Periodontitis and oxidative stress: Current trends in the study of pathogenetic relationships and methods of correction

Abstract

The review addresses modern concepts of the pathogenetic role of oxidative stress (OS) and deficiency of antioxidant defense factors in the development of inflammatory periodontal diseases based on experimental and clinical reports. The pathogenesis of this disease is multifactorial and generally involves the interaction of the biofilm formation, predisposing factors, and body immunogenicity. A close relationship has been demonstrated between periodontitis as an inflammatory process with cardiovascular, neurodegenerative, autoimmune, and oncological diseases. In recent years, much attention has been paid to reactive oxygen species (ROS) due to their central role in the progression of many inflammatory diseases, including those related with periodontal tissues. Six key OS genes (CXCR4, SELL, FCGR3B, FCGR2B, PECAM1, and ITGAL) have been identified in periodontitis that are mainly related with leukocyte intercellular adhesion, phagocytosis, and cellular extravasation. Patients with periodontitis have an increased number of certain neutrophil phenotypes with excessive reactivity in the form of increased production of ROS and proinflammatory mediators, which contributes to the impairment of their chemotactic capability. Both local and systemic redox imbalances have been observed. Periodontitis is associated with increased levels of OS markers in the gingival fluid, gingival tissue, saliva, plasma, serum, and blood cells. There are also changes in the total antioxidant status (TAS), superoxide dismutase (SOD), catalase (CAT), glutathione reductase (GR), glutathione peroxidase (GPO), myeloperoxidase, vitamins C and D, carotenoids, uric acid, reduced glutathione (GSH), and melatonin. Multiple evidence for the effectiveness of antioxidant therapy (polyphenolic compounds, carotenoids, flavonoids, anthocyanins, water- and fat-soluble vitamins, etc.) for periodontitis decisively warrant their use as a part of the therapeutic approach.