Relationship Between HSP27 and HSP70 with Th17/Treg Imbalance and Prognosis in Anterior Region with Severe Periodontitis

LIU Bing; LIU Tingting; WANG Suping

doi:10.3969/j.issn.1004-437X.2026.04.009

Abstract：Objective To investigate the relationship between serum heat shock protein(HSP)27,HSP70 with helper T cell/regulatory T cell(Th17/Treg)imbalance and prognosis in patients with severe periodontitis(SP)in anterior teeth area.Methods A total of 120 patients with SP in the anterior region attending the First Affiliated Hospital of Zhengzhou University from January 2021 to March 2024 were selected as the SP group,and another 100 physically examined healthy persons during the same period were selected as the control group,and the patients with SP in the anterior region were classified into the group with poor prognosis(36 cases)and the group with good prognosis(84 cases)according to the prognosis after treatment.The levels of serum and gingival sulcus fluid HSP27 and HSP70 were detected by enzyme-linked immunosorbent assay,the proportion of Th 17 and Treg in peripheral blood was detected by flow cytometry,and the ratio of Th17/Treg was calculated.The correlation between serum HSP27,HSP70 and Th17 ratio,Treg ratio and Th17/Treg ratio in peripheral blood of SP patients in anterior teeth area were analyzed by Pearson/Spearman correlation analysis,the influencing factors of poor prognosis of SP patients in anterior teeth area were analyzed by multivariate logistic regression analysis,the value of serum HSP27 and HSP70 in evaluating the poor prognosis of SP patients in anterior teeth area were analyzed by receiver operating characteristic(ROC)curve.Results Compared with control group,the levels of serum and gingival sulcus fluid HSP27 and HSP70 were increased in SP group(P＜0.05).Compared with control group,the proportion of Th17 and the ratio of Th17/Treg in peripheral blood were increased,and the proportion of Treg in peripheral blood was decreased in SP group(P＜0.05).Pearson/Spearman correlation analysis showed that,serum HSP27 and HSP70 were positively correlated with Th17 and Th17/Treg ratio,and negatively correlated with Treg(P＜0.05).After 3 months of follow up,the incidence of poor prognosis in 120 patients was 30.00％(36/120).Multifactorial logistic regression analysis showed that baseline probing depth(PD)were risk factors for poor prognosis in patients with SP in the anterior region,and elevated serum and gingival sulcus fluid HSP27 and HSP70 were protective factors(P＜0.05).ROC curve analysis showed that,the area under the curve(AUC)of serum and gingival crevicular fluid HSP27 and HSP70 combined with baseline PD for predicting poor prognosis in patients with SP in the anterior dental region was 0.903,which was greater than the predicted value of individual indicators.Conclusion The levels of serum HSP27 and HSP70 in SP patients in anterior teeth area increased,which were relate to Th17/Treg imbalance and prognosis.The combination of serum and gingival crevicular fluid HSP27 and HSP70 with baseline PD had high evaluation value for poor prognosis in patients with anterior teeth area SP.