MACROPHAGE AND MAST CELL DERIVED CHEMOKINE (CXCL8, CCL5, CXCL1 AND CCL2) RATIOS IN PERI-IMPLANTITIS: AS INDICATORS OF IMMUNE DYSREGULATION

Background: Peri-implantitis is an inflammatory condition that damages the tissues surrounding dental implants. It develops when the body's immune response to bacterial biofilm and implant-related factors becomes dysregulated. Key signaling proteins called chemokines as CXCL8, CXCL1, CCL5 and CCL2orchestrate the recruitment of immune cells like neutrophils and macrophages. Shifts in the balance between these chemokines may reflect an underlying immune disturbance around implants.

Aim: This study aimed to measure and compare the levels of CXCL8, CXCL1, CCL5, and CCL2 and their relative ratios in the peri-implant sulcular fluid of three groups: individuals with healthy implants, patients diagnosed with peri-implantitis, and a control group with no implants.

Materials and Methods: In a case-control study, a total of 80 participants were divided into three groups: healthy controls without implants (n=30), patients with healthy osseointegrated implants (n=30), and patients with peri-implantitis (n=20). We recorded demographic data and clinical parameters including probing depth (PD) and plaque index. PISF samples were collected using PerioPaper strips and stored at -80°C until analysis. Chemokine concentrations were determined using ELISA.

Results: Probing depth and plaque index were significantly higher in the peri-implantitis group compared to the healthy implant and control groups (p<0.005). All four chemokines were elevated in peri-implantitis compared to both healthy groups: CXCL8 (773.9 ± 112.7 pg/mL), CXCL1 (327.1 ± 188.4 pg/mL), CCL5 (243.5 ± 48.8 pg/mL), and CCL2 (729.3 ± 86.9 pg/mL) (p<0.005). The ratios between chemokines revealed distinct patterns: (CXCL8/CCL5) was highest in healthy implants, (CXCL1/CCL2) increased progressively from controls to peri-implantitis, (CXCL8/CXCL1) declined across groups, and (CCL5/CCL2) dropped in healthy implants before rising slightly in peri-implantitis (p<0.05).

Conclusion: Peri-implantitis is associated with deeper pockets, more plaque and higher levels of neutrophil and macrophage related chemokines. Importantly, composite ratios (CXCL8/CCL5) and (CXCL1/CCL2) distinguished between health and disease more clearly than individual chemokine levels alone pointing to a shift in immune signaling. These ratios could potentially serve as useful biomarkers for early identification and tracking of peri-implant inflammation.

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