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Journal Article Systematic Review Ppublish 33 citations

PubMed: 30474205 DOI: 10.1111/jre.12629

The therapeutic potential of regulatory T lymphocytes in periodontitis: A systematic review.

J Periodontal Res 54(3):207-217

Authors: Emilio Alfredo Cafferata, Alfredo Jerez, Rolando Vernal, Gustavo Monasterio, Nikolaos Pandis, Clovis M Faggion

Affiliations

  • Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.
  • Faculty of Dentistry, Universidad Peruana Cayetano Heredia, Lima, Perú.
  • Department of Oral Surgery, Section of Periodontology, School of Dentistry, Universidad de Concepción, Concepción, Chile.
  • Dentistry Unit, Faculty of Health Sciences, Universidad Autónoma de Chile, Santiago, Chile.
  • Department of Orthodontics and Dentofacial Orthopedics, Dental School/Medical Faculty, University of Bern, Bern, Switzerland.
  • Department of Periodontology and Operative Dentistry, Faculty of Dentistry, University of Münster, Münster, Germany.

Abstract

This systematic review aimed to: (a) generate a descriptive synthesis of preclinical studies assessing the therapeutic potential of regulatory T lymphocytes (Tregs) to arrest periodontitis, (b) evaluate the methodological heterogeneity of the reviewed animal studies and (c) assess the risk of bias (RoB) of the included studies. The electronic search for animal studies included the MEDLINE, EMBASE, Web of Science and LILACS databases. In addition, a manual search assessed the high-ranked scientific journals in "periodontics/immunology" and the references listed in the included studies. There were no language, year or publication status restrictions. Two independent reviewers selected and extracted the data, and Cohen's Kappa coefficient was calculated to determine the inter-examiner agreement. The Systematic Review Center for Laboratory Animal Experimentation's (SYRCLE) tool was used to assess the RoB. A total of 21 of the 425 studies obtained from the database search were included. Treg function was mainly described in Porphyromonas gingivalis-induced periodontitis (57.1%) in mice (76.2%), where Treg suppression was strongly related to disease progression and Treg induction was strongly related to immuno-inflammatory response reduction. Of those 21 studies, eight included eight animal experiments using three distinct therapeutic approaches, including: P. gingivalis-driven immunization (n = 3), retinoic acid inoculation (n = 2) and anti-inflammatory molecules in polymeric carriers (n = 3), which could modulate the Treg activity through cytokine production (interleukin-10 and transforming growth factor-β1), CC-chemokine- and CC-chemokine receptor-mediated chemoattraction (CCL22 and CCR4) or Th17-associated receptor activator of nuclear factor κB ligand (RANKL) downregulation. However, the studies with animal experiments did not specify the randomization sequences and housing conditions that were used, and therefore, 42.11% of the entries were rated as unclear RoB. Distinct therapeutic strategies involving Tregs could potentially suppress the immuno-inflammatory response and restore alveolar bone homeostasis during periodontitis. Nevertheless, important methodological variability, poor reporting of treatment effect estimates and unclear RoB suggest using caution when assessing the results of these studies.

MeSH

T-Lymphocytes, Regulatory, Chemokines, Lymphocytes, Therapeutics, Periodontitis, T-Lymphocytes, Animal Experimentation

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