Department of Periodontology, Dental Research Division, Guarulhos University, Praça Tereza Cristina, 229, Guarulhos, São Paulo, Brazil.
Department of Oral Biology, College of Dentistry, University of Florida, 1600 SW Archer Rd., Room D10-6, Gainesville, FL, USA.
Arch Oral Biol. 2020 Dec;120:104957. doi: 10.1016/j.archoralbio.2020.104957. Epub 2020 Oct 22.
The aims of this study were: 1) to compare the levels of cytokines between healthy and diseased sites, in patients with untreated periodontitis; 2) to correlate cytokine levels with each other and with key periodontal pathogens, in healthy and diseased sites.
Paired gingival crevicular fluid (GCF) samples were obtained from two healthy (probing depth (PD) and clinical attachment level (CAL) ≤3 mm without bleeding) and two diseased sites (PD and CAL ≥5 mm with bleeding on probing [BoP]) of patients with generalized stage III/IV grade B/C periodontitis. GCF levels of eighteen cytokines and subgingival levels of seven periodontal pathogens were assessed by multiplex immunoassay and qPCR, respectively.
A total of 112 subjects and 448 GCF samples were analyzed. The GCF levels of GM-CSF, IL-17, IL-1β, IL-2, IL-21, IL-23 and TGF-β were significantly higher in the diseased than in the healthy sites (p < 0.05). Levels of IL-8 and MIP-1α were significantly higher in the healthy than in the diseased sites (p < 0.05). In the healthy sites, IL-8 and MIP-1α formed an independent cluster of cytokines and, MIP-1α positively correlated with Porphyromonas gingivalis (p < 0.05). In deep sites, smoking negatively associated with GM-CSF, IL-10, IL-17, IL-23, IL-5, IL-6, IL-7, IL-8 and MIP-1α levels (p < 0.05).
Diseased sites exhibited increased levels of T helper 17-related cytokines and TGF-β while healthy sites presented increased levels of the chemokines, IL-8 and MIP-1α. Patients with periodontitis may not only have inflammation in diseased deep sites, but also present significant hidden subclinical inflammation in their shallow clinically healthy sites.
本研究旨在：1）比较未经治疗的牙周炎患者健康和患病部位的细胞因子水平；2）在健康和患病部位，将细胞因子水平彼此相关，并与关键牙周病原体相关联。
从患有广泛性 III/IV 级 B/C 期牙周炎的患者的两个健康部位（探诊深度（PD）和临床附着水平（CAL）≤3mm 且无出血）和两个患病部位（PD 和 CAL≥5mm 且探诊时有出血[BoP]）获得配对的龈沟液（GCF）样本。通过多重免疫测定法评估 18 种细胞因子的 GCF 水平，通过 qPCR 评估 7 种牙周病原体的龈下水平。
共分析了 112 名受试者和 448 份 GCF 样本。与健康部位相比，患病部位 GM-CSF、IL-17、IL-1β、IL-2、IL-21、IL-23 和 TGF-β 的 GCF 水平明显更高（p<0.05）。健康部位的 IL-8 和 MIP-1α 水平明显高于患病部位（p<0.05）。在健康部位，IL-8 和 MIP-1α 形成了一个独立的细胞因子簇，并且 MIP-1α 与牙龈卟啉单胞菌呈正相关（p<0.05）。在深部部位，吸烟与 GM-CSF、IL-10、IL-17、IL-23、IL-5、IL-6、IL-7、IL-8 和 MIP-1α 水平呈负相关（p<0.05）。
患病部位表现出 Th17 相关细胞因子和 TGF-β水平增加，而健康部位则表现出趋化因子 IL-8 和 MIP-1α 水平增加。牙周炎患者不仅在患病的深部部位存在炎症，而且在其浅部临床健康的部位也存在明显的隐匿性亚临床炎症。
