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Characterization of macrophages infiltrating peri-implantitis lesions

Journal article
Authors T. Fretwurst
C. Garaicoa-Pazmino
K. Nelson
W. V. Giannobile
C. H. Squarize
Lena Larsson
R. M. Castilho
Published in Clinical Oral Implants Research
Pages 8
ISSN 0905-7161
Publication year 2020
Published at Institute of Odontology
Pages 8
Language en
Links dx.doi.org/10.1111/clr.13568
Keywords dental implants, histology, inflammation, macrophages, nitric oxide, synthase, Peri-implantitis, periodontitis, 2017 world workshop, consensus report, m2 macrophages, classification, activation, diseases, polarization, expression, tissue, m1, Dentistry, Oral Surgery & Medicine, Engineering
Subject categories Dentistry

Abstract

Objectives The mechanisms involved in the initiation and progression of peri-implantitis lesions are poorly understood. It was the aim to determine the content and activation status of macrophages present in human peri-implantitis lesions and compare the current findings with the macrophage polarization associated with periodontitis lesions. Material and Methods A total of 14 patients were studied in this investigation. Seven were soft tissue biopsies from dental implants affected by peri-implantitis that required explantation. Seven biopsies were from chronic periodontal disease. Immunofluorescence stains were performed using biomarkers to identify macrophages (CD68(+)) undergoing M1 polarization (iNOS(+)) and M2 polarization (CD206(+)), along with Hoechst 33,342 to identify DNA content. All samples were stained and photographed, and double-positive cells for CD68 and iNOS or CD68 and CD206 were quantified. Results All peri-implantitis biopsies examined revealed a mixed population of macrophages undergoing M1 polarization and M2 polarization. Further analysis demonstrated the co-expression of iNOS and CD206, which indicates the presence of a heterogenic immune response on peri-implantitis lesions. Macrophage polarization in peri-implantitis lesions presents a distinct pattern than in periodontitis. We observed a significant increase in the population of M1 macrophages on peri-implantitis samples compared to periodontal disease samples. Conclusion Our results demonstrate that peri-implantitis has higher numbers of macrophages displaying a distinct macrophage M1 polarization signature compared to periodontitis lesions. This pattern may explain, in part, the distinct nature of peri-implantitis progression vs. periodontitis in humans.

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