Expression of NLRC4 Inflammasome and its Correlation with Treponema Denticola in Stage III/IV Periodontitis with Type II Diabetes mellitus

To evaluate the expression of NLRC4 inflammasome and correlate with Treponema denticola (T. denticola) levels, so as to comprehend their role in mediating chronic inflammation in individuals with periodontitis (PD) and Type 2 Diabetes Mellitus (T2DM).

Materials and Methods: A total of fifty-one subjects were recruited and grouped as those systemically and periodontally healthy (PH, n=17), those systemically healthy with PD (PD, n=17), and those with T2DM with PD (PD+T2DM, n=17). Site specific probing pocket depth, clinical attachment level, plaque index, and gingival index were recorded. Thereafter, samples of subgingival plaque and gingival tissue taken with biopsy using an internal bevel incision were procured at sites evidencing the disease state. T. denticola was quantified using qPCR, and NLRC4 expression was evaluated with immunohistochemistry.

Results: Compared to the PH controls, significantly higher expression and intensity of NLRC4 inflammasome was observed in the PD and PD with T2DM groups, with a significantly greater expression in the PD+T2DM group (p<0.05). In all three groups, NLRC4 expression (mean percentage, intensity) and T. denticola levels showed a significant positive correlation (p<0.05).

Conclusion: The subgingival plaque, T. denticola levels in PD were significantly related to NLRC4 expression, both in the presence and absence of T2DM. NLRC4 activation possibly plays a role in establishing a hyperinflammatory state in diabetes mellitus modified PD.