Proinflammatory cytokines in early childhood caries: Salivary analysis in the mother/children pair

Systematic assessment of salivary inflammatory markers and dental caries in children: an exploratory study

OBJECTIVE

To investigate associations between a wide panel of salivary inflammatory markers and the presence of dental caries among children.

MATERIAL AND METHODS

In this exploratory, cross-sectional study, 176 children, aged 7-9, underwent a dental examination. Information on the children's oral health habits and lifestyles was collected from their mothers. In addition, saliva samples were collected and analyzed using a multiplex immunoassay. Of 92 inflammatory markers measured, 56 were included in the statistical analyses. To identify potential inflammatory markers associated with caries, we applied low to advanced statistical analyses. First, we performed traditional logistic regression analysis followed by Bonferroni corrections. Thereafter, a more robust and less conservative statistical approach, i.e. Least Absolute Shrinkage and Selection Operator (LASSO), was applied. The models were adjusted for potential confounders.

RESULTS

Of the 176 children in the study, 22.2% were affected by caries. Among the 56 salivary inflammatory markers, only macrophage colony-stimulating factor 1 (CSF1) was selected by the LASSO and found to be positively associated with the presence of caries.

CONCLUSIONS

The observed association between CSF1 and the presence of caries may be of clinical value in caries risk management and early diagnosis. Larger studies are warranted to assess the replicability of our findings.

The consumption of milk supplemented with probiotics decreases the occurrence of caries and the salivary concentration of hβD-3 in children

OBJECTIVES

This study evaluated the effect of milk supplemented with Lactobacillus rhamnosus SP1 on the occurrence of caries and the salivary concentration of human β-defensin-3 (hβD-3) in preschool children with high caries risk.

MATERIALS AND METHODS

A sample of 42 children was randomly assigned to two groups; children in the intervention group were given 150 mL of milk supplemented with 10⁷ CFU/mL of Lactobacillus rhamnosus SP1, while children in the control group were given standard milk, for 10 months. The occurrence of dental caries was assessed using the International Caries Detection and Assessment System (ICDAS), and the concentration of hβD-3 was measured in unstimulated saliva using an ELISA test at baseline and after the intervention.

RESULTS

There was an increase in the number of teeth with carious lesions (d_ICDAS2-6 mft) in the control group, and this increase was statistically significant (p = 0.0489). The concentration of hβD-3 in saliva from the intervention group decreased from 597.91 to 126.29 pg/mL (p = 0.0061), unlike in the control group, where no change in hβD-3 salivary concentration was found.

CONCLUSIONS

These findings showed that regular intake of probiotic-supplemented milk in preschool children with high caries risk decreased the occurrence of caries and the salivary levels of hβD-3.

CLINICAL RELEVANCE

Our results suggest the need for developing and implementing probiotic supplementation, as adjuvants to the conventional treatments for caries and allow to considerate the salivary levels of hβD-3 as markers of oral tissue homeostasis.

Unstimulated Parotid Saliva Sampling in Juvenile Idiopathic Arthritis and Healthy Controls: A Proof-of-Concept Study on Biomarkers

The aims of this proof-of-concept study were to develop a collecting method for unstimulated parotid saliva in juvenile idiopathic arthritis (JIA) patients and healthy children and to investigate if inflammatory biomarkers could be detected in these samples. Forty-five children with JIA (median age of 12 years and 25th–75th percentile of 10–15 years; 33 girls and 12 boys) and 16 healthy children as controls (median age of 13 years and 25–75th percentile of 10–13 years; 11 girls and 5 boys) were enrolled in this study. Unstimulated parotid saliva was collected with a modified Carlson–Crittenden collector. The salivary flow rate and salivary concentrations of total protein and inflammatory mediators were assessed. The Meso Scale Discovery electrochemiluminescence immunoassay was used for analyzing protein concentrations and the inflammatory biomarkers. Sufficient parotid saliva volumes to be analyzed could be collected with the collection device. JIA patients had a lower sampling saliva volume (p = 0.008) and saliva flow rate (p = 0.039) than controls. The total protein concentrations and inflammatory biomarkers were measured in the last six healthy subjects. The median protein concentration was 1312 µg/mL (25th percentile: 844 µg/mL and 75th percentile: 2062 µg/mL; n = 6) and quantifiable concentrations of 39 inflammatory proteins could be assessed in these samples. In conclusion, this study indicates that the saliva sampling method, as used in the present study, is able to collect sufficient sample volumes in children, and that it is possible to analyze various inflammatory biomarkers in the collected saliva.

Alteration of cytokines in saliva of children with caries and obesity

Caries and obesity are multifactorial diseases with inflammatory components, whose processes involve cells and molecules, such as cytokines. Therefore, the objective of this work was to compare the concentrations of IL-6, IL-8, IL-15, and IL-18 in the salivary samples of children with caries and obesity. The study was carried out with 80 children: 43 with a normal weight and 37 with obesity. The diagnosis of caries was carried out using the ICDAS system. Salivary samples were used to measure the cytokine levels via the ELISA technique. Our results show that children with obesity and dental cavities have high levels of IL-6 and IL-15. Similarly, obese children have elevated levels of these two cytokines, while children with cavitated carious lesions presented alterations in their concentrations of IL-6 and IL-8. In conclusion, our data suggest that IL-6 has a significant effect on both obesity and caries, although IL-8 is more related to caries, and IL-15 is more related to obesity.

[The content of vascular endothelial grow factor in saliva and serum in patients with periodontitis.]

To study the concentration of vasculoendothelial growth factor (VEGF) in mixed saliva and serum of patients in normal conditions and with generalized periodontitis. The main group (n = 42) was represented by patients with generalized periodontitis. The comparison group (n = 36) consisted of patients without periodontal tissue diseases. The concentration of VEFR was determined by the method of enzyme-linked immunosorbent assay (ELISA) using a commercial test-system "VEGF - IFA - BEST" (A-8784) ("Vector - Best", Russia). The median values VEFR in saliva were 5.49 times higher than the values for serum in the main group (p = 0.000000) and 7.01 times in the comparison group (p = 0.000000). The concentration of VEFR in the saliva of the examined main group exceeded the similar values of the comparison group (p = 0,014857); the median and interquartile range for the main group was 1098.45 (925.5; 1291) pg/ml, and for the comparison group 1360.5 (998.9; 2062) pg/ml. There were no differences in the serum VEFR concentration (p = 0.775124). No significant correlation was found between the serum VEFR content and the mixed saliva. The Spearman's rank correlation coefficient for the main group was R = 0,0184358, and for the comparison group, respectively, R = 0.188932. The source of VEFR in saliva are the glands and cells of the oral mucosa, and not the process of exudation from blood serum. The high content of VEFR in the saliva of healthy people and a decrease in its level during periodontitis indicates the important role of this protein in the processes of maintaining the normal state of periodontal tissues and reparation of tissues of the oral mucosa.

Association between early childhood caries and malnutrition in a sub-urban population in Nigeria

Background

To determine the association between malnutrition and early childhood caries (ECC) in children resident in sub-urban, Nigeria.

Methods

This study was a subset of a larger cross-sectional study the data of which was generated through a household survey conducted in Ile-Ife, Nigeria. The study’s explanatory variable was malnutrition (underweight, overweight, wasting and stunting) and the outcome variable was ECC. Poisson regression analysis was used to determine the association between ECC and malnutrition. Variables (sex, frequency of sugar consumption, maternal knowledge of oral hygiene, oral hygiene status) associated with ECC in the primary study were adjusted for to obtain the adjusted prevalence ratio (APR).

Results

Of the 370 children, 20 (5.41%) were underweight, 20 (5.41%) were overweight, 67 (18.11%) were wasting, 120 (32.43%) were stunted and 18 (4.86%) had ECC. Factors associated with ECC were being stunted, underweight, overweight and fair oral hygiene. The prevalence of ECC was lower in children who were stunted (APR: 0.14; 95% CI: 0.03–0.69; p = 0.02), almost seven times higher in children who were overweight (APR: 6.88; 95% CI: 1.83–25.85; p < 0.001), and predictively absent in children who were underweight (APR: 0; 95% CI: 0–0; p < 0.001) when compared with children who had normal weight. Non-significant risk indicators for ECC included consuming sugar between meals three times a day or more, having low socioeconomic status and being female.

Conclusions

For this study population, the indicators of malnutrition – being stunted, underweight, overweight - and fair oral hygiene were risk indicators for ECC. The frequency of sugar consumption was not a significant risk indicator when malnutrition was included as an explanatory variable for ECC in the study population.