Comparison of immunoexpression of dendritic cells, mast cells and blood vessels in periodontal disease between adults and elderly.

OBJECTIVE: The aim of this study was to compare, in adults and elderly individuals, the immunoexpression of immature and mature dendritic cells (DCs), mast cells, and blood vessels in healthy and diseased gingival tissues. MATERIALS AND METHODS: The expressions of immunohistochemical markers, including CD1a (immature dendritic cells), CD83 (mature dendritic cells), tryptase (mast cells) and CD34 (blood vessels), were analyzed in gingival biopsies from elderly (n = 27) and adult (n = 127) patients presenting health, gingivitis and periodontitis. Positive cells for each specimen and marker were counted. RESULTS: There were no differences in the immunostaining of DCs, mast cells and the amount of blood vessels among gingival biopsies with health, gingivitis and periodontitis in adult and elderly subjects (p > 0.05). Immature DCs were more frequent in tissues with gingivitis and periodontitis in elderly patients, when compared to adults (p < 0.05). Furthermore, degranulated mast cell counts were higher, whereas the number of microvessels was lower in gingivitis in the elderly, when compared to adults (p < 0.05). CONCLUSIONS: Diseased periodontal sites in the elderly present an overall significant overexpression of immature DCs and degranulated mast cells, in relation to those of adults. Furthermore, gingivitis in elderly is associated with decreased microvessel growth. These immunoinflammatory differences between elderly and adults may have implications in periodontal tissue breakdown in the late adulthood. Further studies should be performed to elucidate this hypothesis. CLINICAL RELEVANCE: Understading the relationship between aging and changes in immune cells during periodontal inflammation may lead to therapeutic targets for the future management of periodontal diseases.

Análise de células dendríticas, mastócitos e vascularização na doença periodontal biofilme induzida em idosos / Analysis of dendritic cells, mast cells and vasculature in biofilm-induced periodontal disease in the elderly

A microbiota e o sistema imune do idoso apresentam algumas alterações, favorecendo ao aparecimento de infecções e doenças inflamatórias. A doença periodontal é um exemplo, permeando entre fase imediata e tardia, pode ter alterações em sua evolução com o envelhecimento humano. Compreender a doença periodontal e sua relação com o ciclo da vida é importante para a prevenção, tratamento e cura. Este estudo tem como objetivo avaliar a quantidade de mastócitos (triptase), células dendríticas imaturas (CD1a), células dendríticas maduras (CD83) e vasos sanguíneos (CD34) em 154 tecidos periodontais saudáveis e doentes (27 idosos e 127 adultos). Foi utilizada a técnica de imunoistoquímica através da imunomarcação do CD1a, CD83, triptase e CD34, sendo contabilizados em 5 campos de maior número de células positivas, no aumento de 1000x. Para o CD34, ainda foram calculadas a área e o perímetro microvascular para todos os vasos sanguíneos presentes, e dos vasos com presença do endotélio vascular alto. Não houve diferença na imunomarcação das células dendríticas, dos mastócitos e na quantidade de vasos sanguíneos nos tecidos gengivais, entre os casos de gengiva clinicamente saudável, gengivite induzida por biofilme e periodontite estágios II, III e IV, avaliando isoladamente os grupos etários: adultos e idosos. As células dendríticas imaturas são mais numerosas no idoso com o quadro clínico de gengivite e periodontite. Os adultos com gengivite induzida por biofilme possuem maior quantidade de vasos sanguíneos que o grupo idoso. A área microvascular e o perímetro microvascular dos vasos sanguíneos com o endotélio vascular alto apresentaram maiores nos idosos nos casos de gengivite. Este estudo concluiu que nesta amostra não houve diferença na quantidade de células dendríticas imaturas e maduras, mastócitos na doença periodontal dentro dos grupos etário, porém as células dendríticas imaturas estão mais presentes no idoso podendo estar relacionado a algum decréscimo funcional. Em relação aos vasos sanguíneos, há presença de HEVs em adultos e idosos, não havendo diferença entre os diagnósticos. Nos idosos com gengivite há um aumento da área microvascular e perímetro microvascular, necessitando de estudos que justifiquem esta diferença (AU).

The elderly's microbiota and immune system show some changes, favoring the onset of infections and inflammatory diseases. Periodontal disease is an example, permeating between immediate and adaptative stages, it can have changes in its evolution with human aging. Understanding periodontal disease and its relationship with the life cycle is important for prevention, treatment and cure. This study aims to assess the amount of mast cells (tryptase), immature dendritic cells (CD1a), mature dendritic cells (CD83) and blood vessels (CD34) in 154 healthy and sick periodontal tissues (27 elderly and 127 adults). The immunohistochemistry technique was used through the immunostaining of CD1a, CD83, tryptase and CD34, being counted in 5 fields with a greater number of positive cells, in the 1000x increase. For CD34, the microvascular area and perimeter were also calculated for all blood vessels present, and for vessels with the presence of high vascular endothelium. There was no difference in the immunostaining of dendritic cells, mast cells and the amount of blood vessels in the gingival tissues, between cases of clinically healthy gingiva, biofilm-induced gingivitis and stages II, III and IV periodontitis, evaluating the age groups: adults and elderly. Immature dendritic cells are more numerous in the elderly with the clinical picture of gingivitis and periodontitis. Adults with biofilm-induced gingivitis have a greater amount of blood vessels than the elderly group. The microvascular area and the microvascular perimeter of the blood vessels with the high vascular endothelium were larger in the elderly in cases of gingivitis. This study concluded that in this sample there was no difference in the amount of immature and mature dendritic cells, mast cells in periodontal disease within the age groups, however, immature dendritic cells are more present in the elderly and may be related to some functional decrease. Regarding blood vessels, there are HEVs in adults and the elderly, with no difference between diagnoses. In the elderly with gingivitis there is an increase in the microvascular area and microvascular perimeter, requiring studies that justify this difference (AU).