Tissue Levels of CD80, CD163 and CD206 and Their Ratios in Periodontal and Peri-Implant Health and Disease

Round 1

Reviewer 1 Report

This study looked at the levels of CD80 (pro-inflammatory) and CD163, CD206 (anti-inflammatory) in periodontal and peri-implantitis compared with healthy tissue. Tissue levels were not significantly different but ratios varied with the diseased states showing an elevated CD80/CD163 ratio – significantly higher in periodontitis, trending higher in peri-implantitis – compared with healthy tissues.

The study is well-designed given the limitations that come along with this type of study. The data is well-presented but there is only a small amount of data. I’m not convinced there is enough data for a full paper although I understand more experiments would be difficult.

The manuscript would also benefit from more discussion about what these results mean and how this fits into the bigger picture. It is not clear in the introduction why the study was necessary.  Both periodontitis and peri-implantitis are known to be inflammatory conditions so you would expect there to be a more pro-inflammatory milieu. The discussion would benefit from an elaboration of what is meant by the sentence in lines 231-232 about clinical manifestation.

The figure legends are very brief and should be expanded. Eg. Figure 3 - are those representative samples?

Author Response

Thank you very much for your constructive comments. We agree that our study has the limitation of the small sample size of data. However, our study is the first to demonstrate the associations between total CD80, CD163 and CD206 tissue levels and periodontal/peri-implant diseases. Macrophage polarization in periodontal diseases has been a hot topic recently and various research groups identified different macrophage phenotypes in periodontal/peri-implant tissues using above-mentioned surface markers. Yet, none of these studies described a relation between the total tissue levels of these immune-regulatory molecules and periodontal/peri-implant diseases. Thus, we humbly believe that our study has the potential to be acknowledged by the oral health community and provide insight for future research.

The introduction and discussion sections were changed according to the recommendations. The aim of this study was to focus on total levels of CD80, CD163 and CD206 rather than the cell numbers expressing them, which we try to clarify in the text now. We apologize of the unclear/inaccurate definition of clinical manifestation; the paragraph was changed and now discussed in more detail.

The figure legends are now expanded.

 

Reviewer 2 Report

An interesting, well-written article with scientific significance. Congratulations!

Author Response

Thank you for your constructive and supportive comments.

Reviewer 3 Report

Review on Yilmaz et al’s tissue levels of CD80, CD163, and CD206 and their ratios in periodontal and peri-implant health and disease

 

Dear Authors,

Reading your “discussion” I got lost a bit. I recommend relating your results to histopathological lesion (Page and Schroeder) in the discussion part. In clinical periodontal health practically, there is a limited acute histological lesion (initial) that nowadays referred as homeostatic inflammation would provide a better understanding of your study. The fact that you have used tissue homogenates means that CD protein levels reflect not just the intracellular, but the soluble and the extravesicular CDs all together.  

The higher levels of CD proteins of peri implant health and disease probably can be devoted to the different anatomy of peri-implant tissues compared to the true periodontium. It is hard to interpret the overall levels of CDs in this relationship. Please, interpret your results more in the periodontal context. 

Author Response

Thank you for your constructive comments. We changed the discussion mentioning the structural and immune response-wise differences between the periodontal and peri-implant tissues in health and disease, also focusing on Page and Schroeder’s model.

 

Round 2

Reviewer 1 Report

I am happy with the changes to the Introduction and Discussion. They have improved the quality of the manuscript.

Minor points - 

Line 66,67 - sentence has immunostaining twice

More detail in the figure legends would be useful so reader doesn't have to go back to the text to work out what the data shows.

I don't think you should have p=0.054 in Figure 2 if that is not considered statistically significant (figure legend states that p values represent significant differences). If you want to leave it in there then have all the p values.

Line 247 - response should be respond, differ is not needed in sentence

Author Response

Thank you for your constructive and supportive comments. The minor points are now corrected in the manuscript:

Line 66, 67 the sentence is corrected.

The figure legends are extended.

The Figure 2 is changed now, excluding p =.054.

Line 247, the sentence is corrected.