Periodontal diseases are the leading cause of tooth loss in adults. Gingivitis and periodontitis are the most common periodontal diseases. Both present biofilm-mediated acute or chronic inflammatory changes in gingiva. Gingivitis is characterized by acute inflammation, whereas periodontitis usually presents as chronic inflammation. On the histological level,bacterial components trigger the activation of immune cells, such as macrophages, lymphocytes, plasma cells, and mast cells1,2. These immune cells, especially macrophages, interact with local cells (including gingival epithelial cells, fibroblasts, endothelial cells, and osteoblasts) resulting in inflammatory lesions in periodontal tissue3,4. Experimental models of periodontal diseases have been established in various types of animals, such as rats, hamsters, rabbits, ferrets, canines, and primates. However, the physiopathology of animal models is different from that of humans, making it difficult to analyze cellular and molecular mechanisms and evaluate new medicines of periodontal diseases5. Co-cultivation of periodontal bacteria and monolayer human oral epithelial cells has been used to investigate the mechanism of periodontal infections6. Nevertheless, monolayer cultures of oral cells lack the three-dimensional (3D) cellular architecture of intact tissue; therefore, they cannot mimic the in vitro situation.
Here, 3D inflammatory human tissue equivalents of gingiva (iGTE) are established to represent periodontal diseases in vitro. This 3D model of periodontal diseases occupies an intermediate position between monolayer cell cultures and animal models. Three types of human cells, including HaCaT keratinocytes, gingival fibroblasts, and THP-1 macrophages, are co-cultivated on collagen gel, and stimulated by inflammatory initiators to build iGTE. IGTE closely simulates the in vivo conditions of cell differentiation, cell-cell interaction, and macrophage activation in gingiva. This model has many possible applications for drug screening and testing new pharmacological approaches in periodontal diseases, as well as for analyzing cellular and molecular mechanisms in wound healing, inflammation, and tissue regeneration.