Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, São Paulo, Brazil.
Division of Restorative Dentistry and Periodontology, Trinity College Dublin, Dublin Dental University Hospital, Dublin, Ireland.
Int Endod J. 2024 Dec;57(12):1769-1782. doi: 10.1111/iej.14139. Epub 2024 Aug 27.
The aim of this study is to investigate the expression of inflammatory biomarkers (TNF-α, IL-10, IL-1β) and the pulpitis-associated miRNA (miR-30a-5p and miR-128-3p) in pulp tissue samples from unrestored teeth with a vital normal pulp (NP), teeth with symptomatic irreversible pulpitis (IP) and in unrestored teeth with periodontal disease, unresponsive to periodontal therapy, and a vital pulp (EP).
Thirty patients were included in this observational study (10 teeth with NP, 10 teeth with IP, 10 teeth with EP). Dental pulp tissues samples were collected from patients during root canal treatment (RCT). RNA was extracted and qRT-PCR of target genes (tumour necrosis factor [TNF]-α, interleukin [IL]-1β, IL-10) and miRNAs (has-miR-30a-5p, has-miR-128-3p) performed to assess the expression profile. Fold-change in expression was calculated using the formula 2. One-way anova with post-hoc Tukey's was used to determine significant differences between groups. The significance level was set at 5% (p < .05). All teeth were also followed up clinically for 1 year and evaluated for a range of endodontic and periodontal-related outcomes.
All investigated genes significantly increased in expression and miRNAs significantly decreased in expression in the IP and EP groups compared with the NP group (p < .05). With regards to TNF-α and IL-1β there were no significant differences in expression between the IP and EP groups (p > .05), whereas IL-10 expression levels were significantly reduced in the EP compared with the IP group (p < .05). Both miR-30a-5p and miR-128-3p showed significantly reduced expression in both IP and EP lesions, compared with NP (p < .05); however, no significant differences in miRNA expression were observed between IP and EP groups (p > .05). One year after root canal treatment and periodontal maintenance, tooth mobility and probing depth were significantly reduced in the EP group (p < .05).
Pulp tissues from teeth with IP and EP presented similar levels of altered inflammatory markers compared with NP. TNF-α, IL-10, IL-1β cytokines and miRNAs (miR-30a-5p and miR-128-3p) are potential objective biomarkers to indicate pulpal inflammatory status, aiding diagnosis and directing clinical decision-making. RCT may be beneficial to improve stage III periodontitis unresponsive to non-surgical periodontal treatment, but further research is required.
本研究旨在探讨未修复的活髓正常（NP）牙、有症状的不可复性牙髓炎（IP）牙和牙周病、对牙周治疗无反应的活髓（EP）牙牙髓组织样本中炎症生物标志物（TNF-α、IL-10、IL-1β）和牙髓炎相关 miRNA（miR-30a-5p 和 miR-128-3p）的表达。
本观察性研究纳入了 30 名患者（NP 组 10 颗牙，IP 组 10 颗牙，EP 组 10 颗牙）。在根管治疗（RCT）期间从患者中采集牙髓组织样本。提取 RNA，采用 qRT-PCR 检测靶基因（肿瘤坏死因子[TNF]-α、白细胞介素[IL]-1β、IL-10）和 miRNA（has-miR-30a-5p、has-miR-128-3p）的表达谱。使用公式 2 计算表达的倍数变化。采用单因素方差分析和事后 Tukey 检验比较组间差异。显著性水平设为 5%（p<.05）。所有牙齿均在临床随访 1 年，评估一系列与牙髓和牙周相关的结果。
与 NP 组相比，IP 和 EP 组所有研究基因的表达均显著上调，miRNA 的表达均显著下调（p<.05）。TNF-α 和 IL-1β 两组间表达无显著差异（p>.05），而 EP 组 IL-10 表达水平明显低于 IP 组（p<.05）。miR-30a-5p 和 miR-128-3p 在 IP 和 EP 病变中均明显低于 NP（p<.05）；然而，两组间 miRNA 表达无显著差异（p>.05）。根管治疗和牙周维护 1 年后，EP 组牙齿动度和探诊深度明显降低（p<.05）。
与 NP 相比，IP 和 EP 牙髓组织中炎症标志物水平相似。TNF-α、IL-10、IL-1β 细胞因子和 miRNA（miR-30a-5p 和 miR-128-3p）可能是指示牙髓炎症状态的潜在客观生物标志物，有助于诊断和指导临床决策。RCT 可能有利于改善对牙周治疗无反应的牙周病 III 期患者，但需要进一步研究。
