Changes in Periodontal Parameters and Microbiome Composition of Periodontal Pocket in Patients with Chronic Inflammatory Diseases Receiving Targeted Anti-Cytokine Therapy

Abstract

Periodontitis is associated with systemic chronic inflammatory diseases. There is limited evidence on the influence of anti-cytokine therapies on the periodontal condition and microbiome in the tooth pocket of such patients, so the aim of this study was to elucidate this issue. In this observational trial, the periodontal status and the gingival crevicular fluid of 13 patients with different chronic inflammatory diseases were obtained before the initiation of anti-cytokine treatment and 14 weeks after. Gingival crevicular fluid was collected for 16S rRNA gene sequencing from a clinically healthy tooth and the deepest measured pocket. The Shannon Diversity Index significantly increased in the deepest pockets of patients (p = 0.039). The data showed alterations in the diversity of the subgingival microbiome over the course of the study, implying a shift towards a healthier condition after starting anti-cytokine therapy. Additional investigations are needed to analyze whether the administration of selective biologicals can improve periodontal conditions in patients with or without chronic inflammatory diseases.

Keywords: anti-cytokine therapy; chronic inflammation; microbiome; periodontitis.

Figure 1

Flowchart of study cohort.

Figure 2

Relative abundances of the core measurable microbiome. (a) From clinically healthy and (b) from deepest pockets at the first and second examinations. The transverse lines show the OTUs that occur separately from each other.

Figure 3

Alpha diversity (Shannon Index) for clinically healthy periodontal pockets (green) and deepest periodontal pockets (orange) of each patient at their first and second examinations * p < 0.05.

Figure 4

Principal coordinates analysis of the Jaccard Index for samples. (a) From clinically healthy pockets and (b) from clinically deepest measured pockets of the participants. The first study time point is shown in green, and the second time point after initiation of anti-cytokine therapy is shown in orange.