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维持性血液透析患者慢性牙周炎与炎症细胞因子的关系。

Relationship between chronic periodontitis and inflammatory cytokines in patients undergoing maintenance hemodialysis.

机构信息

Department of Preventive Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, 639 Zhizaoju Road, Shanghai, China.

Department of Endodontics, Shanghai Stomatological Hospital, Fudan University; Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, 356 Beijingdong Road, Shanghai, China.

出版信息

Clin Oral Investig. 2022 Nov;26(11):6699-6709. doi: 10.1007/s00784-022-04629-0. Epub 2022 Jul 21.

Abstract

OBJECTIVES

To investigate the correlation between serum and gingival crevicular fluid (GCF) levels of inflammatory cytokines and the association with periodontal parameters in patients with maintenance hemodialysis (MHD) and healthy control.

MATERIALS AND METHODS

Patients who were undergoing MHD were enrolled as the MHD group. Healthy individuals who underwent oral examination were selected as the control group after matching for the MHD group. All participants underwent a full-mouth periodontal evaluation, and the levels of eight inflammatory cytokines, including IL-1β, IL-17, IL-6, IL-8, and tumor necrosis factor-α (TNF-α), monocyte chemoattractant protein-1 (MCP-1), matrix metalloproteinase-8 (MMP-8), and C-reactive protein (CRP), in the GCF and serum were measured.

RESULTS

A total of 63 MHD patients and 75 healthy persons were included. The prevalence of moderate/severe periodontitis was significantly higher in the MHD group than in the control group (88.9 vs. 66.7%, P < 0.05). The GCF levels of CRP, TNF-α, MCP-1, and MMP-8 were higher in patients in the MHD group with moderate/severe periodontitis than in the control group (P < 0.05). Serum CRP, MCP-1, TNF-α, and MMP-8 levels were positively correlated with the GCF CRP levels (P < 0.05). The GCF and serum CRP levels were positively correlated with the periodontal clinical parameters (P < 0.05).

CONCLUSIONS

Serum CRP, MCP-1, TNF-α, and MMP-8 may relate with the GCF CRP levels. The GCF and serum CRP levels correlated positively with the periodontal clinical parameters, including the VPI, PPD, and CAL, indicating that CRP may play an important role between periodontitis and ESRD.

CLINICAL RELEVANCE

The present study indicated that GCF and serum CRP levels correlated positively with the periodontal clinical parameters, and the CRP levels may be selected as an indicator to evaluate the severity of inflammation and the effectiveness, prognosis of periodontal treatment in ESRD patients.

摘要

目的

探讨维持性血液透析(MHD)患者血清和龈沟液(GCF)中炎症细胞因子水平的相关性及其与牙周参数的关系。

材料和方法

将接受 MHD 的患者纳入 MHD 组,选择经口腔检查匹配的健康个体作为 MHD 组的对照组。所有参与者均进行全口牙周评估,并测量 GCF 和血清中 8 种炎症细胞因子(白细胞介素-1β、白细胞介素-17、白细胞介素-6、白细胞介素-8 和肿瘤坏死因子-α(TNF-α)、单核细胞趋化蛋白-1(MCP-1)、基质金属蛋白酶-8(MMP-8)和 C 反应蛋白(CRP)的水平。

结果

共纳入 63 例 MHD 患者和 75 名健康人。MHD 组中中重度牙周炎的患病率明显高于对照组(88.9%比 66.7%,P<0.05)。MHD 组中中重度牙周炎患者的 GCF CRP、TNF-α、MCP-1 和 MMP-8 水平均高于对照组(P<0.05)。血清 CRP、MCP-1、TNF-α和 MMP-8 水平与 GCF CRP 水平呈正相关(P<0.05)。GCF 和血清 CRP 水平与牙周临床参数呈正相关(P<0.05)。

结论

血清 CRP、MCP-1、TNF-α和 MMP-8 可能与 GCF CRP 水平有关。GCF 和血清 CRP 水平与牙周临床参数呈正相关,包括 VPI、PPD 和 CAL,表明 CRP 可能在牙周炎和 ESRD 之间发挥重要作用。

临床意义

本研究表明,GCF 和血清 CRP 水平与牙周临床参数呈正相关,CRP 水平可作为评估 ESRD 患者炎症严重程度和牙周治疗效果、预后的指标。

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