Periodontal, bacteriological, immunological, and inflammatory parameters in the same subject

Objective: To evaluate the associations among clinical periodontal, bacteriological, immunological, and inflammatory mediator parameters in the same subject.

Methods: Selected periodontal pathogens in plaque, cervical, and vaginal samples (measured using DNA probes), serum IgG levels against these pathogens (measured using ELISA), and serum TNF-α, IL-6, IL-1β, IL-10, and CRP levels (Immulite^® chemiluminescent enzyme immunometric assay) were evaluated in 265 predominantly Hispanic pregnant women. Oral examination and plaque sample collection were performed around 18.2 weeks (SD=3.4) and serum and cervico-vaginal sample collection, around 17.9 weeks (SD=3.3).

Results: Vaginal levels of F.nucleatum ssp. nucleatum were higher (mean log₁₀=3.6; SE=0.3) in subjects with signs of clinical periodontal disease (measured using PSR) compared to those without clinical periodontal disease (mean log₁₀=3.1; SE=0.2; p=0.04). Similarly, cervical levels of A. actinomycetemcomitans were higher in women with clinical periodontal disease (mean log₁₀=3.5; SE=0.3 vs. mean log₁₀=2.97; SE=0.2; p=0.06) but was not statistically significant.

Furthermore, plaque levels of P. gingivalis were significantly correlated with TNF-α levels (r=0.17; p=0.009) and serum IgG levels against P.gingivalis (r=0.33; p<0.0001). Cervical levels of P. gingivalis were significantly correlated with both IL-6 (r=0.14; p=0.03) and CRP levels (r=0.15; p=0.03). Similarly, cervical levels of P. intermedia were significantly correlated with TNF-α (r=0.15; p=0.02) and IL-6 (r=0.18; p=0.0007) levels. Plaque levels of A. actinomycetemcomitans were significantly correlated with TNF-α (r=0.22; p=0.0009). Finally, cervical levels of A. actinomycetemcomitans were significantly correlated with the IgG levels against A. actinomycetemcomitans (r=0.32; p<0.0001), and plaque levels of P. intermedia samples were significantly correlated with IgG against P. intermedia (r=0.15; p=0.02).

Conclusion: As expected, some periodontal pathogen levels are correlated with clinical periodontal disease, levels of serum IgG, and cytokines. Further exploration of these correlations may shed light on the usefulness of these parameters in predicting pregnancy and neonatal outcomes. Supported by NIH/NIDCR RO1 DE 015594.