Host-response: understanding the cellular and molecular mechanisms of host-microbial interactions - consensus of the Seventh European Workshop on Periodontology

Abstract
Background: Major challenges in periodontology include understanding the
pathophysiology, the interplay between various components of the host response,
parallels with other diseases and identifying biomarkers of the disease.
Objectives: Four reviews were compiled with the aim of better understanding: (1) the
role of polymorphic nuclear leucocytes (PMNs), i.e. neutrophils; (2) the function of
cytokine networks in the host response; (3) whether parallels exist with rheumatoid
arthritis (RA); and (4) whether useful biomarkers currently exist to help in the
management of periodontal disease.
Material and Methods: Based on the focused questions, electronic and manual
searches were conducted for human, animal and cellular studies on the above topics.
Results: Papers fulfilling the inclusion criteria were selected and reviews were written
and reviewed and corrected before the academy meeting to produce consensus statements.
Conclusion: The following consensus statements were produced. PMNs are important in
the pathophysiology of periodontal disease but there is limited evidence on their much
quoted destructive potential. Cytokine networks are enormously complex and we are really
at the beginning of understanding their role in the disease process. RA has both similarities
and marked differences to periodontal disease although the existing utilization of anticytokine
therapies and other molecules in its treatment may have importance in
periodontal disease therapy. Biomarkers for periodontal disease have yet to be completely
defined but the ratio of receptor activator of NF-kB ligand to osteoprotegerin appears to be
a biomarker test with utility for detecting bone destruction.