Oral pathologic conditions and impaired cytokine response in patients with previous cerebral abscess or cervical necrotizing soft tissue infection

BACKGROUND: Microorganisms involved in cerebral abscess (CA) and cervical necrotizing soft tissue infection (NSTI) are frequently commensals of the oral cavity. Yet, the reasons for their ability to cause severe opportunistic infections remains unknown. The purpose of this study was to evaluate the dental characteristics and examine the stimulated immune response in patients with a history of CA or cervical NSTI.

METHODS: This observational study includes a clinical dental examination, and the collection of blood samples from 18 previous CA patients and four previous cervical NSTI patients. Whole blood cells were stimulated with LPS, R848, Poly I:C and anti-CD3/-CD28 beads in TruCulture tubes. The concentrations of TNF-α, IL-1β, IL-6, IL-8, IL-10, IL-12, IL-17A, IFN-α, and IFN-γ were subsequently measured by Luminex technology and compared with corresponding values from a healthy reference group. P-values of ≤ 0.001 were considered statistically significant.

RESULTS: For patients with previous CA, decreased production of IFN-α, IFN-γ, and IL-12 was seen after stimulation of cells with LPS and Poly I:C (p ≤ 0.001). Moreover, cells from patients with previous cervical NSTI showed decreased production of IFN-α and IFN-γ after stimulation with LPS and Poly I:C (p ≤ 0.001). Nineteen out of 22 participants (86%) had oral pathologic conditions at the dental examination.

CONCLUSION: The cytokine secretion for the LPS- and Poly I:C-stimulus suggests an impaired proinflammatory response within the innate immune response against bacterial and viral pathogens. A high prevalence of oral pathologic conditions was found at the clinical dental examinations. However, none of the patients experienced recurrence of CA or NSTI.