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牙周病患者牙周治疗对降低系统性健康人群慢性炎症的影响。

Effect of Periodontal Treatment on Reducing Chronic Inflammation in Systemically Healthy Patients With Periodontal Disease.

机构信息

Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.

Center of Oral Clinical Examination.

出版信息

Am J Med. 2024 Mar;137(3):273-279.e2. doi: 10.1016/j.amjmed.2023.11.001. Epub 2023 Nov 19.

Abstract

BACKGROUND

We determined the effects and an accurate marker of periodontal treatment on serum interleukin (IL)-6 and high-sensitivity C-reactive protein (HsCRP) levels in systemically healthy individuals with periodontal disease.

METHODS

This multicenter study included systemically healthy individuals with periodontal disease who received initial periodontal treatment and had no periodontal treatment history. Periodontal parameters, including periodontal inflamed surface area, masticatory efficiency, and periodontal disease classification; serum IL-6 and HsCRP levels; and serum immunoglobulin (Ig)G titers against periodontal pathogens were evaluated at baseline and after treatment. Subjects were classified as low or high responders (group) based on periodontal inflamed surface area changes.

RESULTS

There were 153 participants. Only periodontal inflamed surface area changes were markedly different between low and high responders. Periodontal treatment (time point) decreased both serum IL-6 and HsCRP levels. The interaction between group and time point was remarkable only for serum IL-6 levels. Changes in serum immunoglobulin (Ig)G titers against periodontal pathogens were not associated with IL-6 changes in high responders. We analyzed the indirect effect of serum anti-Porphyromonas gingivalis type 2 IgG titer changes using mediation analysis and found no significance. However, the direct effect of group (low or high responder) on IL-6 changes was considerable.

CONCLUSIONS

Periodontal treatment effectively decreased serum IL-6 levels, independent of periodontal pathogen infection, in systemically healthy individuals with periodontal disease.

摘要

背景

我们旨在确定牙周治疗对牙周病患者血清白细胞介素(IL)-6 和高敏 C 反应蛋白(HsCRP)水平的影响及其确切标志物。

方法

本多中心研究纳入了牙周病患者,这些患者均为系统健康人群,且既往无牙周治疗史。在基线和治疗后评估牙周参数(包括牙周炎受累面积、咀嚼效率和牙周病分类)、血清 IL-6 和 HsCRP 水平以及针对牙周病原体的血清免疫球蛋白(Ig)G 滴度。根据牙周炎受累面积的变化,将受试者分为低应答者和高应答者(组)。

结果

共纳入 153 名参与者。仅低应答者和高应答者的牙周炎受累面积变化差异显著。牙周治疗(时间点)降低了血清 IL-6 和 HsCRP 水平。仅血清 IL-6 水平在组与时间点之间存在显著交互作用。高应答者的血清针对牙周病原体的 IgG 滴度变化与 IL-6 变化无关。我们通过中介分析对血清抗牙龈卟啉单胞菌 IgG 滴度变化的间接效应进行了分析,未发现其有统计学意义。然而,组(低应答者或高应答者)对 IL-6 变化的直接影响是显著的。

结论

牙周治疗可有效降低牙周病患者血清 IL-6 水平,而与牙周病原体感染无关。

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