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Korgaonkar J, Tarman AY, Ceylan Koydemir H, Chukkapalli SS. Periodontal disease and emerging point-of-care technologies for its diagnosis. LAB ON A CHIP 2024. [PMID: 38874483 DOI: 10.1039/d4lc00295d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
Periodontal disease (PD), a chronic inflammatory disorder that damages the tooth and its supporting components, is a common global oral health problem. Understanding the intricacies of these disorders, from gingivitis to severe PD, is critical for efficient treatment, diagnosis, and prevention in dental care. Periodontal biosensors and biomarkers are critical in improving oral health diagnostic skills. Clinicians may accomplish early identification, tailored therapy, and efficient tracking of periodontal diseases by using these technologies, ushering in a new age of accurate oral healthcare. Traditional periodontitis diagnostic methods frequently rely on physical probing and visual examinations, necessitating the development of point-of-care (POC) devices. As periodontal disorders necessitate more precise and rapid diagnosis, incorporating novel innovations in biosensors and biomarkers becomes increasingly crucial. These innovations improve our capacity to diagnose, monitor, and adapt periodontal therapies, bringing in the next phase of customized and effective dental healthcare. The review discusses the characteristics and stages of PD, clinical treatment techniques, prominent biomarkers and infection-associated factors that may be employed to determine PD, biomedical sensing, and POC appliances that have been created so far to diagnose stages of PD and its progression profile, as well as predicting future developments in this field.
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Affiliation(s)
- Jayesh Korgaonkar
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA.
- Center for Remote Health Technologies and Systems, Texas A&M Engineering and Experiment Station, College Station, TX 77843, USA
| | - Azra Yaprak Tarman
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA.
- Center for Remote Health Technologies and Systems, Texas A&M Engineering and Experiment Station, College Station, TX 77843, USA
| | - Hatice Ceylan Koydemir
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA.
- Center for Remote Health Technologies and Systems, Texas A&M Engineering and Experiment Station, College Station, TX 77843, USA
| | - Sasanka S Chukkapalli
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA.
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Toraman A, Sağlam E, Savran L, Köseoğlu S. Evaluation of Salivary Il-38 Levels in Periodontitis: A Cross-Sectional Study. J Interferon Cytokine Res 2024. [PMID: 38497769 DOI: 10.1089/jir.2023.0233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024] Open
Abstract
The goal of the current study was to assess levels of salivary interleukin (IL)-38, IL-1β, and IL-10 in various periodontal clinical conditions. In total, 60 (20 healthy, 20 gingivitis, and 20 stage II-III, grade A-B periodontitis) subjects were included in the study. Demographic and clinical periodontal parameters were recorded. Samples were examined for IL-38, IL-1β, and IL-10 levels by means of enzyme-linked immunosorbent assay. Results demonstrated that the periodontitis group had significantly lower salivary IL-38 levels (P < 0.05) than the healthy group. Salivary IL-10 levels did not differ significantly between the groups (P > 0.05). The salivary IL-1β levels of gingivitis (P < 0.001) and periodontitis groups (P < 0.01) were significantly higher than those of the healthy group. The present study indicated that IL-38 level is decreased in periodontal disease. The results suggested a possible role of IL-38 in the periodontal inflammation process. Clarifying the mechanisms of IL-38 in the inflammatory process may contribute to the development of novel treatment strategies in periodontal diseases.
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Affiliation(s)
- Ayşe Toraman
- Department of Periodontology, Hamidiye Faculty of Dentistry, Health Sciences University, Istanbul, Türkiye
| | - Ebru Sağlam
- Department of Periodontology, Faculty of Dentistry, İstanbul Medeniyet University, Istanbul, Türkiye
| | - Levent Savran
- Department of Periodontology, Faculty of Dentistry, İzmir Katip Çelebi University, Izmir, Türkiye
| | - Serhat Köseoğlu
- Department of Periodontology, Faculty of Dentistry, İstanbul Medeniyet University, Istanbul, Türkiye
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Cennamo N, Bencivenga D, Annunziata M, Arcadio F, Stampone E, Piccirillo A, Della Ragione F, Zeni L, Guida L, Borriello A. Plasmon resonance biosensor for interleukin-1β point-of-care determination: A tool for early periodontitis diagnosis. iScience 2024; 27:108741. [PMID: 38269096 PMCID: PMC10805648 DOI: 10.1016/j.isci.2023.108741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 11/17/2023] [Accepted: 12/12/2023] [Indexed: 01/26/2024] Open
Abstract
Among pro-inflammatory cytokines, Interleukin-1β is crucially involved in several inflammatory-based diseases and even cancer. Increased Interleukin-1β levels in oral fluids have been proposed as an early marker of periodontitis, a broadly diffused chronic inflammatory condition of periodontal-supporting tissues, leading eventually to tooth loss. We describe the development of a portable surface-plasmon-resonance-based optical fiber probe suitably coated with an anti-Interleukin-1β antibody monolayer. A pico-nanomolar linear range of determination was obtained in both buffer solution and saliva with a rapid (3 min) incubation and high selectivity in presence of interferents. Higher Interleukin-1β concentration in the saliva of a periodontitis patient compared to a healthy control was determined. These measurements were validated by an automated ELISA system. Our results sustain the potential applicability of the proposed SPR-POF as diagnostic point-of-care device for real-time monitoring of salivary Interleukin-1β, that can support early detection of oral inflammatory-based pathologies and rapid and timely therapeutic decisions.
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Affiliation(s)
- Nunzio Cennamo
- Department of Engineering, University of Campania “Luigi Vanvitelli”, Via Roma, 9, Aversa, CE 81031, Italy
| | - Debora Bencivenga
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, via De Crecchio, 7 80138 Naples, Italy
| | - Marco Annunziata
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, via De Crecchio, 6 80138 Naples, Italy
| | - Francesco Arcadio
- Department of Engineering, University of Campania “Luigi Vanvitelli”, Via Roma, 9, Aversa, CE 81031, Italy
| | - Emanuela Stampone
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, via De Crecchio, 7 80138 Naples, Italy
| | - Angelantonio Piccirillo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, via De Crecchio, 6 80138 Naples, Italy
| | - Fulvio Della Ragione
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, via De Crecchio, 7 80138 Naples, Italy
| | - Luigi Zeni
- Department of Engineering, University of Campania “Luigi Vanvitelli”, Via Roma, 9, Aversa, CE 81031, Italy
| | - Luigi Guida
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, via De Crecchio, 6 80138 Naples, Italy
| | - Adriana Borriello
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, via De Crecchio, 7 80138 Naples, Italy
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Subbappa A, Lokesh KS, Chaya SK, Kaleem Ullah M, Siddaiah JB, Bhojraj N, Mahesh PA. Unmasking the Silent Threat: Periodontal Health's Impact on COPD Severity and Hospitalization. J Pers Med 2023; 13:1714. [PMID: 38138940 PMCID: PMC10744674 DOI: 10.3390/jpm13121714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/04/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
OBJECTIVE This study investigated the relationship between chronic obstructive pulmonary disease (COPD) and periodontitis, focusing on how periodontal health impacts COPD airflow limitation, exacerbations, and hospitalization. BACKGROUND Periodontitis, a multifactorial inflammatory disease, is characterized by destruction of tooth-supporting structures, while COPD is a global pulmonary disorder with high mortality. METHODS A total of 199 COPD patients aged over 40 years underwent lung function tests (spirometry), 6 min walk test, and St George's Respiratory Questionnaire-COPD (SGRQ-C) to assess lung health. Periodontal indices such as probing depth (PD), clinical attachment loss (CAL), and plaque index (PI) were assessed. RESULTS We found a significant negative correlation between periodontal disease severity and lung function (lower FEV1, FVC, and FEV1/FVC ratio) after adjusting for smoking. Likewise, periodontal parameters (PPD, PI, and CAL) exhibited negative correlations with lung function. These periodontal indices were independently associated with airflow limitation severity, exacerbations frequency, and prior-year hospitalization. Linear regression indicated that each unit increase in PPD, PI, and CAL corresponded to estimated increases in GOLD airflow limitation grading (0.288, 0.718, and 0.193, respectively) and number of exacerbations (0.115, 0.041, and 0.109, respectively). In logistic regression, PPD, PI, and CAL adjusted odds ratios (ORs) were estimated to increase by 1.29 (95%CI: 1.03-1.62), 3.04 (95%CI: 1.28-7.2), and 1.26 (95%CI: 1.06-1.49), respectively, for hospitalization in previous year. CONCLUSION Periodontitis is associated with COPD airflow limitation, exacerbation, and hospitalization, with PI being the most clinically relevant periodontal factor. Dentists and physicians should monitor and increase awareness among COPD patients to maintain oral hygiene for prevention of periodontal diseases and mitigate its effect on COPD progression.
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Affiliation(s)
- Anitha Subbappa
- Department of Periodontology, JSS Dental College & Hospital, JSS Academy of Higher Education and Research, Mysuru 570015, India;
| | - Komarla Sundararaja Lokesh
- Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru 570015, India; (K.S.L.); (S.K.C.); (J.B.S.)
| | - Sindaghatta Krishnarao Chaya
- Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru 570015, India; (K.S.L.); (S.K.C.); (J.B.S.)
| | - Mohammed Kaleem Ullah
- Centre for Excellence in Molecular Biology and Regenerative Medicine (A DST-FIST Supported Center), Department of Biochemistry (A DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education and Research, Mysore 570015, India;
- Division of Infectious Disease and Vaccinology, School of Public Health, University of California, Berkeley, CA 94720, USA
| | - Jayaraj Biligere Siddaiah
- Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru 570015, India; (K.S.L.); (S.K.C.); (J.B.S.)
| | - Nandlal Bhojraj
- Department of Periodontology, JSS Dental College & Hospital, JSS Academy of Higher Education and Research, Mysuru 570015, India;
| | - Padukudru Anand Mahesh
- Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru 570015, India; (K.S.L.); (S.K.C.); (J.B.S.)
- Special Interest Group—Environment and Respiratory Diseases, JSS Academy of Higher Education and Research, Mysuru 570015, India
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Santamaria P, Sari A, Nibali L. Molecular profiling of gingival crevicular fluid fails to distinguish between infrabony and suprabony periodontal defects. J Clin Periodontol 2023; 50:1315-1325. [PMID: 37438680 DOI: 10.1111/jcpe.13849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/08/2023] [Accepted: 06/25/2023] [Indexed: 07/14/2023]
Abstract
AIM To assess the differential molecular profiling of gingival crevicular fluid (GCF) from infrabony and suprabony periodontal defects compared with healthy sites. MATERIALS AND METHODS Seventy-five samples from 25 patients with untreated periodontitis stage III-IV were included. Clinical and radiological parameters as well as GCF samples were collected from an infrabony defect, a suprabony defect and a periodontally healthy site per patient. A multiplex bead immunoassay was performed to assess the level of 18 biomarkers associated with inflammation, connective tissue degradation and regeneration/repair. RESULTS GCF volume was higher in periodontal sites compared with healthy sites, with no significant difference between infrabony and suprabony defects. Fourteen biomarkers were elevated in infrabony and suprabony sites compared with healthy sites (p < .05). Only interleukin-1α levels were increased in infrabony compared with suprabony sites, whereas there was no difference in probing pocket depth. CONCLUSIONS Although the GCF molecular profile clearly differentiates periodontally affected sites from healthy sites, the different architecture between infrabony and suprabony defects is not reflected in GCF biomarker changes.
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Affiliation(s)
- Pasquale Santamaria
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Aysegul Sari
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Luigi Nibali
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
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Ortiz-Echeverri AM, Gallego-González C, Castaño-Granada MC, Tobón-Arroyave SI. Risk indicators associated with peri-implant diseases: a retrospective cross-sectional study of Colombian patients with 1 to 18 years of follow-up. J Periodontal Implant Sci 2023; 53:53.e45. [PMID: 37681355 DOI: 10.5051/jpis.2300140007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 05/30/2023] [Accepted: 06/04/2023] [Indexed: 09/09/2023] Open
Abstract
PURPOSE Peri-implant mucositis (PIM) and peri-implantitis (PI) are multicausal conditions with several risk factors contributing to their pathogenesis. In this study, we retrospectively investigated risk variables potentially associated with these peri-implant diseases (PIDs) over a follow-up period of 1 to 18 years. METHODS The study sample consisted of 379 implants placed in 155 patients. Single-visit clinical and radiographic evaluations were employed to determine the presence or absence of PIDs. Parameters related to the patient, site, surgery, implant, and prosthetic restoration were documented. The relationships between risk variables and the occurrence of PIDs were individually examined and adjusted for confounders using multivariate binary logistic regression models. RESULTS The prevalence rates of PIM and PI were 28.4% and 36.8% at the patient level and 33.5% and 24.5% at the implant level, respectively. Poor oral hygiene, active gingivitis/periodontitis, preoperative alveolar ridge deficiency, early or delayed implant placement, implant length of 11.0 mm or less, and poor restoration quality were strong and independent risk indicators for both PIDs. Furthermore, a follow-up period of more than 5 years and a loading time of more than 4 years were important indicators for PI. Simultaneously, age and smoking status acted as modifiers of the effect of mesiodistal (MD) and buccolingual (BL) widths of restoration on PI. CONCLUSIONS In this study population, oral hygiene, periodontal status, preoperative alveolar ridge status, implant placement protocol, implant length, and the quality of coronal restoration appear to be robust risk indicators for both PIM and PI. Additionally, the length of follow-up and functional loading time are robust indicators of PI. Furthermore, the potential modifying relationships of age and smoking status with the MD and BL widths of restoration may be crucial for the development of PI.
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Affiliation(s)
| | - Carolina Gallego-González
- Periodontology Section, University Health Care Provider (IPS Universitaria), University of Antioquia, Medellín, Colombia
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Paladines N, Dawson S, Ryan W, Serrano-Lopez R, Messer R, Huo Y, Cutler CW, Ramos-Junior ES, Morandini AC. Metabolic reprogramming through mitochondrial biogenesis drives adenosine anti-inflammatory effects: new mechanism controlling gingival fibroblast hyper-inflammatory state. Front Immunol 2023; 14:1148216. [PMID: 37350964 PMCID: PMC10282177 DOI: 10.3389/fimmu.2023.1148216] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 05/25/2023] [Indexed: 06/24/2023] Open
Abstract
Introduction Fibroblasts are the dominant stromal cells in the gingival lamina propria with a well-established relevance in regulation of inflammation, and in innate immunity. This is exemplified by their hypersecretion of CXCL8, enhancing leukocyte infiltration in chronic and sustained inflammatory conditions. We have previously shown adenosine to be a key metabolic nucleoside that regulates stromal inflammation, but the underlying mechanisms linking adenosine to the metabolic status of fibroblasts and to the resultant inflammatory response are unclear. This study examined, by seahorse real-time cell metabolic analysis, the bioenergetics of the stromal fibroblast response to extracellular adenosine and IL-1β, focusing on CXCL8 secretion by primary human gingival fibroblasts (HGF). Methods Markers of the glycolytic pathway and mitochondrial biogenesis were tracked through immunoblot. Further, the influence of adenosine on mitochondrial accumulation was measured by uptake of MitoTracker Red fluorescent probe and assessment of the role of FCCP (a mitochondrial uncoupler) in CXCL8 secretion and mitochondrial accumulation. Results Our results show that the anti-inflammatory response of HGF to extracellular adenosine, typified by reduced CXCL8 secretion, is mediated by mitochondrial oxidative phosphorylation, reflected in higher oxygen consumption rate (OCR). In the presence of IL-1β, adenosine-treated cells induced higher ATP production, basal respiration and proton leak compared to IL-1β without adenosine. Surprisingly, adenosine had no additional effect on the IL-1β-induced higher glycolysis rate demonstrated by the extracellular acidification rate (ECAR). In addition, the higher OCR in adenosine-stimulated cells was not due to the mitochondrial fuel dependency or capacity, but due to an increase in mitochondrial biogenesis and accumulation in the cells with concomitant decrease in mitophagy-required p-PINK1 marker. We detected the accumulation of functional mitochondria with increased activation of the AMPK/SIRT1/PGC-1α pathway. The adenosine-induced uptake of MitoTracker was abrogated by PGC-1α inhibition with SR-12898. In addition, the adenosine effects on reduced CXCL8 were ablated by treatment with FCCP, a potent uncoupler of mitochondrial oxidative phosphorylation. Conclusion Our findings reveal a key role for mitochondrial bioenergetics in regulation of CXCL8-mediated inflammation by HGF through the adenosine/AMPK/SIRT1/PGC-1α axis. Therapeutically targeting this pathway in gingival fibroblasts might be a promising future strategy to modulate stromal-mediated sustained hyper-inflammatory responses.
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Affiliation(s)
- Nathalie Paladines
- Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia, Augusta University, Augusta, GA, United States
| | - Shantiece Dawson
- Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia, Augusta University, Augusta, GA, United States
| | - Weston Ryan
- Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia, Augusta University, Augusta, GA, United States
| | - Rogelio Serrano-Lopez
- Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia, Augusta University, Augusta, GA, United States
| | - Regina Messer
- Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia, Augusta University, Augusta, GA, United States
| | - Yuqing Huo
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA, United States
- Vascular Biology Center, Augusta University, Augusta, GA, United States
| | - Christopher W. Cutler
- Department of Periodontics, Dental College of Georgia, Augusta University, Augusta, GA, United States
| | - Erivan S. Ramos-Junior
- Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia, Augusta University, Augusta, GA, United States
| | - Ana Carolina Morandini
- Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia, Augusta University, Augusta, GA, United States
- Department of Periodontics, Dental College of Georgia, Augusta University, Augusta, GA, United States
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Ye Y, Xu X, Mao B, Tang X, Cui S, Zhao J, Zhang Q. Evaluation of heat-inactivated Limosilactobacillus fermentum CCFM1139 and its supernatant for the relief of experimental periodontitis in rats. Food Funct 2023; 14:2847-2856. [PMID: 36880339 DOI: 10.1039/d2fo02938c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Periodontitis is a chronic inflammatory disease induced by subgingival microbial dysbiosis, characterised by inflammation of the soft tissues of the periodontium and progressive loss of alveolar bone. Limosilactobacillus fermentum CCFM1139 is a probiotic with the potential to relieve periodontitis in vitro and in vivo. Due to the cost of active strain in production applications, we considered the effectiveness of bacterial components and metabolites in alleviating experimental periodontitis. Therefore, this study investigated the effect of heat-inactivated Limosilactobacillus fermentum CCFM1139 and its supernatant in the development of experimental periodontitis through animal experiments. The results showed that active, heat-inactivated Limosilactobacillus fermentum CCFM1139 and its supernatant all significantly reduced IL-1β levels in gingival tissue and serum (p < 0.05). Micro-computed tomography (micro CT) analysis showed that the active and heat-inactivated Limosilactobacillus fermentum CCFM1139 reduced alveolar bone loss in rats with periodontitis by 25.6% and 15.9% respectively (p < 0.05), with no change in percentage of bone volume (p > 0.05). In histomorphometric analysis, active Limosilactobacillus fermentum CCFM1139 showed better results in reducing alveolar bone loss and reducing inflammatory cell recruitment at the second molar. In addition, there was no significant difference in the number of tartrate-resistant acid phosphatase (TRAP) positive cells after in all experimental groups (p > 0.05). Therefore, heat-inactivated Limosilactobacillus fermentum CCFM1139 or its supernatant also have the ability to relieve periodontitis, and their alleviating effect may focus on the regulation of inflammatory response.
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Affiliation(s)
- Yuhan Ye
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu 214122, P. R. China.
- State Key Laboratory of Dairy Biotechnology, Shanghai Engineering Research Center of Dairy Biotechnology, Dairy Research Institute, Bright Dairy & Food Co., Ltd, Shanghai 200436, China
| | - Xianyin Xu
- Department of Stomatology, Wuxi Children's Hospital, Wuxi, Jiangsu 214023, P. R. China
| | - Bingyong Mao
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu 214122, P. R. China.
- State Key Laboratory of Dairy Biotechnology, Shanghai Engineering Research Center of Dairy Biotechnology, Dairy Research Institute, Bright Dairy & Food Co., Ltd, Shanghai 200436, China
| | - Xin Tang
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu 214122, P. R. China.
- State Key Laboratory of Dairy Biotechnology, Shanghai Engineering Research Center of Dairy Biotechnology, Dairy Research Institute, Bright Dairy & Food Co., Ltd, Shanghai 200436, China
| | - Shumao Cui
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu 214122, P. R. China.
- State Key Laboratory of Dairy Biotechnology, Shanghai Engineering Research Center of Dairy Biotechnology, Dairy Research Institute, Bright Dairy & Food Co., Ltd, Shanghai 200436, China
| | - Jianxin Zhao
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu 214122, P. R. China.
- State Key Laboratory of Dairy Biotechnology, Shanghai Engineering Research Center of Dairy Biotechnology, Dairy Research Institute, Bright Dairy & Food Co., Ltd, Shanghai 200436, China
| | - Qiuxiang Zhang
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu 214122, P. R. China.
- State Key Laboratory of Dairy Biotechnology, Shanghai Engineering Research Center of Dairy Biotechnology, Dairy Research Institute, Bright Dairy & Food Co., Ltd, Shanghai 200436, China
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Tailor R, Medara N, Chopra A, Swarnamali H, Eberhard J, Jayasinghe TN. Role of prebiotic dietary fiber in periodontal disease: A systematic review of animal studies. Front Nutr 2023; 10:1130153. [PMID: 36998913 PMCID: PMC10043215 DOI: 10.3389/fnut.2023.1130153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 02/21/2023] [Indexed: 03/16/2023] Open
Abstract
BackgroundPeriodontitis is a chronic inflammatory condition affecting the supporting structures of a tooth in the oral cavity. The relationship between dietary fiber and periodontitis is poorly understood. The objective of this systematic review is to investigate if an intake of dietary fiber modulates periodontal disease in animal models and any concomitant effects on systemic inflammation, microbiota and their metabolites.MethodsAnimal studies using periodontitis models with any form of fiber intervention were included. Studies with comorbidities that were mutually inclusive with periodontitis and animals with physiological conditions were excluded. Search strategy with MeSH and free-text search terms were finalized and performed on the 22nd of September 2021.CINAHL Complete, EMBASE, MEDLINE, SciVerse Scopus® and Web of Science Core Collection databases were used to identify studies. SYRCLE’s risk of bias tool and CAMARADES were used for quality assessment. Results were synthesized utilizing Covidence© web-based platform software to remove duplicates, and the remaining studies were manually filtered.ResultsA total of 7,141 articles were retrieved from all databases. Out of 24 full-text articles assessed for eligibility, four studies (n = 4) were included. Four studies involved the use of β-(1,3/1,6)-glucan (n = 3) and mannan oligosaccharide (n = 1) at differing dosages for different study durations. All studies utilized a ligature-induced model of periodontitis in rats, either Wistar (n = 3) or Sprague–Dawley (n = 1). A dose-dependent relationship between the increased fiber intake and decrease in alveolar bone loss and pro-inflammatory markers was observed.ConclusionThe number of included studies is limited and narrow in scope. They highlight the importance of pre-clinical trials in this field with broader dietary fiber intervention groups before proceeding to clinical trials. The use of dietary fiber as an intervention shows promise in the reduction of inflammatory conditions like periodontitis. However, further research is required to delineate the relationship between diet and its effects on microbiota and their metabolites such as short chain fatty acids in animal models of periodontitis.
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Affiliation(s)
- Rohan Tailor
- The Charles Perkins Centre, The University of Sydney, Darlington, NSW, Australia
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Darlington, NSW, Australia
| | - Nidhi Medara
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Darlington, NSW, Australia
| | - Aditi Chopra
- Department of Periodontology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Hasinthi Swarnamali
- Health and Wellness Unit, Faculty of Medicine, University of Colombo, Colombo, Western Province, Sri Lanka
| | - Joerg Eberhard
- The Charles Perkins Centre, The University of Sydney, Darlington, NSW, Australia
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Darlington, NSW, Australia
| | - Thilini N. Jayasinghe
- The Charles Perkins Centre, The University of Sydney, Darlington, NSW, Australia
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Darlington, NSW, Australia
- *Correspondence: Thilini N. Jayasinghe,
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Salah R, Abdulbaqi HR. Short-Term (4 Day) Effects of Oral Rinsing with Miswak and Green Tea on Gingival Crevicular Fluid Flow and IL-1β Levels: A Pilot Study. Healthcare (Basel) 2023; 11:healthcare11020226. [PMID: 36673594 PMCID: PMC9859132 DOI: 10.3390/healthcare11020226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/07/2023] [Accepted: 01/09/2023] [Indexed: 01/13/2023] Open
Abstract
Despite the antiplaque effect of mouth-rinsing with a combination composed of miswak (Salvadora persica L.) and green tea (Camellia sinensis var. assamica) extracts, no data are available regarding its effect on gingival tissue at the molecular level. This pilot study aimed to assess the effect of oral rinsing with this combination on gingival crevicular fluid (GCF) flow and IL-1β levels. Ten subjects rinsed with either the combination, 0.12% chlorhexidine gluconate (CHX) or distilled water without toothbrushing for 4 days after receiving baseline polishing. GCF IL-1β concentration, influx, resting volume and plaque quantity were measured at baseline and after 4 days for each intervention. No significant differences in GCF flow or resting volume were detected after rinsing with the different mouthwashes. A significant increase in GCF IL-1β concentration was evident only after rinsing with distilled water. Rinsing with combination induced a significant reduction in GCF influx (-0.086 ± 0.222) compared to CHX (0.088 ± 0.247) and distilled water (0.075 ± 0.201). Less plaque was detected after rinsing with combination and CHX. Short-term oral rinsing with this combination could potentially induce no significant changes in GCF flow and IL-1β concentration, and might retard inflammation. Thus, it might be considered in the production of natural oral healthcare products.
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11
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Cai R, Wang L, Zhang W, Liu B, Wu Y, Pang J, Ma C. The role of extracellular vesicles in periodontitis: pathogenesis, diagnosis, and therapy. Front Immunol 2023; 14:1151322. [PMID: 37114060 PMCID: PMC10126335 DOI: 10.3389/fimmu.2023.1151322] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 03/28/2023] [Indexed: 04/29/2023] Open
Abstract
Periodontitis is a prevalent disease and one of the leading causes of tooth loss. Biofilms are initiating factor of periodontitis, which can destroy periodontal tissue by producing virulence factors. The overactivated host immune response is the primary cause of periodontitis. The clinical examination of periodontal tissues and the patient's medical history are the mainstays of periodontitis diagnosis. However, there is a lack of molecular biomarkers that can be used to identify and predict periodontitis activity precisely. Non-surgical and surgical treatments are currently available for periodontitis, although both have drawbacks. In clinical practice, achieving the ideal therapeutic effect remains a challenge. Studies have revealed that bacteria produce extracellular vesicles (EVs) to export virulence proteins to host cells. Meanwhile, periodontal tissue cells and immune cells produce EVs that have pro- or anti-inflammatory effects. Accordingly, EVs play a critical role in the pathogenesis of periodontitis. Recent studies have also presented that the content and composition of EVs in saliva and gingival crevicular fluid (GCF) can serve as possible periodontitis diagnostic indicators. In addition, studies have indicated that stem cell EVs may encourage periodontal regeneration. In this article, we mainly review the role of EVs in the pathogenesis of periodontitis and discuss their diagnostic and therapeutic potential.
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Affiliation(s)
- Rong Cai
- Department of Stomatology, Air Force Medical Center, The Fourth Military Medical University, Beijing, China
| | - Lu Wang
- Department of Critical Care Medicine, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Wei Zhang
- Department of Stomatology, Air Force Medical Center, The Fourth Military Medical University, Beijing, China
| | - Bing Liu
- Department of Stomatology, Air Force Medical Center, The Fourth Military Medical University, Beijing, China
| | - Yiqi Wu
- Department of Critical Care Medicine, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jianliang Pang
- Department of Stomatology, Air Force Medical Center, The Fourth Military Medical University, Beijing, China
- *Correspondence: Chufan Ma, ; Jianliang Pang,
| | - Chufan Ma
- Department of Stomatology, Air Force Medical Center, The Fourth Military Medical University, Beijing, China
- *Correspondence: Chufan Ma, ; Jianliang Pang,
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12
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Arroyo E, Oliveira-Alves MG, Chamorro-Petronacci CM, Marichalar-Mendia X, Bravo-López SB, Blanco-Carrión J, Pérez-Sayáns M. Protein-based salivary biomarkers for the diagnosis of periodontal diseases: Systematic review and meta-analysis. J Taibah Univ Med Sci 2022; 18:737-747. [PMID: 36852252 PMCID: PMC9957757 DOI: 10.1016/j.jtumed.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 10/20/2022] [Accepted: 12/09/2022] [Indexed: 12/24/2022] Open
Abstract
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.
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Affiliation(s)
- Esteban Arroyo
- Department of Diagnosis and Surgery, Araraquara, School of Dentistry, Sao Paulo State University (Unesp), Araraquara, SP, Brazil
| | - Mónica G. Oliveira-Alves
- Technology Research Center (NPT), Universidade Mogi das Cruzes, Mogi das Cruces, Brazil,School of Medicine, Anhembi Morumbi University, Sao José dos Campos, Brazil
| | - Cintia M. Chamorro-Petronacci
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Dentistry, University of Santiago de Compostela, Spain,ORALRES Group Instituto de Investigación de Santiago (IDIS), Spain
| | - Xabier Marichalar-Mendia
- Grupo GIU21/042, Department of Nursing I, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, Leioa, Bizkaia, Spain,BioCruces-Bizkaia Health Research Institute, Barakaldo, Spain,Corresponding address: Department of Nursing I, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, 48940, Leioa, Bizkaia, Spain.
| | - Susana B. Bravo-López
- Proteomic Platform, Health Research Institute, Santiago de Compostela, A Coruña, Spain
| | - Juan Blanco-Carrión
- Periodontology Unit, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain,Odontología Médico-Quirúrgica (OMEQUI) Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Mario Pérez-Sayáns
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Dentistry, University of Santiago de Compostela, Spain,ORALRES Group Instituto de Investigación de Santiago (IDIS), Spain
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13
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Spahr A, Divnic‐Resnik T. Impact of health and lifestyle food supplements on periodontal tissues and health. Periodontol 2000 2022; 90:146-175. [PMID: 35916868 PMCID: PMC9804634 DOI: 10.1111/prd.12455] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
According to the new classification, periodontitis is defined as a chronic multifactorial inflammatory disease associated with dysbiotic biofilms and characterized by progressive destruction of the tooth-supporting apparatus. This definition, based on the current scientific evidence, clearly indicates and emphasizes, beside the microbial component dental biofilm, the importance of the inflammatory reaction in the progressive destruction of periodontal tissues. The idea to modulate this inflammatory reaction in order to decrease or even cease the progressive destruction was, therefore, a logical consequence. Attempts to achieve this goal involve various kinds of anti-inflammatory drugs or medications. However, there is also an increasing effort in using food supplements or so-called natural food ingredients to modulate patients' immune responses and maybe even improve the healing of periodontal tissues. The aim of this chapter of Periodontology 2000 is to review the evidence of various food supplements and ingredients regarding their possible effects on periodontal inflammation and wound healing. This review may help researchers and clinicians to evaluate the current evidence and to stimulate further research in this area.
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Affiliation(s)
- Axel Spahr
- Discipline of Periodontics, School of Dentistry, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Tihana Divnic‐Resnik
- Discipline of Periodontics, School of Dentistry, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
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14
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Sari A, Dogan S, Nibali L, Koseoglu S. Evaluation of IL-23p19/Ebi3 (IL-39) gingival crevicular fluid levels in periodontal health, gingivitis, and periodontitis. Clin Oral Investig 2022; 26:7209-7218. [DOI: 10.1007/s00784-022-04681-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 08/10/2022] [Indexed: 11/28/2022]
Abstract
Abstract
Objectives
IL-23p19/Ebi3 (IL-39) was described as a new IL-12 family member. The aim of this study is to evaluate the gingival crevicular fluid (GCF) IL-39 levels in periodontal diseases and health and to correlate them to GCF levels of IL-1β and periostin.
Materials and methods
Sixty-six adult patients were included in the study. The study design was comprised of three groups, each containing 22 individuals: the periodontally healthy (PH), gingivitis (G), and periodontitis (P) groups. The clinical periodontal parameters were recorded and GCF samples were collected from the participants. GCF interleukin (IL)-39, IL-1β, and periostin levels were examined using the enzyme-linked immunosorbent assay.
Results
GCF IL‑1β, periostin, and IL-39 levels were higher in the P and G groups than in the PH group (p < 0.001). Positive correlations were detected between all GCF biochemical parameters and clinical periodontal parameters (p < 0.05). In the multivariate generalized linear regression analysis, the P (β = 37.6, 95% CI = 22.9–52.4) and G (β = 28.4, 95% CI = 15.8–41) groups were associated with GCF IL-39 levels (p < 0.001).
Conclusion
IL-39 levels were elevated in the presence of periodontal disease paralleling the increase in IL‑1β and periostin levels. IL-39 may have a role in the periodontal inflammation process.
Statement of clinical relevance
IL-39, a new cytokine from the IL-12 family, can be a possible predictor marker of periodontal diseases.
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15
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Gafar AM, Ramadan AM, ElSaid NA, Nurelhuda NM. Effect of Gum Arabic on plaque-induced gingivitis: A randomised controlled trial. Saudi Dent J 2022; 34:494-502. [PMID: 36092515 PMCID: PMC9453537 DOI: 10.1016/j.sdentj.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 06/02/2022] [Accepted: 06/08/2022] [Indexed: 12/03/2022] Open
Abstract
New approaches to treating periodontal diseases aim to balance sustaining the natural oral microbiota and modifying the host immune response. Gum Arabic (GA) is a natural polysaccharide rich in prebiotics. The aim of this study was to assess the effect of GA on clinical (Plaque Index (PI), Gingival Index (GI)) and immunological (Gingival Crevicular Fluid Interleukin 1 Beta (GCF IL-1 β)) parameters in patients with plaque-induced gingivitis. Materials and methods This placebo-controlled, double-blinded randomised clinical trial was conducted at the Department of Periodontology at Khartoum Dental Teaching Hospital, Khartoum, Sudan, from July to October 2016. Patients diagnosed with plaque-induced gingivitis meeting the study eligibility criteria were enrolled. At baseline, PI, GI and GCF IL-1β were measured. Patients received full-mouth scaling and were randomly assigned to receive either GA powder (intervention group) or Microcrystalline cellulose powder (placebo group). The patients were instructed to apply the treatment twice a day throughout the study. The PI, GI and GCF IL-1β were reassessed after 30 and 60 days. Results A total of 60 patients were enrolled (30 in each group). Compared to the placebo group, the intervention group showed a statistically significant reduction in GI scores after 30 days and improved PI scores at 30 and 60 days. Between baseline and 60 days, patients who received GA exhibited a significant reduction in GCF IL-1β levels compared to the placebo group. Conclusion GA was found to be effective in controlling plaque and gingivitis. Clinical Trial Registration. ISRCTN registry ISRCTN14209449.
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16
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Dikilitaş A, Karaaslan F, Seçkin E. Comparison of gingival crevicular fluid levels of IL-1b and IL-6 in subjects with gingivitis and stage III grade C periodontitis. BALKAN JOURNAL OF DENTAL MEDICINE 2022. [DOI: 10.5937/bjdm2203142d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background/Aim: Periodontal diseases are inflammatory diseases that occur against microbial pathogens. Cytokines are biologically active molecules involved in this inflammatory process. This study aims to evaluate interleukin-1 beta (IL-1b) and interleukin-6 (IL-6) cytokine levels in the gingival crevicular fluid (GCF) of individuals with stage III grade C (SIIIGC) periodontitis, gingivitis (G) and periodontally healthy (PH). Material and Methods: A total of 64 individuals, including 22 PH, 22 G and 20 SIIIGC periodontitis were included in this study. Plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment loss (CAL) parameters were evaluated. GCF samples were analyzed by enzyme-linked immunosorbent assay (ELISA) kits. Results: IL-1b and IL-6 levels in the GCF were significantly higher in the SIII-GC periodontitis group compared to the other groups (P <0.05). There was no significant difference between IL-1b and IL-6 levels in the PH and G groups (P > 0.05). GCF IL-1b and IL-6 levels were positively associated with the whole mouth and sampling area clinical periodontal parameters (P < 0.001). Conclusions: GCF IL-1b and IL-6 total amounts are effective in determining the regions and individuals under risk in SIII-GC periodontitis. Moreover, GCF IL-1b and IL-6 levels were seen to be effective determinants in differentiating gingivitis and periodontitis.
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17
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Dikilitaş A, Karaaslan F, Seçkin E. Comparison of gingival crevicular fluid levels of IL-1b and IL-6 in subjects with gingivitis and stage III grade C periodontitis. BALKAN JOURNAL OF DENTAL MEDICINE 2022. [DOI: 10.5937/bjdm20220824-004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Background/Aim: Periodontal diseases are inflammatory diseases that occur against microbial pathogens. Cytokines are biologically active molecules involved in this inflammatory process. This study aims to evaluate interleukin-1 beta (IL-1b) and interleukin-6 (IL-6) cytokine levels in the gingival crevicular fluid (GCF) of individuals with stage III grade C (SIII-GC) periodontitis, gingivitis (G) and periodontally healthy (PH). Material and Methods: A total of 64 individuals, including 22 PH, 22 G and 20 SIII-GC periodontitis were included in this study. Plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment loss (CAL) parameters were evaluated. GCF samples were analyzed by enzyme-linked immunosorbent assay (ELISA) kits. Results: IL-1b and IL-6 levels in the GCF were significantly higher in the SIII-GC periodontitis group compared to the other groups (P <0.05). There was no significant difference between IL-1b and IL-6 levels in the PH and G groups (P > 0.05). GCF IL-1b and IL-6 levels were positively associated with the whole mouth and sampling area clinical periodontal parameters (P < 0.001). Conclusions: GCF IL-1b and IL-6 total amounts are effective in determining the regions and individuals under risk in SIII-GC periodontitis. Moreover, GCF IL-1b and IL-6 levels were seen to be effective determinants in differentiating gingivitis and periodontitis.
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18
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Koidou VP, Hagi-Pavli E, Cross S, Nibali L, Donos N. Molecular profiling of intrabony defects' gingival crevicular fluid. J Periodontal Res 2021; 57:152-161. [PMID: 34788472 DOI: 10.1111/jre.12948] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 10/07/2021] [Accepted: 10/12/2021] [Indexed: 12/29/2022]
Abstract
AIM To profile, for the first time, the gingival crevicular fluid (GCF) of intrabony defects against a wide array of inflammatory and regenerative markers. MATERIALS AND METHODS Twenty-one patients contributed one intrabony defect and one periodontally healthy site. Clinical and radiographic measures were obtained. GCF samples were analyzed with multiplex bead immunoassays over 27 markers previously identified by our group. Comparisons were performed using Wilcoxon matched-pairs signed-ranks tests, using a Bonferroni corrected α = 0.05/27 = 0.0019. RESULTS Intrabony defect sites presented significantly increased GCF volume and disease-associated clinical and radiographic characteristics (p < .05). Intrabony defect sites presented significantly increased IL-1α, IL-1β, IL-6, IFN-γ, and MMP-8 levels compared with periodontally healthy sites (p < .0019). For regeneration markers, significantly higher FGF basic and VEGF levels were observed (p < .0019). Notably, traits of cell senescence were identified for the first time in the GCF. CONCLUSIONS The differentiation of intrabony defects from periodontally healthy control sites can be based on clinical and radiographic measures and on a differentiated GCF profile that is site-specific. Alongside catabolic processes, through significant up-regulation of inflammation and connective tissue remodeling, unique molecular characteristics of intrabony defects may render them a microenvironment amenable to regeneration. Traits of the senescence-associated secretory phenotype may suggest the existence of senescent cells during periodontal inflammation in intrabony defects.
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Affiliation(s)
- Vasiliki P Koidou
- Centre for Oral Clinical Research, Queen Mary University of London Barts and The London School of Medicine and Dentistry, London, UK.,Centre for Immunobiology & Regenerative Medicine, Queen Mary University of London Barts and The London School of Medicine and Dentistry, London, UK
| | - Eleni Hagi-Pavli
- Centre for Immunobiology & Regenerative Medicine, Queen Mary University of London Barts and The London School of Medicine and Dentistry, London, UK
| | - Samantha Cross
- Centre for Clinical Trials and Methodology, Queen Mary University of London Barts and The London School of Medicine and Dentistry, London, UK
| | - Luigi Nibali
- Centre for Oral Clinical Research, Queen Mary University of London Barts and The London School of Medicine and Dentistry, London, UK.,Centre for Host Microbiome Interactions, King's College London, London, UK
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Queen Mary University of London Barts and The London School of Medicine and Dentistry, London, UK.,Centre for Immunobiology & Regenerative Medicine, Queen Mary University of London Barts and The London School of Medicine and Dentistry, London, UK
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19
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Shcherba V, Krynytska I, Marushchak M, Korda M. Does thyroid dysfunction influence inflammatory mediators in experimental periodontitis? Endocr Regul 2021; 55:131-141. [PMID: 34523300 DOI: 10.2478/enr-2021-0014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objective. The aim of the present study was to investigate the presence of inflammatory mediators in rats with only periodontitis and periodontitis in a setting of hyper- and hypo-thyroidism and to analyze the correlative linkages between inflammatory mediators and thyroid hormones. Methods. White male 12-14 weeks old inbred rats (n=48) weighing 180-200 g were employed in the experiment. They were randomly divided into the following groups: Group I - control group, Group II - group with a model of periodontitis, Group III - group with a periodontitis in a setting of hyperthyroidism, and Group IV - group with periodontitis in a setting of hypothyroidism. The presence of tumor-necrosis factor-α (TNF-α) and interleukins IL-1β and IL-10 in the periodontal homogenate supernatant was studied by a solid-phase enzyme-linked immunosorbent assay. Results. It was shown that experimental lipopolysaccharide (LPS)-induced periodontitis is accompanied by hyperproduction of pro-inflammatory cytokines (TNF-α, IL-1β) and reduction of anti-inflammatory cytokines (IL-10), whereas TNF-α underwent to maximum changes. Thyroid dysfunction exacerbates cytokine imbalance and severity of inflammation in experimental LPS-induced periodontitis, especially pronounced at hyperthyroidism, as evidenced by the predominance of TNF-α and IL-1β levels in the periodontal homogenate supernatant by 38.5% (р<0.01) and 75.6% (p<0.001), respectively, hyperthyroid over the euthyroid, and by 20.1% (p<0.05) and 24.1% (p<0.05), respectively, over the hypothyroid rats. Conclusions. Thyroid dysfunction, especially hyperthyroidism, may play an important role in the pro-inflammatory response in periodontitis. Hyperproduction of inflammatory mediators in thyroid dysfunction can induce a noticeable damage in the whole apparatus of the periodontium, thereby causing progression of periodontitis.
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Affiliation(s)
- Vitaliy Shcherba
- I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Inna Krynytska
- I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Mariya Marushchak
- I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Mykhaylo Korda
- I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
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20
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Tütüncüoğlu S, Cetinkaya BO, Pamuk F, Avci B, Keles GC, Kurt-Bayrakdar S, Lütfioğlu M. Clinical and biochemical evaluation of oral irrigation in patients with peri-implant mucositis: a randomized clinical trial. Clin Oral Investig 2021; 26:659-671. [PMID: 34251534 DOI: 10.1007/s00784-021-04044-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 06/21/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This randomized clinical trial aimed to compare the efficacy of an oral irrigator and an interdental brush in patients with peri-implant mucositis clinically and biochemically at different time points (at baseline and at the 2nd, 4th, and 12th weeks). MATERIALS AND METHODS Forty-five patients with at least one implant with peri-implant mucositis were included in the present study (n = 45). The patients were divided into three groups: oral irrigator + toothbrush (OI group, n = 15), interdental brush + toothbrush (IB group, n = 15), and toothbrush only (control) (C group, n = 15). The modified plaque index (mPlI), modified sulcus bleeding index (mSBI), probing pocket depth (PPD), probing attachment level (PAL), and bleeding on probing (BOP) were recorded at baseline and at the 2nd, 4th, and 12th weeks. The levels of interleukin 1 beta (IL-1β), transforming growth factor-beta (TGF-β), tissue-type plasminogen activator (t-PA), and plasminogen activator inhibitor-1 (PAI-1) were also determined in the peri-implant crevicular fluid samples biochemically. RESULTS The mSBI and t-PA at the 2nd week (p = 0.003; p = 0.003); the mPlI, mSBI, BOP, t-PA, and PAI-1 at the 4th week (p < 0.05; p < 0.001; p < 0.001; p = 0.015; p = 0.011); and the mPlI, mSBI, IL-1β, t-PA, and PAI-1 at the 12th week (p < 0.05; p < 0.001; p = 0.013; p < 0.001; p = 0.002) were significantly lower in the OI group compared with those in the C group. Meanwhile, PAI-1 at the 2nd week, mSBI at the 4th week, and t-PA at the 12th week were significantly lower in the OI group compared with those in the IB group (p < 0.001; p = 0.011; p = 0.003). At the 2nd, 4th, and 12th weeks, all other parameters were not statistically different in the three groups. CONCLUSION The clinical indexes (such as mSBI and BOP) that play an important role in the diagnosis of peri-implant mucositis showed the lowest means (although limited) in the OI group at all evaluation time points. Moreover, when the clinical and biochemistry results were interpreted altogether, it became apparent that the OI group exhibited similar or more effective results than the IB group in resolving peri-implant mucositis. In light of the foregoing, this study concluded that the use of an oral irrigator can be as effective as an interdental brush in interdental cleaning. CLINICAL RELEVANCE In this study, it is suggested that the regular use of an oral irrigator along with a toothbrush could be an appropriate alternative to other oral hygiene products such as dental floss and interdental brush for the management of peri-implant mucositis by preventing the accumulation of dental plaque (NCT03844035).
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Affiliation(s)
| | - Burcu Ozkan Cetinkaya
- Faculty of Dentistry, Department of Periodontology, Ondokuz Mayis University, Samsun, Turkey
| | - Ferda Pamuk
- Faculty of Dentistry, Department of Periodontology, Beykent University, Istanbul, Turkey
| | - Bahattin Avci
- Faculty of Medicine, Department of Biochemistry, Ondokuz Mayis University, Samsun, Turkey
| | - Gonca Cayir Keles
- Faculty of Dentistry, Department of Periodontology, Istanbul Okan University, Istanbul, Turkey
| | - Sevda Kurt-Bayrakdar
- Faculty of Dentistry, Department of Periodontology, Eskisehir Osmangazi University, Eskisehir, Turkey.
| | - Müge Lütfioğlu
- Faculty of Dentistry, Department of Periodontology, Ondokuz Mayis University, Samsun, Turkey
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21
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Aleksandrowicz P, Brzezińska-Błaszczyk E, Kozłowska E, Żelechowska P, Borgonovo AE, Agier J. Analysis of IL-1β, CXCL8, and TNF-α levels in the crevicular fluid of patients with periodontitis or healthy implants. BMC Oral Health 2021; 21:120. [PMID: 33726736 PMCID: PMC7968186 DOI: 10.1186/s12903-021-01478-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 03/03/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Our study aimed to assess the level of IL-1β, CXCL8, and TNF-α in peri-implant sulcular fluid (PISF) collected from patients with no clinical symptoms of mucositis or peri-implantitis and compare them with cytokine concentration in gingival crevicular fluid (GCF) acquired from patients with healthy periodontium and those with varying severity of periodontitis. METHODS A total of 189 subjects were included in the study, and GCF/PISF samples were checked for IL-1β, CXCL8, and TNF-α levels using an ELISA test. RESULTS The IL-1β level in PISF in patients with implants was significantly lower than in GCF in patients with mild, moderate, or severe periodontitis. The CXCL8 level in PISF was considerably lower than in patients with moderate periodontitis. The TNF-α level in PISF in patients with implants was markedly higher compared to subjects with healthy periodontium or patients with mild periodontitis. CONCLUSION Analysis of cytokine levels may help describe the pathogenesis and early diagnosis of peri-implantitis and prevision in high-risk patients.
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Affiliation(s)
| | | | - Elżbieta Kozłowska
- Department of Experimental Immunology, Medical University of Lodz, Lodz, Poland
| | - Paulina Żelechowska
- Department of Experimental Immunology, Medical University of Lodz, Lodz, Poland
| | | | - Justyna Agier
- Department of Experimental Immunology, Medical University of Lodz, Lodz, Poland.
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22
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Medara N, Lenzo JC, Walsh KA, Reynolds EC, Darby IB, O'Brien-Simpson NM. A review of T helper 17 cell-related cytokines in serum and saliva in periodontitis. Cytokine 2020; 138:155340. [PMID: 33144024 DOI: 10.1016/j.cyto.2020.155340] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/21/2020] [Accepted: 10/06/2020] [Indexed: 12/24/2022]
Abstract
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.
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Affiliation(s)
- Nidhi Medara
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC 3053, Australia.
| | - Jason C Lenzo
- Centre for Oral Health Research, The University of Melbourne, 720 Swanston Street, Carlton, VIC 3053, Australia.
| | - Katrina A Walsh
- Department of Surgery, The University of Melbourne, Austin Health, Lance Townsend Building, Level 8, 145 Studley Road, Heidelberg, VIC 3084, Australia.
| | - Eric C Reynolds
- Centre for Oral Health Research, The University of Melbourne, 720 Swanston Street, Carlton, VIC 3053, Australia.
| | - Ivan B Darby
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC 3053, Australia.
| | - Neil M O'Brien-Simpson
- Centre for Oral Health Research, The University of Melbourne, 720 Swanston Street, Carlton, VIC 3053, Australia.
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23
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Campello CP, Pellizzer EP, Vasconcelos BCDE, Moraes SLD, Lemos CAA, Muniz MTC. Evaluation of IL-6 levels and +3954 polymorphism of IL-1β in burning mouth syndrome: A systematic review and meta-analysis. J Oral Pathol Med 2020; 49:961-968. [PMID: 32274841 DOI: 10.1111/jop.13018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 02/29/2020] [Accepted: 03/29/2020] [Indexed: 12/30/2022]
Abstract
This study evaluated IL-6 salivary levels as well as the +3954 polymorphism of IL-1β in patients with burning mouth syndrome and healthy individuals, through case-control studies. This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We conducted this research in PubMed/MEDLINE, Cochrane Library and Web of Science databases. The risk of bias was measured based in the Newcastle-Ottawa Scale. Researches with a group of patients with burning mouth syndrome and a control group in which the presence of the +3954 polymorphism of IL-1β and/ or IL-6 salivary levels through non-stimulated saliva were evaluated to detect if this interleukin concentrations are increased in patients and if the polymorphism is a risk factor for this syndrome. We identified seven studies with total of 440 participants, 229 patients with burning mouth syndrome and 211 healthy controls, ages 24-84 years old. The female gender was predominant. Patients in the majority of studies did not present increased levels of IL-6 and the +3954 polymorphism of IL-1β is not a risk factor for this syndrome. A few studies researched biomarkers in this pathology and more investigations are required not only to identify salivary levels and the polymorphism evaluated, but also other interleukins and polymorphisms in order to clarify the etiopathogenesis of this syndrome as well as for propose new diagnostic methods and treatments.
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Affiliation(s)
- Camilla Porto Campello
- Postgraduate Program in Biotechnology, Rede Nordeste de Biotecnologia- RENORBIO, UFRPE/UPE, Recife, Brazil
| | - Eduardo Piza Pellizzer
- Department of Dental Materials and Prosthodontics, Dental School, Universidade Estadual Paulista- UNESP, Araçatuba, Brazil
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24
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Rocha FRG, Delitto AE, de Souza JAC, González-Maldonado LA, Wallet SM, Rossa Junior C. Relevance of Caspase-1 and Nlrp3 Inflammasome on Inflammatory Bone Resorption in A Murine Model of Periodontitis. Sci Rep 2020; 10:7823. [PMID: 32385413 PMCID: PMC7210885 DOI: 10.1038/s41598-020-64685-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 04/06/2020] [Indexed: 12/11/2022] Open
Abstract
This study investigates the role of NLRP3 inflammasome and its main effector Caspase-1 in inflammation and alveolar bone resorption associated with periodontitis. Heat-killed Aggregatibacter actinomycetemcomitans (Aa) was injected 3x/week (4 weeks) into gingival tissues of wild-type (WT), Nlrp3-KO and Caspase1-KO mice. Bone resorption was measured by µCT and osteoclast number was determined by tartrate-resistant acid phosphatase (TRAP) staining. Inflammation was assessed histologically (H/E staining and immunofluorescence of CD45 and Ly6G). In vitro studies determined the influence of Nlrp3 and Caspase-1 in Rankl-induced osteoclast differentiation and activity and on LPS-induced expression of inflammation-associated genes. Bone resorption was significantly reduced in Casp1-KO but not in Nlrp3-KO mice. Casp1-KO mice had increased in osteoclast numbers, whereas the inflammatory infiltrate or on gene expression were similar to those of WT and Nlrp3-KO mice. Strikingly, osteoclasts differentiated from Nlrp3-deficient macrophages had increased resorbing activity in vitro. LPS-induced expression of Il-10, Il-12 and Tnf-α was significantly reduced in Nlrp3- and Casp1-deficient macrophages. As an inceptive study, these results suggest that Nlrp3 inflammasome does not play a significant role in inflammation and bone resorption in vivo and that Caspase-1 has a pro-resorptive role in experimental periodontal disease.
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Affiliation(s)
- Fernanda R G Rocha
- Department of Oral Biology, College of Dentistry, University of Florida, Gainesville, FL, USA.,Department of Diagnosis and Surgery, UNESP-State University of Sao Paulo, School of Dentistry at Araraquara, Araraquara, SP, Brazil
| | - Andrea E Delitto
- Department of Physical Therapy, University of Florida Health Science Center, Gainesville, FL, USA
| | - Joao A Chaves de Souza
- Department of Stomatology, School of Dentistry, Federal University of Goias (UFG), Goiania, GO, Brazil
| | - Laura A González-Maldonado
- Department of Diagnosis and Surgery, UNESP-State University of Sao Paulo, School of Dentistry at Araraquara, Araraquara, SP, Brazil
| | - Shannon M Wallet
- Department of Oral and Craniofacial Health Sciences, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Carlos Rossa Junior
- Department of Diagnosis and Surgery, UNESP-State University of Sao Paulo, School of Dentistry at Araraquara, Araraquara, SP, Brazil.
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25
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Cheng R, Wu Z, Li M, Shao M, Hu T. Interleukin-1β is a potential therapeutic target for periodontitis: a narrative review. Int J Oral Sci 2020; 12:2. [PMID: 31900383 PMCID: PMC6949296 DOI: 10.1038/s41368-019-0068-8] [Citation(s) in RCA: 122] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 10/07/2019] [Accepted: 10/17/2019] [Indexed: 02/05/2023] Open
Abstract
Interleukin(IL)-1β, a pro-inflammatory cytokine, was elevated and participates in periodontitis. Not only the link between IL-1β and periodontitis was proved by clinical evidence, but also the increased IL-1β triggers a series of inflammatory reactions and promotes bone resorption. Currently, IL-1β blockage has been therapeutic strategies for autoimmune and autoinflammatory diseases such as rheumatoid arthritis, cryopyrin-associated periodic syndromes, gout and type II diabetes mellitus. It is speculated that IL-1β be a potential therapeutic target for periodontitis. The review focuses on the production, mechanism, present treatments and future potential strategies for IL-1β in periodontitis.
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Affiliation(s)
- Ran Cheng
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhiwu Wu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Mingming Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Meiying Shao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Tao Hu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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26
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Ereş G, Su Akgün Demirtaş C, Toptaş E, Yılmaz AD, Sengüven B, Kamburoğlu K. Correlations between the Peptide Hormone Ghrelin and Proinflammatory Cytokines in Experimental Periodontitis Models of Female Rats at Different Stages of the Life Cycle. Arch Oral Biol 2019; 108:104518. [PMID: 31472279 DOI: 10.1016/j.archoralbio.2019.104518] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 07/20/2019] [Accepted: 08/06/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The aim of this study was to examine the correlations between the levels of ghrelin and inflammatory and bone metabolism markers in rats with periodontitis. DESIGN Thirty female Wistar rats (6 trial rats and 4 control rats in each group) were divided into pubertal, adult and postmenopausal groups. Periodontitis was induced by ligatures. On the 21 st day, blood was collected and all rats were then sacrificed. The levels of osteocalcin, osteoprotegerin, alkaline phosphatase, tumour necrosis factor alpha (TNF-α), interleukin 1 beta (IL-1β), acylated ghrelin, total ghrelin and soluble receptor activator of nuclear factor-kB ligands in the blood samples were measured using enzyme-linked immunosorbent assays. The jaws were decalcified in a Tris-EDTA solution and embedded in paraffin and 4-5 μm sections were cut for IL-β, TNF -α and ghrelin staining. RESULTS Significantly higher serum alkaline phosphatase levels were detected in the trial rats in the pubertal group than in the control rats (p = 0.033). In the postmenopausal group, ghrelin levels positively correlated with interleukin 1 beta levels (r = 0.708, p < 0.05). Among all trial rats, the postmenopausal group exhibited significantly higher levels of acylated ghrelin than the other groups (p = 0.001). Significantly higher osteoprotegerin levels were observed in the control rats than in the trial rats in the postmenopausal group (p = 0.012). Inflammation scores were significantly higher in adult trial rats than in controls (p = 0.024); significantly higher TNF-α levels were detected in postmenopausal experimental rats than in the adult experimental group (p = 0.025). CONCLUSIONS We concluded that total ghrelin levels in serum only correlated with IL-β levels in postmenopausal rats.
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Affiliation(s)
- Gülden Ereş
- Department of Periodontology, Faculty of Dentistry, Ankara University, Ankara, Turkey.
| | | | - Ece Toptaş
- Department of Periodontology, Faculty of Dentistry, Ankara University, Ankara, Turkey.
| | - Ayça Dilara Yılmaz
- Molecular Biology Laboratory, Faculty of Dentistry, Ankara University, Ankara, Turkey.
| | - Burcu Sengüven
- Department of Oral Pathology, Faculty of Dentistry, Gazi University, Ankara, Turkey.
| | - Kıvanç Kamburoğlu
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey.
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Patel RP, Amirisetty R, Kalakonda B, Penumatsa NV, Koppolu P. Influence of Smoking on Gingival Crevicular Fluid Interleukin 1β and Interleukin-8 in Patients with Severe Chronic Periodontitis among a Rural Population in India. Niger Med J 2019; 59:33-38. [PMID: 31303689 PMCID: PMC6590105 DOI: 10.4103/nmj.nmj_142_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Background and Objective: Smoking is widely prevalent among rural Indian populations. Smoking is considered a significant risk factor for periodontal diseases. The aim of the present study was to evaluate the influence of smoking on the inflammatory cytokines interleukin (IL) IL-1β and IL-8 in gingival crevicular fluid (GCF) and compare these between smokers and nonsmokers with periodontitis in diseased and healthy sites. Materials and Methods: A total of thirty patients with severe chronic periodontitis (15 smokers and 15 nonsmokers) participated in this study. Clinical parameters assessed were gingival index, bleeding on probing, probing depth (PD), and clinical attachment level. One diseased and one healthy site from each of the periodontitis patients were selected for GCF collection and assigned to the following four groups: healthy sites in smoker (SH), diseased sites in smoker (SD), healthy sites in nonsmoker (NH), and diseased sites in nonsmoker (ND) and were analyzed by enzyme-linked immunosorbent assay test (Quantikine®). Results: Intragroup comparisons revealed statistically significant levels of IL-1β in ND sites compared to NH sites (P < 0.005) and SD sites showed statistically significantly higher levels of IL-1β compared to SH sites (P < 0.0001). However, there was no significant difference in IL-8 levels between NH and ND sites as well as between SH and SD sites. Intergroup comparisons revealed that SH sites exhibited significantly lower amounts of IL-8 (P < 0.01) compared to NH sites and SD sites showed significantly lower levels of IL-8 compared to ND sites (P < 0.001). However, the comparison of NH and SH sites as well as ND and SD sites showed no significant difference in the levels of IL-1β. Conclusions: Cytokine levels were significantly elevated in periodontitis patients. Smokers exhibited a decrease in IL-8 and increase in IL-1β levels. Hence, this reflects the influence of smoking on immunosuppression and its role in the pathogenesis of periodontal disease.
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Affiliation(s)
- Ritu Prabha Patel
- Department of Periodontics, Chhattisgarh Dental College and Research Institute, Rajnandgaon, Chhattisgarh, India
| | - Ramesh Amirisetty
- Department of Periodontics, Chhattisgarh Dental College and Research Institute, Rajnandgaon, Chhattisgarh, India
| | - Butchibabu Kalakonda
- Department of Preventive Dental Sciences, Al Farabi Colleges, Riyadh, Saudi Arabia
| | - Narendra Varma Penumatsa
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdul Aziz University, Alkharj, Saudi Arabia
| | - Pradeep Koppolu
- Department of Preventive Dental Sciences, College of Dentistry, Dar Al Uloom University, Riyadh, Saudi Arabia
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28
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A New Approach for the Diagnosis of Systemic and Oral Diseases Based on Salivary Biomolecules. DISEASE MARKERS 2019; 2019:8761860. [PMID: 30906485 PMCID: PMC6398069 DOI: 10.1155/2019/8761860] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 12/18/2018] [Accepted: 01/29/2019] [Indexed: 12/20/2022]
Abstract
Early diagnosis represents the target of contemporary medicine and has an important role in the prognosis and further treatment. Saliva is a biofluid that generated a high interest among researchers due to its multiple advantages over other body fluids. The multitude of components that can act as biomarkers influenced the existing technologies to develop protocols that could allow saliva to become the new noninvasive diagnostic method. Saliva as a diagnostic tool can bring substantial addition to the diagnostic armamentarium, providing important information about oral and general health. The diagnostic applications of saliva extended and had a rapid evolution due to the advancement in salivaomics. The present review summarizes the latest researches in saliva-related studies and explores the information and correlations that saliva can offer regarding the systemic and oral diseases, highlighting its great potential of diagnosis. It is expected that in the future specific guidelines and results regarding the salivary diagnostics are to be available, together with high-sensitivity and specificity tests for multiple systemic and oral diseases.
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29
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Point-of-Care Periodontitis Testing: Biomarkers, Current Technologies, and Perspectives. Trends Biotechnol 2018; 36:1127-1144. [DOI: 10.1016/j.tibtech.2018.05.013] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 05/25/2018] [Accepted: 05/30/2018] [Indexed: 01/29/2023]
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30
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Wu YC, Ning L, Tu YK, Huang CP, Huang NT, Chen YF, Chang PC. Salivary biomarker combination prediction model for the diagnosis of periodontitis in a Taiwanese population. J Formos Med Assoc 2018; 117:841-848. [DOI: 10.1016/j.jfma.2017.10.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 10/02/2017] [Accepted: 10/16/2017] [Indexed: 11/15/2022] Open
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31
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Lee CH, Chen YW, Tu YK, Wu YC, Chang PC. The potential of salivary biomarkers for predicting the sensitivity and monitoring the response to nonsurgical periodontal therapy: A preliminary assessment. J Periodontal Res 2018; 53:545-554. [DOI: 10.1111/jre.12544] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2018] [Indexed: 12/25/2022]
Affiliation(s)
- C.-H. Lee
- Department of Dentistry; National Taiwan University Hospital; Taipei Taiwan
| | - Y.-W. Chen
- Department of Dentistry; National Taiwan University Hospital; Taipei Taiwan
- Graduate Institute of Clinical Dentistry; School of Dentistry; National Taiwan University; Taipei Taiwan
| | - Y.-K. Tu
- Institute of Epidemiology and Preventive Medicine; College of Public Health; National Taiwan University; Taipei Taiwan
| | - Y.-C. Wu
- Institute of Epidemiology and Preventive Medicine; College of Public Health; National Taiwan University; Taipei Taiwan
| | - P.-C. Chang
- Department of Dentistry; National Taiwan University Hospital; Taipei Taiwan
- Graduate Institute of Clinical Dentistry; School of Dentistry; National Taiwan University; Taipei Taiwan
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32
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Gupta S, Chhina S, Arora SA. A systematic review of biomarkers of gingival crevicular fluid: Their predictive role in diagnosis of periodontal disease status. J Oral Biol Craniofac Res 2018; 8:98-104. [PMID: 29892530 DOI: 10.1016/j.jobcr.2018.02.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 02/05/2018] [Accepted: 02/07/2018] [Indexed: 12/28/2022] Open
Abstract
The objective of the study was to conduct a systematic review of the literature so as to evaluate and summarize the diagnostic and prognostic potential of GCF. Included studies were systematically analyzed based on PRISMA (Preferred Reporting Items For Systematic Reviews and Meta Analyses) and studies were identified based on the-PICO (Glossary of evidence based terms 2007): 1)Patients with chronic periodontitis.2)Intervention- NSPT (Non-SurgicalPeriodontal therapy); NSPT + Chemotherapeutics.3)Comparison between treated v/s non treated sites.4)Outcomes measured: Analysis of variation in constituents of GCF. Electronic database search of Pubmed, Medline, Google Scholar and Scopus was performed using (MeSH) terms- Gingival Crevicular fluid and Cytokines, MMP's, NE, PGE-2, A2M, B2M, ALP, AST, Osteocalcin and Calprotectin. Articles published between year 2000-2016 were reviewed and were included based on inclusion and exclusion criteria. Based on this systematic review of literature, it can be concluded that analysis of constituents of GCF can be used as an effective and efficient diagnostic tool of periodontal diseases. These biomarkers in turn with their prognostic significance could act as a valuable tool in the combat of periodontal disease.
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Affiliation(s)
- Stuti Gupta
- I.T.S. Dental College, Hospital and Research Centre, Knowledge Park 3, Greater Noida, Uttar Pradesh, 201308, India
| | - Shivjot Chhina
- I.T.S. Dental College, Hospital and Research Centre, Knowledge Park 3, Greater Noida, Uttar Pradesh, 201308, India
| | - Sachit Anand Arora
- I.T.S. Dental College, Hospital and Research Centre, Knowledge Park 3, Greater Noida, Uttar Pradesh, 201308, India
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33
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Concentration of MMP-8 and IL-1β in gingival crevicular fluid in patients with chronic and aggressive periodontitis. Cent Eur J Immunol 2017; 42:342-346. [PMID: 29472810 PMCID: PMC5820986 DOI: 10.5114/ceji.2017.72824] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 03/01/2017] [Indexed: 02/06/2023] Open
Abstract
Modern research confirms the role of inflammatory mediators in the pathomechanism of periodontal tissue destruction. The aim of the study was to determine concentrations of MMP-8 and IL-1β in gingival crevicular fluid (GCF) in patients with advanced chronic and aggressive periodontitis. The authors measured the concentrations of the above inflammatory mediators in gingival crevicular fluid of deep pockets (PD ≥ 6 mm) and shallow pockets (PD 4-5 mm) in 33 patients with advanced chronic periodontitis and in 16 patients with aggressive periodontitis. The control group consisted of 16 individuals with healthy periodontium. In all patients levels of MMP-8 and IL-1β in GCF were determined with the ELISA method. The study showed significantly higher concentrations of MMP-8 and IL-1β in GCF of both deep and shallow pockets in patients with periodontitis compared to healthy subjects. No difference in concentrations of the tested mediators was observed with reference to diagnosis of aggressive periodontitis (AP) or chronic periodontitis (CP).
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34
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Han N, Zhang F, Li G, Zhang X, Lin X, Yang H, Wang L, Cao Y, Du J, Fan Z. Local application of IGFBP5 protein enhanced periodontal tissue regeneration via increasing the migration, cell proliferation and osteo/dentinogenic differentiation of mesenchymal stem cells in an inflammatory niche. Stem Cell Res Ther 2017; 8:210. [PMID: 28962660 PMCID: PMC5622495 DOI: 10.1186/s13287-017-0663-6] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 08/29/2017] [Accepted: 09/06/2017] [Indexed: 02/06/2023] Open
Abstract
Background Periodontitis is a widespread infectious disease ultimately resulting in tooth loss. The number of mesenchymal stem cells (MSCs) in patients with periodontitis is decreased, and MSC functions are impaired. Rescuing the impaired function of MSCs in periodontitis is the key for treatment, especially in a manner independent of exogenous MSCs. Our previous study found that overexpressed insulin-like growth factor binding protein 5 (IGFBP5) could promote exogenous MSC-mediated periodontal tissue regeneration. Here, we investigate the role of IGFBP5 protein in MSCs and periodontal tissue regeneration independent of exogenous MSCs in an inflammatory niche. Methods TNFα was used to mimic the inflammatory niche. Lentiviral IGFBP5 shRNA was used to silence IGFBP5 and recombinant human IGFBP5 protein (rhIGFBP5) was used to stimulate the periodontal ligament stem cells (PDLSCs) and bone marrow stem cells (BMSCs). The effects of IGFBP5 on PDLSCs were evaluated using the scratch-simulated wound migration, Transwell chemotaxis, alkaline phosphatase (ALP) activity, Alizarin red staining, Cell Counting Kit-8, Western blot, Real-time PCR, Co-IP and ChIP assays. The swine model of periodontitis was used to investigate the functions of IGFBP5 for periodontal regeneration and its anti-inflammation effect. Results We discovered that 0.5 ng/ml rhIGFBP5 protein enhanced the migration, chemotaxis, osteo/dentinogenic differentiation and cell proliferation of MSCs under the inflammatory condition. Moreover, 0.5 ng/ml rhIGFBP5 application could rescue the impaired functions of IGFBP5-silenced-MSCs in the inflammatory niche. Furthermore, local injection of rhIGFBP5 could promote periodontal tissue regeneration and relieve the local inflammation in a minipig model of periodontitis. Mechanistically, we found that BCOR negatively regulated the expression of IGFBP5 in MSCs. BCOR formed a protein complex with histone demethylase KDM6B and raised histone K27 methylation in the IGFBP5 promoter. Conclusions This study revealed that rhIGFBP5 could activate the functions of MSCs in an inflammatory niche, provided insight into the mechanism underlying the activated capacities of MSCs, and identified IGFBP5 as a potential cytokine for improving tissue regeneration and periodontitis treatment independent of exogenous MSCs and its potential application in dental clinic. Electronic supplementary material The online version of this article (doi:10.1186/s13287-017-0663-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nannan Han
- Laboratory of Molecular Signaling and Stem Cells Therapy, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing, 100050, China.,Department of Periodontology, Capital Medical University School of Stomatology, Beijing, 100050, China
| | - Fengqiu Zhang
- Department of Periodontology, Capital Medical University School of Stomatology, Beijing, 100050, China
| | - Guoqing Li
- Laboratory of Molecular Signaling and Stem Cells Therapy, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing, 100050, China.,Molecular Laboratory for Gene Therapy and Tooth Regeneration, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing, 100050, China
| | - Xiuli Zhang
- Laboratory of Molecular Signaling and Stem Cells Therapy, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing, 100050, China.,Department of Periodontology, Capital Medical University School of Stomatology, Beijing, 100050, China
| | - Xiao Lin
- Laboratory of Molecular Signaling and Stem Cells Therapy, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing, 100050, China.,Department of Implant Dentistry, Capital Medical University School of Stomatology, Beijing, China
| | - Haoqing Yang
- Laboratory of Molecular Signaling and Stem Cells Therapy, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing, 100050, China
| | - Lijun Wang
- Laboratory of Molecular Signaling and Stem Cells Therapy, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing, 100050, China.,Department of Endodontics, Capital Medical University School of Stomatology, Beijing, China
| | - Yangyang Cao
- Laboratory of Molecular Signaling and Stem Cells Therapy, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing, 100050, China
| | - Juan Du
- Laboratory of Molecular Signaling and Stem Cells Therapy, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing, 100050, China.,Molecular Laboratory for Gene Therapy and Tooth Regeneration, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing, 100050, China
| | - Zhipeng Fan
- Laboratory of Molecular Signaling and Stem Cells Therapy, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing, 100050, China.
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35
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Kuru BE, Laleman I, Yalnızoğlu T, Kuru L, Teughels W. The Influence of a Bifidobacterium animalis Probiotic on Gingival Health: A Randomized Controlled Clinical Trial. J Periodontol 2017; 88:1115-1123. [PMID: 28753102 DOI: 10.1902/jop.2017.170213] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND There is growing interest in the use of probiotics in periodontal therapy; however, until now, most research has focused on lactobacilli probiotics. The aim of this study is to evaluate the effect of 4-week use of yogurt supplemented with Bifidobacterium animalis subsp. lactis DN-173010 versus a placebo yogurt, followed by a 5-day non-brushing period. METHODS Individuals were included in this single-mask, randomized, controlled study if probing depth (PD) was ≤3 mm and attachment loss was ≤2 mm. After professional prophylaxis, they were randomized into two groups receiving yogurt containing either placebo or B. animalis for 28 days, followed by a 5-day non-brushing period. Outcome measures were plaque index (PI), gingival index (GI), bleeding on probing (BOP), PD, gingival crevicular fluid (GCF) volume, and total amount and concentration of interleukin (IL)-1β in GCF. These were measured at baseline, after 28 days of study product use, and subsequently after 5 days of plaque accumulation. RESULTS Fifty-one patients were analyzed. No intergroup differences could be detected before and after intake of study products. However, after plaque accumulation, significantly better results for all parameters were seen in the probiotic group compared with the control group (P <0.001): lower PI and GI, less BOP, less increase in GCF volume, and lower IL-1β total amount/concentration. CONCLUSION The use of a probiotic yogurt supplemented with B. animalis can have a positive effect on plaque accumulation and gingival inflammatory parameters after refraining from oral hygiene practices.
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Affiliation(s)
- Bahar Eren Kuru
- Department of Periodontology, School of Dentistry, Marmara University, Istanbul, Turkey.,Department of Periodontology, School of Dentistry, Yeditepe University, Istanbul, Turkey
| | - Isabelle Laleman
- Department of Oral Health Sciences, KU Leuven Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Tuğçe Yalnızoğlu
- Department of Periodontology, School of Dentistry, Marmara University, Istanbul, Turkey
| | - Leyla Kuru
- Department of Periodontology, School of Dentistry, Marmara University, Istanbul, Turkey
| | - Wim Teughels
- Department of Oral Health Sciences, KU Leuven Dentistry, University Hospitals Leuven, Leuven, Belgium
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Isaza-Guzmán DM, Medina-Piedrahíta VM, Gutiérrez-Henao C, Tobón-Arroyave SI. Salivary Levels of NLRP3 Inflammasome-Related Proteins as Potential Biomarkers of Periodontal Clinical Status. J Periodontol 2017; 88:1329-1338. [PMID: 28691886 DOI: 10.1902/jop.2017.170244] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Emerging evidence suggests that activation of inflammasomes plays a central mechanism in pathogenesis of periodontitis. This study aims to compare salivary levels of nod-like receptor family pyrin domain containing protein (NLRP) 3, apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC), cysteine aspartase (caspase)-1, and interleukin (IL)-1β from individuals with aggressive (AgP) or chronic periodontitis (CP) and healthy controls (HC), as well as elucidate its association with periodontal clinical status. METHODS Saliva samples from individuals with CP (n = 75), AgP (n = 20), and HC (n = 69) were collected. Periodontal status was assessed by measurement of probing depth, clinical attachment level, and extent and severity of disease. Salivary levels of analytes were analyzed by enzyme-linked immunosorbent assay. Association between biomarkers with CP or AgP was analyzed using multivariate binary logistic regression models. RESULTS Significantly higher levels of NLRP3, ASC, and IL-1β were detected in periodontitis groups in comparison to the periodontally HC group. However, no significant differences were observed for caspase-1 levels between clinical groups, and only NLRP3 salivary concentration was significantly higher in AgP compared with CP patients. Also, positive significant correlations among NLRP3, ASC, and IL-1β salivary concentrations and clinical parameters were observed. Logistic regression analyses revealed a strong/independent association of NLRP3, ASC, and IL-1β salivary levels with CP and AgP. CONCLUSION Although the concentration of caspase-1 in saliva samples makes its determination useless for detection of periodontal disease and/or its severity, salivary levels of NLRP3, ASC, and IL-1β may act as strong/independent indicators of amount and extent of periodontal breakdown in both CP and AgP and could potentially be used for prevention and therapy of this group of diseases.
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Affiliation(s)
- Diana M Isaza-Guzmán
- Laboratory of Immunodetection and Bioanalysis, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Verónica M Medina-Piedrahíta
- Laboratory of Immunodetection and Bioanalysis, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Carolina Gutiérrez-Henao
- Laboratory of Immunodetection and Bioanalysis, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Sergio I Tobón-Arroyave
- Laboratory of Immunodetection and Bioanalysis, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
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Jentsch HFR, Arnold N, Richter V, Deschner J, Kantyka T, Eick S. Salivary, gingival crevicular fluid and serum levels of ghrelin and chemerin in patients with periodontitis and overweight. J Periodontal Res 2017. [DOI: 10.1111/jre.12476] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- H. F. R. Jentsch
- Department of Cariology, Endodontology and Periodontology; Centre for Periodontology; University Hospital of Leipzig; Leipzig Germany
| | - N. Arnold
- Department of Cariology, Endodontology and Periodontology; Centre for Periodontology; University Hospital of Leipzig; Leipzig Germany
- Private Dental Practice; Hartha Germany
| | - V. Richter
- Clinical Chemistry and Molecular Diagnostics; Institute for Laboratory Medicine; University Hospital of Leipzig; Leipzig Germany
| | - J. Deschner
- Experimental Dento-Maxillo-Facial Medicine; University of Bonn; Bonn Germany
| | - T. Kantyka
- Malopolska Centre of Biotechnology; Jagiellonian University; Kraków Poland
- Broegelmann Research Laboratory; Department of Clinical Science; University of Bergen; Bergen Norway
| | - S. Eick
- Laboratory of Oral Microbiology; Department of Periodontology; School of Dental Medicine; University of Bern; Bern Switzerland
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Barros SP, Williams R, Offenbacher S, Morelli T. Gingival crevicular fluid as a source of biomarkers for periodontitis. Periodontol 2000 2017; 70:53-64. [PMID: 26662482 DOI: 10.1111/prd.12107] [Citation(s) in RCA: 199] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2015] [Indexed: 12/12/2022]
Abstract
In evaluating the pathogenesis of periodontal diseases, the diagnostic potential of gingival crevicular fluid has been extensively explored during the last twenty years, from initially just confirming health and disease states to more recently investigating it as a potential prognostic tool. As host susceptibility is a critical determinant in periodontal disease pathogenesis, the inflammatory mediator levels present in gingival crevicular fluid represent relevant risk indicators for disease activity. Considerable work has been carried out to identify the many different cytokine inflammatory pathways and microbial stimuli that are associated with periodontal disease pathogenesis. Now, 'omics' approaches aim to summarize how these pathways interact and probably converge to create critical inflammatory networks. More recently, gingival crevicular fluid metabolomics appears promising as an additional diagnostic method. Biofilm structure and the host inflammatory response to the microbial challenge may induce specific inflammatory signatures. Host genetics and epigenetics may also modulate microbial colonization, adding to the multiplicity of potential causal pathways. Omics analyses of gingival crevicular fluid, measuring microbial and host interactions in association with the onset and progression of periodontal diseases, still show the potential to expand the landscape for the discovery of diagnostic, prognostic and therapeutic markers.
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Schulze‐Späte U, Mizani I, Salaverry KR, Chang J, Wu C, Jones M, Kennel PJ, Brunjes DL, Choo T, Kato TS, Mancini D, Grbic J, Schulze PC. Periodontitis and bone metabolism in patients with advanced heart failure and after heart transplantation. ESC Heart Fail 2017; 4:169-177. [PMID: 28451454 PMCID: PMC5396042 DOI: 10.1002/ehf2.12126] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 10/05/2016] [Accepted: 11/08/2016] [Indexed: 12/12/2022] Open
Abstract
AIMS Heart failure (HF) is a multi-organ, pro-inflammatory syndrome that impairs bone metabolism. Pro-inflammatory cytokines and bone catabolism enhance periodontal disease, a local inflammatory, bacteria-induced disease that causes bone loss and periodontal soft tissue destruction. METHODS AND RESULTS Medical and dental examinations were performed on patients with HF (n = 39), following heart transplantation (post-HTx, n = 38) and controls (n = 32). Blood, saliva, and gingival crevicular fluid were analysed for bone metabolism and inflammation markers. HF average New York Heart Association classification was III. Average time since HTx was 1414 days. Pro-inflammatory tumour necrosis factor-alpha was higher in HF and HTx as compared with controls (P < 0.05). Both HF and HTx participants had higher levels of bone resorption marker C-terminal telopeptide and parathyroid hormone with subjects in the HF group having the highest serum levels of all groups (P ≤ 0.05). In contrast, 25-hydroxyvitamin D was lowest in HF. HF patients had greater clinical attachment loss, cumulative pockets depth (greater than 3 mm) and probing depth (P < 0.05) as compared with controls. Cumulative pockets depth correlated significantly with measures of the inflammatory burden, β-glucuronidase in saliva (r = 0.4863, P < 0.01), interleukin-1b in saliva (r = 0.5149, P < 0.01), and gingival crevicular fluid (r = 0.6056, P < 0.001) in HF. However, adjustment of periodontal results for measures of oral hygiene (plaque, bleeding on probing), systemic 25-hydroxyvitamin D, and race attenuated significant differences between groups. CONCLUSIONS Patients with HF exhibit more severe periodontal disease associated with increased bone turnover markers when compared with control patients. However, local and systemic factors may account for this association and should be evaluated in future studies.
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Affiliation(s)
- Ulrike Schulze‐Späte
- Division of Periodontics, College of Dental MedicineColumbia UniversityNew YorkNYUSA
- Section of Geriodontics, Department of Conservative Dentistry and PeriodontologyUniversity Hospital Jena, Friedrich Schiller UniversityJenaGermany
| | - Iman Mizani
- Division of Periodontics, College of Dental MedicineColumbia UniversityNew YorkNYUSA
| | | | - Jaime Chang
- Division of Periodontics, College of Dental MedicineColumbia UniversityNew YorkNYUSA
| | - Christina Wu
- Division of CardiologyColumbia University College of Physicians and SurgeonsNew YorkNYUSA
| | - Meaghan Jones
- Division of CardiologyColumbia University College of Physicians and SurgeonsNew YorkNYUSA
| | - Peter J. Kennel
- Division of CardiologyColumbia University College of Physicians and SurgeonsNew YorkNYUSA
| | - Danielle L. Brunjes
- Division of CardiologyColumbia University College of Physicians and SurgeonsNew YorkNYUSA
| | - Tse‐Hwei Choo
- Department of PsychiatryColumbia University College of Physicians and SurgeonsNew YorkNYUSA
| | - Tomoko S. Kato
- Division of CardiologyColumbia University College of Physicians and SurgeonsNew YorkNYUSA
| | - Donna Mancini
- Division of CardiologyColumbia University College of Physicians and SurgeonsNew YorkNYUSA
- Department of CardiologyThe Mount Sinai HospitalNew YorkNYUSA
| | - John Grbic
- Division of Periodontics, College of Dental MedicineColumbia UniversityNew YorkNYUSA
| | - P. Christian Schulze
- Division of CardiologyColumbia University College of Physicians and SurgeonsNew YorkNYUSA
- Division of Cardiology, Angiology, Pneumology and Intensive Medical CareUniversity Hospital Jena, Friedrich‐Schiller‐UniversityJenaGermany
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Tobón-Arroyave SI, Isaza-Guzmán DM, Pineda-Trujillo N. Association Study of Vitamin D Receptor (VDR) - Related Genetic Polymorphisms and their Haplotypes with Chronic Periodontitis in Colombian Population. J Clin Diagn Res 2017; 11:ZC60-ZC66. [PMID: 28384983 DOI: 10.7860/jcdr/2017/23967.9451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 11/19/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION There is strong evidence that both genetic and environmental factors may affect the periodontal clinical status. However, epidemiological evidence on the association between Vitamin D Receptor (VDR) polymorphisms and Chronic Periodontitis (CP) has been inconsistent. AIM The focus of this study was to identify if a possible association between VDR Single-Nucleotide Polymorphisms (SNPs) may be implicated in the aetiopathogenesis of CP in Colombian population. MATERIALS AND METHODS One hundred and ten CP patients and 50 Healthy Controls (HC) were recruited. Periodontal status was assessed based on probing depth, clinical attachment level, extent, and severity of periodontal breakdown. The polymerase chain reaction-restriction fragment length polymorphism method was used to identify the VDR rs7975232, rs1544410, rs2228570, and rs731236 SNPs from saliva samples. Odds Ratios (ORs) along with their 95% Confidence Intervals (CIs) were computed to compare the distribution of genotypes/alleles between HC and CP patients, alongside with analysis of Linkage Disequilibrium (LD) and haplotype associations between SNPs. Also, an analysis of the interaction between genetic findings and those significant demographic factors was performed for all SNPs. RESULTS There was no association neither between the different genotypes/allele frequencies nor haplotypes and CP. Similarly, no significant differences in extent or severity amongst genotype/allele groups were observed. Even so, interaction analysis revealed significant synergistic interactions between each SNP and age associated with the disease status. CONCLUSION Although these results do not support that VDR SNPs could be identified as independent risk predictor variables for CP in the Colombian population, synergistic biological interactive effects of all these SNPs related to age might play a significant role in the pathogenic pathways of CP.
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Affiliation(s)
- Sergio Iván Tobón-Arroyave
- Professor, Laboratory of Immunodetection and Bioanalysis, Faculty of Dentistry, University of Antioquia , Medellín, Antioquia, Colombia
| | - Diana María Isaza-Guzmán
- Professor, Laboratory of Immunodetection and Bioanalysis, Faculty of Dentistry, University of Antioquia , Medellín, Antioquia, Colombia
| | - Nicolás Pineda-Trujillo
- Professor, Gene Mapping Research Group, Faculty of Medicine, University of Antioquia , Medellín, Antioquia, Colombia
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Marchesan JT, Jiao Y, Moss K, Divaris K, Seaman W, Webster-Cyriaque J, Zhang S, Yu N, Song C, Bencharit S, Teles R, Offenbacher S. Common Polymorphisms in IFI16 and AIM2 Genes Are Associated With Periodontal Disease. J Periodontol 2017; 88:663-672. [PMID: 28387608 DOI: 10.1902/jop.2017.160553] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND The single nucleotide polymorphism (SNP) context of a previously identified periodontitis-associated locus is investigated, and its association with microbial, biologic, and periodontal disease clinical parameters is examined. METHODS A 200-kb spanning region of 1q12 previously highlighted in a genome-wide association scan among 4,766 European American individuals (SNP rs1633266) was annotated. Two haplotype blocks were selected. Association of these polymorphisms with data on microbial plaque composition, gingival crevicular fluid (GCF)-interleukin (IL)-1β levels, and clinical parameters of periodontal disease were examined. Descriptive analysis of IFI16 and AIM2 protein expression in gingival tissues from healthy individuals (n = 2) and individuals with chronic periodontitis (n = 2) was done via immunohistochemistry. RESULTS The highlighted locus is a 100-kb region containing the interferon γ-inducible protein 16 (IFI16) and absent in melanoma 2 (AIM2) genes. Two haplotype blocks, rs6940 and rs1057028, were significantly associated with increased extent bleeding on probing and levels of microorganisms Porphyromonas gingivalis, Tannerella forsythia, and Campylobacter rectus (P ≤0.05). Haplotype block rs1057028 was also significantly associated with pathogens Fusobacterium nucleatum and Aggregatibacter actinomycetemcomitans, increased GCF-IL-1β levels, and extent of probing depth ≥4 mm (P ≤0.05). Prevalence of severe periodontitis (biofilm-gingival interface P3 classification) was positively associated with haplotype block rs1057028. Similar trends were observed for haplotype block rs1057028. IFI16 and AIM2 protein expression was observed in multiple cell types of gingival tissues, including inflammatory cells. CONCLUSION This study found IFI16 and AIM2 SNPs associated with higher levels of periodontal microorganisms and an increased percentage of periodontal disease clinical parameters, suggesting the need for functional studies and additional fine-mapping of variants in the 1q12-locus.
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Affiliation(s)
- Julie T Marchesan
- Department of Periodontology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC.,General Oral Health Clinic, School of Dentistry, University of North Carolina at Chapel Hill
| | - Yizu Jiao
- Department of Periodontology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Kevin Moss
- General Oral Health Clinic, School of Dentistry, University of North Carolina at Chapel Hill
| | - Kimon Divaris
- Department of Pediatric Dentistry, School of Dentistry and Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | - William Seaman
- UNC Lineberger, School of Medicine, University of North Carolina at Chapel Hill
| | - Jennifer Webster-Cyriaque
- UNC Lineberger, School of Medicine, University of North Carolina at Chapel Hill.,Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill
| | - Shaoping Zhang
- Department of Periodontology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC.,General Oral Health Clinic, School of Dentistry, University of North Carolina at Chapel Hill
| | - Ning Yu
- Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI
| | - Catharine Song
- Department of Periodontology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Sompop Bencharit
- Department of Prosthodontics, School of Dentistry, University of North Carolina at Chapel Hill
| | - Ricardo Teles
- Department of Periodontology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC.,General Oral Health Clinic, School of Dentistry, University of North Carolina at Chapel Hill
| | - Steven Offenbacher
- Department of Periodontology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC.,General Oral Health Clinic, School of Dentistry, University of North Carolina at Chapel Hill
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Yilmaz Ö, Lee KL. The inflammasome and danger molecule signaling: at the crossroads of inflammation and pathogen persistence in the oral cavity. Periodontol 2000 2017; 69:83-95. [PMID: 26252403 DOI: 10.1111/prd.12084] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2014] [Indexed: 12/27/2022]
Abstract
Inflammasomes are an oligomeric assembly of multiprotein complexes that activate the caspase-1-dependent maturation and the subsequent secretion of inflammatory interleukin-1beta and interleukin-18 cytokines in response to a 'danger signal' in vertebrates. The assessment of their significance continues to grow rapidly as the complex biology of various chronic inflammatory conditions is better dissected. Increasing evidence strongly links inflammasomes and host-derived small 'danger molecule ATP' signaling with the modulation of the host immune response by microbial colonizers as well as with potential altering of the microbiome structure and intermicrobial interactions in the host. All of these factors eventually lead to the destructive chronic inflammatory disease state. In the oral cavity, a highly dynamic and multifaceted interplay takes place between the signaling of endogenous danger molecules and colonizing microbes on the mucosal surfaces. This interaction may redirect the local microenvironment to favor the conversion of the resident microbiome toward pathogenicity. This review outlines the major components of the known inflammasome complexes/mechanisms and highlights their regulation, in particular, by oral microorganisms, in relation to periodontal disease pathology. Better characterization of the cellular and molecular biology of the inflammasome will probably identify important potential therapeutic targets for the treatment and prevention of periodontal disease, as well as for other debilitating chronic diseases.
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Hasiuk P, Hasiuk N, Kindiy D, Ivanchyshyn V, Kalashnikov D, Zubchenko S. Characteristics of cellular composition of periodontal pockets. Interv Med Appl Sci 2016; 8:172-177. [PMID: 28180007 PMCID: PMC5283776 DOI: 10.1556/1646.8.2016.4.5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Purpose The development of inflammatory periodontal disease in young people is an urgent problem of today's periodontology, and requires a development of new methods that would give an opportunity not only to diagnose but also for prognosis of periodontitis course in a given patients contingent. Results Cellular structure of periodontal pockets is presented by hematogenous and epithelial cells. Our results are confirmed by previous studies, and show that the penetration of periodontal pathogens leads to formation in periodontal tissue of a highly active complex compounds—cytokines that are able to modify the activity of neutrophils and reduce their specific antibacterial properties. Cytokines not only adversely affect the periodontal tissues, but also cause further activation of cells that synthesized them, and inhibit tissue repair and process of resynthesis of connective tissue by fibroblasts. Conclusion Neutrophilic granulocytes present in each of the types of smear types, but their functional status and quantitative composition is different. The results of our cytological study confirmed the results of immunohistochemical studies, and show that in generalized periodontitis, an inflammatory cellular elements with disorganized epithelial cells and connective tissue of the gums and periodontium, and bacteria form specific types of infiltration in periodontal tissues.
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Affiliation(s)
- Petro Hasiuk
- Orthopedic Dentistry Department, State Higher Educational Institution, I. Horbachevsky Ternopil State Medical University , Ternopil, Ukraine
| | - Nataliya Hasiuk
- Therapeutic Dentistry Department, State Higher Educational Institution, I. Horbachevsky Ternopil State Medical University , Ternopil, Ukraine
| | - Dmytro Kindiy
- Propedeutics of Orthopedic Dentistry Department, Ukrainian Medical Dental Academy , Poltava, Ukraine
| | - Victoriya Ivanchyshyn
- Pediatric Dentistry Department, Danylo Halytsky Lviv National Medical University , Lviv, Ukraine
| | - Dmytro Kalashnikov
- Propedeutics of Orthopedic Dentistry Department, Ukrainian Medical Dental Academy , Poltava, Ukraine
| | - Sergiy Zubchenko
- Propedeutics of Orthopedic Dentistry Department, Ukrainian Medical Dental Academy , Poltava, Ukraine
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Killeen AC, Harn JA, Erickson LM, Yu F, Reinhardt RA. Local Minocycline Effect on Inflammation and Clinical Attachment During Periodontal Maintenance: Randomized Clinical Trial. J Periodontol 2016; 87:1149-57. [DOI: 10.1902/jop.2016.150551] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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45
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Cytotoxicity of three commercial mouthrinses on extracellular matrix metabolism and human gingival cell behaviour. Toxicol In Vitro 2016; 34:88-96. [DOI: 10.1016/j.tiv.2016.03.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Revised: 03/14/2016] [Accepted: 03/25/2016] [Indexed: 11/19/2022]
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46
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Villa-Correa YA, Isaza-Guzmán DM, Tobón-Arroyave SI. Influence of Periodontal Clinical Status on Salivary Levels of Glutathione Reductase. J Periodontol 2016; 87:716-24. [PMID: 26777764 DOI: 10.1902/jop.2016.150618] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Inadequate antioxidant balance may play a role in the excessive tissue breakdown in periodontitis. Because aggressive periodontitis (AgP) not only differs from chronic periodontitis (CP) in terms of clinical manifestations, this study investigates whether the salivary levels of glutathione reductase (GR) may be linked with periodontal status. METHODS Saliva samples from patients with CP (n = 121), patients with AgP (n = 18), and healthy controls (n = 69) were collected. Periodontal status was assessed by criteria based on probing depth, clinical attachment level, and extent and severity of periodontal breakdown. GR salivary levels were analyzed by spectrophotometry. The association among GR concentration and CP or AgP was analyzed individually and adjusted for confounding using multivariate binary logistic regression models. RESULTS GR levels not only differed significantly between the two periodontitis groups, being significantly greater in patients with AgP, but also were significantly greater than those observed in healthy controls. Synchronously, positive significant correlations between salivary GR concentration and clinical parameters were observed. After binary logistic regression analysis, both GR salivary levels ≥15.38 and ≥24.20 mU/mL were associated independently with CP and AgP, respectively. A significant interaction effect was also detected between increased GR salivary concentration and aging in the CP group. CONCLUSIONS Increased GR salivary concentration may be a strong/independent prognostic indicator of the amount and extent of oxidative stress-induced periodontal damage in both CP and AgP. Likewise, saliva samples might reflect an interactive effect of GR levels associated with the aging-related cumulative characteristics of periodontal damage in CP.
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Affiliation(s)
| | - Diana María Isaza-Guzmán
- Laboratory of Immunodetection and Bioanalysis, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Sergio Iván Tobón-Arroyave
- Laboratory of Immunodetection and Bioanalysis, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
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48
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Mootha A, Malaiappan S, Jayakumar ND, Varghese SS, Toby Thomas J. The Effect of Periodontitis on Expression of Interleukin-21: A Systematic Review. Int J Inflam 2016; 2016:3507503. [PMID: 26998377 PMCID: PMC4779837 DOI: 10.1155/2016/3507503] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 12/24/2015] [Accepted: 01/11/2016] [Indexed: 01/11/2023] Open
Abstract
Purpose. Inflammation and tissue breakdown are led by an array of inflammatory destructive mediators associated with initiation and progression of inflammatory diseases like periodontitis. Current evidence shows that these inflammatory mediators have a definitive role in the pathogenesis of various systemic diseases with an inflammatory component. Interleukin-21 (IL-21) has been associated with systemic diseases like rheumatoid arthritis and Crohn's disease that follow a chronic inflammatory cascade. Similarly recent studies have associated Interleukin-21 levels with periodontitis. This systematic review was aimed to assess the levels of IL-21 in subjects with periodontitis. Methods. A complete literature search was done in PubMed, Medline, Science Direct, and Cochrane databases and Google Scholar based on the inclusion/exclusion criteria. Six relevant articles were procured. Full text was read individually by two reviewers and data extraction was done based on STROBE statement. Results. After data extraction five observational and one interventional study were obtained. All the studies showed an increased expression of IL-21 in periodontitis and the interventional study showed reduction in IL-21 levels after nonsurgical periodontal therapy (NSP). Conclusion. Interleukin-21 levels are higher in periodontitis than controls. With this limited evidence further longitudinal studies are required to consider this as a definitive inflammatory marker.
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Affiliation(s)
- Archana Mootha
- Department of Periodontics, Saveetha Dental College and Hospitals, No. 162, Poonamallee High Road, Velappanchavadi, Chennai 600077, India
| | - Sankari Malaiappan
- Department of Periodontics, Saveetha Dental College and Hospitals, No. 162, Poonamallee High Road, Velappanchavadi, Chennai 600077, India
| | - N. D. Jayakumar
- Department of Periodontics, Saveetha Dental College and Hospitals, No. 162, Poonamallee High Road, Velappanchavadi, Chennai 600077, India
| | - Sheeja S. Varghese
- Department of Periodontics, Saveetha Dental College and Hospitals, No. 162, Poonamallee High Road, Velappanchavadi, Chennai 600077, India
| | - Julie Toby Thomas
- Department of Periodontics, Saveetha Dental College and Hospitals, No. 162, Poonamallee High Road, Velappanchavadi, Chennai 600077, India
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Ramos UD, Ayub LG, Reino DM, Grisi MF, Taba M, Souza SL, Palioto DB, Novaes AB. Antimicrobial photodynamic therapy as an alternative to systemic antibiotics: results from a double-blind, randomized, placebo-controlled, clinical study on type 2 diabetics. J Clin Periodontol 2016; 43:147-55. [DOI: 10.1111/jcpe.12498] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Umberto D. Ramos
- Department of Bucco-Maxillo-Facial Surgery and Traumatology and Periodontology; School of Dentistry of Ribeirao Preto; University of Sao Paulo; Ribeirão Preto SP Brazil
| | - Lauro G. Ayub
- Department of Bucco-Maxillo-Facial Surgery and Traumatology and Periodontology; School of Dentistry of Ribeirao Preto; University of Sao Paulo; Ribeirão Preto SP Brazil
| | - Danilo M. Reino
- Department of Bucco-Maxillo-Facial Surgery and Traumatology and Periodontology; School of Dentistry of Ribeirao Preto; University of Sao Paulo; Ribeirão Preto SP Brazil
| | - Márcio F.M. Grisi
- Department of Bucco-Maxillo-Facial Surgery and Traumatology and Periodontology; School of Dentistry of Ribeirao Preto; University of Sao Paulo; Ribeirão Preto SP Brazil
| | - Mário Taba
- Department of Bucco-Maxillo-Facial Surgery and Traumatology and Periodontology; School of Dentistry of Ribeirao Preto; University of Sao Paulo; Ribeirão Preto SP Brazil
| | - Sérgio L.S. Souza
- Department of Bucco-Maxillo-Facial Surgery and Traumatology and Periodontology; School of Dentistry of Ribeirao Preto; University of Sao Paulo; Ribeirão Preto SP Brazil
| | - Daniela B. Palioto
- Department of Bucco-Maxillo-Facial Surgery and Traumatology and Periodontology; School of Dentistry of Ribeirao Preto; University of Sao Paulo; Ribeirão Preto SP Brazil
| | - Arthur B. Novaes
- Department of Bucco-Maxillo-Facial Surgery and Traumatology and Periodontology; School of Dentistry of Ribeirao Preto; University of Sao Paulo; Ribeirão Preto SP Brazil
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Korte DL, Kinney J. Personalized medicine: an update of salivary biomarkers for periodontal diseases. Periodontol 2000 2015; 70:26-37. [DOI: 10.1111/prd.12103] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2015] [Indexed: 01/01/2023]
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