Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Clin Exp Rheumatol. 2019 Mar-Apr;37(2):208-214. Epub 2018 Jul 19.
The immune system has an important role in the development of systemic lupus erythematosus (SLE) and chronic periodontitis (CP). Altered cytokines levels characterise both diseases and contributes to periodontal tissue damage in CP and to macrocomplexes deposition with connective tissue destruction in SLE. This study aimed to evaluate the production of salivary cytokines in patients with SLE and its association with periodontal status.
The sample comprised 70 SLE patients and 70 paired controls. SLE activity and damage were scored using Systemic Lupus Erythematosus Disease Activity Index 2000 and Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index. Subjects were classified as without or with CP. Salivary concentrations of IL-33, MMP2/TIMP2, RANK and OPG were measured by ELISA, while IL-2, IFNγ, TNFα, IL-4, IL-6, IL-10 and IL-17A were determined by Cytometric Bead Array. Linear regression models analysed association among SLE, CP and salivary cytokines.
IL-6 and IL-17A concentrations were significantly higher in SLE/CP patients than controls/CP. Concentrations of IL-6, IL-17A and IL-33 were increased in SLE/CP individuals when compared to SLE without CP. Multivariate model revealed association of cumulative dose of corticoids with periodontal damage and of IL-33 salivary concentration with SLE activity.
Our findings suggest that long-term therapy with corticoids would contribute with periodontal destruction in SLE patients. Moreover, the increased levels of IL-6, IL-17A and IL-33 in saliva of SLE subjects with CP may signal it as possible inflammatory pathways in this process.
免疫系统在系统性红斑狼疮（SLE）和慢性牙周炎（CP）的发展中起着重要作用。这两种疾病的特征都有细胞因子水平的改变，并导致 CP 中牙周组织损伤和 SLE 中结缔组织破坏的大复合物沉积。本研究旨在评估 SLE 患者唾液细胞因子的产生及其与牙周状况的关系。
样本包括 70 例 SLE 患者和 70 例配对对照。使用系统性红斑狼疮疾病活动指数 2000 评分和系统性红斑狼疮国际合作临床/美国风湿病学会损伤指数对 SLE 活动度和损伤进行评分。将受试者分为无 CP 或有 CP。通过 ELISA 测定唾液中 IL-33、MMP2/TIMP2、RANK 和 OPG 的浓度，通过 Cytometric Bead Array 测定 IL-2、IFNγ、TNFα、IL-4、IL-6、IL-10 和 IL-17A 的浓度。线性回归模型分析 SLE、CP 和唾液细胞因子之间的关系。
SLE/CP 患者的 IL-6 和 IL-17A 浓度明显高于对照组/CP。与 SLE 无 CP 患者相比，SLE/CP 患者的 IL-6、IL-17A 和 IL-33 浓度增加。多变量模型显示皮质激素累积剂量与牙周损伤有关，IL-33 唾液浓度与 SLE 活性有关。
我们的发现表明，长期皮质激素治疗可能会导致 SLE 患者的牙周破坏。此外，CP 中 SLE 患者唾液中 IL-6、IL-17A 和 IL-33 水平的升高可能表明这是该过程中可能的炎症途径。
