n-3 PUFA Effects on Local and Systemic Host Responses

Local and systemic inflammatory responses are coupled with the chronic infection and disease processes of periodontitis. While the oral microbial biofilms clearly trigger this inflammatory response, recent studies have suggested that variations in disease expression may be more related to differences in the characteristics of host responses to this microbial challenge. Dietary supplementation with n-3 PUFA has been shown to significantly alter chronic inflammatory diseases such as rheumatoid arthritis and inflammatory bowel disease. Objective: This report describes local (gingival crevicular fluid; GCF) and systemic inflammatory and immune responses in periodontitis patients treated with n-3 PUFA. Methods: A double-blind randomized controlled trial with 4 groups of patients: (1) oral hygiene instruction + placebo; (2) OHI + PUFA; (3) scaling/root planing + placebo; (4) S/RP + PUFA. GCF and serum were collected at baseline, 8, 16 and 28 weeks of the study. Mediators included: GCF (IgG, PGE₂, IL-1Β, IL-6, IL-8); Serum (Isoprostane, MMP-1,2,9, SAP, CRP, BPI, LBP, IgG antibodies). Results: In GCF, IgG, PGE₂, and IL-1Β were generally unaffected by any of the treatments. However, both IL-6 and IL-8 increased significantly in Grp 1 & 2, while S/RP without (Grp 3) or with PUFA (Grp 4) kept these inflammatory mediators at baseline levels. Serum results demonstrated MMP-2, MMP-9, SAP, and LBP were decreased in treated groups vs. Grp 1. Conclusions: The findings support that local and systemic host responses are affected by periodontal therapy. In this initial evaluation, it appeared that PUFA administration supports the effects of S/RP, although PUFA with only oral hygiene instruction provided minimal benefit. Support by NCRR grant P20 RR020145.