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Age and Periodontal Health—Immunological View

  • Epidemiology (M Laine, Section Editor)
  • Published:
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Abstract

Purpose of the Review

Aging clearly impacts a wide array of systems, in particular the breadth of the immune system leading to immunosenescence, altered immunoactivation, and coincident inflammaging processes. The net result of these changes leads to increased susceptibility to infections, increased neoplastic occurrences, and elevated frequency of autoimmune diseases with aging. However, as the bacteria in the oral microbiome that contribute to the chronic infection of periodontitis is acquired earlier in life, the characteristics of the innate and adaptive immune systems to regulate these members of the autochthonous microbiota across the lifespan remains ill-defined.

Recent Findings

Clear data demonstrate that both cells and molecules of the innate and adaptive immune response are adversely impacted by aging, including in the oral cavity, yielding a reasonable tenet that the increased periodontitis noted in aging populations is reflective of the age-associated immune dysregulation. Additionally, this facet of host-microbe interactions and disease needs to accommodate the population variation in disease onset and progression, which may also reflect an accumulation of environmental stressors and/or decreased protective nutrients that could function at the gene level (i.e., epigenetic) or translational level for production and secretion of immune system molecules.

Summary

Finally, the majority of studies of aging and periodontitis have emphasized the increased prevalence/severity of disease with aging, all based upon chronological age. However, evolving areas of study focusing on “biological aging” to help account for population variation in disease expression may suggest that chronic periodontitis represents a co-morbidity that contributes to “gerovulnerability” within the population.

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Acknowledgements

We want to thank M.J. Steffen, J. Stevens, and Dr. S.S. Kirakodu for expert technical support in developing biologic marker data for these types of studies. We also acknowledge the substantial contribution of the clinical personnel in the Delta Dental of Kentucky Clinical Research Center including L. Johnston, D. Dawson, D. Fogle, and H. Gallivan.

Funding

This work was supported by USPHS grants RR020145, DE017793, GM110788, GM103538, and TR000117 from the National Institutes of Health and funding from the Center for Oral Health Research in the UK College of Dentistry, as well as the Office of Research Infrastructure Programs (ORIP) of the National Institutes of Health (NIH) through Grant Number 5P40OD012217 to the Caribbean Primate Research Center. Infrastructure support was also provided, in part, by grants from the National Center for Research Resources G12RR003051 (National Center for Research Resources) and G12MD007600 (National Institute on Minority Health and Health Disparities) from the National Institutes of Health.

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Authors and Affiliations

  1. Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, 1001 Shadow Lane. B#221, MS 7425, Las Vegas, NV, 89106, USA

    Jeffrey L. Ebersole, L. Nguyen & O. A. Gonzalez

  2. Division of Periodontology, College of Dentistry, University of Kentucky, Lexington, KY, USA

    D. A. Dawson III

  3. Department of Periodontics, JBE College of Dental Medicine, Medical University of South Carolina, Charleston, SC, USA

    P. Emecen Huja

  4. Department of Oral Health Sciences, JBE College of Dental Medicine, Medical University of South Carolina, Charleston, SC, USA

    S. Pandruvada

  5. Department of Kinesiology and Nutrition, School of Allied Health Sciences, University of Nevada Las Vegas, Las Vegas, NV, USA

    A. Basu

  6. Southern Nevada Health District, Las Vegas, NV, USA

    Y. Zhang

  7. Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA

    O. A. Gonzalez

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  1. Jeffrey L. Ebersole
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  2. D. A. Dawson III
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  3. P. Emecen Huja
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  4. S. Pandruvada
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  6. L. Nguyen
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  7. Y. Zhang
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  8. O. A. Gonzalez
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Correspondence to Jeffrey L. Ebersole.

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Supplemental Figure 1

Schematic of identified immunosenescence effects on cells of the innate and adaptive immune system. (JPG 103 kb)

Supplemental Figure 2

Transcriptomic profiles of gingival tissue genes associated with a range of pathways regulating the host responses to oral microbial challenge. The findings document the significant impact of aging on the biologic response features of these oral tissues, with certain pathways being elevated in aging (red) and others being decreased (blue) during aging processes. (JPG 68 kb)

Supplemental Figure 3

Schematic describing the contribution of cells and biomolecules to innate and adaptive immunity with interactions that link these host response systems to afford protection from infection and noxious challenge. (JPG 67 kb)

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Ebersole, J.L., Dawson, D.A., Emecen Huja, P. et al. Age and Periodontal Health—Immunological View. Curr Oral Health Rep 5, 229–241 (2018). https://doi.org/10.1007/s40496-018-0202-2

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