Department of Dental Clinic, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Department of Dental Clinic, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Environmental Biogeochemistry Wolfgang C. Pfeiffer Laboratory, Federal University of Rondonia (UNIR).
Am J Obstet Gynecol. 2016 Jun;214(6):749.e1-749.e11. doi: 10.1016/j.ajog.2015.12.008. Epub 2015 Dec 13.
The biologic plausibility of the possible association between periodontitis and adverse pregnancy outcomes has been assessed with the use of different experimental models. However, most experimental studies did not induce periodontitis in the animals but promoted an acute microbial challenge with selected periodontal pathogens or their products subcutaneous or intravenous or intraamniotic. The present study was then conducted to verify the biologic plausibility of such association by experimentally inducing periodontitis in Wistar rats.
An experimental study on an animal model by the induction of periodontitis in 50% of sites and assessment of the presence of cytokines in the gingival tissue, serum, placenta, cord, and amniotic fluid was designed to test the null hypothesis that experimental periodontitis that is induced on rats does not result in adverse pregnancy outcomes.
Forty female Wistar rats were included in 2 groups: a periodontally healthy (without ligatures) and an experimentally induced periodontitis group (test, with ligatures). Forty-five days after the induction, the mating was initiated. Males were placed with females in the ratio of 1:2 for a period of 12 hours. The bodyweight of the female, from then on, was recorded daily. When the pregnancy was confirmed on day 20, laparotomy was performed. The amniotic fluid, placenta, umbilical cord, blood (serum) and maternal and gingival tissue samples were subjected to quantitative analysis for interleukin 1α, -6, -10, -4, -12p70, and -17a, tumor necrosis factor-α, and interferon-γ by multiplex methods. Mean scores, standard deviations, and standard errors for estimated measures were calculated. For cytokines analyses, the Mann-Whitney test was conducted to compare the concentration of the analytes from control and test groups in the different tissues samples. For comparison of cytokines reduction from gingival tissue to serum and from serum to placenta, the Wilcoxon Test was performed. Spearman's correlation was conducted among cytokines in the 5 different tissues that were evaluated.
The induced periodontitis in Wistar rats did not result in adverse outcomes of pregnancy. There were no statistically significant differences between groups in relation to prematurity, fetal, or birth weight. Regarding cytokines, there were no statistically significant differences in concentrations that were measured in each tissue between the groups with periodontitis and controls. Furthermore, all cytokine levels in the placenta, except interleukin-6, were diminished compared with the amniotic fluid or maternal serum, which suggested that the cytokines cannot easily be transferred via this tissue in maternal-fetal or fetomaternal direction. The fertility rate was reduced significantly in the group with periodontitis.
Periodontitis that is induced in rats is not a risk factor for preterm birth or low birthweight.
人们已经使用不同的实验模型来评估牙周炎与不良妊娠结局之间可能存在的关联的生物学合理性。然而,大多数实验研究并没有在动物中诱发牙周炎,而是通过皮下或静脉内或羊膜内注射选择的牙周致病菌或其产物来促进急性微生物挑战。因此,本研究旨在通过在 Wistar 大鼠中诱导牙周炎来验证这种关联的生物学合理性。
设计了一项动物模型的实验研究,即在 50%的部位诱导牙周炎,并评估牙龈组织、血清、胎盘、脐带和羊水内细胞因子的存在,以检验实验性牙周炎不会导致不良妊娠结局的无效假设。
将 40 只雌性 Wistar 大鼠纳入 2 组:牙周健康(无结扎)和实验性诱导牙周炎组(实验组,结扎)。诱导后 45 天开始交配。雄性与雌性的比例为 1:2,持续 12 小时。从那时起,每天记录雌性的体重。在第 20 天确认怀孕后,进行剖腹手术。对羊水、胎盘、脐带、血液(血清)和母体及牙龈组织样本进行定量分析,采用多重方法检测白细胞介素 1α、-6、-10、-4、-12p70 和-17a、肿瘤坏死因子-α和干扰素-γ。计算估计量的平均值、标准差和标准误差。对于细胞因子分析,采用 Mann-Whitney 检验比较对照组和实验组在不同组织样本中的分析物浓度。为比较牙龈组织到血清和血清到胎盘的细胞因子减少,采用 Wilcoxon 检验。对 5 种不同组织中的细胞因子进行 Spearman 相关分析。
在 Wistar 大鼠中诱导的牙周炎并未导致妊娠结局不良。早产、胎儿或出生体重在两组间无统计学差异。关于细胞因子,在牙周炎组和对照组的每个组织中,测量的浓度均无统计学差异。此外,胎盘内除白细胞介素-6 外的所有细胞因子水平均低于羊水或母血清,表明细胞因子不易通过该组织在母胎或胎母方向上转移。牙周炎组的生育力显著降低。
在大鼠中诱导的牙周炎不是早产或低出生体重的危险因素。