Effects of calcium hydroxide intracanal medications on T helper (Th1, Th2, Th9, Th17, and Tfh) and regulatory T (Treg) cell cytokines in apical periodontitis: a CONSORT RCT.
J Endod 2022;
48:975-984. [PMID:
35487475 DOI:
10.1016/j.joen.2022.04.010]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 04/13/2022] [Accepted: 04/18/2022] [Indexed: 12/30/2022]
Abstract
INTRODUCTION
This CONSORT RCT investigated T helper (Th1, Th2, Th9, Th17, and Tfh), regulatory T (Treg) cell-type cytokines, and their networks in apical periodontitis (AP). We also assessed the effects of calcium hydroxide [Ca(OH)2] intracanal medications (ICMs) on helper T and Treg cell-type cytokines.
METHODS
Twenty teeth with primary endodontic infection and apical periodontitis (PEIAP) were randomly divided into two groups: Ca(OH)2 + saline solution (SSL; n = 10) and Ca (OH)2 + 2% Chlorhexidine-gel (2% CHX-gel; n = 10). Samples were collected from the periradicular tissue fluid (PTF) before (PTFs1) and after 14 days of ICMs (PTFs2). The Human High Sensitivity T Cell Panel was used to quantify target T-helper (Th)1: IL-2, 12, and IFN-γ; Th2: IL-4, -5, -13; Th9: IL-9; Th17: IL-17; T follicular helper cells (Tfh): IL-21; and Treg-cell-type cytokine: IL-10.
RESULTS
Th1-type cytokines were higher, compared to Th2-type, at PTFs1. Positive (+) associations were found among all Th1-type cytokines and all Th2-type cytokines. There were negative (-) correlations between all Th1- and Th2-type cytokines. Size of radiolucent lesions (SRL) and symptoms (TTP and/or POP) were positively correlated with Th1-type cytokines, IL-17, and IL-21 but negatively correlated with Th2-type cytokines and IL-10 (all, p < 0.001). Both ICMs increased Th2-type cytokines and IL-10 (P < 0.05) and decreased Th1- type cytokines, IL-17, and IL-21 (P < 0.05), with no differences among them (P > 0.05).
CONCLUSIONS
Complex T-cell cytokine networks are involved in AP. Both Ca(OH)2 ICMs effectively increased IL-4, IL-5, IL-10, and IL-13 and lowered IL-2, IL-12, IL-17, IL-21, and IFN-γ.
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