Altered levels of inhibitory cytokines in patients with thalassemia major and gingival inflammation / Níveis alterados de citocinas inibitórias em pacientes com talassemia major e inflamação gengival

Objective: To evaluate local and systemic levels of interleukin-10 (IL-10), IL-33, and tumor necrosis factor alpha (TNF-α) in Thalassemia major (TM) in the presence of gingival inflammation. Material and Methods: 58 patients (TM, n=29 and systemically healthy controls, n=29) were included to the study. IL-10, IL-33, and TNF-α levels were evaluated in gingival crevicular fluid (GCF), saliva and serum. Clinical periodontal measurements were recorded. Results: GCF IL-33 total amounts in TM and gingivitis group were elevated compared to systemically and periodontally healthy group (p=0.01). GCF IL-10, IL33 and TNF-α concentrations were higher in TM and periodontally healthy group than the systemically healthy and gingivitis group (p=0.02, p=0.008, p=0.003). Serum IL-10 levels were elevated in TM and gingivitis compared to the systemically healthy and gingivitis (p=0.0009) and systemically and periodontally healthy (p=0.0007) groups. Serum IL-10 and TNF-α levels in TM and periodontally healthy group were higher than systemically and periodontally healthy group (p=0.01 and p=0.02). Conclusion: TM may potentially alter circulating levels of IL-33 and IL-10 and therefore, may affect the degree of periodontal inflammation locally or vice versa. Yet, the underlying mechanism linking the hematologic condition is not clear and deserves further investigation. (AU)

Objetivo: Avaliar os níveis locais e sistêmicos de interleucina-10 (IL-10), IL-33 e fator de necrose tumoral alfa (TNF-α) na Talassemia Major (TM) na presença de inflamação gengival. Material e Métodos: 58 pacientes (TM, n = 29 e controles sistemicamente saudáveis, n = 29) foram incluídos no estudo. Os níveis de IL-10, IL-33 e TNF-α foram avaliados em fluido crevicular gengival (FCG), saliva e soro. As medições periodontais clínicas foram registradas. Resultados: As quantidades totais de IL-33 no FCG do grupo de TM e gengivite foram elevadas em comparação com o grupo sistemicamente e periodontalmente saudável (p = 0,01). As concentrações de IL-10 , IL-33 e TNF-α do FCG foram maiores no grupo TM e periodontalmente saudáveis do que no grupo sistemicamente saudável e gengivite (p = 0,02, p = 0,008, p = 0,003). Os níveis séricos de IL-10 estavam elevados na TM e gengivite em comparação com os grupos sistemicamente saudável e gengivite (p = 0,0009) e sistemicamente e periodontalmente saudáveis (p = 0,0007). Os níveis séricos de IL-10 e TNF-α no grupo TM e periodontalmente saudáveis foram maiores do que os grupos sistemicamente e periodontalmente saudáveis (p = 0,01 ep = 0,02). Conclusão: A TM pode alterar potencialmente os níveis circulantes de IL-33 e IL-10 e, portanto, pode afetar o grau de inflamação periodontal localmente ou vice-versa. No entanto, o mecanismo subjacente que liga a condição hematológica não é claro e merece uma investigação mais aprofundada. (AU)

Salivary Adiponectin and Leptin Levels are Increased in Women with Gestational Diabetes Mellitus and Gingival Inflammation.

PURPOSE: Gestational diabetes mellitus (GDM) is defined as glucose intolerance with first onset or diagnosis in pregnancy. This study evaluated clinical and biochemical parameters in a possible association between GDM and gingival inflammation. MATERIALS AND METHODS: A total of 87 pregnant women - 44 with GDM and 43 without (NGDM) - were included. Subgroups were created according to gingival inflammation. Plaque index (PI), bleeding on probing (BOP), and probing depth (PD) were recorded. RESULTS: Age, anthropometric variables and baby weight (g) were all statistically significantly higher in the GDM group (p < 0.0001). Systolic and diastolic blood pressure (mmHg), saliva, serum leptin and adiponectin levels were similar in the GDM and NGDM groups (p = 0.605, p = 0.662, p = 0.737, and p = 0.596, respectively). Salivary adiponectin levels were statistically significantly higher in the two subgroups with gingivitis compared to those with clinically healthy periodontium (p < 0.01). Serum adiponectin levels were statistically significantly higher in the NGDM subgroup with gingivitis than the NGDM group with clinically healthy periodontium (p < 0.05). Statistically significant positive correlations were found between PD, PI, BOP and saliva adiponectin levels in the GDM group (p < 0.05). Positive correlations were also found between clinical periodontal parameters and saliva, serum levels of adiponectin in the control group without GDM (p < 0.05). CONCLUSION: The higher salivary adiponectin levels in the gingivitis groups suggest that gingival inflammation is more likely to influence local inflammatory parameters both in the presence and absence of GDM. Further larger-scale studies are required to better clarify the possible interactions between gingival inflammation and GDM.

Saliva levels of caspase-1, TNF-α, and IFN-γ in primary Sjögren's syndrome: oral mucosal abnormalities revisited

Background/aim: Abnormalities in oral mucosal immunity contribute to complex pathogenesis of primary Sjögren's syndrome (pSjS). We aimed to measure saliva and serum levels of caspase-1, tumor necrosis factor-alpha (TNF-α) and interferon gamma (IFN-γ) in patients with pSjS. Materials and methods: We studied 43 pSjS patients fulfilling the AECG criteria and 30 age/sex-matched healthy controls, as well as 39 rheumatoid arthritis (RA) patients as a disease control group. ESSDAI scores were less than seven in all patients with pSjS, indicating low disease activity. Quantitative analyses were made in serum and whole saliva samples. The statistical analysis was performed using SPSS 19.0. Results: While no significant difference was found in serum measurements, saliva levels of TNF-α and caspase-1 were significantly higher in pSjS patients versus healthy controls when using the Mann-Whitney U test. On the other hand, in the pSjS group, saliva levels of TNF-α and caspase-1 were also significantly higher compared to the RA group using Student's t-test. In the pSjS group, those parameters did not show any correlation with disease duration, seropositivity, and smoking. Conclusion: Despite low disease activity, saliva TNF-α and caspase-1 levels were found to be significantly higher in the pSjS group, which may suggest a possible advantage of local anticytokine treatments in selected cases.

Clinical periodontal status and inflammatory cytokines in primary Sjögren syndrome and rheumatoid arthritis.

BACKGROUND: The aim of the present study is to compare the clinical periodontal findings as well as gingival crevicular fluid (GCF) and plasma levels of tumor necrosis factor-alpha (TNF-α), interleukin-1beta (IL-1ß), interferon gamma (IFN-γ) and caspase-1 in primary Sjögren syndrome (pSS) and rheumatoid arthritis (RA) subjects. METHODS: In the present case control study plasma and GCF samples were collected, full-mouth recordings comprising plaque index (PI), bleeding on probing (BOP) and probing depth (PD) were performed in 44 subjects with pSS, 39 subjects with RA and 30 systemically healthy subjects. Plasma and GCF TNF-α, IL-1ß, IFN-gamma and caspase-1 levels were determined by enzyme-linked immunosorbent assay. RESULTS: There were no differences in GCF and plasma levels of IFN-γ and TNF-α in all the study groups (p > 0.05). GCF levels of IL-1ß were higher in pSS group than healthy group (p = 0.035). Caspase-1 GCF levels were significantly higher in pSS group than RA group (p = 0.032). Highest plasma IL-1ß levels were detected in pSS compared to RA and healthy groups (p < 0.001). Healthy group has higher caspase-1 plasma levels than pSS and RA groups (p < 0.001). CONCLUSIONS: The results of the present study reveal that the periodontal status of patients with pSS does not differ from systemically healthy subjects. Further studies involving longitudinal assessments on larger populations with standardized patient inclusion criteria are needed to confirm the findings.

Saliva, Serum Levels of Interleukin-21, -33 and Prostaglandin E2 in Patients with Generalised Aggressive or Chronic Periodontitis.

PURPOSE: This cross-sectional study aims to evaluate saliva, serum levels of interleukin-21 (IL-21), IL-33, and prostaglandin E2 (PGE2) in patients with generalised chronic periodontitis or aggressive periodontitis. MATERIALS AND METHODS: Before initiation of any periodontal treatment, saliva and serum samples were collected and clinical periodontal measurements were recorded from 94 participants (25 aggressive periodontitis patients, 25 chronic periodontitis patients, 44 periodontally healthy individuals). IL-21, IL-33 and PGE2 levels in serum and saliva samples were determined by ELISA. Data were tested statistically using Kruskal-Wallis, Mann-Whitney U-, and Spearman-rho rank tests. RESULTS: Saliva IL-33 levels were statistically significantly higher in the chronic than the aggressive group (p < 0.05). Serum IL-33, saliva and serum IL-21 and PGE2 levels were similar in the two periodontitis groups. Saliva IL-33 levels correlated with age in the chronic periodontitis group (p < 0.05). Statistically significant positive correlations were found between serum, saliva PGE2 levels and plaque index (p < 0.05). IL-33 and IL-21 levels in serum samples positively correlated in the periodontitis groups (p < 0.05). CONCLUSION: IL-21 and PGE2 analysis did not exhibit discriminating data between generalised chronic and aggressive periodontitis, but the present findings support the role of these cytokines in periodontitis. Statistically significantly higher saliva IL-33 levels in the chronic periodontitis group warrant further research.

Gingival Inflammation and Salivary or Serum Granulocyte-Secreted Enzymes in Patients With Polycystic Ovary Syndrome.

BACKGROUND: The objective of this cross-sectional study is to investigate levels of salivary and serum matrix metalloproteinase (MMP)-9, myeloperoxidase (MPO), neutrophil elastase (NE), and MMP-9/tissue inhibitor of MMP-1 (TIMP)-1 ratio in patients with polycystic ovary syndrome (PCOS) and systemically healthy controls in the presence or absence of gingivitis. METHODS: Serum and salivary levels of these biomarkers were evaluated in the following: 1) periodontally healthy women with PCOS (n = 45); 2) women with PCOS and gingivitis (n = 35); 3) systemically and periodontally healthy women (n = 25); and 4) systemically healthy women with gingivitis (n = 20). Enzyme-linked immunosorbent assay was used to determine levels of these biomarkers. A full-mouth clinical periodontal evaluation was performed for each patient. RESULTS: Salivary MMP-9 and NE levels, as well as MMP-9/TIMP-1 ratios, were higher in the systemically healthy women with gingivitis compared with periodontally healthy women with PCOS (P <0.001; P <0.01; and P <0.0001, respectively). Serum MMP-9 and MPO levels were higher in women with PCOS and gingivitis compared with periodontally healthy women with PCOS (P <0.05). Serum MMP-9 levels were lower in healthy women with gingivitis than systemically and periodontally healthy women or women with PCOS and gingivitis (P <0.05). PCOS groups exhibited a positive correlation among clinical periodontal parameters and serum MMP-9 levels or salivary MPO, NE levels, and MMP-9/MMP-1 ratio. Correlation was negative among clinical periodontal parameters and serum MMP-9 levels and MMP-9/TIMP-1 ratio in systemically healthy patients (P <0.05). CONCLUSIONS: The present findings emphasize that PCOS and gingival inflammation are associated with each other, as evidenced by salivary and serum levels of neutrophilic enzymes. This interaction may contribute to the perturbation of ovarian remodeling in PCOS.

Proteolytic Mediators in Gestational Diabetes Mellitus and Gingivitis.

BACKGROUND: This study evaluates levels of matrix metalloproteinase (MMP)-8, MMP-9, and tissue inhibitor of MP-1 (TIMP-1) in biofluids of women with gestational diabetes mellitus (GDM) and systemically healthy counterparts with different statuses of periodontal health. METHODS: Seventy-one women with GDM and gingivitis (Gg), 30 women with GDM and healthy periodontium (Gh), 28 systemically and periodontally healthy women (Hh), and 37 systemically healthy women with gingivitis (Hg) were evaluated. MMP-8, MMP-9, and TIMP-1 levels were determined in gingival crevicular fluid (GCF), saliva, and serum by immunofluorometric and enzyme-linked immunosorbent assays. Full-mouth clinical periodontal parameters were recorded. RESULTS: GCF and serum MMP-8 concentrations, serum MMP-9 concentrations, and serum MMP-8/MMP-1 and MMP-9/MMP-1 molar ratios were significantly higher in Gg compared with Hg group (P <0.05). Serum MMP-8 levels and salivary TIMP-1 levels were higher in Gh compared with Hg group (P <0.05) whereas salivary MMP-8/TIMP-1 molar ratio was lower in Gh compared with Hg group (P <0.05). Elevated concentrations of GCF MMP-8 and MMP-9 were found in Gg compared with Gh group (P <0.05). Significant correlations were found between local levels of biomarkers and clinical periodontal parameters in only GDM group. CONCLUSION: GDM may modulate both local and circulating levels of MMP-8 especially when associated with gingivitis.

Clinical periodontal status and inflammatory cytokines in gestational diabetes mellitus.

OBJECTIVES: The aim of the present cross-sectional study was to compare clinical periodontal findings as well as gingival crevicular fluid (GCF) and serum levels of tumour necrosis factor-alpha (TNF-α), interleukin-10 (IL-10), and IL-33 between women with and without gestational diabetes mellitus (GDM). METHODS: Serum and GCF samples were collected, full-mouth recordings comprising plaque index, bleeding on probing and probing depth were performed in 96 females with GDM (cases) and 65 non-diabetic pregnant females (controls). Age, smoking status, pre-pregnancy body mass index, pregnancy outcomes were recorded. Serum and GCF IL-10, IL-33, TNF-α levels were determined. RESULTS: The GDM group was significantly older than the control group with an age difference of 3.27 years (mean ages were 32.05 and 28.78 years, respectively) (p<0.0001). Plaque Index (50.0 and 30.0 p=0.005), bleeding on probing (50.0 and 30.0 p=0.003) values were significantly higher in the GDM group. Serum TNF-α concentrations were significantly higher in the nonGDM group than the GDM group (p=0.001). GCF IL-10 concentrations and total amounts were significantly higher in the GDM group than the controls (p=0.004 and p<0.0001, respectively). CONCLUSION: Elevated GCF IL-10 levels may be a consequence of higher levels of inflammation as indicated by higher PI and BOP in the GDM group. However, the investigated clinical parameters may not have prominent effects on TNF-α and IL-33 levels. These findings provide further support for the importance of periodontal health during pregnancy.

Association of thalassemia major and gingival inflammation: A pilot study.

OBJECTIVES: This cross-sectional study aimed to investigate the relationship between thalassemia major (TM) and gingival inflammation through the salivary, serum, and gingival crevicular fluid (GCF) levels of matrix metalloproteinase (MMP)-8, MMP-9 and tissue inhibitor of MMP (TIMP)-1. METHODS: Biofluid samples and full-mouth clinical periodontal recordings were obtained from 29 otherwise healthy patients with TM and 25 systemically healthy (SH) individuals. Biofluid samples were evaluated by immunofluorometric assay (IFMA) and enzyme-linked immunoassays (ELISAs). Data were tested statistically by Kolmogorov Simirnov, Mann-Whitney U tests, Spearman correlation analysis. RESULTS: Age, smoking status, bleeding on probing, plaque index were similar in the study groups, but probing depth, gender data exhibited significant differences (p=0.037 for both). Salivary MMP-8, MMP-9, TIMP-1 concentrations were significantly higher in the TM than SH group (p=0.014; p<0.001; p=0.042, respectively). Serum TIMP-1 concentrations were significantly higher; MMP-8/TIMP-1, MMP-9/TIMP-1 molar ratios were significantly lower in the TM than SH group (p<0.001; p=0.005; p=0.022, respectively). Very few GCF samples revealed biochemical data above the detection limits. Numerous correlations were found between clinical periodontal parameters and biochemical data. CONCLUSIONS: It may be suggested that TM may exacerbate the local inflammatory response as manifested in salivary MMP-8, MMP-9, TIMP-1 levels.

Increased infection with key periodontal pathogens during gestational diabetes mellitus.

AIM: Gestational diabetes mellitus (GDM), gingivitis, infection with specific periodontal pathogens and systemic inflammation each increase the risk for poor pregnancy outcome. We set out to monitor the interactions of gingivitis and GDM with respect to oral infection and the systemic inflammatory burden. MATERIALS AND METHODS: Four case-control groups (n = 117) were recruited, (1) No gingivitis, No GDM (n = 27); (2) Gingivitis, No GDM (n = 31); (3) No gingivitis, GDM (n = 21); and (4) Gingivitis, GDM (n = 38). Oral infection with three key periodontal pathogens was determined by PCR. Systemic inflammation was determined by quantification of CRP by EIA. RESULTS: Gingivitis during pregnancy was associated with oral infection with Porphyromonas gingivalis, Filifactor alocis and Treponema denticola and combinations thereof (all p < 0.01). GDM was also associated with increased infection with individual and multiple oral pathogens (all p < 0.05). Gingivitis during pregnancy led to a 325% increase in systemic CRP (mean, 2495 versus 8116 ng/ml, p < 0.01). CONCLUSIONS: Diabetes and gingivitis act in concert to increase risk biomarkers for poor pregnancy outcome.

The Association Between Thalassemia Major and Periodontal Health.

BACKGROUND: The aim of this cross-sectional study is to compare the local and systemic levels of soluble receptor activator of nuclear factor-κB ligand (sRANKL), osteoprotegerin (OPG), a proliferation-inducing ligand (APRIL), B-cell activating factor (BAFF), interleukin (IL)-6, and IL-8 in biofluids of patients with thalassemia major (TM) with or without gingivitis. METHODS: Seventy-seven patients are included in this study (TM, n = 29; systemically healthy, n = 48). Gingival crevicular fluid (GCF), saliva, and serum levels of IL-6, IL-8, sRANKL, OPG, BAFF, and APRIL were determined by enzyme-linked immunosorbent assay. Data were analyzed by appropriate non-parametric or parametric statistical tests. RESULTS: Median GCF, serum, and saliva levels for BAFF (P <0.001) and IL-6 and IL-8 (P <0.005) were higher in TM gingivitis than in systemically healthy gingivitis (P <0.001). GCF, serum, and saliva levels for APRIL, sRANKL, IL-6, and IL-8 were higher in TM than in systemically and periodontally healthy comparison groups (P <0.05). Positive correlations were found between bleeding on probing (BOP), plaque index (PI) scores, and GCF APRIL, serum sRANKL, serum OPG, and sRANKL concentrations in TM groups (P <0.05). Several significant positive correlations were found between BOP, PI scores, and biofluid parameters also in systemically healthy groups. CONCLUSION: TM may have a role in the underlying systemic hematologic condition and potentially affect gingival inflammation via dysregulation of lymphocytes and increased activation of osteoclasts.

Elevated matrix metalloproteinase-8 in saliva and serum in polycystic ovary syndrome and association with gingival inflammation.

This study aimed to investigate the levels of matrix metalloproteinase-8 (MMP-8) and tissue inhibitors of MMP-1 (TIMP-1) in saliva and serum samples of women with polycystic ovary syndrome (PCOS; n = 80) and matched systemically healthy controls (n = 45), with varying degrees of gingival inflammation. Salivary levels of MMP-8 and the MMP-8/TIMP-1 ratio were significantly elevated in women with PCOS, who also exhibited more gingivitis than systemically healthy women. No major changes were observed in salivary TIMP-1 levels with regard to PCOS. Serum levels of MMP-8 and the MMP-8/TIMP-1 ratio were significantly higher in women with PCOS, irrespective of the presence of gingivitis, while there were no differences in TIMP-1 levels. A positive correlation was indicated between probing depth, bleeding on probing, plaque index and salivary or serum MMP-8 levels or MMP-8/TIMP-1 ratio in the case of PCOS, while a negative such correlation was revealed for TIMP-1 in systemically healthy women. Increased levels of MMP-8 in saliva and serum seem to be more pronounced in women with PCOS, and potentiated in the presence of gingival inflammation. Alterations in MMP/TIMP system triggered by local and systemic inflammation may be implicated in the pathogenesis of PCOS, or the deterioration of its clinical presentation.

Evaluation of biochemical parameters and local and systemic levels of osteoactive and B-cell stimulatory factors in gestational diabetes in the presence or absence of gingivitis.

BACKGROUND: Gestational diabetes mellitus (GDM) is defined as varying glucose intolerance, with first onset or recognition in pregnancy. This study evaluates clinical and biochemical parameters in a possible association between GDM and gingivitis. METHODS: A total of 167 pregnant females was included in the study. There were 101 females with GDM and 66 females without GDM. Subgroups were created according to the presence or absence of gingival inflammation. Plaque index, bleeding on probing, and probing depth were recorded at four sites per tooth. Serum, saliva, and gingival crevicular fluid (GCF) levels of interleukin (IL)-6, IL-8, soluble receptor activator of nuclear factor-kappa B ligand (sRANKL), osteoprotegerin (OPG), B-cell activating factor (BAFF), and a proliferation-inducing ligand (APRIL) were determined by enzyme-linked immunosorbent assay. Data were analyzed by Kruskal-Wallis and Mann-Whitney U tests and Spearman correlation analysis. RESULTS: Age and anthropometric indices were higher in the GDM than non-GDM group (P <0.0001). Clinical periodontal recordings, serum BAFF, IL-8, and saliva sRANKL levels were higher in the GDM group (P <0.05). Saliva IL-6 level was higher in the GDM with gingivitis group than non-GDM with gingivitis group (P = 0.044). Serum and GCF BAFF (P <0.0001), serum, saliva, and GCF APRIL (P <0.0001; P <0.0001; P = 0.032, respectively), GCF OPG (P = 0.036), and serum and saliva sRANKL (P <0.0001) were higher in the GDM with gingivitis group than GDM without gingivitis group. CONCLUSIONS: The inflammatory response seems to be more pronounced in females with GDM. The observed increase in both local and systemic levels of inflammatory cytokines may suggest an interaction between gingivitis and GDM.

Association between polycystic ovary syndrome, oral microbiota and systemic antibody responses.

Polycystic ovary syndrome (PCOS) is a hormonal disorder of women that not only is the leading cause of infertility but also shows a reciprocal link with oral health. This study aimed to investigate the hypothesis that the levels of putative periodontal pathogens in saliva and their antibody response in serum are elevated in PCOS, compared to systemic health. A total of 125 women were included in four groups; 45 women with PCOS and healthy periodontium, 35 women with PCOS and gingivitis, 25 systemically and periodontally healthy women, 20 systemically healthy women with gingivitis. Salivary levels of seven putative periodontal pathogens were analyzed by quantitative real-time polymerase chain reaction and serum antibody levels were analyzed by ELISA. In women with PCOS, salivary Porphyromonas gingivalis, Fusobacterium nucleatum, Streptococcus oralis and Tannerella forsythia levels were higher than matched systemically healthy women, particularly in the case of gingivitis. Aggregatibacter actinomycetemcomitans and Treponema denticola levels were similar among study groups. The presence of PCOS also enhanced P. gingivalis, Prevotella intermedia and S. oralis serum antibody levels, when gingivitis was also present. Gingival inflammation correlated positively with levels of the studied taxa in saliva, particularly in PCOS. The presence of P. gingivalis and F. nucleatum in saliva also exhibited a strong positive correlation with the corresponding serum antibody levels. In conclusion, as an underlying systemic endocrine condition, PCOS may quantitatively affect the composition of oral microbiota and the raised systemic response to selective members of this microbial community, exerting a confounding role in resultant gingival inflammation and periodontal health. The most consistent effect appeared to be exerted on P. gingivalis.

Periodontal disease and systemic diseases in an older population.

OBJECTIVE: To evaluate the relationship between older adults' medical and oral conditions and their self-reports of periodontal conditions with clinically obtained data. BACKGROUND: Concerns about oral health of elders and its association with systemic diseases have been gaining more attention. METHODS: A total of 201 older subjects were interviewed about their previous medical and dental histories and were asked to complete a health questionnaire. Each subject received full mouth exam, including counting number of natural teeth remaining, gingival (GI) and plaque index (PI), CPITN and denture status. RESULTS: Elders who completed health questionnaires had mean age of 62.5. Mean CPITN score was 1.62(± 1.12), PI was 1.57(± 1.48), and GI was 1.55(± 1.31). Women had higher prevalence of CVD and osteoporosis than men (p=0.008, p=0.0001, respectively). Subjects who reported bleeding upon brushing had higher PI and GI scores (p=0.03, p=0.05, respectively). Smokers were more likely to describe their periodontal tissues as unhealthy (72.3% vs. 27.7%, p=0.01), whereas self-reports of healthy vs. unhealthy gums did not differ between non-smokers. CONCLUSION: These findings suggest that a number of systemic conditions are associated with indicators of periodontal disease, and self-reports of oral conditions are independent of systemic diseases.

Saliva and serum levels of pentraxin-3 and interleukin-1ß in generalized aggressive or chronic periodontitis.

BACKGROUND: Pentraxin-3 (PTX3) is a multifactorial protein involved in immunity and inflammation, which is rapidly produced and released by several cell types in response to inflammatory signals. The aim of the present study is to evaluate saliva, serum levels of PTX3, interleukin (IL)-1ß in patients with generalized chronic periodontitis (CP) or aggressive periodontitis (AgP), and periodontally healthy individuals. METHODS: A total of 94 participants (25 patients with AgP, 25 patients with CP, and 44 periodontally healthy individuals matched with AgP and CP groups) were recruited. Saliva and serum samples were collected. Clinical periodontal measurements were recorded. PTX3, IL-1ß levels in serum, and saliva samples were determined by enzyme-linked immunosorbent assay. Data were tested statistically using Kruskal-Wallis, Mann-Whitney U, and Spearman ρ rank test. RESULTS: Serum and saliva data were similar in CP and AgP groups. Saliva levels of IL-1ß were significantly higher in the AgP and CP groups than controls (P <0.05). Salivary PTX3 levels were similar in the CP and control groups. Significantly higher salivary concentrations of PTX3 were detected in the AgP group than the control group (P <0.05). Saliva PTX3 levels correlated with plaque index and bleeding on probing in the CP group (P <0.05). Serum and saliva PTX3 levels correlated with those of IL-1ß in the AgP group (P <0.05). CONCLUSIONS: It may be suggested that PTX3 is related with periodontal tissue inflammation. Its salivary concentrations may have a diagnostic potential. Additional intervention and follow-up studies coupling PTX3 concentrations with microbiologic analysis would better clarify its role in periodontal diseases.

Is interleukin-17 involved in the interaction between polycystic ovary syndrome and gingival inflammation?

BACKGROUND: Polycystic ovarian syndrome (PCOS) is a hormonal disorder of females of reproductive age that impacts their oral and systemic health. The aim of this study is to evaluate interleukin-17A (IL-17A), IL-17F, IL-17A/F, and IL-17E (IL-25) levels in gingival crevicular fluid (GCF), saliva, and serum of non-obese females with PCOS and with either a clinically healthy periodontium or gingivitis. METHODS: Thirty-one females with PCOS, 30 females with PCOS and gingivitis, and 12 systemically and periodontally healthy females participated in the study. Clinical periodontal measurements, body mass index, and Ferriman-Gallwey score (FGS) (a measure of hirsutism in females) were recorded. Circulating levels of sex hormones, cortisol, and insulin were also determined. Levels of IL-17 cytokines were measured by enzyme-linked immunosorbent assay. RESULTS: The general linear model multivariate analysis, adjusting for age or plaque index, showed that the two groups with PCOS had higher concentrations of IL-17A, IL-17F, and IL-17A/F in serum and higher levels of IL-17A and IL-17F in GCF and saliva but lower serum IL-17E than systemically healthy females. Levels of IL-17E were lowest in females with PCOS and gingivitis who also had the highest FGS. Serum IL-17A and IL-17F levels correlated positively with FGS and periodontal probing depth (all ρ >0.33; P <0.005). Serum IL-17E showed the reverse relationship and also correlated negatively with IL-17A (ρ >-0.28; P <0.05). CONCLUSIONS: IL-17 levels are altered in non-obese females with PCOS and may influence gingival inflammation. Additional studies are warranted to clarify the relationship between PCOS and gingivitis.

Is there an interaction between polycystic ovary syndrome and gingival inflammation?

BACKGROUND: The aim of this study is to evaluate the gingival crevicular fluid (GCF), saliva, and serum concentrations of tumor necrosis factor-α (TNF-α), TNF-α receptor-1 (TNF-αR1), TNF-αR2, and interleukin-6 (IL-6) in non-obese females with polycystic ovary syndrome (PCOS) and either clinically healthy periodontium or gingivitis. METHODS: Thirty-one females with PCOS and healthy periodontium, 30 females with PCOS and gingivitis, and 12 systemically and periodontally healthy females were included in the study. GCF, saliva, and serum samples were collected, and clinical periodontal measurements, body mass index, and Ferriman-Gallwey score (FGS) were recorded. Sex hormones, cortisol, and insulin levels were measured. TNF-α, TNF-αR1, TNF-αR2, and IL-6 were determined by enzyme-linked immunosorbent assay. Kruskal-Wallis followed by Bonferroni-corrected post hoc Mann-Whitney U tests were used to analyze the data. RESULTS: The PCOS + gingivitis group revealed significantly higher GCF, saliva, and serum IL-6 concentrations than the PCOS + healthy group (P <0.0001). The two PCOS groups exhibited significantly higher saliva TNF-α concentrations than the control group (P = 0.024 and P = 0.013, respectively). The FGS index was significantly higher in the PCOS + gingivitis group than the PCOS + healthy group (P = 0.030). The PCOS + gingivitis group revealed significantly higher insulin concentration than the PCOS + healthy and control groups (P = 0.014 and P <0.0001, respectively). Serum TNF-α, TNF-αRs, and serum, GCF, and salivary IL-6 levels correlated with the clinical periodontal measurements. CONCLUSIONS: PCOS and gingival inflammation appear to act synergistically on the proinflammatory cytokines IL-6 and TNF-α. Thus, PCOS may have an impact on gingival inflammation or vice versa. Additional studies are warranted to clarify the possible relationship between PCOS and periodontal disease.