Clinical trial NCT02833285: B Cell Functions in Periodontitis
Official title: Periodontitis and Inflammation : Biological and Clinical Approach of B Cell Role.
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Chronic Periodontitis
Aggressive Periodontitis
Lead sponsor: University Hospital, Brest
Sponsor class: OTHER
First posted: 2016-07-14
Enrollment: 60
Sex: ALL
Minimum age (years): 18
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: CASE_CONTROL
Time perspective: CROSS_SECTIONAL
Sampling method: PROBABILITY_SAMPLE
Study population: Male or female from 18 to 75 years old before periodontal treatment

Brief summary: The inflammatory response involves many players from the immune response, including B lymphocytes. These cells are responsible for the synthesis of immunoglobulins in response to the presence of an antigen. They are characteristic of chronic inflammation. There are several subsets of B cells characterized by specific membrane markers. Once activated, these cells express many factors contributing to tissue destruction seen in periodontitis and particularly in osteoclastogenesis (receptor activator of nuclear factor kappa-B ligand, tumor necrosis factor, interleukin-6, macrophage inflammatory protein-1α and Monocyte Chemoattractant Protein-3).

During the establishment of a periodontal disease, an important inflammatory infiltrate is observed in the gum. This infiltrate is characterized by the presence of many B lymphocytes. B cell subsets in the blood and the gum of patients with periodontitis have been little studied. However, the number of autoreactive B cells (cluster of differentiation (CD)19+, CD5+) has been reported to be higher in the blood of patients with periodontal disease. In the gum, the rate of B and T cells increases with the level of inflammation and is correlated with the severity of the inflammatory process. Activation of B cells is a prerequisite for the progression of gingivitis to periodontitis. B cell distribution could then be an indicator of disease progression, but also allow to study the response to treatment.

The aim of this pilot study is to characterize B cell subsets in the blood and the gum of patients with periodontitis, according to disease activity. Analysis of B cells in the blood could highlight the association of a particular subpopulation with aggressive periodontal disease and evidence a particular biological profile of the host response. The investigators also wish to observe the evolution of this phenotype following an unconventional surgical therapy.

This study would better understand the pathogenesis of periodontal disease and refine the diagnosis, prognosis and treatment of periodontitis, and thus participate in the development of personalized medicine. Biological monitoring of therapeutic effects may be initiated and allow more effectively prevent recurrence.


Eligibility criteria: Inclusion Criteria:

* Requiring periodontal surgery
* In good health
* Having signed consent

Exclusion Criteria:

* Minor
* Patient having taken antibiotics in the previous 3 months
* Patients with systemic diseases including chronic inflammatory disease
* Pregnancy
* orthodontic treatment ongoing

Primary outcomes:
measure: Phenotype of B cells in the blood and gums
timeFrame: 3 months
Secondary outcomes:
Other outcomes:
Locations:
city: Brest
country: France
facility: CHRU de Brest
Study officials:
affiliation: University Hospital of Brest
name: PERS Jacques-Olivier
role: PRINCIPAL_INVESTIGATOR
References:
citation: Demoersman J, Pochard P, Framery C, Simon Q, Boisrame S, Soueidan A, Pers JO. B cell subset distribution is altered in patients with severe periodontitis. PLoS One. 2018 Feb 15;13(2):e0192986. doi: 10.1371/journal.pone.0192986. eCollection 2018.