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牙周非手术治疗对化疗牙周炎乳腺癌患者龈沟液细胞因子谱的影响。

Effects of non-surgical periodontal therapy on the cytokine profile in gingival crevicular fluid of breast cancer patients with periodontitis undergoing chemotherapy.

机构信息

Department of Oral & Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo, USP, Ribeirão Preto, São Paulo, Brazil.

Department of Gynecology and Obstetrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.

出版信息

Support Care Cancer. 2021 Dec;29(12):7505-7513. doi: 10.1007/s00520-021-06194-w. Epub 2021 Jun 8.

Abstract

OBJECTIVE

This study evaluated the effect of non-surgical periodontal therapy (NSPT) on the cytokine profile in gingival crevicular fluid (GCF) in patients with breast cancer and periodontitis.

METHODS

Forty patients were allocated into the periodontitis group (P) (n = 20) and breast cancer with periodontitis group (BC/P) (n = 20). Two days before the removal of infectious foci from the oral cavity and NSPT, as well as periodontal reevaluations, C-reactive protein, neutrophils (10μL), and platelets (10μL), were evaluated. The following cytokines in GCF, interleukin (IL)-4, IL-10, IL-2, IL-6, IL-1β, tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ), and transforming growth factor-β (TGF-β) were evaluated by the Luminex assay at baseline, and 45 and 180 days after therapy. Cytokine levels were analyzed for correlations with the clinical parameters: clinical attachment level (CAL), probing depth (PD), bleeding on probing (BOP), and plaque index (PI).

RESULTS

After NSPT, IL-2, TNF-α, and TGF-β were downregulated (p<0.05) in the BC/P. In the P group, INF-γ, IL-2, and TNF-α were downregulated (p<0.05), and TGF-β was increased (p<0.05). At 180 days, IL-6 in GCF was significantly positively correlated with PD and CAL (r=0.45, r=0.56) in the BC/P (p<0.05). In the P group, IL-1β in GCF was positively correlated with PD and CAL (r=0.56, r=0.59) at 45 days (p<0.05).

CONCLUSION

NSPT, before the start of chemotherapy, helps to reduce the inflammatory markers associated with the activity of periodontal disease, favoring a less inflammatory pattern, to avoid the exacerbation of periodontitis.

摘要

目的

本研究评估了非手术性牙周治疗(NSPT)对乳腺癌伴牙周炎患者龈沟液(GCF)中细胞因子谱的影响。

方法

将 40 名患者分为牙周炎组(P)(n=20)和乳腺癌伴牙周炎组(BC/P)(n=20)。在口腔感染病灶清除和 NSPT 前 2 天以及牙周再评估时,评估 C 反应蛋白、中性粒细胞(10μL)和血小板(10μL)。在基线、治疗后 45 天和 180 天,通过 Luminex 分析评估 GCF 中的以下细胞因子:白细胞介素(IL)-4、IL-10、IL-2、IL-6、IL-1β、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)和转化生长因子-β(TGF-β)。分析细胞因子水平与临床参数的相关性:临床附着水平(CAL)、探诊深度(PD)、探诊出血(BOP)和菌斑指数(PI)。

结果

NSPT 后,BC/P 组中 IL-2、TNF-α和 TGF-β下调(p<0.05)。在 P 组中,INF-γ、IL-2 和 TNF-α下调(p<0.05),TGF-β增加(p<0.05)。在 180 天时,BC/P 组 GCF 中的 IL-6 与 PD 和 CAL 呈显著正相关(r=0.45,r=0.56)(p<0.05)。在 P 组中,GCF 中的 IL-1β在 45 天时与 PD 和 CAL 呈正相关(r=0.56,r=0.59)(p<0.05)。

结论

在化疗开始前进行 NSPT 有助于降低与牙周病活动相关的炎症标志物,有利于减轻炎症模式,避免牙周炎恶化。

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