Toll-like receptor-4 activation by subgingival biofilm and periodontal treatment response

Ren Jie Jacob Chew, Yi Ling Tang, Xin Yi Sheena Lin, Feng Jun Bryan Oh, Ruiqi Paul Sim, Erica Jade Anwar, Philip M. Preshaw (Lead / Corresponding author), Kai Soo Tan (Lead / Corresponding author)

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1 Citation (Scopus)
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Abstract

Objectives: This study aims to investigate longitudinally the activation of Toll-like receptor-4 (TLR-4) by subgingival biofilm samples before and after nonsurgical periodontal therapy (NSPT). 

Materials and methods: Forty periodontitis patients received NSPT and were reviewed 3 and 6 months post-treatment. Subgingival biofilm was sampled from 4 teeth per patient, at baseline and each follow-up time point. TLR-4 activation was determined using the HEK-BLUE™/hTLR4 system. Changes in TLR-4 activation and probing pocket depths (PPDs) were evaluated using generalised linear models, and the association between TLR-4 activation and pocket reduction (defined as 6-month PPDs ≤ 3mm) was determined using generalised estimating equations. 

Results: At 6 months, the mean TLR-4 activation by subgingival biofilm samples was significantly reduced from 11.2AU (95%CI 7.1AU, 15.4AU) to 3.6AU (95%CI 2.3AU, 4.8AU, p < 0.001), paralleling significant reductions in mean PPDs at sampled sites. The response to NSPT was associated with longitudinal TLR-4 activation profiles, with significantly higher TLR-4 activation by subgingival biofilm obtained from sites that did not achieve pocket reduction, compared to sites at which pocket reduction was achieved. 

Conclusions: The activation of TLR-4 by subgingival biofilm samples was reduced after NSPT, and this reduction was significantly associated with the clinical improvements (PPD reductions) at sampled sites. Clinical relevance: This study demonstrated an association between the longitudinal profile of TLR-4 activation by subgingival biofilm and periodontal treatment response. Longitudinal monitoring of TLR-4 activation by subgingival biofilm may potentially identify non-responsive sites, enabling targeted additional treatment.

Clinical relevance: This study demonstrated an association between the longitudinal profile of TLR-4 activation by subgingival biofilm and periodontal treatment response. Longitudinal monitoring of TLR-4 activation by subgingival biofilm may potentially identify non-responsive sites, enabling targeted additional treatment.

Original languageEnglish
Pages (from-to)2139–2147
Number of pages9
JournalClinical Oral Investigations
Volume27
Early online date31 Jan 2023
DOIs
Publication statusPublished - May 2023

Keywords

  • Biomarkers
  • Endotoxins
  • Lipopolysaccharides
  • Periodontal debridement
  • Periodontitis

ASJC Scopus subject areas

  • General Dentistry

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