Screening of periodontal and salivary parameters in patients with frequent acute exacerbation of chronic obstructive pulmonary disease / 中华口腔医学杂志

Objective@#To screen the risk factors of patients with frequent acute exacerbation of chronic obstructive pulmonary disease (COPD) by detecting the clinical indicators of periodontitis and the level of bacterial and inflammatory markers in saliva.@*Methods@#Thirty-eight COPD patients in their stable period were recruited and detected from Beijing Chao-Yang Hospital,Capital Medical University during December 2016 to May 2017. The periodontal index were recorded. The levels of inflammatory factors in saliva samples were examined by using enzyme linked immunosorbent assay (ELISA). The bacteria composition in the saliva samples were identified by using 16SrRNA gene pyrosequencing. All patients were followed up and monitored for acute exacerbation of COPD for 12 months. The patients were divided into frequent acute exacerbation group (≥2 times/year, n=10) and non frequent acute exacerbation group (<2 times/year, n=28).@*Results@#In univariate analysis, the patients′ average age of frequent acute exacerbation group (69.0±7.3) was significantly older than that of non-frequent acute exacerbation group (61.8±8.3) (P=0.02). The numbers of remaining teeth ≤26 [100% (10/10)] was significantly higher and plaque index ≤2.5 (2/10) in frequent acute exacerbation group was significantly lower compared with the remaining teeth ≤26 [43% (12/28)] and the plaque index ≤2.5 [71% (21/28)] in non-frequent acute exacerbation group (P=0.02, P=0.01). The proportions of salivary inflammatory factors interleukin-6 (IL-6) level ≤60 ng/L (10%),C-reactive protein (CRP) level ≤1 550 μg/L (30%), matrix metalloproteinase-8 (MMP-8) level ≤140 μg/L (30%) and fibrinogen level ≤90 mg/L (30%) in frequent acute exacerbation group were significantly lower compared with salivary inflammatory factors IL-6 level ≤60 ng/L (71%),CRP level ≤1 550 μg/L (71%), MMP-8 level ≤140 μg/L (86%) and fibrinogen level ≤90 mg/L (71%) in non-frequent acute exacerbation group (P<0.05). The differences of relative abundances of salivary bacteria,such as species of Chloroflexi, Anaerolineae, Anaeroales, Corynebacteriales, Anaerolineaceae, Tissierellaceae, Leptotrichiaceae, Corynebacteriaceae, Leptotrichia, Moryella, Lachnoanaerobaculum and Corynebacterium between frequent acute exacerbation group and non-frequent acute exacerbation group were significantly different (P<0.05). In multivariate logistics regression analysis,the level of IL-6 >60 ng/L and the relative abundance of Corynebacteriales >0.2 had significant difference (P<0.05).@*Conclusions@#The level of IL-6 and the relative abundance of Corynebacteriales might be the markers of frequent acute exacerbation in COPD patients.

Inhibition of CD4+T cell infiltration by interleukin-10 competent B cells in periodontitis tissues / 中华口腔医学杂志

Objective@#To study the immune regulation function of high expressing interleukin-10 (IL-10) in B cells on CD4+T-cells in periodontitis mouse model.@*Methods@#Twenty-four 7-weeks-old female C57BL/6 mice were randomly and equally assigned into 4 groups: the healthy control group (HC group, n=6), the ligation combined Porphyromonasgingivalis (Pg) infection group (P group, n=6), the ligation combined Pg infection with non-stimulated B cell transfer group (P+NSB group, n=6) and the ligation combined Pg infection with stimulated B cell transfer group (P+SB group, n=6). Ligation combined Pg infection of the maxillary second molar was used to induce periodontitis of mice. The exogenous non-stimulated B cells or stimulated B cells were injected into the palate gingivalat the 5th day after ligation, and all mice were sacrificed at the 14th day. HE stain was used to detect the histological of periodontal tissues, toluidine blue stain was used to analysis the alveolar bone loss, immunofluorescence stain was used to detect the expression of CD4+T-cell and IL-10, immunohistochemical was used to detect the expression of receptor activator of NF-κB ligand (RANKL) and IL-1β.@*Results@#Results of HE staining showed that more hyperplasia of gingival epithelium and the alveolar bone resorption in P group, P+NSB group and P+SB group compared with HC group. Results of toluidine blue staining showed that the alveolar bone losses in P group [(0.668±0.041) mm2], P+NSB group [(0.750±0.039) mm2] and P+SB group [(0.517±0.038) mm2] were significantly increased compared with that in HC group [(0.336±0.029) mm2](F=146.051, P<0.01), and the alveolar bone resorption was significantly increased in P+NSB group compared with that in P group (F=146.051, P<0.01). However, compared with P+NSB group and P group, the alveolar bone loss in P+SB groupwas significantly decreased (F=146.051, P<0.01). Results of immunofluorescence staining showed that CD4+T-cells expressed in P group [(287.5±37.9) cell/mm2], P+NSB group [(314.6±53.3) cell/mm2] and P+SB group [(185.4±42.9) cell/mm2] were higher than that in HC group [(12.5±13.7) cell/mm2)(F=71.284, P<0.01). Compared with P group and P+NSB group, CD4+T-cells expression in group P+SB was decreased (F=71.284, P<0.01). IL-10 levels were increased in P group [(111.7±20.4) cell/mm2], P+NSB group [(126.7±15.1) cell/mm2] and P+SB group [(191.0±22.6) cell/mm2] compared with that in HC group [(22.7±4.3) cell/mm2] (F=98.516, P<0.01), and the IL-10 expressed in P+SB group was significantly higher than those in P+NSB group and P group. Results of immunohistochemical tests showed that RANKL expressions in gingival tissues among P group [(674.0±71.5) cell/mm2], P+NSB group [(831.0±97.5) cell/mm2] and P+SB group [(420.1±40.8) cell/mm2] were significantly higher than that in HC group [(69.3±29.1) cell/mm2] (F=154.886, P<0.01). However, it dramatically decreased in P+SB group compared with those in P group and P+NSB group.The IL-1βexpression in P group [(447.8±40.8) cell/mm2], P+NSB group [(512.5±38.2) cell/mm2] and P+SB group [(281.6±32.4) cell/mm2] were significantly higher than that in HC group [(50.8±20.9) cell/mm2], and it also higher in P+NSB group compared with in P group. However, it decreased in P+SB group compared with those in P group and P+NSB group (F=221.185, P<0.01).@*Conclusions@#High expression IL-10 in B cell smight inhibit alveolar bone loss, RANKL and IL-1β expressions and CD4+T-cell infiltration through IL-10.

Influence of non-surgical periodontal treatment on the quality of life in chronic obstructive pulmonary disease patients with chronic periodontitis / 中华口腔医学杂志

Objective@#To evaluate the effects of periodontal therapy on the quality of life in chronic obstructive pulmonary disease (COPD) patients with chronic periodontitis (CP).@*Methods@#In a randomized controlled pilot study, 60 COPD patients with CP were randomly assigned into three groups to receive scaling and root planing (SRP) treatment, supragingival scaling treatment and oral hygiene instructions only with no periodontal treatment, respectively. The scores of each patient′s quality of life at baseline, 1 year and 2 years, respectively, were evaluated by using the standardized St George′s respiratory questionnaire (SGRQ). The SGRQ was composed of three dimensions: symptoms, activity, and impact. A score was calculated for each section and a total summary score was also calculated. A high score indicated poor health and a decrease in the score indicates an improvement in quality of life.@*Results@#There were no statistically significant differences among the three groups for age, gender, body mass index, smoking status, lung funtion, periodontal parameters and the SGRQ scores (including total, symptoms, activity and impacts scores) among three groups at baseline (all P>0.05). The SGRQ scores were all significantly correlated with major lung function parameters (r=-0.54 --0.28). The result of ANCOVA analysis adjusted for the influence of baseline measurements showed that the total scores of two periodontal treatment groups were significantly lower (P=0.01) than that of control group at 2-year follow-up (SRP group: 31.1±12.1; scaling group: 28.9±9.8; control group: 46.5±24.9). The symptoms score of SRP group (45.4±19.7) was significantly lower (P=0.03) than that of control group (53.6±25.4) at 2-year follow-up. The impacts scores of two treatment groups were significantly lower (P=0.02) than that of control group at 2-year follow-up (SRP group: 15.2±8.3; scaling group: 14.9±7.7; control group: 34.8±18.8).@*Conclusions@#Our preliminary results from this study suggest that non-surgical periodontal treatment in COPD patients with CP might improve the quality of life of the COPD patient.

Relationship between oral microecological imbalance and general health / 中华口腔医学杂志

Oral microecosystem comprises the different anatomic microniches of the oral cavity, oral microbiome living in them and the bathing fluid, saliva. Dynamic balance of the ecosystem plays an important role in keeping human health whereas disease conditions supervene when the microbial equilibrium is broken. Hence, the researchers have focused more attention on it recently. In this paper, the relationship between oral microecological homeostasis and general health was systematically reviewed from such aspects as the composition of oral microecosystem, the effects of its imbalance on oral and general health, and the methods currently used to modulate the oral microecology.

Clinical significance of interleukin-6 and -8 in patients with chronic periodontal disease and acute exacerbation of chronic obstructive pulmonary disease / 中华口腔医学杂志

Objective@#To investigate the serum levels of interleukin (IL)-6 and -8 in patients with chronic periodontal disease and acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and the possible relationship between IL-6 and IL-8 with two diseases.@*Methods@#A total of 40 cases of healthy subjects (control group 1) from graduate school of Anhui Medical University, and 120 cases (40 cases in each of the 3 groups) of eligible patients were collected, of which 40 were patients with chronic periodontal disease and AECOPD (experimental group) from Department of Respiratory Medicine, The First Affiliated Hospital of Anhui Medical University and Anhui NO.2 Provincial People's Hospital, 40 were patients with chronic periodontal disease (control group 2) from Department of Stomatology, The First Affiliated Hospital of Anhui Medical University, 40 were patients with AECOPD (control group 3) from Department of Respiratory Medicine, The First Affiliated Hospital of Anhui Medical University. The clinical indicators of all subjects were collected, including tooth mobility degree, probing depth (PD), bleeding index (BI), attachment level (AL), vital capacity max (VC Max), forced expiratory volume in first second (FEV1) and forced expiratory volume in first second to forced vital capacity (FEV1/FVC) ratio. Enzyme linked immunosorbent assay (ELISA) was used to detect the serum levels of IL-6 and IL-8 in the subjects of four groups.@*Results@#The attachment levels had no significant differences between experimental group and control group 2 (P>0.05). The pulmonary function indices of experimental group including VC MAX% pre[(56.1±11.1)%], FEV1 %pre [(44.8±12.2)%], FEV1/FVC(%) [(56.8±11.4)%] were significantly different from those in control group 3 [(66.3±10.1)%, (53.0±10.4)%, (66.5±8.2)%, respectively]. The IL-6 levels of experimental group, control groups 1, 2 and 3 were (14.4±3.9), (2.1±1.1), (4.8±1.9) and (8.6±1.4) ng/L, respectively. And the IL-8 levels were (35.3±33.3), (4.8±1.7), (9.7±3.3) and (15.6±9.6) ng/L. In experimental group the IL-6 and IL-8 levels were significantly higher than those in control groups 1, 2, and 3 (P<0.01). In control group 2 and 3 the IL-6 and IL-8 levels were significantly higher than that in control group 1 (P< 0.01).@*Conclusions@#The IL-6 and IL-8 levels of experimental group were significantly increased. IL-6 and IL-8 may be associated with the development of periodontal disease and AECOPD closely.

Detection and clinical significance of serum IL-2, IL-4, IL-6, IL-10, IFN-γ and TNF-α in patients with chronic periodontitis and chronic periodontitis complicated with chronic obstructive pulmonary disease / 中国医师杂志

Objective To explore the expression level and clinical significance of serum interleukin-2 (IL-2),IL-4,IL-6,IL-10,interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α) in patients with chronic periodontitis and chronic periodontitis complicated with chronic obstructive pulmonary disease (COPD).Methods From August 2015-August 2016,31 COPD patients combined with chronic periodontitis were set as group A,31 patients with chronic periodontitis were set as group B,and another 31 healthy subjects were selected as the control group in Chaoyang Hospital.Each group extracted fasting venous blood 4 ml,serum inflammatory factors levels (IL-2,IL-4,IL-6,IL-10,IFN-γ and TNF-α) were measured by cytometric bead array (CBA),periodontal condition [plaque index (PLI),clinical attachment loss (CAL),probing depth (PD),bleeding index (BI)] and lung function index [first 1 s forced expiratory volume％ of predicted value (FEV1％),first 1 s forced expiratory volume occupies the percentage of vital capacity (FEV1/FVC)] were compared.Results The PLI,CAL,PD and BI levels in group B were higher than those in control group,indicators of group A were higher than group B,the difference was statistically significant (P ＜ 0.05).There was no significant difference in FEV1 ％ and FEV1/FVC between group B and control group,indicators of group A were less than group B and control group,the difference was statistically significant (P ＜ 0.05).The serum levels of IL-4,IL-6,IFN-γ and TNF-α in group B were higher than those in control group,indicators of group A were significantly higher than group B,the levels of IL-2 and IL-10 in group B were significantly lower than those in control group,indicators of group A were significantly less than group B (P ＜ 0.05).Conclusions Periodontal status and lung function of chronic periodontitis and chronic periodontitis with COPD patients is not good,the serum levels of IL-4,IL-6,IFN-γ,and TNF-α were increased,and the serum levels of IL-2 and IL-10 were decreased,which might be important risk factors for chronic periodontitis and COPD happen and progress.Therefore,treatment regimen can be adjusted by detecting the levels of above indicators.

Detection and clinical significance of serum IL-2, IL-4, IL-6, IL-10, IFN-γ and TNF-α in patients with chronic periodontitis and chronic periodontitis complicated with chronic obstructive pulmonary disease / 中国医师杂志

Objective To explore the expression level and clinical significance of serum interleukin-2 (IL-2),IL-4,IL-6,IL-10,interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α) in patients with chronic periodontitis and chronic periodontitis complicated with chronic obstructive pulmonary disease (COPD).Methods From August 2015-August 2016,31 COPD patients combined with chronic periodontitis were set as group A,31 patients with chronic periodontitis were set as group B,and another 31 healthy subjects were selected as the control group in Chaoyang Hospital.Each group extracted fasting venous blood 4 ml,serum inflammatory factors levels (IL-2,IL-4,IL-6,IL-10,IFN-γ and TNF-α) were measured by cytometric bead array (CBA),periodontal condition [plaque index (PLI),clinical attachment loss (CAL),probing depth (PD),bleeding index (BI)] and lung function index [first 1 s forced expiratory volume％ of predicted value (FEV1％),first 1 s forced expiratory volume occupies the percentage of vital capacity (FEV1/FVC)] were compared.Results The PLI,CAL,PD and BI levels in group B were higher than those in control group,indicators of group A were higher than group B,the difference was statistically significant (P ＜ 0.05).There was no significant difference in FEV1 ％ and FEV1/FVC between group B and control group,indicators of group A were less than group B and control group,the difference was statistically significant (P ＜ 0.05).The serum levels of IL-4,IL-6,IFN-γ and TNF-α in group B were higher than those in control group,indicators of group A were significantly higher than group B,the levels of IL-2 and IL-10 in group B were significantly lower than those in control group,indicators of group A were significantly less than group B (P ＜ 0.05).Conclusions Periodontal status and lung function of chronic periodontitis and chronic periodontitis with COPD patients is not good,the serum levels of IL-4,IL-6,IFN-γ,and TNF-α were increased,and the serum levels of IL-2 and IL-10 were decreased,which might be important risk factors for chronic periodontitis and COPD happen and progress.Therefore,treatment regimen can be adjusted by detecting the levels of above indicators.

Comparison of the effects of Ginkgo biloba extract and minocycline hydrochlovide on periodontitis / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To compare the clinical effect of Ginkgo biloba extract gel (Ginkgo biloba extract,EGB) and minocycline hydrochloride (Periocline) on periodontitis and their inhibition on putative periodontal pathogens.</p><p><b>METHODS</b>Thirty patients with moderate-to-severe periodontitis were selected. The patients were divided into an experimental group and a positive control group (minocycline hydrochloride). Supragingival and subgingival scaling were performed on all patients. Subgingival plaque samples were collected before treatment, 1 week, 2 months and 4 months after treatment. The four major periodontal pathogens Porphyromonas gingivalis (Pg), Bacteroides forsythus (Bf), Prevotella intermedia (Pi), Treponema denticola (Td) were detected by polymerase chain reaction. Clinical indexes plaque index (PLI), bleeding index (BI) and probing depth (PD), attachment loss (AL) were examined before treatment, 3 months and 6 months after treatment. The results were statistically analyzed.</p><p><b>RESULTS</b>The detection rates of the 4 periodontal pathogens were Td (83.3%), Tf (95.0%), Pi (80.0%), Pg (81.7% ) in experimental group and Td (83.3%), Tf (95.0%), Pi (80.0%), Pg (81.7%) in control group before treatment. The detection rates in experimental group were not significantly different with those in control group after treatment, except for the detection rate of Pg 1 week after treatment (P < 0.01, the detection of Pg was 56.7% in experimental group and 53.3% in control group 1 week after treatment). The PLI and BI were not significantly different between experimental group and control group after treatment (P > 0.05). The difference was statistically significant at 6 months after treatment [(3.5 ± 0.5) mm for experimental group and (3.2 ± 0.4) mm for control group, P = 0.00]. The mean of AL decreased with time. The difference was statistically significant at 6 months after treatment [ (4.5 ± 0.4) mm for experimental group and (4.3 ± 0.4) mm for control group at 6 months, P = 0.01].</p><p><b>CONCLUSIONS</b>The inhibition effects of EGB and minocycline hydrochloride were comparable for major periodontal pathogens within short term.</p>

Primary study of the relationship between periodontitis and COPD / 实用口腔医学杂志

Objective:To explore the relationship between Chronic Obstructive Pulmonary Disease (COPD) and periodontitis. Methods: 498 subjects were recruited in this study and were divided into three groups: mild periodontitis group (77, 15.5%), moderate periodontitis group (143, 28.7%), and severe periodontitis group (278, 55.8%). Clinical examination indexes included probing depth (PD), attachment loss (AL), sulcus bleeding index (SBI), plaque index (PLI) and the level of the alveolar resorption. Lung function of each subjects were also examined. Results: The levels of AL, PLI and alveolar resorption in COPD group were higher than non-COPD group. Significant differences of "FEV1% pre"(F=3.59,P=0.028) and "FEV1/FVC"(F=4.84,P=0.008) were found among different degrees of periodontitis. Negative relationship was found between the level of "FEV1% pre" and the periodontal index (AL, PLI, alveolar resorption), and the same relationship was found for "FEV1/FVC". Conclusion: Correlation is found between COPD and the periodontitis index (AL, PLI, alveolar resorption).