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Periodontal DiseasesNCT03225950

Interaction Between Immune Cells and Bacteria Associated With Periodontitis

An observational study of Periodontal Diseases and Periodontitis, run by University of Copenhagen at 2 sites in Denmark.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study evaluates the interaction between host immune cells and bacteria associated with periodontitis. It comprises biological material from donors with and without periodontal disease. Read more about this study

Who is it for?
Ages 19 to 60 yearsHealthy volunteers can take part
What is being tested?
Anti-CCP- and anti-P.g.-antibodies titers, Analysis of selected single nucleotide polymorphisms (SNPs) and periodontitis-associated bacteria presence
How many people
90 participants
Where
2 sitesDenmark
Study dates
1 Feb 2017to 23 Mar 2020
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 19 to 60 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Study population: This study includes 170 participants, which are legally competent e.i. above 18 years of age and general decision competent. The participants are divided into three groups: 1) Participants with chronic periodontitis (n=35), 2) participants with aggressive periodontitis (n=35) and 3) healthy participants without periodontal disease (n=100). The participants are recruited from the Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark and assigned to a group in accordance with the periodontal disease classification system in 1999 American Academy of Periodontology.

Who may be able to join

  • 50-60 years of age.
  • Interproximal attachment loss at minimum 3 teeth besides molars and incisors.
  • Clinical attachment loss at minimum 10 sites identified by bleeding and pus upon probing.
  • Visible radiographic bone loss.
  • Medically healthy donors.
  • 19-40 years of age.
Show all 13Show fewer
  • Interproximal attachment loss at minimum 3 teeth besides molars and incisors.
  • Clinical attachment loss at minimum 10 sites identified by bleeding and pus upon probing.
  • Visible radiographic bone loss.
  • Medically healthy donors.
  • Inclusion criteria for healthy donors: (age: 19-40 years; 50-60 years)
  • No sign of inflammatory conditions or other general systemic diseases.
  • Medically healthy donors.

Who cannot join

  • Pregnant and breastfeeding.
  • Antibiotic treatment within 6 months.
  • Suffer from periodontal manifestations caused by systemic diseases e.i. genetic diseases, haematologic anomalies or syndromes.

Trial locations and contacts

2 sites in 1 country.

Denmark2 sites
  • Institute for Inflammation Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen University Hospital.

    Copenhagen, 2200

  • Section for Periodontology, Microbiology and Community Dentistry, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen

    Copenhagen, 2200

Other trials in Denmark

About this study

This study evaluates the interaction between host immune cells and bacteria associated with periodontitis. It comprises biological material from donors with and without periodontal disease. Specifically, we collect a spit and blood sample to conduct in vitro stimulations and measurements of selected parameters related to periodontitis to clarify obscure areas in the immunologic pathogenesis of this disease.

Read the detailed description

Periodontitis is a prevalent, multifactorial inflammatory disease characterized by the interaction between microorganisms organized in biofilms on tooth surfaces and host immune cells, leading to an inflammatory destruction of the tooth-supporting tissues and - if left untreated - eventually tooth loss. Periodontitis affects up to 50% of the population in the United States of America, and is classified in an aggressive and a chronic form depending on genetic factors, age of onset, speed and severity of attachment loss.

The onset of periodontitis is caused by an immunologic imbalance between host immune cells and residing microorganisms in subgingival pockets. The host immune cells are capable of enhancing both a protective and a destructive inflammatory response towards the microorganisms through the release of inflammatory mediators e.i. proinflammatory and antiinflammatory cytokines.

The role of antibodies in periodontitis is also unclear. Some studies show an excessive antibody level against bacteria associated with periodontitis e.g. Porphyromonas gingivalis (P.g.).

In general, this study contributes to a profound understanding of the host immune cells role in the onset and pathogenesis of periodontitis by comparing healthy versus diseased donors immunologic responses toward pathogene and apathogene microorganisms and their genetic background.

Being tested
In vitro stimulation of blood with periodontitis-associated- and control bacteria, Anti-CCP- and anti-P.g.-antibodies titers, Analysis of selected single nucleotide polymorphisms (SNPs), periodontitis-associated bacteria presence
Keywords
Periodontal disease, Periodontitis, Aggressive periodontitis, Dysbiosis, Inflammation, Regulation, Cytokines, Bacteria, Porphyromonas gingivalis, Saliva, Anti-CCP, Peptidyl arginine deiminases, Single nucleotide polymorphisms
Medical subject headings
Periodontal Diseases, Periodontitis, Aggressive Periodontitis, Immune System Diseases, Periodontal Pocket, Inflammation, Gingivitis, Dysbiosis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • In vitro stimulation of blood with periodontitis-associated- and control bacteriaOther

    Peripheral mononuclear blood cells are stimulated with periodontitis-associated- and control bacteria to measure the amount of positive cytokine-producing cells.

  • Anti-CCP- and anti-P.g.-antibodies titersDiagnostic test

    Anitbody titers will be measured in saliva and serum samples.

  • Analysis of selected single nucleotide polymorphisms (SNPs)Genetic

    DNA obtained from saliva samples will be used to determine the genotype of the participants for selected SNPs.

  • periodontitis-associated bacteria presenceDiagnostic test

    Determination of the presence of periodontitis-associated bacteria e.i. Porphyromonas gingivalis in saliva and blood samples.

Study groups in NCT03225950
Study groupRoleWhat they receive
Chronic periodontitis donors* Donors are medically healthy. * Slow to moderate attachment loss and bone destruction. * Good correlation between etiological factors and serverity of attachment loss.
Receives: Other: In vitro stimulation of blood with periodontitis-associated- and control bacteria; Diagnostic Test: Anti-CCP- and anti-P.g.-antibodies titers; Genetic: Analysis of selected single nucleotide polymorphisms (SNPs); Diagnostic Test: periodontitis-associated bacteria presence
Aggressive periodontitis donors* Donors are medically healthy. * Rapid attachment loss and bone destruction. * Familial aggregation. * No correlation between etiological factors and serverity of attachment loss.
Receives: Other: In vitro stimulation of blood with periodontitis-associated- and control bacteria; Diagnostic Test: Anti-CCP- and anti-P.g.-antibodies titers; Genetic: Analysis of selected single nucleotide polymorphisms (SNPs); Diagnostic Test: periodontitis-associated bacteria presence
Control donors* Donors are medically healthy. * No sign of inflammatory conditions.
Receives: Other: In vitro stimulation of blood with periodontitis-associated- and control bacteria; Diagnostic Test: Anti-CCP- and anti-P.g.-antibodies titers; Genetic: Analysis of selected single nucleotide polymorphisms (SNPs); Diagnostic Test: periodontitis-associated bacteria presence

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. periodontitis-associated- and control bacterial stimulation of host immune cells.

    Identification and determination of the amount of cytokine-producing immune cells when stimulated with bacteria associated with periodontitis including pro- and antiinflammatory cytokines.

    Genuses: Porphyromonas, Prevotella, Eikenella, Aggregatibacter, Actinomyces, Lactobacillus, Bifidobacterium, Rothia.

    Measured: Aug. 2020

  2. Anti-cyclic citrullinated peptides (anti-CCP) antibodies titers.

    Determination of the prevalence of anti-CCP-positive periodontitis patients through measure of anti-CCP antibody titers in serum samples and correlation with the level of antibodies to P. gingivalis, and to the abundancy of the bacterium in saliva.

    Measured: Aug. 2020

  3. P. gingivalis presence and related antibodies.

    Determination of P. gingivalis presence in saliva and serum samples through RT-qPCR and determination of the level of antibodies towards the bacterium using in-house Luminex-based technology.

    Measured: Aug. 2020

  4. Single nucleotide polymorphism (SNP) analysis.

    Investigation of the potential association between periodontitis and selected polymorphisms in the PADI genes using multiplex bead-based SNP assays with the Luminex technology.

    Measured: Aug. 2020

Secondary outcomes (2)
  1. Cytokine profile in saliva.

    Determination of the cytokine profile in saliva samples from subject with periodontitis and healthy controls with Luminex based technology.

    Measured: Aug. 2020

  2. Presence of other periodontal bacteria.

    Determination of the presence of other periodontal bacteria through RT-qPCR assays.

    Measured: Aug. 2020

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Jul 2017
  2. Study start1 Feb 2017
  3. Primary completion12 Oct 2018
  4. Study completion23 Mar 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Cross-sectional
Enrolment
90 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03225950
Sponsor's protocol ID
H-16024734
Status last verified
Oct 2018
First submitted
19 Jul 2017
Last updated
24 Mar 2020
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: IPD will not be available to other researchers in accordance with our approved Human Subjects Protection application in Denmark.

Publications

  • Bartold PM, Van Dyke TE. Periodontitis: a host-mediated disruption of microbial homeostasis. Unlearning learned concepts. Periodontol 2000. 2013 Jun;62(1):203-17. doi: 10.1111/j.1600-0757.2012.00450.x.

    PubMed 23574467
  • Neely AL, Holford TR, Loe H, Anerud A, Boysen H. The natural history of periodontal disease in man. Risk factors for progression of attachment loss in individuals receiving no oral health care. J Periodontol. 2001 Aug;72(8):1006-15. doi: 10.1902/jop.2001.72.8.1006.

    PubMed 11525431
  • Eke PI, Dye BA, Wei L, Slade GD, Thornton-Evans GO, Borgnakke WS, Taylor GW, Page RC, Beck JD, Genco RJ. Update on Prevalence of Periodontitis in Adults in the United States: NHANES 2009 to 2012. J Periodontol. 2015 May;86(5):611-22. doi: 10.1902/jop.2015.140520. Epub 2015 Feb 17.

    PubMed 25688694
  • Armitage GC. Development of a classification system for periodontal diseases and conditions. Northwest Dent. 2000 Nov-Dec;79(6):31-5.

    PubMed 11413609
  • Haffajee AD, Socransky SS, Patel MR, Song X. Microbial complexes in supragingival plaque. Oral Microbiol Immunol. 2008 Jun;23(3):196-205. doi: 10.1111/j.1399-302X.2007.00411.x.

    PubMed 18402605
  • Damgaard C, Holmstrup P, Van Dyke TE, Nielsen CH. The complement system and its role in the pathogenesis of periodontitis: current concepts. J Periodontal Res. 2015 Jun;50(3):283-93. doi: 10.1111/jre.12209. Epub 2014 Jul 5.

    PubMed 25040158
  • Liu YC, Lerner UH, Teng YT. Cytokine responses against periodontal infection: protective and destructive roles. Periodontol 2000. 2010 Feb;52(1):163-206. doi: 10.1111/j.1600-0757.2009.00321.x. No abstract available.

    PubMed 20017801
  • Kinane DF, Preshaw PM, Loos BG; Working Group 2 of Seventh European Workshop on Periodontology. Host-response: understanding the cellular and molecular mechanisms of host-microbial interactions--consensus of the Seventh European Workshop on Periodontology. J Clin Periodontol. 2011 Mar;38 Suppl 11:44-8. doi: 10.1111/j.1600-051X.2010.01682.x.

    PubMed 21323703
  • Pussinen PJ, Jousilahti P, Alfthan G, Palosuo T, Asikainen S, Salomaa V. Antibodies to periodontal pathogens are associated with coronary heart disease. Arterioscler Thromb Vasc Biol. 2003 Jul 1;23(7):1250-4. doi: 10.1161/01.ATV.0000072969.71452.87. Epub 2003 Apr 24.

    PubMed 12714435
  • Pussinen PJ, Nyyssonen K, Alfthan G, Salonen R, Laukkanen JA, Salonen JT. Serum antibody levels to Actinobacillus actinomycetemcomitans predict the risk for coronary heart disease. Arterioscler Thromb Vasc Biol. 2005 Apr;25(4):833-8. doi: 10.1161/01.ATV.0000157982.69663.59. Epub 2005 Feb 3.

    PubMed 15692101
  • Berglundh T, Donati M. Aspects of adaptive host response in periodontitis. J Clin Periodontol. 2005;32 Suppl 6:87-107. doi: 10.1111/j.1600-051X.2005.00820.x.

    PubMed 16128832
  • Fillatreau S. Cytokine-producing B cells as regulators of pathogenic and protective immune responses. Ann Rheum Dis. 2013 Apr;72 Suppl 2:ii80-4. doi: 10.1136/annrheumdis-2012-202253. Epub 2012 Dec 19.

    PubMed 23253921
  • Belstrom D, Paster BJ, Fiehn NE, Bardow A, Holmstrup P. Salivary bacterial fingerprints of established oral disease revealed by the Human Oral Microbe Identification using Next Generation Sequencing (HOMINGS) technique. J Oral Microbiol. 2016 Jan 14;8:30170. doi: 10.3402/jom.v8.30170. eCollection 2016.

    PubMed 26782357
  • Belstrom D, Holmstrup P, Bardow A, Kokaras A, Fiehn NE, Paster BJ. Comparative analysis of bacterial profiles in unstimulated and stimulated saliva samples. J Oral Microbiol. 2016 Mar 16;8:30112. doi: 10.3402/jom.v8.30112. eCollection 2016.

    PubMed 26987356
  • Massarenti L, Nielsen CH, Danielsen AK, Jensen PO, Enevold C, Damgaard C. Evaluation of circulating IgG antibodies against Porphyromonas gingivalis or its gingipains as serological markers of periodontitis and carriage of the bacterium. J Periodontol. 2025 Feb;96(2):119-128. doi: 10.1002/JPER.23-0766. Epub 2024 Jun 17.

    PubMed 38884611

Questions about this trial

What is this clinical trial studying?

An observational study of Periodontal Diseases and Periodontitis, run by University of Copenhagen at 2 sites in Denmark.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 13 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 24 Mar 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Denmark. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

periodontitis-associated- and control bacterial stimulation of host immune cells. (time frame: Aug. 2020). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03225950, which also lists 16 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Mar 2020.

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