Gomes Marcio A B, Rodrigues Flavio H, Afonso-Cardoso Sandra R, Buso Antonio M, Silva Adriano G, Favoreto Silvio, Souza Maria A
Instituto de Ciências Biomédicas, Universidade Federal de Uberlandia, Uberlandia, Minas Gerais, Brazil.
J Periodontal Res. 2006 Jun;41(3):177-83. doi: 10.1111/j.1600-0765.2005.00851.x.
Diabetes mellitus and periodontal disease have high incidence in the general population and are associated with various degrees of dysfunction in the immune system. It has been shown that diabetic patients with severe periodontal disease have more complications of diabetes and less effective metabolic control compared with diabetic patients with healthy gingiva. Patients with diabetes and severe periodontal disease present higher levels of serous immunoglobulin A (IgA). Elevation of the IgA1 isotype is thought to contribute to this phenomenon. Another important event in the diabetes-periodontitis association is the disturbance in local and systemic production of inflammatory cytokines.
In this study we tested the hypothesis that type 2 diabetic patients with chronic moderate periodontal disease have differences in salivary IgA1 titers and cytokine expression when compared with the chronic severe periodontal disease cases.
We utilized a jacalin-IgA capture assay to determine the IgA1 titers in total saliva and reverse transcriptase-polymerase chain reaction to detect mRNA for interferon gamma (IFN-gamma) and tumor necrosis factor alpha (TNF-alpha) in total saliva samples of 13 patients with chronic moderate periodontal disease and 10 with chronic severe periodontal disease.
We observed a predominance of IgA1 titers of 64 (45.5%) in saliva samples from chronic severe periodontal disease patients and titers averaging 512 (30.8%) in chronic moderate periodontal disease patients. We detected mRNA for IFN-gamma in six out of 10 chronic severe periodontal disease subjects and in two out of 13 chronic moderate periodontal disease patients. TNF-alpha expression was similar in both groups. Our data suggest that higher levels of IgA1 may exert partial protection of the periodontal tissue in chronic moderate periodontal disease diabetic patients when compared to severe periodontal disease. Despite the small number of patients, IFN-gamma expression had a trend association with severity of periodontitis and TNF-alpha gene expression did not correlate with severity of periodontal disease.
糖尿病和牙周病在普通人群中发病率较高，且与免疫系统的各种功能障碍有关。研究表明，患有严重牙周病的糖尿病患者比牙龈健康的糖尿病患者有更多的糖尿病并发症，代谢控制效果也较差。糖尿病合并严重牙周病的患者血清免疫球蛋白A（IgA）水平较高。IgA1亚型的升高被认为是导致这一现象的原因。糖尿病与牙周炎关联中的另一个重要事件是局部和全身炎症细胞因子产生的紊乱。
在本研究中，我们检验了这样一个假设，即与慢性重度牙周病患者相比，患有慢性中度牙周病的2型糖尿病患者唾液中IgA1滴度和细胞因子表达存在差异。
我们采用红豆蔻凝集素-IgA捕获测定法来测定全唾液中的IgA1滴度，并使用逆转录聚合酶链反应来检测13例慢性中度牙周病患者和10例慢性重度牙周病患者全唾液样本中干扰素γ（IFN-γ）和肿瘤坏死因子α（TNF-α）的mRNA。
我们观察到，慢性重度牙周病患者唾液样本中IgA1滴度以64（45.5%）为主，而慢性中度牙周病患者的平均滴度为512（30.8%）。我们在10例慢性重度牙周病受试者中的6例以及13例慢性中度牙周病患者中的2例中检测到了IFN-γ的mRNA。两组中TNF-α的表达相似。我们的数据表明，与重度牙周病相比，较高水平的IgA1可能对慢性中度牙周病糖尿病患者的牙周组织起到部分保护作用。尽管患者数量较少，但IFN-γ表达与牙周炎严重程度有趋势性关联，而TNF-α基因表达与牙周病严重程度无关。
