Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, 06230, Turkey.
Department of Pediatric Immunology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Odontology. 2021 Apr;109(2):474-482. doi: 10.1007/s10266-020-00565-1. Epub 2020 Nov 7.
Severe congenital neutropenia (SCN) is a primary immunodeficiency characterized by defect in neutrophil count. Increased risk of infections in addition to periodontal problems, such as ulcerations of oral mucosa, gingival inflammation, and rapid loss of attachment are common in the course of the disease. The aim of the present study is to define the causal relationship between the severity of periodontal inflammation and severe congenital neutropenia through identification of cytokine profile in gingival crevicular fluid (GCF). A case-control study was performed in patients diagnosed with SCN and healthy controls. Demographic data, the molecular defect, laboratory work-up were gathered from the hospital registry. Periodontal indices were recorded and GCF samples were analyzed using multiplex analysis for the simultaneous measurements of the particular cytokines and chemokines. The present study included 14 patients and 22 control subjects. Both groups were comparable in terms of age and sex. Severity of gingival inflammation measured by the criteria of Löe was higher in the SCN cases (p < 0.05). Moreover, GCF levels of IFN-α, TNF-α, IL-10, IL-13, IL-15, IL-17, IL-2, IL-7, IL-33, IP-10, MIG, MIP-1β were significantly higher in the controls. Decreased cytokine secretion seems to correlate with the decrease in neutrophil counts. The severity of gingival inflammation in SCN patients may be due to the bacterial overgrowth and the change in the content of the oral flora due to the decreased neutrophil counts. Therefore, regular periodontal examinations, the motivation of oral hygiene as well as the compliance with therapy in SCN patients contribute to the periodontal health.
严重先天性中性粒细胞减少症(SCN)是一种以中性粒细胞计数缺陷为特征的原发性免疫缺陷。在疾病过程中,除了牙周问题(如口腔黏膜溃疡、牙龈炎症和附着迅速丧失)外,感染风险增加也很常见。本研究旨在通过鉴定牙龈沟液(GCF)中的细胞因子谱来确定牙周炎严重程度与严重先天性中性粒细胞减少症之间的因果关系。对诊断为 SCN 的患者和健康对照组进行了病例对照研究。从医院登记处收集人口统计学数据、分子缺陷和实验室检查结果。记录牙周指数,并使用多重分析同时分析 GCF 样本,以测量特定的细胞因子和趋化因子。本研究纳入了 14 名患者和 22 名对照者。两组在年龄和性别方面具有可比性。SCN 病例的牙龈炎症严重程度(根据 Löe 标准)更高(p<0.05)。此外,GCF 中 IFN-α、TNF-α、IL-10、IL-13、IL-15、IL-17、IL-2、IL-7、IL-33、IP-10、MIG、MIP-1β 的水平在对照组中明显更高。细胞因子分泌减少似乎与中性粒细胞计数减少有关。SCN 患者牙龈炎症的严重程度可能是由于中性粒细胞计数减少导致细菌过度生长和口腔菌群组成改变。因此,定期进行牙周检查、鼓励口腔卫生以及 SCN 患者坚持治疗有助于保持牙周健康。