Chemerin is a chemokine-like protein closely related to inflammation and immune regulation. Studies have indicated that it may be involved in the immune inflammatory process of periodontitis. Th1/Th2 cell imbalance is also important for the occurrence and development of periodontitis, but the relationship between Chemerin and Th1/Th2 cell imbalance and its effect on the early response to root surface debridement (RSD) remains unclear. This single-center, prospective observational study included 82 healthy controls and 129 periodontitis patients (Stage II-IV). Gingival crevicular fluid (GCF) samples were collected to measure Chemerin, interferon-gamma (IFN-γ), and interleukin-4 (IL-4) levels, with Th1/Th2 balance assessed by the IFN-γ/IL-4 ratio. C-reactive protein (CRP) and periodontal parameters were recorded. All periodontitis patients underwent RSD and were classified into good (n = 88) or poor (n = 41) early response groups after 6 weeks. Statistical analyses included correlation analysis, multivariate logistic regression, ROC curve analysis with bootstrap internal validation, model calibration, and decision curve analysis. Compared to controls, periodontitis patients showed significantly elevated GCF-Chemerin (4.82 ± 1.01 vs. 2.21 ± 0.38 ng/mL, p < 0.001) and IFN-γ/IL-4 ratio (2.34 ± 0.71 vs. 1.26 ± 0.29, p < 0.001), with increased IFN-γ and decreased IL-4 (both p < 0.001). GCF-Chemerin correlated positively with IFN-γ/IL-4 ratio (r = 0.40, p < 0.001). The poor early response group exhibited higher baseline levels of both biomarkers, which remained elevated post-treatment. Multivariate analysis identified Chemerin (OR = 9.00, p < 0.001), IFN-γ/IL-4 ratio (OR = 8.31, p < 0.001), clinical attachment level (CAL), and probing pocket depth (PPD) as independent factors associated with early response. The combined model (AUC = 0.886, bootstrap-corrected = 0.884) significantly outperformed individual biomarkers (p < 0.05), achieving 87.8% sensitivity and 75.0% specificity. Sensitivity analyses confirmed stable internal performance, and calibration and decision curve analyses demonstrated good internal predictive accuracy and clinical utility. GCF Chemerin and IFN-γ/IL-4 ratio are elevated in periodontitis and associated with immune imbalance. Their combined assessment provides good internal predictive performance for early response after RSD, with potential value as adjunctive biomarkers for personalized risk stratification in periodontitis management pending external validation.

Association of gingival crevicular fluid chemerin and Th1/Th2 imbalance with early response to root surface debridement in periodontitis

期刊论文
发表日期：

2026年7月14日

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Feng Wei,
Dan Wang,
XiMeng Zhang,
YuKun Lv

摘要

Chemerin is a chemokine-like protein closely related to inflammation and immune regulation. Studies have indicated that it may be involved in the immune inflammatory process of periodontitis. Th1/Th2 cell imbalance is also important for the occurrence and development of periodontitis, but the relationship between Chemerin and Th1/Th2 cell imbalance and its effect on the early response to root surface debridement (RSD) remains unclear. This single-center, prospective observational study included 82 healthy controls and 129 periodontitis patients (Stage II-IV). Gingival crevicular fluid (GCF) samples were collected to measure Chemerin, interferon-gamma (IFN-γ), and interleukin-4 (IL-4) levels, with Th1/Th2 balance assessed by the IFN-γ/IL-4 ratio. C-reactive protein (CRP) and periodontal parameters were recorded. All periodontitis patients underwent RSD and were classified into good (n = 88) or poor (n = 41) early response groups after 6 weeks. Statistical analyses included correlation analysis, multivariate logistic regression, ROC curve analysis with bootstrap internal validation, model calibration, and decision curve analysis. Compared to controls, periodontitis patients showed significantly elevated GCF-Chemerin (4.82 ± 1.01 vs. 2.21 ± 0.38 ng/mL, p < 0.001) and IFN-γ/IL-4 ratio (2.34 ± 0.71 vs. 1.26 ± 0.29, p < 0.001), with increased IFN-γ and decreased IL-4 (both p < 0.001). GCF-Chemerin correlated positively with IFN-γ/IL-4 ratio (r = 0.40, p < 0.001). The poor early response group exhibited higher baseline levels of both biomarkers, which remained elevated post-treatment. Multivariate analysis identified Chemerin (OR = 9.00, p < 0.001), IFN-γ/IL-4 ratio (OR = 8.31, p < 0.001), clinical attachment level (CAL), and probing pocket depth (PPD) as independent factors associated with early response. The combined model (AUC = 0.886, bootstrap-corrected = 0.884) significantly outperformed individual biomarkers (p < 0.05), achieving 87.8% sensitivity and 75.0% specificity. Sensitivity analyses confirmed stable internal performance, and calibration and decision curve analyses demonstrated good internal predictive accuracy and clinical utility. GCF Chemerin and IFN-γ/IL-4 ratio are elevated in periodontitis and associated with immune imbalance. Their combined assessment provides good internal predictive performance for early response after RSD, with potential value as adjunctive biomarkers for personalized risk stratification in periodontitis management pending external validation.