Periodontitis and Inflammation: Study on Biological Samples
- Conditions
- Periodontitis
- Interventions
- Other: Biological sampling in Control CaseOther: Biological sampling in Gingivitis CaseOther: Biological sampling in Periodontitis Case
- Registration Number
- NCT06012019
- Lead Sponsor
- Assistance Publique - Hôpitaux de Paris
- Brief Summary
Periodontitis is a major public health problem because it is widespread in the adult population. It leads to the irreversible destruction of the anchoring tissues of the teeth, and represents a modifiable risk factor for systemic inflammatory pathologies. This chronic inflammatory disease, which is associated with oral dysbiosis involving Porphyromonas gingivalis, is triggered by a permissive immune response. It is preceded by a reversible clinical phase, during which there is no bone resorption process: gingivitis. The understanding of the key mechanisms involved in the evolution from gingivitis to periodontitis, which will allow to early identify patient at risk of periodontitis, remain unclear at this time.
Neutrophils are the main cells of inflammation present within the periodontal pockets. The excess of certain neutrophils or the alteration of their functions is associated with the triggering of periodontitis, whereas their activity, finely orchestrated, would be a key to periodontal homeostasis. It is likely that some periodontal bacteria, including P. gingivalis, but also products of matrix catabolism could deregulate the physiological functions of neutrophils towards pro-inflammatory and catabolic profiles. Moreover, to date, the differentiation and role of neutrophil subsets in periodontal homeostasis as well as in gingivitis and its evolution into periodontitis remain poorly studied.
The investigators hypothesize that various subsets of neutrophils may play different roles during the development of periodontitis (evolution of gingivitis to periodontitis).
The primary objective is to characterize neutrophil subtypes associated with periodontal destruction during periodontitis.
Secondary objectives are :
1. Identify specific interactions of tissue-activated neutrophils with the matrix microenvironment during periodontitis
2. Identify specific interactions of tissue or oral (salivary) activated neutrophils with the oral microbiota during periodontitis
3. Identify specific oral (salivary) neutrophil subtypes in periodontal health, gingivitis and periodontitis
4. Evaluate the function, including pro-osteoclastogenic function, of oral neutrophils compared to blood neutrophils stimulated by infection
- Detailed Description
It's a cross-sectional, monocenter prospective, open-label, non randomized case control study to collect tissue, crevicular, salivary, and serum samples as part of the patient's routine care in oral medicine departments to form a biological collection. The samples and the clinical data of the patients.
Patients will be recruited in the oral medicine departments of AP-HP Charles Foix hospital (Ivry/seine) by periodontists in three groups (Cases : Group 1 : Gingivitis, Group 2 : Periodontitis, and Controls = healthy periodontium. All patients will require surgical care).
The time-line of the research is consistent with the usual patient management in oral medicine departments. Inclusion period is 36 months. There is no specific follow-up due to the research. Gingival tissue sampling during surgery of patients will be performed after their inclusion.
Assessment Criteria :
1. Neutrophil subtypes analysis based on co-expression of neutrophil function markers from a panel of 24 markers by imaging on sections.
2. Identification by immunohistofluorescence (on tissues) of the expression of matrix proteins described as regulating neutrophil function, and search of co-location between these proteins and certain neutrophil subtypes.
3. Identification by immunohistofluorescence (on tissue) of key bacteria of oral dysbiosis in periodontitis, and search for co-localization between these bacteria and certain neutrophil subtypes.
4. Assessment of neutrophil sub-types present in the patient's saliva and study of the correlation within tissue neutrophils during periodontal health, gingivitis and periodontitis.
5. Differentiation and activity of osteoclasts in co-culture with isolated oral /blood neutrophils in patients.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 60
Common criteria for all patient groups
- Patient > 18 years old
- Patient affiliated to a national health insurance
- Patient who speaks and understands French well enough to be able to read and understand the study information note.
- Patient who does not object to his participation in the study
Specific Criteria :
- Control Group = BOP < 10%, PI<20%, PD≤ 3mm
- Gingivitis cases = BOP ≥ 10%, PD≤ 3mm
- Periodontitis cases = BOP ≥ 10%, PD> 3mm
- Patients who have received antibiotic prophylaxis, antibiotic therapy, or anti-inflammatory treatment within 3 months prior to inclusion
- Pregnant or breastfeeding women
- Patients suffering from a disease with defective neutrophil number, activity, activation or function
- Patient deprived of liberty by judicial or administrative decision.
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Control Biological sampling in Control Case BOP \< 10%, PI \< 20%, PD≤ 3mm Patients with gingival health on intact or reduced periodontium without a history of periodontitis and requiring surgical care such as dental avulsion or aesthetic surgeries Gingivitis Cases Biological sampling in Gingivitis Case BOP ≥ 10%, PD≤ 3mm according to Chicago 2017 Patients requiring surgical care such as dental avulsion or pre-prosthetic periodontal surgeries Periodontitis Cases Biological sampling in Periodontitis Case Patients with stage 3 or 4 periodontitis (Chicago 2017) ; BOP ≥ 10%, PD≥ 4mm Patients requiring surgical care such as dental avulsion or pre-prosthetic periodontal surgeries
- Primary Outcome Measures
Name Time Method Description of neutrophil subtypes associated with periodontal destruction in periodontitis based on coexpression of markers of neutrophil function . 36 months Distinction of neutrophil subtypes based on coexpression of markers of neutrophil function from a panel of 24 markers by imaging on tissue sections
- Secondary Outcome Measures
Name Time Method Evaluate the differenciation, particularly proosteoclastogenic, of oral neutrophils, in comparison with blood neutrophils, stimulated by infection using morphological criteria like the number of nuclei and cell size 36 months osteoclast differentiation will be analyzed using morphological criteria, like the number of nuclei
Evaluate the activity, particularly proosteoclastogenic, of oral neutrophils, in comparison with blood neutrophils, stimulated by infection, using functional criteria such as expression of activity markers by Trap staining 36 months Osteoclast activity will be assessed by functional criteria such as expression of activity markers (Trap staining)
Describe oral (salivary) neutrophil subtypes during periodontal health, gingivitis and periodontitis based on coexpression of markers of neutrophil function. 36 months Evaluation of neutrophil subtypes present in patient saliva and study of correlation with tissue neutrophils during periodontal health, gingivitis and periodontitis
Evaluate the activity, particularly proosteoclastogenic, of oral neutrophils, in comparison with blood neutrophils, stimulated by infection, using functional criteria such as resorption activity (size of lacunae formed by the cells on culture dishes) 36 months Osteoclast activity will be assessed by functional criteria such as resorption activity (size of lacunae formed by the cells on specific culture dishes)
Identify interactions of activated tissue or oral neutrophils with the oral microbiota using Immunohistofluorescence identification of key bacteria and investigation of co-localization between bacteria and certain subtypes of neutrophils 36 months Immunohistofluorescence identification (on tissue) of key bacteria in oral dysbiosis during periodontitis and investigation of co-localization between bacteria and certain subtypes of neutrophils
Evaluate the differenciation, particularly proosteoclastogenic, of oral neutrophils, in comparison with blood neutrophils, stimulated by infection using morphological criteria like the cell size 36 months osteoclast differentiation will be analyzed using morphological criteria, like cell size
Identify specific interactions of activated tissue neutrophils with the matrix microenvironment during periodontitis using Immunohistofluorescence identification of the expression of some matrix proteins. 36 months Immunohistofluorescence identification (on tissue) of the expression of matrix proteins described as regulators of neutrophil function, and search for co-localization between said proteins/peptides and certain subtypes of neutrophils
Trial Locations
- Locations (1)
Charles-Foix Hospital
🇫🇷Ivry-sur-Seine, France