Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.
Department of Pediatric Gastroenterology, Hacettepe University Medical School, Ankara, Turkey.
J Periodontol. 2022 Jul;93(7):1048-1059. doi: 10.1002/JPER.21-0514. Epub 2021 Dec 22.
To evaluate the cytokine profile in gingival crevicular fluid (GCF) and serum of pediatric inflammatory bowel disease (IBD) patients and determine the cluster patterns of cytokines.
Fifty IBD patients and 21 systemically healthy children were enrolled in the study. The GCF samples were collected from the participants during periodontal examination and periodontal indices were recorded. Based on activity indexes and response to conventional treatment, patients with IBD were further categorized into subgroups as: remission, active disease, and treatment-resistant. Serum samples were obtained from IBD patients to determine serum levels of cytokines. The levels of pro- (interleukin (IL)-1β, IL-12, IL-21, IL-22, IL-23, IL-17A, IL-17F) and anti-inflammatory (IL-4, IL-10) cytokines in serum and GCF were measured using Enzyme-linked Immunosorbent Assay (ELISA) kits.
Among 50 IBD patients, 58% were in remission, 20% had active disease, and 22% were defined as treatment-resistant. The severity of gingival inflammation measured by the criteria of Löe had increasing trends in IBD patients with active disease and treatment resistance. GCF IL-1β level was lower and GCF IL-4 and GCF IL-23 levels were higher in IBD patients compared to healthy controls. In the active disease group, more cytokine clusters occurred compared to the control group and other IBD subgroups, as explained by increased cytokine-cytokine interactions.
Considering the increased complexity of cytokine interactions and the increased severity of gingival inflammation in patients with active disease, it can be concluded that disease activity might have an impact on gingival inflammation in pediatric patients with IBD.
评估小儿炎症性肠病（IBD）患者龈沟液（GCF）和血清中的细胞因子谱，并确定细胞因子的聚类模式。
本研究纳入了 50 例 IBD 患者和 21 例系统性健康儿童。在牙周检查期间采集参与者的 GCF 样本，并记录牙周指数。根据活动指数和对常规治疗的反应，将 IBD 患者进一步分为缓解组、活动疾病组和治疗抵抗组。从 IBD 患者中采集血清样本以确定血清细胞因子水平。使用酶联免疫吸附试验（ELISA）试剂盒测量血清和 GCF 中促炎（白细胞介素（IL）-1β、IL-12、IL-21、IL-22、IL-23、IL-17A、IL-17F）和抗炎（IL-4、IL-10）细胞因子的水平。
在 50 例 IBD 患者中，58%处于缓解期，20%处于活动期，22%被定义为治疗抵抗。根据 Löe 标准测量的牙龈炎症严重程度在活动期和治疗抵抗的 IBD 患者中呈上升趋势。与健康对照组相比，IBD 患者的 GCF IL-1β 水平较低，GCF IL-4 和 GCF IL-23 水平较高。在活动疾病组中，与对照组和其他 IBD 亚组相比，发生了更多的细胞因子簇，这可以解释为细胞因子-细胞因子相互作用增加。
考虑到细胞因子相互作用的复杂性增加以及活动期疾病患者牙龈炎症的严重程度增加，可以得出结论，疾病活动可能会对小儿 IBD 患者的牙龈炎症产生影响。
