Correlation of Serum and Salivary Cytokines Level With Clinical Parameters in Metabolic Syndrome With Periodontitis

Relationship Between Diabetes Mellitus and Periodontal/Peri-Implant Disease: A Contemporaneous Review

The prevalence of diabetes mellitus (DM), a major chronic disease and a leading cause of death and disability around the world, is rising. According to the latest data, the global prevalence of DM has increased to 463 million (9.3% of adults) in 2019 and is estimated to reach 700 million by 2045. Periodontal disease, result of periodontium inflammation, is a common, chronic disease and has long been considered one of the complications of DM. Moreover, literature reflects a spectrum of conflicting viewpoints on the effect of diabetic conditions on the implant treatment strategies. The current review aims to update the recent epidemiologic evidence regarding the relationship between DM and periodontal/peri-implant disease, emphasising the effects of glycaemic control on the severity of these diseases and describing the pathobiological mechanisms underlying this association. This review's findings indicate a bidirectional relationship between DM and periodontal/peri-implant disease and that this relationship seems causal, implying that controlling these two diseases might help prevent each other's incidence. Additionally, the severity of periodontal/peri-implant disease is directly related to metabolic control. Although patients with diabetes can obtain implant success similar to those in systemically healthy individuals, an increased risk of peri-implantitis has been reported in DM patients. Therefore, the importance of glycaemic control and maintaining proper oral hygiene cannot be overstated.

Associations Between Direct and Indirect Forms of Racism Exposure and Stress-Induced Inflammatory Response and Health in Pregnancy

Theory and research suggest chronic direct and indirect exposures to racism impact health, and stress-responsive inflammation may play a role in these paths. This study examines links between forms of racism-related stress, salivary markers of inflammation during acute psychosocial stress, and perinatal mental and physical health in a racially heterogenous sample. Pregnant people (n = 108, 27% non-white) self-reported personal and vicarious exposure to racism (racial microaggressions, online racism, overt racial/ethnic discrimination) and racial collective self-esteem, as well as affective symptoms and general physical health. Five saliva samples collected before and after the Trier Social Stress Test were assayed for pro-inflammatory cytokines and C-reactive protein. Results revealed associations between racism-related stress and greater inflammatory reactivity/delayed recovery to acute stress, between racial collective self-esteem and lower levels of inflammation, and between profiles of inflammatory responses to stress and mental and physical symptoms. We discuss implications for understanding perinatal health disparities.

Assesement of serum Sfrp5/Wnt-5a level and its utility in the risk stratification of treatment naïve patients with metabolic syndrome

Our study focused on investigating the clinical significance of serum Sfrp5/Wnt-5a levels as a risk marker in metabolic syndrome (MetS). The study involved a total of 107 treatment-naive MetS cases and 100 controls with similar age and sex belonging to northern India. The profiling of clinical, biochemical, and anthropometric variables was done. ELISA methods were employed for serum cytokine estimation. Serum Sfrp5 was inversely correlated with BMI, WC, SBP, DBP, FPG, TG, fasting insulin level, and HOMA-IR in both males and females. The best cutoff value for Sfrp5 to predict MetS in males was ≤40.48 ng/ml (sensitivity 53.70% and specificity 90.48%), while in female, it was ≤66.67 ng/ml (sensitivity 98.11% and specificity 34.48%). MetS occurrence decreased with increasing concentration of Sfrp5 with an odds ratio (OR) of 0.95 (95% CI = 0.92-0.98, P < .001) in male and 0.93 (95% CI = 0.91-0.97, P < .001) in female. Quartile analysis revealed that odds of MetS significantly decreased in quartile 4 vs. 1, 0.06 (95% CI = 0.01-0.25), P = .001 and 0.13 (95% CI = 0.04-0.44), P = .001, respectively, in male and female. The inverse association of serum concentration of Sfrp5 with MetS might have a useful addition to the available risk marker as well as a therapeutic target for MetS.

STUDY OF IMMUNE-INFLAMMATORY RESPONSE CHANGES IN ORAL FLUID IN PATIENTS WITH DISEASES OF PERIODONTAL TISSUES IN COMBINATION WITH GENERAL SOMATIC PATHOLOGY

OBJECTIVE

The aim: To determine the concentration of markers of the immune-inflammatory response (IL-1β, IL-10, IL-1β / IL-10, hsCRP) in oral fluid in patients with diseases of periodontal tissues in combination with general somatic pathology.

PATIENTS AND METHODS

Materials and methods: The study was conducted at Danylo Halytsky Lviv National Medical University, Department of therapeutic dentistry FPGE, Lviv, Ukraine. The patients were divided into two groups: the main group - 144 patients (with periodontal tissue diseases on the background of general somatic pathology) and the control group - 30 somatically and dentally healthy persons, in whose oral fluid was determined the concentration of IL-1β, IL-10, hsCRP by the enzyme immunoassay method.

RESULTS

Results: As a result of our research, it was found that in people with periodontal tissue diseases, against the background of general somatic pathology, there is an activation of the immune-inflammatory response, which aggravates the course of general somatic and dental diseases in this contingent of patients.

CONCLUSION

Conclusions: Therefore, in patients with periodontal tissue diseases on the background of somatic diseases, a significant increase in the level of the pro-in-flammatory cytokine IL-1β and hsCRP was determined against the background of a decrease in the anti-inflammatory cytokine IL-10 in the oral fluid compared to the values in the control group.

Protein-based salivary biomarkers for the diagnosis of periodontal diseases: Systematic review and meta-analysis

Objective

This systematic review and meta-analysis was aimed at determining differentially expressed protein-based biomarkers detectable in the saliva for the diagnosis of major periodontal diseases.

Methods

A literature review was conducted through January 31, 2022. The methodological quality and risk of bias were assessed with the Newcastle-Ottawa scale for case-control studies. Heterogeneity among studies was analysed with the Q statistical test and the I² test. p-values lower than 0.10 and I² values higher than 50% indicated high heterogeneity among studies; therefore, the random-effects model was used. The analysis of biological pathways associated with the differentially expressed protein markers was performed with the STITCH integration analysis tool and was limited to interactions with high confidence levels (0.7).

Results

Of all protein-based biomarkers detected, 12 were suitable for meta-analysis: IL-1β, MIP-1α, albumin, TNF-α, ICTP, Ig-A, lactoferrin, MMP-8, IL-6, IL-8, IL-17 and PGE2. The salivary markers with high applicability were IL-1β for differentiating patients with chronic periodontal disease from patients with gingivitis with an OE = 73.5 pg/mL; ICTP for differentiating patients with chronic periodontal disease from healthy control patients with an OE = 0.091 ng/mL; and PGE2 for differentiating patients with chronic periodontal disease from healthy control patients with an OE = 36.3 pg/mL.

Conclusions

The biomarkers with the highest differential expression and the greatest potential for clinical applicability are IL-1β for differentiating periodontitis from gingivitis, and ICTP and PGE2 for differentiating periodontitis from healthy status.

A Review of Psychological Stress among Students and Its Assessment Using Salivary Biomarkers

Numerous psychoneuroimmune factors participate in complex bodily reactions to psychological stress, and some of them can be easily and non-invasively measured in saliva (cortisol, alpha-amylase, proinflammatory cytokines). Cortisol plays a crucial role in the stress response; thus, stressful events (academic examinations, cardiac surgery, dental procedures) are accompanied by an increase in cortisol levels. (A correlation between cortisol blood levels and salivary values has already been confirmed, particularly during stress). Academic stress is defined as everyday stress among students that has an impact on aspects of their psychological and physiological well-being. For example, exams are considered one of the most acute stressful experiences for students. The strength of the association between academic self-efficacy, psychological stress, and anxiety depends on a variety of factors: the type of academic challenge (e.g., oral exam), the presence of an audience, etc. Higher stress levels were predominantly recorded among younger students, primarily regarding their academic tasks and concerns (grades, exams, competing with peers for grades, fear of failing the academic year, etc.). The measurement of stress levels during academic stress can improve our understanding of the character and influence of stressful events in populations of students, preventing adverse reactions to long-term stress, such as a decreased immune response and increased anxiety.

Salivary Neurotrophins Brain-Derived Neurotrophic Factor and Nerve Growth Factor Associated with Childhood Obesity: A Multiplex Magnetic Luminescence Analysis

Obesity is linked with higher inflammatory markers and is characterized by chronic low-grade inflammation. Neurotrophins brain-derived neurotrophic factor (BDNF) and β-nerve growth factor (β-NGF), in addition to their neuronal functions, act on several immune cells and have been recently designated as metabokines due to their regulatory role in energy homeostasis and food intake. The current study evaluates the salivary BDNF and β-NGF and their association with anthropometric measurement, blood pressure, and salivary insulin in children. Anthropometric measurements and saliva samples were obtained from 76 children, aged 6–10 years. Multiplex analysis was carried out for the salivary analysis of BDNF, NGF, and insulin by human magnetic Luminex performance assay. Statistical analysis was performed to analyze the best fit diagnostic value for biomarkers and the relationship of the neurotrophic levels of BDNF and NGF with obesity measures and blood pressure. Salivary BDNF and β-NGF showed a significantly higher concentration in obese children than normal-weight children. Both neurotrophins are positively associated with obesity anthropometric measures, blood pressure, and salivary insulin. Multinominal regression analysis reported a significant association between salivary BDNF, β-NGF, insulin, and systolic pressure adjusted for age, gender, income, and maternal education. The salivary concentration of BDNF and NGF was higher in obese children, and it is positively associated with anthropometric measures, suggesting that neurotrophins can be used as a non-invasive predictor of obesity-related complications in children.

Salivary Adipokine and Cytokine Levels as Potential Markers for the Development of Obesity and Metabolic Disorders

Currently, the number of people suffering from obesity is increasing worldwide. In addition, the disease is affecting younger individuals. Therefore, it is essential to search for new diagnostic methods and markers for early assessment of the risk of obesity, metabolic disorders, and other comorbidities. The discovery of the secretory function of adipose tissue and coexistence of low-grade chronic inflammation with obesity set a new direction in this disease diagnosis using the assessment of the concentration of inflammatory markers secreted by adipose tissue. The aim of this review was to determine, based on previous findings, whether saliva can be useful in the diagnosis of obesity and its early metabolic complications and whether it can be an alternative diagnostic material to serum.

Measuring salivary markers of inflammation in health research: A review of methodological considerations and best practices

There is an increasing interest in using saliva to measure inflammatory biomarkers. Compared to blood, saliva is non-invasive, requires a lower biosafety classification, and requires less specialized personnel to collect. As the assessment of inflammation in saliva becomes more popular in psychoneuroimmunology research, the development of gold-standard methodological practices is paramount. This paper reviews different considerations for designing studies to assess salivary measures of inflammation. We review saliva collection procedures, sample storage and processing considerations, assay techniques, flow rate, correspondence with blood-based markers, and potential demographic and health moderators of levels of salivary markers of inflammation. Together, this review highlights critical gaps for future research, including calls for standardization of study protocols, transparent reporting of results, assessing predictive validity of markers of salivary inflammation for disease, and the need for assessment of participants' oral and general health status. Although additional work is needed to elucidate gold standards for study design, measurement, and analysis, salivary markers of inflammation may be a useful tool for understanding oral and peripheral inflammation dynamics non-invasively.

A review of T helper 17 cell-related cytokines in serum and saliva in periodontitis

Periodontitis is a chronic inflammatory disease with a complex underlying immunopathology. Cytokines, as molecular mediators of inflammation, play a role in all stages of disease progression. T helper 17 (Th17) cells are thought to play a role in periodontitis. Th17 cell development and maintenance requires a pro-inflammatory cytokine milieu, with many of the cytokines implicated in the pathogenesis of periodontitis. Serum and saliva are easily accessible biofluids which can represent the systemic and local environment to promote the development of Th17 cells. Here we review human clinical studies that investigate IL-1β, IL-4, IL-6, IL-10, IL-17A, IL-17F, IL-21, IL-22, IL-23, IL-25, IL-31, IL-33, IFN-γ, sCD40L and TNF-α in serum and saliva in periodontitis. We highlight their putative role in the pathogenesis of periodontitis and place them within a wider context of animal and other clinical studies.

The effect of acute stress on salivary markers of inflammation: A systematic review and meta-analysis

BACKGROUND

Salivary biomarkers of inflammation are increasingly used in stress research. This systematic review and meta-analysis provides a quantitative summary of changes in salivary inflammatory markers in response to acute stress.

METHOD

The review included 1558 participants (42 unique samples, 33 studies) obtained through electronic databases (PubMed, PsycINFO, Embase), reference treeing, and articles identified by a 2015 review on a similar topic. To be eligible, articles had to be quantitative and assess change in at least one biomarker of salivary inflammation in response to acute stress in adults. The primary outcome was magnitude of change in inflammatory biomarkers (Cohen's d for repeated measures [dav]).

RESULTS

Measures of salivary inflammation included: C-reactive protein (CRP), granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-13, IL-17A, IL-18, IL-21, interferon (IFN)-α, IFN-γ, and tumor necrosis factor (TNF)-α. Cytokines IL-6 (k = 26, dav = 0.27), IL-10 (k = 11, dav = 0.34), TNF-α (k = 10, dav = 0.57), and IFN-γ (k = 6, dav = 0.28) significantly increased in response to stress. Post hoc sensitivity analyses revealed that IL-1β (k = 19, dav = 0.16) and IL-8 (k = 7, dav = 0.30) also increased from pre- to post-stress, but findings with IFN-γ did not hold after removing one outlier study. Examination of moderators suggested that study methodology and sample demographics moderated some associations.

CONCLUSIONS

This meta-analysis revealed that certain salivary inflammatory cytokines increase in response to acute stress. Significant heterogeneity in results and moderator analyses suggest need for standardization of research protocols. Directions for future research are discussed.

Positive and Negative Affect and Salivary Markers of Inflammation Among Young Adults

BACKGROUND

Emerging evidence suggests that higher circulating levels of inflammatory biomarkers in blood are associated with higher negative affect (NA) and lower positive affect (PA). To our knowledge, the unique associations between NA and PA in daily life and salivary biomarkers of inflammation have not been examined. This study examined these associations in young adults.

METHODS

Measures of NA and PA were created from aggregated daily measures of affect (morning and evening ratings averaged across 14 days). We investigated associations between these measures and salivary C-reactive protein (CRP) and interleukin (IL)-6 in a sample of 108 young adults (60% female, mean age = 20.45 ± 1.47), a subset of whom had self-reported chronic back pain (n = 49). CRP and IL-6 were determined from saliva obtained at the end of the daily diary period.

RESULTS

After covarying for age, gender, body mass index, chronic pain status, salivary flow rate, and NA, higher PA was associated with lower salivary CRP (β = - 0.02, 95% CI (- 0.03, - 0.00) sr2 = .06, p = .01) but not IL-6; removing NA from this model did not change results. In a model with the same covariates (and PA), NA was not significantly related to CRP or IL-6. Chronic back pain status and gender did not moderate results.

CONCLUSIONS

Findings suggest that higher PA may be associated with lower salivary CRP in young adults, even after accounting for NA and demographic characteristics. Findings highlight the utility of assessing emotional states in relation to salivary markers of inflammation in future biobehavioral research.

Comparative proteomic analysis of saliva from dogs with and without obesity-related metabolic dysfuntion

Dogs develop only some of the components of the human metabolic syndrome (MetS). Thus, in order to study possible MetS-related alterations in dogs, human MetS criteria were adapted to define canine MetS or so-called obesity-related metabolic dysfunction (ORMD). The main objective of this study was to identify changes in the salivary proteome of obese dogs with ORMD in comparison with obese dogs without ORMD which may constitute potential salivary biomarkers for assessing ORMD. In a first phase, 12 adult obese dogs with ORMD (N = 6) and without ORMD (N = 6) were included in the study. Subsequently, and with the aim of validating and strengthening the results, additional 12 obese dogs (6 with and 6 without ORMD) were tested in an independent experiment following the same protocol. Saliva samples were subjected to a quantitative proteomics analysis and the levels of nine salivary proteins were found to be significantly different between groups, among them those which had greatest fold-change were proteins involved in glycolysis and oxidative stress. In conclusion, despite metabolic syndrome to include different combinations of diseases, the observation of differences in salivary proteome suggests a potential of this fluid to understand the pathophysiology of the disease. SIGNIFICANCE: This is the first study evaluating proteomes of saliva in dogs, as a non invasive sample, in order to increase knowledge about the metabolic/physiopathological changes related to obesity-related metabolic dysfunction (ORMD) together with the identification of potential biomarkers for its diagnosis. As approximately 20% of dogs with naturally occurring obesity were described to suffer ORMD associated with insulin resistance and hypoadiponectinemia, the fact that indicate possible links between ORMD and associated diseases.

Salivary Biomarkers in Psychoneuroimmunology

As molecular biology advances, an increasing number of proteins are becoming detectable at very low levels in different biological tissues. In this regard, saliva holds vast promise. Unlike blood, saliva can be sampled 1) non-invasively; 2) across all ages (newborn to elderly); 3) in the field; 4) by study participants; and 5) many times per day. With respect to psychoneuroimmunology (PNI), physiological measures of stress such as cortisol have been well characterized. Alpha amylase provides another physiological index of stress; it is a measure of autonomic nervous system activation and is quantifiable in saliva. Other salivary measures, such as inflammatory biomarkers and immunoglobulin A (IgA), provide valuable information pertaining to the effects of stress on inflammation, mucosal immunity, and oral health. Importantly, due to various methodological issues and a lack of strong correlation between saliva and blood measures, investigators should proceed with caution in drawing conclusions from measures of salivary inflammation that pertain to systemic immunity or generalized health.

The roles of NADPH oxidase in modulating neutrophil effector responses

Neutrophils are phagocytic innate immune cells essential for killing bacteria via activation of a wide variety of effector responses and generation of large amounts of reactive oxygen species (ROS). Majority of the ROS in neutrophils is generated by activation of the superoxide-generating enzyme nicotinamide adenine dinucleotide phosphate (NADPH) oxidase. Independent of their anti-microbial function, NADPH oxidase-derived ROS have emerged as key regulators of host immune responses and neutrophilic inflammation. Data from patients with inherited defects in the NADPH oxidase subunit alleles that ablate its enzyme function as well as mouse models demonstrate profound dysregulation of host inflammatory responses, neutrophil hyper-activation and tissue damage in response to microbial ligands or tissue trauma. A large body of literature now demonstrates how oxidants function as essential signaling molecules that are essential for the regulation of neutrophil responses during priming, degranulation, neutrophil extracellular trap formation, and apoptosis, independent of their role in microbial killing. In this review we summarize how NADPH oxidase-derived oxidants modulate neutrophil function in a cell intrinsic manner and regulate host inflammatory responses. In addition, we summarize studies that have elucidated possible roles of oxidants in neutrophilic responses within the oral mucosa and periodontal disease.

Associations of Salivary BPIFA1 Protein in Chronic Periodontitis Patients with Type 2 Diabetes Mellitus

AIMS

To explore the differences in salivary BPI fold containing family A, member 1 (BPIFA1) concentration among type 2 diabetes mellitus (T2DM) subjects with various severities of chronic periodontitis and to determine whether BPIFA1 in saliva can be used as a potential biomarker of T2DM.

METHODS

Unstimulated saliva samples were collected from 44 subjects with T2DM and 44 without T2DM (NDM). Additionally, demographic data and general health parameters, including fasting blood glucose (FBG) and body mass index (BMI), were collected. We also detected full-mouth clinical periodontal parameters including probing pocket depth (PPD), clinical attachment level (CAL), bleeding index (BI), and plaque index (PLI). Salivary BPIFA1, tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) concentrations were also detected.

RESULTS

BPIFA1 in saliva was detected at relatively high levels. T2DM subjects had decreased salivary BPIFA1 concentrations (P = 0.031). In T2DM subjects with nonperiodontitis or severe periodontitis, the level of BPIFA1 was significantly lower compared with that of NDM. Salivary TNF-α concentration displayed a similar trend to BPIFA1 in the NDM group.

CONCLUSIONS

BPIFA1 protein is rich in saliva and might be used as a potential predictive biomarker of T2DM, especially in patients with severe periodontitis and nonperiodontitis. This trial is registered with ChiCTR-ROC-17010310.