Variation in the composition of gingival inflammatory cell infiltrates

Abstract

Biopsy specimens were taken at gingivectomy from 18 adult patients undergoing treatment for chronic marginal periodontitis. They were embedded so that the cut surface of the gingiva was parallel to the top of the block to obtain a comprehensive view in a transversal plane of the inflammatory cell infiltrate near the bottom of the pocket. Sections were stained with HES or with toluidine blue for histological description, and acid alpha-naphthyl acetate esterase (ANAE) was used to differentially stain T lymphocytes, plasma cells and monocytes/macrophages. Sections stained with HES showed that the density and size of the cell infiltrates varied along the circumference of a tooth over very short distances and on various surfaces on neighbouring teeth. Differential counts of cells stained for ANAE demonstrated great variation in the composition of the cell infiltrates, particularly along the pocket epithelium. The predominating ANAE positive cell type in this area was T lymphocytes, while in the central connective tissue, plasma cells predominated. There was no systematic covariation between the localization of the gingiva (i.e. mesial, facial, etc.) and the composition of the cell infiltrates. The local variation in the composition of the cellular infiltrate most likely reflects local variability in the noxious substances (i.e. plaque composition) within the periodontal pocket, and in the resulting local inflammatory response.

Oral and skin keratinocytes are stimulated to secrete monocyte chemoattractant protein‐1 by tumour necrosis factor‐α and interferon‐γ

“…Inflammatory mucocutaneous diseases are characterised, by the accumulation of different populations of leukocytes in the tissues. In conditions such as lichen planus, lichenoid reactions, psoriasis, graft-versus-host disease (17) and periodontal disease (18,19), monocytes together with T lymphocytes accumulate in the skin or oral mucosa. These leave the circulation to accumulate in the connective tissue and may invade the epidermis or epithelium.…”

“…Mononuclear cell infiltrates are also a feature of a number of oral mucosal conditions, including oral lichen planus (17) and periodontal disease (18,19). It is possible, as with the skin, that release of MCP-1 by keratinocytes plays an important role in recruiting this type of inflammatory infiltrate.…”

The gingival tissues: the architecture of periodontal protection

“…They are typically associated with the absence of a gingival pocket and its pocket epithelium and found irrespective of the gingival health status. Chronic inflammatory lesions characterizing experimentally induced or spontaneous gingivitis and periodontitis in adults display a distinctly different type of leukocyte accumulation, always dominated by B-lymphocytes and plasma cells (76,105,106,107,180), with some variations in size, density and composition "over relatively short distances along the soft tissue wall of the periodontal pocket" (77).…”

The changes in T lymphocyte subsets following periodontal treatment in patients with chronic periodontitis

“…Although there are many studies dealing with diseases affecting the oral cavity and T-lymphocyte levels (12,13,(16)(17)(18)(19), there are few studies regarding the local immunoregulator cells in patients with chronic periodontitis (20)(21)(22).…”