Machine learning-assisted immune profiling stratifies peri-implantitis patients with unique microbial colonization and clinical outcomes.
Machine learning-assisted immune profiling stratifies peri-implantitis patients with unique microbial colonization and clinical outcomes.
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作者：
Wang CW;Hao Y;Di Gianfilippo R;Sugai J;Li J;Gong W;Kornman KS;Wang HL;Kamada N;Xie Y;Giannobile WV;Lei YL
理由：种植体周围炎的流行影响超过25%的牙科种植体。目前的治疗依赖于经验性的患者和基于站点的分层，缺乏一致的风险分级系统。研究方法：我们研究了一个独特的接受再生治疗的种植体周围炎患者队列，并进行了全面的临床、免疫和微生物分析。我们使用了一种鲁棒的抗离群值机器学习算法进行免疫去卷积。结果：无监督聚类识别具有不同免疫特征、微生物定植动力学和再生结果的风险组。低危患者表现出M1/M2样巨噬细胞比率升高和B细胞浸润降低。低风险免疫特征的特征是增强的补体信号传导和较高水平的Th 1和Th 17细胞因子。具核梭杆菌和中间普雷沃菌在高危人群中明显富集。尽管手术减少了所有组中种植体周围界面的微生物负荷，但只有低风险个体表现出对关键病原体再定植的抑制。结论：种植体周围的免疫微环境决定了种植体周围的微生物组成和再生过程。免疫特征在改善种植体周围炎的风险分级方面显示出未开发的潜力。
Rationale: The endemic of peri-implantitis affects over 25% of dental implants. Current treatment depends on empirical patient and site-based stratifications and lacks a consistent risk grading system. Methods: We investigated a unique cohort of peri-implantitis patients undergoing regenerative therapy with comprehensive clinical, immune, and microbial profiling. We utilized a robust outlier-resistant machine learning algorithm for immune deconvolution. Results: Unsupervised clustering identified risk groups with distinct immune profiles, microbial colonization dynamics, and regenerative outcomes. Low-risk patients exhibited elevated M1/M2-like macrophage ratios and lower B-cell infiltration. The low-risk immune profile was characterized by enhanced complement signaling and higher levels of Th1 and Th17 cytokines. Fusobacterium nucleatum and Prevotella intermedia were significantly enriched in high-risk individuals. Although surgery reduced microbial burden at the peri-implant interface in all groups, only low-risk individuals exhibited suppression of keystone pathogen re-colonization. Conclusion: Peri-implant immune microenvironment shapes microbial composition and the course of regeneration. Immune signatures show untapped potential in improving the risk-grading for peri-implantitis.