Department of Periodontology, Dental Research Division, Guarulhos University, São Paulo, Brazil.
J Clin Periodontol. 2010 Dec;37(12):1049-58. doi: 10.1111/j.1600-051X.2010.01624.x. Epub 2010 Sep 28.
This study compared the levels of tumour necrosis factor (TNF)-α, interferon (IFN)-γ, interleukin (IL)-4, IL-17 and IL-23 in the gingival crevicular fluid (GCF) from well-controlled and poorly controlled type 2 diabetic subjects with chronic periodontitis, before and after periodontal therapy.
Eighteen well-controlled (glycated haemoglobin levels ≤8%) and 20 poorly controlled (glycated haemoglobin levels >8%) diabetic subjects were enrolled in this study. All subjects were submitted to non-surgical periodontal therapy. GCF sampling and clinical periodontal parameters were assessed before, 3 and 6 months post-therapy. Total amounts and concentrations of TNF-α, IFN-γ, IL-4, IL-17 and IL-23 in the GCF were analysed by enzyme-linked immunosorbent assay (ELISA).
The levels of IL-17 were higher in poorly than in well-controlled subjects (p<0.05), whereas the levels of IFN-γ were increased in well- compared with poorly controlled subjects at all experimental groups (p<0.05). In addition, IL-4 levels were lower in well- than poorly controlled diabetic subjects at baseline (p<0.05). There were no differences between groups for TNF-α and IL-23 at any time points (p>0.05).
These results indicate a predominance of pro-inflammatory T-helper type 1 (Th1)- or Th17-cytokines in sites of chronic periodontitis from type 2 diabetic subjects, according to their glycaemic control.
本研究比较了牙周治疗前后,血糖控制良好和控制不佳的 2 型糖尿病伴慢性牙周炎患者龈沟液(GCF)中肿瘤坏死因子(TNF)-α、干扰素(IFN)-γ、白细胞介素(IL)-4、IL-17 和 IL-23 的水平。
本研究纳入了 18 名血糖控制良好(糖化血红蛋白水平≤8%)和 20 名血糖控制不佳(糖化血红蛋白水平>8%)的糖尿病患者。所有患者均接受非手术牙周治疗。治疗前、治疗后 3 个月和 6 个月时进行 GCF 采样和临床牙周参数评估。通过酶联免疫吸附试验(ELISA)分析 GCF 中 TNF-α、IFN-γ、IL-4、IL-17 和 IL-23 的总量和浓度。
与血糖控制良好的受试者相比,血糖控制不佳的受试者 GCF 中 IL-17 水平更高(p<0.05),而 IFN-γ 水平在所有实验组中均在血糖控制良好的受试者中升高(p<0.05)。此外,在基线时,血糖控制良好的糖尿病患者 GCF 中 IL-4 水平低于血糖控制不佳的受试者(p<0.05)。在任何时间点,TNF-α 和 IL-23 两组之间均无差异(p>0.05)。
根据血糖控制情况,这些结果表明 2 型糖尿病伴慢性牙周炎患者的龈沟液中存在以促炎辅助性 T 细胞 1(Th1)或 Th17 细胞因子为主的情况。