Cytokine Score Corresponds to Periodontal Inflammation Levels

Researchers at New York University (NYU) College of Dentistry have developed a simple score to describe the level of cytokines found in saliva, and they assert this score corresponds to the severity of periodontal inflammation. While more research is needed to test this approach, it could hold promise for measuring how well a patient responds to periodontal therapy, and also predict disease recurrence or detect ongoing inflammation related to systemic conditions.

“Periodontal inflammation is not just apparent upon examination, it is also reflected in the patient’s saliva,” reports Angela Kamer, DMD, MS, PhD, an associate professor in the Ashman Department of Periodontology and Implant Dentistry at NYU and the study’s senior author. Periodontal disease results from complex interactions within the oral microbiome, and gingival inflammation produces high levels of cytokines — small proteins that signal the immune system — especially pro-inflammatory cytokines, such as IL-8, IL-1β, IL-6 and TNFα. In comparison to other sites, cytokines found in saliva are relatively easy to measure, which led researchers to study whether salivary cytokine levels could serve as a marker of periodontal inflammation.

In their investigation, “Periodontal Inflamed Surface Area (PISA) Associates With Composites of Salivary Cytokines,” published in PLoS One, researchers evaluated gingival tissue and saliva in 67 adults who had some degree of periodontal disease, but were otherwise healthy. The saliva samples were analyzed to measure a range of both pro- and anti-inflammatory cytokines — including IL-1β, IL-6, IL-8, IL-13, TNF-α and IL-10 — and the resulting Cytokine Component Index and Composite Inflammatory Index were combined into a single score.

They found that PISA scores were significantly associated with the cytokine scores, independent of other factors, such as age, gender, smoking and body mass index. The authors, who note that higher salivary cytokine scores equate with more severe periodontal inflammation, caution that more research is needed to substantiate this theory. If the cytokine score is validated in larger and more diverse patient populations, they suggest this approach could be used to better understand the progression and recurrence of periodontitis, as well as its potential connection to various systemic diseases.