Is immunesenescence a contributing factor for periodontal diseases?

Abstract

Current concept in periodontal diseases (PDs) states that it is the host's response toward the periodontal pathogens which leads to tissue destruction and attachment loss. Hence the role of immune response in the progression and resolution of PD must be considered vital. Any alteration in the immune system disturbs the homeostasis of the periodontium. Decline in immune system is the hallmark of aging, leading to increased susceptibility of elderly individuals to bacterial infections. The periodontal apparatus which is being constantly exposed to plaque biofilm is more vulnerable to destruction in aged individuals. Ageing related alterations in immune system has been discussed elsewhere as a contributor to various chronic inflammatory diseases like atherosclerosis, preterm, and low birth weight, etc. This paper reviews on the possible role of aging in periodontal destruction through altered immunity. Aging has long been associated with altered systemic inflammation. It has been discussed whether (1) this systemic inflammation is a consequence of increased occurrence of chronic inflammatory diseases upon aging or (2) aging associated systemic inflammation leads to such diseases. The immune responses which are protective at the first stages of life might result detrimental in the elderly. Hence it might be very difficult to individuate genetic profiles that might allow to identify individuals with a major risk for one or more age related diseases. Taking this into consideration, the cause of PDs in elderly is addressed with a systemic approach in order to understand the complex interplay between the aging immunity and PDs.

Variations in inflammatory genes are associated with periodontitis

“…For instance, epithelium thinning and diminished keratinization occur in aged gingival and cellular components of gingival connective tissue decrease with age. These functional and structural alterations in gingival tissues along with a decline of the immune responses may result in an increased susceptibility of the elderly to microbial infections [ 4 ].…”

“…The gingival fibroblasts being constantly affected by the oral bacteria and their products like lipopolysaccharide, release inflammatory cytokines like prostaglandin E2, interleukin (IL)-1-β, and plasminogen activator [ 3 , 4 ] and these pro-inflammatory compound and cytokines may contribute to periodontal destruction [ 23 , 24 ].…”

“…The periodontal apparatus is more vulnerable to destruction in aged individuals and immune senescence may contribute to periodontal disease of elderly [4]. …”

“…Moreover, a variable degree of decline in the immune system efficiency is associated with aging and leads to an increased susceptibility of infections in the elderly. The periodontal apparatus is more vulnerable to destruction in aged individuals and immune senescence may contribute to periodontal disease of elderly [ 4 ].…”

Transcriptome profiling analysis of senescent gingival fibroblasts in response to Fusobacterium nucleatum infection

“…The secreted cytokines then recruit immune cells to combat the infection [ 9 ] whereas the MMPs are associated with wound healing and tissue remodeling [ 10 ]. The susceptibility of GFs to bacterial infection is known to be affected by aging [ 8 , 11 , 12 ] and furthermore, the development and progression of periodontal disease is known to be significantly associated with aging [ 13 , 14 ].…”