Górska Renata, Gregorek Hanna, Kowalski Jan, Laskus-Perendyk Agnieszka, Syczewska Małgorzata, Madaliński Kazimierz
Medical School, Department of Periodontology and Oral Medicine, Warsaw, Poland.
J Clin Periodontol. 2003 Dec;30(12):1046-52. doi: 10.1046/j.0303-6979.2003.00425.x.
The purpose of the present study was to assess the relation between clinical parameters and concentrations of the key (IL-1beta, TNF-alpha, IL-2, IFN-gamma, IL-4, IL-10) cytokines, important in the initiation and progression of periodontal diseases, within inflamed gingival tissues and serum samples from patients with severe chronic periodontitis.
Twenty-five patients with severe chronic periodontitis, who had sites with probing depths (PD) > 5 mm, and 25 periodontally healthy persons were included in the study. Clinical examinations including PD, clinical attachment loss, plaque index, and bleeding index were performed before periodontal treatment. Gingival tissue biopsies were collected from one active site of each patient and from healthy individuals, and blood samples were withdrawn on the day of tissue biopsy. The concentrations of cytokines were determined by an enzyme-linked immunosorbent assay, and the relationship between their profiles in situ and in circulation with clinical parameters was analysed.
The concentrations of IL-1beta, TNF-alpha, IL-2, IFN-gamma were, on average, significantly higher in serum samples and gingival tissue biopsies from periodontitis patients than in healthy controls. However, serum samples from both groups showed high individual variability of cytokine profiles, and no association between cytokine concentrations and clinical parameters of periodontitis was found. On the contrary, the levels of IL-4 and IL-10 in both kinds of samples obtained from patients and controls were generally low or even undetectable, and remained, on average, on the same level. However, the frequency of IL-4 (88% positive samples) and IL-10 (72%) was much higher in healthy gingival tissues. High concentrations of TNF-alpha, IFN-gamma and IL-2 and, especially, a high ratio of IL-1beta/IL-10 and TNF-alpha/IL-4 found in tissue biopsies from periodontitis patients, strongly correlated with the severity of periodontitis.
These results indicate that high variability of cytokine concentrations and low frequency of their detection in serum samples from periodontitis patients make these determinations useless for the detection of disease presence and/or its severity. In contrast, high absolute levels of IL-1beta, TNF-alpha, IL-2 and IFN-gamma and, especially their high ratios to IL-4 and IL-10 found in inflamed tissue biopsies, were closely associated with periodontal disease severity.
本研究旨在评估重度慢性牙周炎患者炎症牙龈组织和血清样本中，临床参数与牙周疾病发生和发展过程中起关键作用的细胞因子（白细胞介素-1β、肿瘤坏死因子-α、白细胞介素-2、干扰素-γ、白细胞介素-4、白细胞介素-10）浓度之间的关系。
本研究纳入了25例重度慢性牙周炎患者，其探诊深度（PD）>5mm，以及25名牙周健康者。在牙周治疗前进行了包括PD、临床附着丧失、菌斑指数和出血指数在内的临床检查。从每位患者的一个活动位点以及健康个体中采集牙龈组织活检样本，并在组织活检当天采集血样。采用酶联免疫吸附测定法测定细胞因子浓度，并分析其在原位和循环中的分布与临床参数之间的关系。
牙周炎患者血清样本和牙龈组织活检样本中白细胞介素-1β、肿瘤坏死因子-α、白细胞介素-2、干扰素-γ的浓度平均显著高于健康对照组。然而，两组血清样本的细胞因子分布个体差异较大，未发现细胞因子浓度与牙周炎临床参数之间存在关联。相反，患者和对照组获得的两类样本中白细胞介素-4和白细胞介素-10的水平普遍较低甚至无法检测到，且平均保持在同一水平。然而，白细胞介素-4（88%阳性样本）和白细胞介素-10（72%）在健康牙龈组织中的出现频率要高得多。在牙周炎患者组织活检样本中发现的高浓度肿瘤坏死因子-α、干扰素-γ和白细胞介素-2，尤其是白细胞介素-1β/白细胞介素-10和肿瘤坏死因子-α/白细胞介素-4的高比值，与牙周炎的严重程度密切相关。
这些结果表明，牙周炎患者血清样本中细胞因子浓度的高度变异性及其低检测频率使得这些检测对于疾病存在和/或严重程度的检测毫无用处。相反，在炎症组织活检样本中发现的白细胞介素-1β、肿瘤坏死因子-α、白细胞介素-2和干扰素-γ的高绝对水平，尤其是它们与白细胞介素-4和白细胞介素-10的高比值，与牙周疾病严重程度密切相关。
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