Monitoring Salivary Immune Profiles in Response to Nonsurgical Periodontal Therapy

Saliva is increasingly recognized as a valuable diagnostic fluid for monitoring oral health status due to its ease of non-invasive collection and rich biomarker content. Limited evidence exists regarding saliva’s ability to aid in assessing the immune activity in periodontal disease (PD) and its resolution. Precise immune subset identification associated with PD pathology may facilitate development of novel diagnostic or prognostic cellular markers. This study examined the prognostic value of saliva in periodontal disease progression in response to non-surgical therapy, by monitoring Myeloid (Macrophages/Monocytes) and Lymphoid (B Cells) immune subsets. This ex-vivo, case-control study focused on salivary immune profiling in human subjects before and after NSPT (n=29/group). Periodontally healthy (n=12) samples from age- and gender-matched controls were collected from subjects presenting for crown lengthening and soft tissue augmentation procedures. Clinical parameters including pocket probing depth (PPD), bleeding on probing (BOP), & plaque index (PI) were measured pre- & post-NSPT. Salivary immune cells were evaluated for flow cytometry and GCF cytokines were quantified by multiplex. Our results show significant reductions in the PPD (6.67x10-5), BOP (1.24x10-8), PI (3.05x10-5), and clinical parameters post-NSPT in PD subjects compared to healthy controls. Assessment of the cellular immune mediators revealed decreased levels of the M1 (CD11b+CD14+HLA-DR+IFNγ+) macrophages and IFNγ+CD19+ B cell populations in PD subjects following NSPT. On the contrary, higher levels of M2 macrophage (CD11b+CD14+HLA-DR+IL-10+) and CD19+IL-10 B regulatory cells was observed in post-NSPT. This correlates with the clinical parameters observed following NSPT. Overall, the reduction in the M1 macrophage and B cell subsets and the converse increase in the regulatory M2 macrophage and B cells correlates with the clinical improvement in periodontal disease. Therefore, saliva can provide relevant clinical information regarding the response of periodontal therapy.