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Clinical data and blood serum were collected at baseline (T0), after step I-III (T1), and after 12 months step IV periodontal therapy (T2). Cytokine IL-1\u03b2, IL-6, IL-8, TNF-\u03b1, IL-10, and IP-10 levels were measured using multiplex kit Bio-Plex Human Pro\u2122 Assay. Linear regression models with cluster robust variance estimates to adjust for repeated observations were used to test intra- and intergroup levels for each marker, IL-6 and IL-8 defined as primary outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Clinical outcomes improved in both groups following therapy (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). IL-6 levels increased with 75.0% from T0-T2 among smokers (<jats:italic>p<\/jats:italic>\u2009=\u20090.004). No significant intra- or intergroup differences were observed for IL-8. Higher levels of TNF-\u03b1 (44.1%) and IL-10 (50.6%) were detected in smokers compared with non-smokers at T1 (<jats:italic>p<\/jats:italic>\u2009=\u20090.007 and<jats:italic>p<\/jats:italic>\u2009=\u20090.037, respectively). From T1-T2, differences in mean change over time for levels of TNF-\u03b1 and IL-10 were observed in smokers compared with non-smokers (<jats:italic>p<\/jats:italic>\u2009=\u20090.005 and<jats:italic>p<\/jats:italic>\u2009=\u20090.008, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Upregulated levels of serum cytokines in smokers indicate a systemic effect of smoking following periodontal therapy. Differences in cytokine levels between smokers and non-smokers demonstrate a smoking induced modulation of specific systemic immunological responses in patients with severe periodontitis.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12903-024-04196-8","type":"journal-article","created":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T10:02:12Z","timestamp":1713261732000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Serum biomarker levels in smokers and non-smokers following periodontal therapy. 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