The epidemiological and clinical studies have provided irrefutable evidence that smoking negatively impacts periodontal health. Cross-sectional and longitudinal data provide strong support that cigarette smoking is a significant risk factor for the development as well as progression of periodontal disease. Studies have shown altered serum and gingival crevicular fluid inflammatory cytokine profiles, immune cell function and altered proteolytic regulation in smokers. However the observations of these studies are not consistent and to date no clear mechanism has emerged to explain how smoking may affect periodontal disease. Hence the present study undertaken to assess the alterations of serum immunoglobulin levels in smokers with periodontitis and study its potential role as a risk indicator of the disease process.

The serum immunoglobulins and subclasses of IgG were studied in 30 smoker patients and 30 non-smoker patients with chronic periodontitis, and 30 healthy subjects. The total serum IgG, IgA and IgM as well as IgG subclasses (IgG1, IgG2, IgG3, and IgG4) were analyzed. The immunoturbidimetric assay was used for the estimation of immunoglobulin G, A, and M levels. The IgG subclasses were analyzed using single radial immunodiffusion assay.

The results of the study showed significantly lower levels of serum IgG and IgA in smokers compared to non-smokers and healthy controls (p<0.001). Even though the serum IgM levels were found to be low in smokers it was not significant. Out of the four subclasses of immunoglobulin G studied the IgG2 was found to be significantly lower among smokers with periodontitis.

The reduced immunoglobulin levels observed in smokers with periodontitis is in agreement with previous reports. These observations indicate that cigarette smoking may be associated with the suppression of B-cell function and immunoglobulin production. The alteration of antibody levels further explains the potential mechanism by which smoking exacerbates periodontal disease. The direct correlations between smoking-induced changes in the functioning of the immune system and compromised periodontal health remain to be established. Further studies at molecular level may highlight the specific mechanism by which tobacco can interact with cells of the immune system and its impact on periodontal disease process.

1. Al-Ghamdi HS, Anil S. Serum antibody levels in smoker and non-smoker saudi subjects with chronic periodontitis.J Periodontol. 2007 Jun;78(6):1043-50.
2. Anil S. Study of the patterns of periodontal destruction in smokers with chronic periodontitis. Indian Journal of Dental Research 2007 ( in Press).