Tobacco smoking, vascular reaction and neutrophil activity in periodontal health and disease

Abstract: Tobacco smoking has considerable negative effects on periodontal health. The mechanisms behind these effects may be related to the inflammatory response. In this thesis, the main aim was to study the influence of tobacco smoking on the inflammatory response in periodontal health and disease. The specific aims were to study the influence of tobacco smoking on the gingival vasculature in periodontal health and in experimentally induced gingivitis (Studies I, II). Secondly, the aim was to study the influence of tobacco smoking on the presence and activity of neutrophil derived protease in periodontal health and disease (Studies III-IV). Finally, the purpose was to investigate the influence of tobacco smoking on neutrophil derived protease and collagenase following periodontal treatment (Study V). In Studies I and II, the influence of tobacco smoking on the vascular reaction, in terms of the number of visible vessels was studied. During the experimental plaque accumulation the number of visible vessels increased over time in both smokers and non-smokers, however, this was less pronounced in smokers. Under clinically healthy periodontal conditions, the number of visible vessels was similar in both smokers and non-smokers. In Studies III and IV, the influence of tobacco smoking on the presence, in GCF, of neutrophil derived elastase and LF and the protease inhibitors alpha-1-AT and alpha-2- MG was studied. It was found that under clinically healthy periodontal conditions, there was no difference between smokers and non-smokers, whereas under periodontal diseased conditions, smokers were found to have lower alpha-2-MG concentration compared to non-smokers. In Study V, following periodontal surgery, the influence of tobacco smoking on the presence, in GCF, of elastase and MMP-8 and the protease inhibitors alpha-1-AT and alpha-2-MG, was studied. In smokers, it was found that the concentrations of elastase, MMP-8, alpha-1-AT and alpha-2-MG remained unchanged during the study period, whereas in non-smokers there was a change toward increased concentrations of alpha-1-AT and alpha-2-MG and decreased concentration of MMP-8. Conclusion The present observations indicate that tobacco smoking exerts an effect on the inflammatory response resulting in suppressed vascular reaction, decreased level of alpha-2-MG and, following surgery, unchanged levels of MMP-8 and alpha-AT and alpha-2-MG compared to non-smokers.