Regulatory T cells – The key immunoregulatory components in the pathophysiology of periodontal diseases: Areview

Background: Periodontitis is a chronic immuno-inflammatory disease that alters the microbial-host interactions. The extent of periodontal damage is influenced by specific types of CD4+ T cells, including Th17 cells and Tregs, which respectively promote or inhibit the immune response. Aim and objectives: This study aims to explore the connection between Tregs and their immune-regulating factors in the development of periodontal diseases. The precise role of Tregs in periodontal disease remains a topic of debate, and this research seeks to contribute to a clearer understanding of their involvement. Materials and Methods: To pertain the relationship between the Tregs and immunoregulatory elements in the pathogenesis of periodontal diseases, a literature search was performed in PubMed/MEDLINE, Scopus, Google Scholar, and Web of Science. Data from case-control, cohort studies, literature, randomized controlled trials, and systematic reviews were included. Review Results:The study included 45 articles. Evidence regarding the exact role of Tregs in periodontal disease is still disputed. Tregs play a role in periodontal homeostasis and its upregulation shown to increase the anti-inflammatory cytokines. Discussion: Tregs exhibit distinct functional characteristics, such as balancing inflammation, performing antigen-specific functions, and regulating the activation and function of immune responses. They play a crucial role in defending against infections and controlling autoimmune diseases. Disruption in Treg cell regulation in periodontal disease may result in periodontal tissue destruction, and an imbalance between Th17 and Treg cells can contribute to the progression of periodontal disease. A limitation of this study is the lack of extensive human trials. Conclusion: Tregs play a role in periodontal homeostasis, and its upregulation has been shown to increase the anti-inflammatory cytokines. Thus, key elements such as Foxp3 (forkhead/winged-helix), a transcription factor, its suppressive function of Tregs mediated by TGF-β and interleukin -10 play a regulatory role in periodontal diseases. Clinical significance: Thus, key elements such as Foxp3, a transcription factor.