Publication

Abstract : Circulating GITR Positive Cell Levels Are Affected In Periodontal Disease Although periodontal disease has been shown to affect the systemic inflammatory state (increased CRP levels, increased leukocyte counts, increase in circulating IL-1, IL-6, TNF-α levels have been reported), its influence on the anti-inflammatory/suppressive immune mechanisms are less well documented. Objective: To identify the levels of Glucocorticoid-Induced TNF-R family related gene (GITR) positive regulatory T cells among the circulating lymphocytes in periodontal health and disease and to correlate this with the non specific inflammatory marker - hs-CRP Materials & methods: Peripheral blood samples were collected from 33 patients (Periodontal health n= 16; Periodontal disease n=17) using venepuncture from the antecubital fossa and dispensed in vaccutainers containing EDTA. Lymphocyte separation was performed using Histopaque-1077 and adequate centrifugation. Cells were Fc blocked (human IgG) and then subjected to fluroscein conjugated anti human GITR antibody, following which flow cytometry analysis (excitation wavelength =488nm) was performed. hs-CRP levels were estimated using standard protocol. Results were analysed statistically using student t test. Results: There was a significant increase in hs-CRP levels in periodontal disease when compared to health (2.22 1.12 vs. 1.17 0.93, p<0.05) .There was a marginal statistically insignificant increase in lymphocyte count in periodontal disease when compared to health. ((3.10.3) x106 vs. (3.00.4) x106, p>0.05) .The mean GITR positive cells was elevated but not significantly so in periodontal disease when compared to health (3, 01,746 1, 21,766 vs. 2, 28,925 86,548 p>0.05 ). Levels of GITR positive regulatory cells correlated well with lymphocyte count but did not correlate with hs-CRP levels Conclusion: The counterbalancing regulatory mechanisms have to be thoroughly investigated before the influence of periodontal disease on the systemic inflammatory state can be fully appreciated.