Comparison of circulating tumour necrosis factor superfamily cytokines in periodontitis patients undergoing supportive therapy: a case-controlled cross-sectional study comparing smokers and non-smokers in health and disease

J Clin Periodontol. 2013 Sep;40(9):875-82. doi: 10.1111/jcpe.12134.


Background: B-cells are prominent immune cells in established periodontitis lesions. Tumour necrosis factor superfamily (TNFSF) cytokines play roles in supporting B-cell function as well as bone re-modelling. The influence of smoking on factors that support B-cell function in periodontitis remains unclear.

Aim: To investigate plasma concentrations of TNF (TNSF1A), soluble receptor activator of nuclear-factor Kappa-B ligand (sRANKL/TNFSF11), a proliferation-inducing ligand (APRIL/TNFSF13), B-cell activating factor (BAFF/TNFSF13B) and Osteoprotegerin (OPG/TNFRSF11B) in smokers and non-smokers with and without chronic periodontitis

Materials & methods: Plasma concentrations of TNFSF and OPG were evaluated in 200 systemically healthy subjects divided into four groups: non-smokers with periodontitis (n = 101), smokers with periodontitis (n = 55), healthy non-smokers (n = 27) and healthy smokers (n = 17).

Results: Periodontitis patients had significantly higher plasma sRANKL, TNF, APRIL and BAFF and lower OPG than healthy subjects (p < 0.01). TNF and sRANKL were significantly greater in smokers with periodontitis (p = 0.011, p = 0.001) and OPG concentrations significantly lower (p = 0.001), whereas APRIL or BAFF were little changed. Plasma APRIL, BAFF, sRANKL and TNF correlated with probing depth and clinical attachment loss.

Conclusion: TNFSF cytokines correlate with periodontitis disease severity. However, only TNF, sRANKL and OPG levels were altered by cigarette smoking. APRIL and BAFF appear as good indicators of disease severity.

Keywords: Osteoprotegerin; periodontitis; smoking TNFSF.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • B-Cell Activating Factor / blood
  • B-Lymphocytes / immunology
  • Bone Remodeling / immunology
  • Case-Control Studies
  • Chronic Periodontitis / immunology
  • Chronic Periodontitis / therapy*
  • Cotinine / blood
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Osteoprotegerin / blood
  • Periodontal Attachment Loss / immunology
  • Periodontal Pocket / immunology
  • Periodontium / immunology
  • RANK Ligand / blood
  • Smoking / immunology*
  • Tumor Necrosis Factor Ligand Superfamily Member 13 / blood
  • Tumor Necrosis Factor-alpha / blood
  • Tumor Necrosis Factors / blood*


  • B-Cell Activating Factor
  • Osteoprotegerin
  • RANK Ligand
  • TNF protein, human
  • TNFRSF11B protein, human
  • TNFSF11 protein, human
  • TNFSF13B protein, human
  • Tumor Necrosis Factor Ligand Superfamily Member 13
  • Tumor Necrosis Factor-alpha
  • Tumor Necrosis Factors
  • Cotinine