Association of TREM-1/PGLYRP1 Axis With Oral Inflammation in Kidney Disease

Objectives: Objectives: TREM-1 is an amplifier of local and systemic inflammation along with its newly identified ligand PGLYRP1. Our aim was to study association of TREM-1 and PGLYRP1 with oral inflammatory burden among chronic kidney disease (CKD) patients in predialysis and in post-transplantation stage.
Methods: Methods: 144 CKD patients were examined (2000-2005) in predialysis- and 53 in follow-up (post-transplantation) stage (2013-2015). Total follow-up time was 157 months. Clinical radiological assessment was done by periodontist (H.R) in our hospital where infection foci were treated prior to kidney transplantation. From medical records, oral inflammatory burden was assessed by calculating Periodontal Inflammatory Burden (PIBI) and Total Dental Index (TDI), and by deep periodontal pockets (two or more sites with ≥6mm periodontal pocket). Stimulated saliva samples and clinical oral examination status were available from 111/144 patients in predialysis- and from 41/53 patients in follow-up stage. Salivary sTREM-1, IL-1ß and PGLYRP1 were measured by ELISA. Results were analyzed by cross-tabulation, Pearson chi-square test.
Results: Results: In predialysis stage higher median PGLYRP1, TREM-1, and IL-1ß concentrations associated with higher MMP-8 concentration (p<0.001) and PIBI (p<0.05). PGLYRP1 and TREM-1 also associated with deeper periodontal pockets (p<0.05). PGLYRP1 associated with higher TDI (p<0.05) and higher teeth median number (p<0.05). In follow-up stage higher PGLYRP1 and TREM-1 associated with one or more sites with ≥4mm or deeper periodontal pockets (p<0.05).
Conclusions: Conclusion: The present data indicate that higher levels of PGLYRP1, sTREM-1 and IL -1ß are associated with poor oral health in CKD patients and positively correlate with number of active periodontal pockets after therapy. Thus, salivary TREM-1/PGLYRP1 axis could be useful as diagnostic marker for oral infection within patients with chronic diseases such as CKD. Acknowledgement: Supported by EVO grant TYH2013334 from the HUCH.