Legert Karin Garming, Tsilingaridis Georgios, Remberger Mats, Ringdèn Olle, Heimdahl Anders, Yucel-Lindberg Tülay, Dahllöf Göran
Division of Oral and Maxillofacial Surgery, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden.
Support Care Cancer. 2015 Jun;23(6):1749-57. doi: 10.1007/s00520-014-2538-z. Epub 2014 Nov 30.
Oral mucositis (OM) is a severe side effect of conditioning for allogeneic hematopoietic stem cell transplantation (HSCT). The aim of the present study was to investigate the relationship between oral mucositis and the levels of pro-inflammatory cytokines-both in serum and in gingival crevicular fluid (GCF), in relation to different conditioning regimens.
We analyzed the levels of pro-inflammatory cytokines IL-1β, TNF-α, IL-6, and IL-7, as well as anti-inflammatory cytokine IL-10 in gingival crevicular fluid (GCF) and in serum from 43 HSCT patients. Twenty-five received reduced intensity conditioning (RIC) and 18 received myeloablative conditioning (MAC). Cytokine levels were determined in GCF and serum before the start of conditioning, and 1 week and 1 month after HSCT. All patients experienced OM with a median score of 2.1 and median peak on day 11.
There was a significant correlation between OM and MAC (p = 0.035). There were no significant differences in GCF volume at the three time points examined. The levels of IL-6 in GCF increased 1 week after transplantation and then returned to baseline (p < 0.001). The levels of IL-10 in GCF decreased after HSCT (p < 0.001) and remained unchanged. The levels of IL-6 in serum significantly (p < 0.001) increased 1 week after HSCT and decreased to baseline levels after 1 month. The levels of IL-10 in serum significantly (p = 0.02) increased 1 month after HSCT.
No correlations between cytokine levels in gingival crevicular fluid and oral mucositis were observed. There was a correlation between severity of OM score and increase in IL-6 in serum. No correlations between cytokine levels in gingival crevicular fluid and in serum were observed.
口腔黏膜炎（OM）是异基因造血干细胞移植（HSCT）预处理的一种严重副作用。本研究旨在探讨口腔黏膜炎与促炎细胞因子水平之间的关系——包括血清和龈沟液（GCF）中的水平，并与不同的预处理方案相关联。
我们分析了43例HSCT患者龈沟液（GCF）和血清中促炎细胞因子白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）和白细胞介素-7（IL-7）以及抗炎细胞因子白细胞介素-10（IL-10）的水平。25例接受了减低强度预处理（RIC），18例接受了清髓性预处理（MAC）。在预处理开始前、HSCT后1周和1个月时测定GCF和血清中的细胞因子水平。所有患者均出现口腔黏膜炎，中位评分为2.1，中位峰值出现在第11天。
口腔黏膜炎与清髓性预处理之间存在显著相关性（p = 0.035）。在检查的三个时间点，GCF体积无显著差异。移植后1周，GCF中IL-6水平升高，然后恢复到基线水平（p < 0.001）。HSCT后，GCF中IL-10水平降低（p < 0.001）且保持不变。HSCT后1周，血清中IL-6水平显著升高（p < 0.001），1个月后降至基线水平。HSCT后1个月，血清中IL-10水平显著升高（p = 0.02）。
未观察到龈沟液中细胞因子水平与口腔黏膜炎之间的相关性。口腔黏膜炎评分的严重程度与血清中IL-6的升高之间存在相关性。未观察到龈沟液和血清中细胞因子水平之间的相关性。
