Pathogenesis of Periodontal Disease in Individuals With Psoriasis

NCT ID: NCT07158125

Last Updated: 2025-09-05

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Total Enrollment: 60 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2025-09-15
• Study Completion Date: 2026-04-06

Brief Summary

The aim of this study is to evaluate the levels of Th17 cell-associated cytokines (IL-17, IL-21, IL-23) and the salivary stress biomarkers cortisol, dehydroepiandrosterone, and Chromogranin A in the pathogenesis of periodontal disease in individuals with psoriasis, thereby revealing immunological and neuroendocrine interactions.

The fundamental question it aims to answer is:

What are the biological mechanisms that may increase the risk of periodontal disease in individuals with psoriasis?

In this context, the periodontal status of individuals with psoriasis will be clinically assessed, followed by analysis of the levels of Th17-associated cytokines and stress biomarkers in gingival crevicular fluid and saliva samples. Additionally, patients will be asked questions from the Social Appearance Anxiety Scale. The periodontal status of individuals with psoriasis will be determined cross-sectionally, and the resulting biomarker levels will be examined. In addition, the data obtained will be evaluated with statistical analysis in relation to disease severity and clinical parameters.

Detailed Description

Psoriasis and periodontitis are chronic inflammatory diseases, and Th17 cells and their secreted cytokines, such as IL-17, IL-21, and IL-23, have been shown to play a significant role in the pathogenesis of both. Recent studies suggest a possible immunological link between these two diseases. Furthermore, in a stress-induced disease like psoriasis, the effects of chronic stress on the immune system are attracting increasing attention. The interaction of neuroendocrine markers, such as cortisol, dehydroepiandrosterone (DHEA), and chromogranin A (CgA), released via the hypothalamic-pituitary-adrenal axis, with immune responses and inflammatory processes may play a significant role in the development of periodontal disease.

This project will jointly examine the immunological and neuroendocrine basis of periodontal disease in individuals with psoriasis. Cortisol, DHEA, and CgA levels will be measured in saliva samples, and the relationship between these biomarkers and periodontal parameters will be analyzed. Cytokine levels related to the Th17 pathways will be examined in gingival crevicular fluid to reveal the impact of psoriasis on periodontal tissue. The Social Appearance Anxiety Scale will also be administered. All data obtained will be statistically analyzed.

In this context, this study aims to investigate the role of these two chronic and inflammatory diseases (periodontitis and psoriasis) in the Th17 axis based on stress biomarkers (IL-17, IL-21, and IL-23). Thus, we plan to evaluate the relationship between periodontitis and psoriasis biochemically using salivary stress markers (cortisol, DHEA, and CgA) and to evaluate the immunopathogenesis of Th17.

The findings of this study may significantly contribute to clinical practice regarding the early diagnosis and management of periodontal disease in individuals with psoriasis. It also aims to encourage multidisciplinary approaches by providing a holistic understanding of the effects of stress on the immune system and periodontal health.

Conditions

Psoriasis

Study Design

• Observational Model Type: CASE_ONLY
• Study Time Perspective: CROSS_SECTIONAL

Study Groups

No psoriasis severity

Patients with a PASI (Psoriasis Area and Severity Index) score of 0

No interventions assigned to this group

Mild psoriasis severity

Patients with a PASI (Psoriasis Area and Severity Index) score of 1-10

No interventions assigned to this group

Moderate psoriasis severity

Patients with a PASI (Psoriasis Area and Severity Index) score of 10-20

No interventions assigned to this group

Severe psoriasis

Patients with a PASI (Psoriasis Area and Severity Index) score of \>20

No interventions assigned to this group

Eligibility Criteria

Inclusion Criteria

• Being between the ages of 18 and 65
• Being diagnosed with psoriasis by a dermatologist
• Having at least 20 teeth
• Not having received periodontal treatment in the last 6 months
• Not having taken antibiotics, steroids, and/or nonsteroidal anti-inflammatory drugs in the last 3 weeks
• Not having any autoimmune disease, osteoporosis, or cancer
• Not using immunosuppressive drugs, oral contraceptives, or bisphosphonates
• Not being pregnant
• Not having an active infectious disease (acute hepatitis, tuberculosis, AIDS)
• Not using chronic medications that affect periodontal tissues (cyclosporine A, phenytoin)
• Not having taken antioxidant supplements in the last 6 months

Exclusion Criteria

• <20 teeth
• Any significant oral infection (i.e., herpes or candidiasis)
• Oral injuries or bleeding unrelated to periodontitis
• Periodontal therapy and antibiotic therapy within the past 3 months
• Salivary gland dysfunction
• Acute illness (fever, sore throat)
• Systemic illness, mental illness, immunosuppressive drugs or immunodeficiency
• Pregnancy or breastfeeding
• Use of antidepressants

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Recep Tayyip Erdogan University Training and Research Hospital

OTHER

Sponsor Role: lead

Responsible Party

Dilek KARADOĞAN

Assoc. Prof. Dr.

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Department of Periodontology of the Faculty of Dentistry of Recep Tayyip Erdogan University

Rize, Rize Province, Turkey (Türkiye)

Countries

Turkey (Türkiye)

Central Contacts

Oguz KOSE, Professor Dr.

Role: CONTACT

oguz.kose@erdogan.edu.tr

+90 541 348 64 65

Facility Contacts

RTEU Faculty of Dentistry, Department of Periodontology

Role: primary

dis@erdogan.edu.tr

+90 464 222 00 00

Other Identifiers

periopsoriasis06/2025

Identifier Type: -

Identifier Source: org_study_id