunologica en los diferentes estadios de caries. La saliva de 60 individuos entre 18 y 30 anos de edad, clasificados de acuerdo al estado de caries: libres de caries (grupo I), caries activa (grupo II) e historia de caries (grupo III), se colecto por salivacion espontanea durante 5 minutos. Los antigenos derivados de S. mutans por sonicacion, fueron reconocidos por IgA e IgG salivales por Western Blot. Los resultados mostraron que todos los individuos estudiados reconocen las proteinas de S. mutans en el rango de 8 a 191 kDa de peso molecular con perfiles de reconocimiento similares para IgA e IgG salival. Se encontro que los sujetos libres de caries reconocen por IgA salival la proteina de 29 kDa, tambien llamada Antigeno A de S. mutans, de manera diferente que los pacientes con caries e historia de caries quienes reconocieron la proteina via IgG. La respuesta protectora frente a S. mutans es mediada por IgA. En conclusion, una respuesta diferencial a la proteina de 29 kDa entre los individuos estudiados, puede ser indicativo de resistencia a la caries dental y tener un papel protector en la induccion de anticuerpos IgA frente a la caries dental, como se encontro en el grupo libre de caries, a diferencia de los sujetos con historia de caries y caries activa.

The aim of this study was to measure the level of immunoglobulin A, G and M in saliva of 3- to 12-year-old children, both healthy and diagnosed with gingivitis. Methods: A sample of 177 children was selected, of whom 24 were healthy and 153 were diagnosed with gingivitis according to Loe´s index. Samples of saliva were taken and the ELISA test was applied to obtain the immunoglobulin concentrations expressed in μg/ml. A relationship was established between the immunoglobulin levels, the disease (gingival index) and Loe´s bacterial plaque index. IgG levels were higher in healthy children. In the group with gingivitis, 95.8% of the children had incipient gingivitis with a low average index of bacterial plaque (1.33). A direct correlation was found between age and gingival index, while an inverse correlation was found between age and bacterial plaque index. The analysis of the behavior of immunoglobulin according to age showed that age was only significantly correlated to IgA levels. The analysis comparing immunoglobulin levels and clinical parameters for gingivitis showed a direct correlation between gingival index and IgM. The gingival index was found that to increase with the age of the subject, even though bacterial plaque decreases. It was also found that age is a better predictor of IgA level than gingival index and bacterial plaque index are; and that gingival index is a better predictor of IgM level than age and bacterial plaque index are.

El objetivo de este estudio fue cuantificar los niveles de inmunoglobulinas A, G y M en saliva de ninos entre 3 - 12 años sanos y con gingivitis. Metodos: la muestra fue de 177 ninos distribuidos en dos grupos: 24 sanos y 153 con diagnostico de gingivitis segun el indice de Loe a quienes se les tomaron muestras de saliva y por medio de la prueba de ELISA se obtuvieron las concentraciones de las inmunoglobulinas expresadas en μg/ml. Resultados: Se encontro que en la saliva de los ninos sanos los niveles de IgG son significativamente mayores que en los ninos con gingivitis. El grupo gingivitis estuvo conformado por un 95.8% de ninos con diagnostico de gingivitis incipiente que presento un promedio bajo de indice de placa bacteriana. Al hacer analisis de correlacion entre las variables estudiadas, se encontro una correlacion directa entre la edad y el indice gingival, una correlacion inversa entre la edad y el indice de placa bacteriana, correlacion directa entre los niveles de IgA y la edad y correlacion directa entre el indice gingival y la IgM. Conclusiones: Se encontro que en la medida en que el individuo crece aumenta el indice gingival, aunque se presenta menor cantidad de placa bacteriana. Tambien se concluyo que la edad es mejor predictor de los niveles de IgA que el indice gingival y el indice de placa bacteriana y que el indice gingival es mejor predictor de los niveles de IgM que la edad y el indice de placa bacteriana.