Читать книгу Periodontics - Fernando Suarez - Страница 65

Systemically, smoking can affect multiple components and mechanisms of the human immune response and subsequently the host response to periodontal pathogens. Smokers have been found to have a higher receptor activator of nuclear factor-κB ligand/osteoprotegerin (RANKL/OPG) ratio, which could partially explain the increased bone loss observed in smoking populations. This alteration in RANKL and OPG is observed not only in saliva¹⁵ but also in serum.¹⁶ Neutrophils constitute the first line of defense toward bacteria that accumulate in the gingival sulcus. Their function can be altered as a result of tobacco use.¹⁷ In later disease stages, antibody production also takes place. During that period, reduced levels of serum immunoglobulin G 2 (IgG2) are identified.¹⁸