Neutrophil extracellular traps behaviors in periodontitis: A mini review

Periodontitis is a multifactorial inflammatory disease brought on by a state of imbalance between the gingival microbiome and the immune responses of the host. Neutrophils are the key cells that play an important role in fighting pathogenic microorganisms in infectious disorders, either by killing them within the cell or secreting antimicrobials attached to large web-like structures known as neutrophil extracellular traps (NETs) through a cell death process known as NETosis. Formation of NETs is important for maintaining homeostasis in periodontal tissues and improvement of health. In periodontitis, an immune-based inflammation impedes NETs formation or causes its destruction, thereby enabling inflammation to progress and destroy periodontal tissues. Polymorphonulear neutrophils (PMNs) inhibit microorganisms and decrease inflammation by secreting of NETs into the pocket environment. Conversely, elevated NET levels can elicit an inflammatory response and provide an environment that is favorable for pathogenic bacteria. NETs biomarkers may prove to be helpful in the diagnosis of periodontitis. However, it is necessary to make future research on the specific mechanism of NETs and the exact interaction between a single bacterium and NETs.