Machado Vanessa, Botelho João, Lopes Joana, Patrão Mariana, Alves Ricardo, Chambrone Leandro, Alcoforado Gil, Mendes José João
Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, 2829-511 Caparica, Portugal.
Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, 2829-511 Caparica, Portugal.
Diagnostics (Basel). 2020 Mar 27;10(4):184. doi: 10.3390/diagnostics10040184.
This systematic review aimed to investigate the influence of periodontitis on post-transplant IL-6 serum levels of solid organ transplanted patients as compared to healthy subjects. Four databases (PubMed, Scholar, EMBASE, and CENTRAL) were searched up to February 2020 (PROSPERO CRD42018107817). Case-control and cohort studies on the association of IL-6 serum levels with a periodontal status of patients after solid organ transplantation were included. The risk of bias of observational studies was assessed through the Newcastle-Ottawa Scale (NOS). Random effects meta-analyses were thoroughly conducted. GRADE assessment provided quality evidence. Four case-control studies fulfilled the inclusion criteria (274 transplant recipients and 146 healthy controls), all of low risk of bias. Meta-analyses revealed significantly higher IL-6 levels in transplanted patients than healthy individuals with low-quality evidence (Mean Difference (MD): 2.55 (95% confidence interval (CI): 2.07, 3.03)). Transplanted patients with periodontitis have higher serum IL-6 levels than transplanted patients without periodontitis with moderate quality evidence (MD: 2.20 (95% CI: 1.00, 3.39)). We found low-quality evidence of higher IL-6 levels than healthy patients in patients with heart and kidney transplant. In these transplanted patients, there was moderate quality evidence that periodontitis is associated with higher IL-6 serum levels. Future research should consider the impact of such a difference in organ failure and systemic complications.
本系统评价旨在研究与健康受试者相比,牙周炎对实体器官移植患者移植后血清白细胞介素-6(IL-6)水平的影响。检索了四个数据库(PubMed、Scholar、EMBASE和CENTRAL)至2020年2月(PROSPERO注册号:CRD42018107817)。纳入了关于实体器官移植后患者IL-6血清水平与牙周状况相关性的病例对照研究和队列研究。通过纽卡斯尔-渥太华量表(NOS)评估观察性研究的偏倚风险。进行了随机效应荟萃分析。GRADE评估提供了质量证据。四项病例对照研究符合纳入标准(274例移植受者和146例健康对照),所有研究的偏倚风险均较低。荟萃分析显示,移植患者的IL-6水平显著高于健康个体,但证据质量较低(平均差(MD):2.55(95%置信区间(CI):2.07,3.03))。有中度质量证据表明,患有牙周炎的移植患者血清IL-6水平高于未患牙周炎的移植患者(MD:2.20(95%CI:1.00,3.39))。我们发现,心脏和肾脏移植患者的IL-6水平高于健康患者,但证据质量较低。在这些移植患者中,有中度质量证据表明牙周炎与较高的血清IL-6水平相关。未来的研究应考虑这种差异对器官衰竭和全身并发症的影响。