Interleukin-6 and Interferon-α Levels in Gingival Crevicular Fluid in HIV-1 Patients with Chronic Periodontitis / Niveles de Interleukin-6 e Interferon-α de Fluido Crevicular Gingival en Pacientes VIH-1 con Periodontitis Crónica

ABSTRACT: The influence of cytokine on the progression of chronic periodontitis in human immunodeficiency virus (HIV) patients is still controversial and poorly investigated. This study aimed to analyze and compare IL-6 and IFN-α levels in the gingival crevicular fluid of HIV-1-positive and HIV-1-negative patients with chronic periodontitis and different grades of tissue destruction and inflammation. Samples from the gingival crevicular sulcus were obtained from 35 HIV-1-positive individuals with chronic periodontitis and 35 seronegative patients with chronic periodontitis. Probing depth and clinical attachment level, as well as the results of the Enzyme-Linked Immunosorbent Assay for confirmation of patient diagnostics, were evaluated. Statistical analyses were performed using Student t, Mann-Whitney and Spearman tests. IL-6 levels were significantly lower, while IFN-α levels were significantly higher in HIV-1 patients. Clinical attachment level was directly associated with IFN-α levels in HIV-1 carriers, connected to probing depth in these patients. Clinical data in association with gingival crevicular fluid cytokine levels may reveal a localized immunological response pattern, which may contribute to the understanding of periodontitis pathogenesis in HIV-1 carriers.

RESUMEN: La influencia de la citocina en la progresión de la periodontitis crónica en pacientes con el virus de la inmunodeficiencia humana (VIH) sigue siendo controvertida y poco investigada. Este estudio tuvo como objetivo analizar y comparar los niveles de interleuquina-6 (IL6) e interferón-α (IFN-α) en el líquido crevicular gingival de pacientes VIH-1-positivos y VIH-1-negativos con periodontitis crónica y diferentes grados de destrucción e inflamación tisular. Se obtuvieron muestras del surco crevicular gingival de 35 individuos VIH-1 positivos con periodontitis crónica y 35 pacientes seronegativos con periodontitis crónica. Se evaluaron la profundidad de sondeo y el nivel de inserción clínica, así como los resultados del Ensayo Inmunoabsorbente Ligado a Enzimas para la confirmación del diagnóstico del paciente. Los análisis estadísticos se realizaron utilizando pruebas t de Student, Mann-Whitney y Spearman. Los niveles de IL-6 fueron significativamente más bajos, mientras que los niveles de IFN-a fueron significativamente más altos en los pacientes con VIH-1. El nivel de inserción clínica se asoció directamente con los niveles de IFN-α en los portadores del VIH1, conectados a la profundidad del sondaje en estos pacientes. Los datos clínicos en asociación con los niveles de citoquinas de los fluidos creviculares gingivales pueden revelar un patrón de respuesta inmunológica localizado, que puede contribuir a la comprensión de la patogénesis de la periodontitis en los portadores del VIH-1.

Análise da metilação e transcrição nos genes TLR-2 e CD14 na periodontite crônica / Analysis of methylation and transcription genes in the TLR-2 and CD14 in chronic periodontitis

A periodontite é uma infecção polimicrobiana e multifatorial, que resulta em danos aos tecidos periodontais, devido à complexa interação entre os peridontopatógenos e a resposta imunoinflamatória do hospedeiro. A metilação do DNA é caracterizada pela adição do grupo metil em citocinas em ilhas CpGs. Esse mecanismo epigenético pode modular a resposta do indivíduo, por interferir na expressão gênica de importantes mediadores inflamatórios. O objetivo desse estudo foi avaliar o padrão de metilação e expressão dos genes CD14 e TLR-2 em indivíduos com e sem periodontite crônica. Foram coletados 20 fragmentos de tecido gengival de indivíduos com periodontite crônica (grupo de periodontite) e 20 amostras de tecido gengival de indivíduos periodontalmente saudáveis (grupo controle). As amostras foram submetidas à avaliação histológica, extração de DNA e digestão por enzimas de restrição e a quantificação do DNA após a digestão foi quantificado por reação em cadeia de polimerase em tempo real (qPCR)...

Detection of selected bacterial species in intraoral sites of patients with chronic periodontitis using multiplex polymerase chain reaction

OBJECTIVE: The aim of this study was to detect the prevalence of selected bacterial species in intraoral sites of patients with chronic periodontitis (CP) using multiplex polymerase chain reaction (PCR). METHODOLOGY: Samples were collected from the tongue dorsum, buccal mucosa, supragingival and subgingival plaque and saliva of 30 patients with untreated CP. Multiplex PCR was used to determine prevalence rates, which were then compared using a chi-square test. Significance level was set at p<0.05. Mean and standard deviation values were used to evaluate variations in prevalence according to site. RESULTS: The prevalence of S. mutans was 70 percent in saliva; 60 percent in samples collected from the tongue dorsum; 50 percent in samples collected from the buccal mucosa; 56.5 percent in the supragingival plaque; and 53.5 percent in the subgingival plaque. The prevalence of E. faecalis ranged from 3.5 percent to 13.5 percent in all intraoral microenvironment. The highest prevalence of P. gingivalis was found in subgingival plaque (53.5 percent), and of P. intermedia in supragingival plaque (33.5 percent), subgingival plaque (30 percent) and tongue dorsum (33.5 percent). The prevalence of bacteria did not vary significantly among the intraoral sites. CONCLUSIONS: All studied bacteria were identified in intraoral sites. S. mutans, P. gingivalis and P. intermedia had high prevalence rates, but the prevalence of E. faecalis was low. Multiplex PCR proved to be an adequate method for epidemiological studies.

Evaluation of the C-reactive protein serum levels in periodontitis patients with or without atherosclerosis.

Background : Several studies suggested an association between periodontal disease and cardiovascular disease (CVD). C- reactive protein is elevated in periodontitis patients and has been found to be a predictor of increased risk for cardiovascular disease. Since, CRP is known to play a role in pathogenesis of atherosclerosis, the present study was undertaken to evaluate the serum levels of CRP in periodontitis patients with or without atherosclerosis. Materials and Methods : A total of 45 patients, 15 chronic periodontitis patients with atherosclerosis (Group A), 15 chronic periodontitis patients with no history of any systemic disease (Group B), and 15 clinically healthy individuals with no history of periodontal or systemic disease (Group C) within age range of 30 to 55 years were selected for the study. PI, PBI, PPD, CAL and radiographic marginal alveolar bone level were assessed in all the three groups. CRP levels were assessed with 'Turbi-latex' kit using turbidimetric analysis. Results : The mean CAL recorded was 4.9mm in group A, 4.6mm in group B and 1.9 mm in group C. The mean radiographic marginal bone level was 45 to 50% in group A, 45 to 50% in group B and 90 to 95% in group C. Mean serum C-reactive protein level was significantly higher in group A (8.9 mg/l), as compared to group B (4.9 mg/l) as well as group C (0.9 mg/l). Conclusion : Within the limits of this study it was concluded that periodontitis may add to the inflammatory burden of the individual and may result in increased risk of atherosclerosis based on serum C-reactive protein concentrations.

Occurrence of Aggregatibacter actinomycetemcomitans in Brazilians with chronic periodontitis

Studies have suggested that A. actinomycetemcomitans is involved in the aetiology of aggressive periodontitis as well as in chronic periodontitis. This study was aimed at elucidating the occurrence of A. actinomycetemcomitans in a Brazilian population with chronic periodontitis. A total of 555 (mean age 33.04 ± 12.45) individuals, living in two large areas of the São Paulo State, namely "Baixada Santista" and "Vale do Paraíba", and diagnosed with mild [180 (mean age 29.59 ± 10.94)], moderate [241 (mean age 31.18 ± 11.45)] or severe [134 (mean age 33.04 ± 12.45)] chronic periodontitis were enrolled in this survey. Clinical exams including measurements of Probing Depth, Clinical Attachment Loss, Plaque and Gingival indices and subgingival microbiological assessments were performed at all population. The genomic DNA of A. actinomycetemcomitans was identified by Polymerase Chain Reaction from periodontal pocket samples. The occurrence of A. actinomycetemcomitans among chronic periodontitis subjects as well as its association with age and gender were statistically analysed using the Chi-square and Odds Ratio tests. The significance of differences was established at 5 percent (p < 0.05). A. actinomycetemcomitans was detected in 102 (18.37 percent) individuals: 29 (16.11 percent) mild; 42 (17.42 percent) moderate; and 31 (23.13 percent) severe chronic periodontitis with no statistical difference among groups. A higher occurrence of the searched bacterium was found both in the youngest group (p < 0.05) as well as in the female group (p < 0.05). This study elucidated that A. actinomycetemcomitans harbored subgingival pockets of our target group of chronic periodontitis subjects and that this bacterium seems to be inversely related to age, but related to the female gender.

Periodontal parameters and BANA test in patents with chronic renal failure undergoing hemodialysis

OBJECTIVES: The aim of this study was to analyze the periodontal parameters of patients with chronic renal failure. MATERIAL AND METHODS: The periodontal status of 16 Brazilian patients aged 29 to 53 (41.7±7.2) years with chronic renal failure (CRF) and another matched group of 14 healthy controls with periodontitis was assessed clinically and microbiologically. Probing pocket depth (PPD), gingival recession (GR), dental plaque index (PLI), gingival index (GI), and dental calculus index (CI) were the clinical parameters recorded for the entire dentition (at least 19 teeth), while the anaerobic periodontopathogen colonization in four sites with the highest PPD was evaluated using the BANA test ("PerioScan"; Oral B). RESULTS: The results for the CRF group and control group, respectively were: PPD: 1.77±0.32 and 2.65±0.53; GR: 0.58±0.56 and 0.51±0.36; PLI: 1.64±0.56 and 1.24±0.67; GI: 0.64±0.42 and 0.93±0.50; CI: 1.17±0.54 and 0.87±0.52. Comparison between groups using the "t" test revealed a significantly increased PPD (p<0.001) in the control group. Comparison of the other clincial parameters by the Mann-Whitney test showed differences only for PLI, which was significantly higher (p<0.05) in the CRF group. Spearman's test applied to each group showed a positive correlation among all clinical parameters, except for GR (p<0.05). None of the groups showed any correlation between GR and GI, while a significant negative correlation between GR and PPD was observed for the CRF group. The percentage of BANA-positive sites was 35.9 percent for the CRF group and 35.7 percent for the control group. The BANA test correlated positively with PPD only in the control group and with GR only in the CRF group. CONCLUSIONS: In spite of a higher PLI and dense anaerobic microbial population even in shallow PPD, patients with CRF exhibited better periodontal conditions than periodontitis patients, which is an evidence of altered response to local irritants.

Community periodontal index of treatment needs index: An indicator of anaerobic periodontal infection.

Background : Community periodontal index of treatment needs (CPITN) index is commonly used to measure periodontal disease. It's uniqueness, apart from assessing the periodontal status, also gives the treatment needs for the underlying condition. Benzoyl-DL-arginine napthylamide (BANA) test is a chair side diagnostic test used to detect the presence of putative periodontal pathogens. We correlated the CPITN scores of patients with BANA test results to assess the validity of CPITN as an indicator of anaerobic periodontal infection. Objectives : The present study was aimed to correlate the CPITN scores with the BANA activity of subgingival plaque. The objective was to assess the validity of CPITN index as indicator of anaerobic periodontal infection. Patients and Methods : A total of 80 sites were selected from 20 patients with generalized chronic periodontitis. After measuring the probing depth with CPITN C probe, the highest score from each sextant was selected according to the CPITN criteria and subgingival plaque samples were collected using a sterile curette and the BANA test was performed. Results : Kendall's tau-b and Chi- square test were used to assess the correlation between the BANA test results and CPITN scores. Results indicated sensitivity (92.86%), specificity (80%) and agreement (91.25%); indicating the validity of CPITN in assessing anaerobic infection. Conclusion : There was a significant correlation between BANA test results and scores 3 and score 4 of CPITN index (P < 0.001) clearly indicating the presence of anaerobic periodontal infection.