Expression of Regulatory T Cell and Related Interleukins in Gingivitis Versus Stage 3, Grade B Generalized Periodontitis: Synergy or Cacophony—A Cross-Sectional Study.

Aim: To raise “personalized periodontal diagnosis and prognosis” knowledge, Tregs, pro/anti-inflammatory interleukins (ILs) beside vitamin D-binding protein (VDBP) in serum and gingival cervical exudate of periodontally healthy individuals, plaque induced gingivitis, and stage 3, grade B periodontitis patients were evaluated. Materials and Methods: An observational trial of different periodontal statuses according to 2018 periodontal classification was established from 60 subjects segregated into three equivalent groups (control periodontally healthy, gingivitis, and stage 3, grade B periodontitis). Peripheral blood and gingival crevicular fluid (GCF) were collected, to get GCF samples, inserted paper point in the pocket of the patient's teeth then the samples were placed with phosphate-buffered saline in Eppendorf. The peripheral blood was collected in ethylenediaminetetraacetic acid coated vacutainer tubes. Frequency of CD4⁺ CD25^+High Tregs was detected using flow cytometry. Cytokines were measured using an enzyme-linked immunosorbent assay. Mann–Whitney U test analysis was manipulated to distinguish the statistical discrepancies. Pearson’s correlation coefficient test was utilized to tie in the studied parameters. Result: Frequency of CD4⁺ CD25^+High T cells were significantly ascendant in periodontitis than gingivitis and healthy (P ≤ 0.01; P = 0.04) and significantly superior in gingivitis than healthy (P = 0.01). There was no interdependence between systemic IL-21, IL-33, IL-22, IL-35, and the periodontal conditions except systemic VDBP, which significantly increased with the progression of the periodontal tissue inflammation. GCF compartments of IL-21, IL-33, and VDBP significantly increased with progression inflammation and GCF compartments of IL-22 and IL-35 significantly decreased with periodontal breakdown. Conclusion: Local increase of Treg is positively associated with increased local pro-inflammatory cytokines. This increment is more aggravated in periodontitis. Therefore, Tregs may have synergistic effects with periodontal disease progression. [ABSTRACT FROM AUTHOR]