Kim David M, Koszeghy Kristian L, Badovinac Rachel L, Kawai Toshihisa, Hosokawa Ikuko, Howell T Howard, Karimbux Nadeem Y
Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, USA.
J Periodontol. 2007 Aug;78(8):1620-6. doi: 10.1902/jop.2007.070011.
Inflammatory and anti-inflammatory mediators may play a significant role in patients with gingivitis. The purpose of this study was to assess the short-term effects of the systemic administration of two different concentrations of aspirin (81 and 325 mg/day, by mouth) on clinical periodontal parameters and gingival crevicular fluid (GCF) levels of 15-epi-lipoxin A4 (15-epi-LXA4), lipoxin A4, leukotriene B4 (LTB4), prostaglandin E2 (PGE2), and interleukin (IL)-6 and -1beta in a sample of naturally occurring gingivitis patients.
At day 0, after initial screening for entry, baseline periodontal parameters, including bleeding on probing (BOP), periodontal probing depths (PDs), and plaque index (PI) were measured, and GCF was sampled from 12 intrasulcular sites with filter paper strips for the measurement of six types of inflammatory and anti-inflammatory mediators using competitive enzyme immunoassay and enzyme-linked immunosorbent assay (prevalues). Forty-seven subjects were assigned randomly to one of three treatment groups: placebo (15 subjects); aspirin, 81 mg (16 subjects); and aspirin, 325 mg (16 subjects) once daily. On day 7, subjects were recalled for the measurement of periodontal parameters and collection of GCF samples for the measurement of six types of mediators (postvalues).
Changes in inflammatory and anti-inflammatory mediator levels were not statistically significant for any of the three treatment groups. However, when pre- and postvalues were compared in the subjects receiving aspirin, 325 mg, there was a negative trend in the relationship between 15-epi-LXA4 and PGE2, whereas the relationship between LTB4 and PGE2 was not as strong. This might indicate that the subjects responding to aspirin-mediated PGE2 suppression effects produced higher 15-epi-LXA4 in GCF than non-responders. No statistically significant differences in PD and PI between pre- and postvalues were found for any of the three treatment groups. However, the results demonstrated a significant increase in BOP when aspirin, 325 mg was compared to placebo (P <0.001) and aspirin, 81 mg (P = 0.001).
Aspirin can have an affect on BOP in naturally occurring gingivitis patients. Although most of the inflammatory mediators did not show significantly detectable changes after aspirin treatment for 7 days, the trend of aspirin-associated increases of 15-epi-LXA4 implied that this recently discovered aspirin-dependent eicosanoid may be associated with the increased incidence of BOP observed in the subjects who received aspirin therapy.
炎症和抗炎介质可能在牙龈炎患者中发挥重要作用。本研究的目的是评估口服两种不同浓度阿司匹林（81毫克/天和325毫克/天）对自然发生的牙龈炎患者样本的临床牙周参数以及龈沟液（GCF）中15-表-脂氧素A4（15-epi-LXA4）、脂氧素A4、白三烯B4（LTB4）、前列腺素E2（PGE2）以及白细胞介素（IL）-6和-1β水平的短期影响。
在第0天，经过初步筛选确定入选后，测量基线牙周参数，包括探诊出血（BOP）、牙周探诊深度（PD）和菌斑指数（PI），并使用滤纸从12个龈沟内位点采集GCF样本，采用竞争性酶免疫测定法和酶联免疫吸附测定法测量六种炎症和抗炎介质（预值）。47名受试者被随机分配到三个治疗组之一：安慰剂组（15名受试者）；81毫克阿司匹林组（16名受试者）；325毫克阿司匹林组（16名受试者），每日一次。在第7天，召回受试者测量牙周参数并采集GCF样本以测量六种介质（后值）。
三个治疗组中任何一组的炎症和抗炎介质水平变化均无统计学意义。然而，在接受325毫克阿司匹林治疗的受试者中比较前后值时，15-epi-LXA4与PGE2之间的关系呈负趋势，而LTB4与PGE2之间的关系则不那么明显。这可能表明对阿司匹林介导的PGE2抑制作用有反应的受试者在GCF中产生的15-epi-LXA4高于无反应者。三个治疗组中任何一组的PD和PI前后值之间均未发现统计学上的显著差异。然而，结果表明，与安慰剂组（P <0.001）和81毫克阿司匹林组（P = 0.001）相比，325毫克阿司匹林组的BOP显著增加。
阿司匹林可对自然发生的牙龈炎患者的BOP产生影响。尽管大多数炎症介质在阿司匹林治疗7天后未显示出明显可检测到的变化，但阿司匹林相关的15-epi-LXA4增加趋势表明，这种最近发现的阿司匹林依赖性类花生酸可能与接受阿司匹林治疗的受试者中观察到的BOP发生率增加有关。
