Role of Triggered Receptor Expressed in Myeloid Cells (TREM) in Periodontal Disease- A Systematic Review

Abstract

Background: Periodontal diseases are chronic inflammatory diseases caused by periodontal pathogenic bacteria which is characterised by inflammation and destruction of periodontal tissues. TREM-Triggered Receptor Expressed on Myeloid cells 1(TREM-1) is a cell surface receptors of the immunoglobulin superfamily, involved in the innate inflammatory response to bacterial and fungal infections. TREM-1 activation and expression occur synergistically with TLR as the TREM family contains both inhibitory and activating receptors capable of TLRs moreover , TREM -1 has also been associated with NOD- like receptors (NLR), responsible for sensing microbial danger and amplifying the inflammatory response. On the molecular level, TREM-1 regulates immune cell function, by forming an intracellular complex with signaling adapter DNAX activating protein of 12FDa(DAP12), is involved in immune response to bacterial and fungal infections particularly by amplifying the production of pro- inflammation cytokines by the host.
Aim: The aim of this systematic review is to evaluate the role of Triggered Receptor Expressed in Myeloid Cells 1(TREM -1) in periodontal disease.
Materials And Methods: Source Used And Search Methodology: Electronic databases were done which included studies of the Pubmed, Pubmed central, Medline, Cochrane database of systematic reviews, Mesh, Science direct, Embase databases up till the month of March 2021. The search was performed using key words and terms mentioned in Table. No limits and language restriction were applied during the electronic search to include all the possible clinical trials in the potential relevant article search phase of the systematic review. No time restriction was applied. The search was completed by checking the reference terms and also the key words given in the relevant articles. A manual hand search was also carried out. The articles were screened on the basis of title and abstract. Full text was then downloaded for the relevant articles which fulfilled the inclusion criteria mentioned.
Results: 11 articles were found relevant according to the inclusion criteria .It was found that 11 studies discussed the role of TREM levels in periodontal disease. 5 studies discussed about sTREM-1 levels and IL levels against periodontal pathogens. 1 study showed P1 study showed up Active Matrix Metalloproteinase (aMMP) Predicts in (TREM -1) In saliva PGLYRP1 AND TREM-1, IL levels in gingival inflammation. 1 study showed TREM-1 , mRNA expression in MM6 cells ( MONO MAC ). 1 study showed TREM -1, TREM-2 in inflamed Human gingiva. 1 study showed TREM -1,PGLYRP 1, MMP 8 in peri implant disease. 1 study showed TREM - 1 Response in periodontium in elderly population.
Conclusion: The current evidence and results prove that further in the field of TREM could throw a light into the understanding of the inflammatory process of periodontal disease. From the systematic review it is evident that TREM levels are increased in periodontal disease, against periodontal pathogens. Synthetic TREM-1 blockade could mitigate the host inflammatory response and be useful as an adjunct therapy for the treatment of periodontal disease.Further studies are needed to show the specific role of sTERM-1 in inflammatory conditions and diagnostic tests will be available for clinical use in dental practices to assist in patient care. TREM-1 modulation to provide therapeutic effects and arrest the tissue destruction common in periodontitis.