{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T20:02:29Z","timestamp":1784404949214,"version":"3.55.0"},"reference-count":40,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["#302129\/2025\u20101"],"award-info":[{"award-number":["#302129\/2025\u20101"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Periodontology"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Individuals with Down syndrome (DS) are particularly vulnerable to early\u2010onset and rapidly progressing periodontitis, yet the local immune\u2010inflammatory alterations that contribute to this susceptibility are not fully understood. This study aimed to characterize cytokine profiles in gingival crevicular fluid (GCF) from individuals with DS and periodontitis and to compare them with those of periodontitis patients without DS and periodontally healthy controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Forty\u2010five participants were enrolled and divided equally into three groups (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a015 each): DS with periodontitis (DSP), periodontitis without DS (P), and systemically and periodontally healthy controls (C). GCF samples were collected from two interproximal sites per participant and analyzed for IL\u20101\u03b2, IL\u20104, IL\u20106, IL\u201010, TNF\u2010\u03b1, and IFN\u2010\u03b3 using multiplex immunoassays. Standard periodontal parameters, including probing depth, attachment level, bleeding on probing, and plaque index, were also recorded. Non\u2010parametric comparisons and multivariate approaches, including principal component analysis and hierarchical clustering, were employed to explore cytokine distribution patterns.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Individuals with DS and periodontitis exhibited a heterogeneous but predominantly pro\u2010inflammatory cytokine profile, characterized by elevated IL\u20101\u03b2, IL\u20106, TNF\u2010\u03b1, and higher Th1\/Th2 and IL\u20101\u03b2\/IL\u201010 ratios. In contrast, the P group demonstrated a Th2\u2010skewed response with higher levels of IL\u20104, IL\u201010, and IFN\u2010\u03b3, suggestive of compensatory immune regulation. Healthy controls consistently displayed the lowest cytokine concentrations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This preliminary study identifies a distinct pro\u2010inflammatory cytokine profile in Down syndrome\u2010associated periodontitis, characterized by heightened IL\u20101\u03b2 responses and a Th1\u2010skewed immune pattern. While limited by sample size and the absence of a DS\u2010healthy control group, these findings provide initial mechanistic insights into the accelerated periodontal breakdown observed in DS and lay the groundwork for future, larger\u2010scale investigations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Plain language summary<\/jats:title>\n                    <jats:p>People with Down syndrome (DS) often develop gum disease, called periodontitis, much earlier and more severely than others. This condition damages the tissues and bone that support the teeth and can lead to tooth loss. Researchers believe that an overactive immune system may play a role, but the exact reasons are not well understood. In this study, we examined the levels of several immune signaling molecules, called cytokines, in the fluid around the gums of people with DS and periodontitis, comparing them with individuals with periodontitis but without DS and with healthy participants. We found that people with DS and periodontitis had higher levels of inflammatory cytokines, showing an exaggerated immune reaction dominated by molecules that promote inflammation. In contrast, people with periodontitis but without DS showed signs of a more balanced immune response, including molecules that help to limit inflammation. These findings suggest that individuals with DS experience a stronger and less controlled inflammatory reaction in their gums, which may explain why their gum disease progresses so rapidly. Understanding these immune differences may help to develop better prevention and treatment strategies for people with Down syndrome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jper.70087","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T12:22:51Z","timestamp":1771503771000},"page":"1467-1480","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Surveying immune and inflammatory alterations in periodontitis among individuals with Down syndrome: A preliminary cross\u2010sectional study"],"prefix":"10.1002","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3026-8369","authenticated-orcid":false,"given":"Leticia Helena","family":"Theodoro","sequence":"first","affiliation":[{"name":"Center for Dental Assistance to Persons with Disabilities (CAOE) School of Dentistry  Ara\u00e7atuba SP Brazil"},{"name":"Department of Diagnostic and Surgery School of Dentistry S\u00e3o Paulo State University (UNESP)  Ara\u00e7atuba SP Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1812-2589","authenticated-orcid":false,"given":"Jo\u00e3o Victor Soares","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Center for Dental Assistance to Persons with Disabilities (CAOE) School of Dentistry  Ara\u00e7atuba SP Brazil"},{"name":"Department of Diagnostic and Surgery School of Dentistry S\u00e3o Paulo State University (UNESP)  Ara\u00e7atuba SP Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2167-9772","authenticated-orcid":false,"given":"Marta A. A.","family":"Nuernberg","sequence":"additional","affiliation":[{"name":"CEUUN Francisco Beltr\u00e3o Campus Unisep University Center  Francisco Beltr\u00e3o Paran\u00e1 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2011-1851","authenticated-orcid":false,"given":"Pedro Henrique","family":"Petrilli","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Surgery School of Dentistry S\u00e3o Paulo State University (UNESP)  Ara\u00e7atuba SP Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9333-4349","authenticated-orcid":false,"given":"Mabelle de Freitas","family":"Monteiro","sequence":"additional","affiliation":[{"name":"Department of Periodontics State University of Campinas (UNICAMP)  Piracicaba SP Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7629-7221","authenticated-orcid":false,"given":"Valdir Gouveia","family":"Garcia","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Surgery School of Dentistry S\u00e3o Paulo State University (UNESP)  Ara\u00e7atuba SP Brazil"},{"name":"Department of Implantology Latin American Institute of Dental Research and Education (ILAPEO)  Curitiba PR Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1110-6233","authenticated-orcid":false,"given":"Rafael Scaf","family":"de Molon","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Surgery School of Dentistry S\u00e3o Paulo State University (UNESP)  Ara\u00e7atuba SP Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1037-591X","authenticated-orcid":false,"given":"Renato Correa Viana","family":"Casarin","sequence":"additional","affiliation":[{"name":"Department of Periodontics State University of Campinas (UNICAMP)  Piracicaba SP 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