Specialized Pro-Resolving Mediators Show Promise
SPMs signal the body to shift from tissue destruction to repair
Previously, I discussed the role of lipid derivatives, called specialized pro-resolving mediators (SPMs), in repairing the tissue damage created by acute inflammation. Recent studies have shown that the resolution of some inflammatory diseases is dependent on the presence of these molecules.1,2 SPMs signal the body to shift from tissue destruction (acute inflammation) to repair. Failure to make this transition can result in a chronic inflammatory state.
These naturally occurring molecules proved difficult to work with in the laboratory. As a result, synthetic derivatives (mimetics) have also been used for testing cellular response. In several studies, these hormones and their mimetics have produced both resolution of the chronic inflammatory phase and tissue repair. Natural SPMs are produced by the body as it metabolizes omega-3 fatty acids. They are found in certain deep-water fish and some vegetable oils, or can be taken as supplements.
Two recent articles highlight the effect of SPMs on inflammatory periodontal diseases. One article discussed Resolvin D1, a SPM that promotes resolution of chronic inflammation and signals repair to begin. In this study, cultures of periodontal ligament fibroblast (PDLF) cells were grown; all were mixed with interleukin 1B that stimulated an inflammatory response, resulting in inhibition of wound healing and proliferation of the fibroblast cells.1 Resolvin D1 was introduced into half of the cultures. It eliminated the inflammatory response by reversing the production of pro-inflammatory cytokines and matrix metalloproteinases. The authors stated that Resolvin D1 demonstrated that it “has a pro wound healing proliferative, and anti-inflammatory impact on the PDLF that favors periodontal regeneration.”1
The second study looked at an SPM mimetic and its effect on inflammatory periodontal lesions. Lipoxins are a class of endogenously biosynthesized mediators that promote the resolution of inflammation. Hasturk et al2 cite studies that show these compounds can limit neutrophil infiltration, promote macrophage polarization, increase macrophage efferocytosis, and restore tissue homeostasis. They state that lipoxins can significantly protect against soft tissue and alveolar bone destruction. The authors identified a patient population of 127 individuals who had at least slight color or texture changes affecting all portions of the gingival margins and interproximal papillae. The test group received an oral rinse containing a SPM; one control group used a placebo rinse; and a third group used no mouthrinse.The authors felt the BLXA4 oral rinse demonstrated significant clinical benefits.2 They also found that topically applied BLXA4 increased systemic levels of SPMs.
These and other studies indicate that it may be possible to use SPMs to control periodontal inflammation and stimulate regeneration of lost periodontal tissues.
Thomas G. Wilson Jr., DDS, Editor in Chief
- Zarrough AE, Hasturk H, Stephens DN, Van Dyke TE, Kantarci K. Resolvin D1 Modulates periodontal ligament fibroblast function. J Periodontol. 2023;94:683-693.
- Hasturk H, Schulte F, Martins M, et al. Safety and preliminary efficacy of a novel host modularity therapy for reducing gingival inflammation. Front Immunol. 2021:12:704163.
From Decisions in Dentistry.November/December 2023; 9(10):6