Impact of non‐surgical periodontal therapy on biomarker levels in inflammatory bowel disease patients with periodontitis

BACKGROUND: This study investigated the effects of non-surgical periodontal therapy (NSPT) on saliva and serum levels of T cell immunoglobulin and mucin domain-containing protein 3 (TIM-3), tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-17, and serum levels of C-reactive protein (CRP) in patients with inflammatory bowel disease (IBD) and/or periodontitis. METHODS: The study included 72 participants, 18 in each of the four groups: systemically and periodontally healthy (HH), systemically healthy with periodontitis (HP), IBD and periodontally healthy (IBH) and IBD with periodontitis (IBP). Clinical periodontal parameters and biomarker levels were evaluated at baseline in all groups and 3 months after NSPT in the periodontitis groups. Biomarker levels were analyzed using ELISA. RESULTS: At baseline, salivary IL-6 and IL-17 levels were significantly elevated in the IBH and IBP groups compared with those in the HH group (all p < 0.05). NSPT led to significant improvements in periodontal clinical parameters. Following NSPT, significant reductions in salivary IL-6, IL-17, TIM-3, and the serum CRP levels were observed in the IBP group (all p < 0.05). No significant changes in serum IL-6, IL-17, TNF-α, or TIM-3 levels were detected (all p > 0.05). Salivary IL-6 levels showed strong diagnostic potential for distinguishing IBP from HH (AUC = 0.932) and HP from IBP (AUC = 0.889). CONCLUSIONS: NSPT may contribute to the modulation of local and systemic inflammation in patients with IBD and periodontitis. Salivary TIM-3 emerged as a potential novel biomarker for periodontal disease detection in this population. TRIAL REGISTRATION: This study has been registered in the ClinicalTrials.gov protocol registration system (Identifier: NCT06245278). PLAIN LANGUAGE SUMMARY: Periodontitis and inflammatory bowel disease (IBD) are common diseases that are related to each other and have a high risk of occurring together. Dysbiosis and chronic immune activation are common features of both diseases. Cytokines such as interleukin (IL)-6, IL-17, and tumor necrosis factor-alpha (TNF-α), as well as inflammatory markers such as C-reactive protein (CRP), are involved in the inflammatory cascades of both diseases. Although the role of T cell immunoglobulin and mucin domain-containing protein 3 (TIM-3) in the pathogenesis of periodontal disease and IBD is not clearly understood, it is thought to play a role in immunity and disease severity. This study included systemically healthy and periodontally healthy individuals (HH), systemically healthy individuals with periodontitis (HP), periodontally healthy individuals with IBD (IBH), and individuals with IBD and periodontitis (IBP). Serum and saliva samples were collected from all participants at baseline and additionally from individuals with periodontitis after non-surgical periodontal therapy (NSPT). Our findings showed significant improvements in clinical parameters following NSPT, particularly in IBD patients, along with concurrent decreases in saliva TIM-3, IL-6, IL-17, and serum CRP levels. In conclusion, periodontal inflammation may increase systemic immune activation in IBD, and periodontal treatment may offer potential benefits in reducing this burden.