Hyper inflammatory monocytes in chronic periodontitis and diabetes mellitus

Abstract

Monocyte subsets with low CD14 expression that co express CD16 are called nonclassic or hyperinflammatory monocytes Previous studies have reported an increase in the percentage of nonclassic monocytes in the peripheral blood of patients with chronic periodontitis To our knowledge there are no reports demonstrating the presence of nonclassic monocyte derived macrophages in the gingival tissue The analysis of monocyte subsets in peripheral blood revealed a decrease in the proportion of classic monocytes in patients with chronic periodontitis compared with individuals with healthy gingiva Conversely the proportion of nonclassic monocytes increased in patients with chronic periodontitis The analysis of gingival tissue from individuals of both groups revealed an increase in the proportion of nonclassic monocyte derived macrophages in patients with chronic periodontitis The proportion of classic macrophages was found to be decreased in patients with chronic periodontitis compared with healthy controls It was observed that type 2 diabetes mellitus patients with poor glycemic control and chronic periodontitis showed more than two fold increase in the proportion of non classical monocytes compared to type 2 diabetes mellitus patients with good glycemic control. Further a positive correlation between HbA1c levels and the proportion of nonclassic monocytes was observed In the invitro study expression of TLR4 key innate immune system receptor was observed higher under high glucose conditions compared to low glucose conditions An up regulation of proinflammatory cytokines TNF alpha and IL1 beta and receptors NOD 1 NOD 2 and a down regulation of SOCS 3 in all the groups compared to control newline