TREM-1 Pathway Biomarkers for Classification of Periodontal Diseases and Monitoring of Treatment Response in Grade B and C Periodontitis.

Abstract

BACKGROUND This study investigated the diagnostic potential of salivary triggering receptor expressed on myeloid cells (TREM)-1, peptidoglycan recognition protein 1 (PGLYRP1) and interleukin (IL)-1β for periodontitis patients and their ability to predict treatment outcome. METHODS Systemically healthy, non-smokers with gingivitis (n = 31), stage III periodontitis (34 grade B: n = 34, grade C: n = 24) and healthy controls (n = 34) were recruited. Periodontitis patients (n = 42) underwent non-surgical periodontal treatment. Saliva was collected at baseline (T0) and post-treatment (T1, T3, T6). Biomarkers were measured using immunoassays. Periodontitis patients were categorised into responders (n = 19) and non-responders (n = 23) based on the number of residual pockets ≥ 5 mm with bleeding on probing at T6. RESULTS TREM-1 was higher in periodontitis than in gingivitis and health, and in periodontitis grade B than in gingivitis (p < 0.05). PGLYRP1 and IL-1β were higher in periodontitis and gingivitis compared to controls (p < 0.01). All biomarkers discriminated periodontitis from health (AUC ≥ 0.9) with high sensitivity (82.1%-92.8%) and specificity (83.3%-88.9%). TREM-1 differentiated periodontitis from gingivitis (AUC = 0.72) with high sensitivity (92.8%) but low specificity (58.1%). Baseline biomarkers did not predict treatment outcome (AUC ≤ 0.61), while T1 levels showed moderate potential (AUC ≥ 0.71). CONCLUSIONS Salivary TREM-1 pathway biomarkers offer diagnostic value for periodontitis, are modulated by therapy but show limited ability to predict treatment outcome. STUDY REGISTRATION The study has been registered in ClinicalTrials.gov (ID: NCT06715176, 4 December 2024).