Study the role of proinflammatory and anti- inflammatory cytokines in Iraqi chronic periodontitis patients

Abstract

Background: Chronic periodontitis is a multifactorial polymicrobial infection characterized by an inflammatoryprocess that leads to destruction of teeth supporting tissues. There is a complex network of pro- and antiinflammatorycytokines acting in the inflamed periodontal tissues. This study was designed to detect the serum levelsof pro-and anti-inflammatory cytokines in chronic periodontitis patients and determine its correlation with differentclinical parameters of the periodontal status, as well as study the correlation among these cytokines and to evaluatethe ratio between pro-and anti-inflammatory cytokines.Subjects and Methods: A total of 50 patients with chronic periodontitis were studied, their ages range from 23-60years with a mean age of 40.1±7.6 years. Apparently healthy volunteers consisted of 25 individuals who were theirage range (21-50) years with a mean age of 33.4±9.1 years considered as control. Periodontal parameters used inthis study were plaque index, gingival index, probing pocket depth, clinical attachment level and bleeding onprobing. Blood samples were collected from CP patients and healthy control groups to assess serum concentrationsof IL-1β, IL-2, IL-6, TNF-α and IL-10 by means of enzyme-linked immune-sorbent assay.Results: The current results revealed that median serum levels of pro-inflammatory cytokines (IL-1β and TNF-α) weresignificantly higher in CP patients than in healthy control groups (p<0.001), whereas the serum levels of IL-2and IL-6were not observed any significant differences between two groups (p>0.05). In contrast serum levels of antiinflammatorycytokines (IL-10) was significantly low in patients when compared to control (p<0.001). On the otherhand, the ratios of IL-1βIL-10 and TNF-αIL-10 were significantly higher in patients when compared with the ratios incontrol group.Regarding correlation between serum cytokines and clinical periodontal parameters, serum IL-1β level was showedsignificant positive correlation with each of plaque index, gingival index, probing pocket depth and clinicalattachment level. On the otherhand no association between serum IL-2 levels and clinical parameters of chronicperiodontitis were found. Moreover; IL-6 was showed significant positive correlation with probing pocket depth, whileTNF-α revealed significant positive association with each of gingival index, probing pocket depth and clinicalattachment level. Conversely, serum IL-10 levels had negative significant correlation with plaque index, probingpocket depth and bleeding on probing. Interestingly strong linear positive correlation was found among each of (IL-1β, IL-6 and TNF-α,).While strong negative correlation was noticed between IL-10 and each of (IL-1β and TNF-α).Conclusion: The present results may provide direct evidence for the systemic activation of immune cells inperiodontitis, and suggests that cytokines may play an important role in pro-inflammatory response in serum ofpatients with chronic periodontitis. Moreover imbalance between pro and anti-inflammatory cytokines could beinvolved in the initiation and progression of chronic periodontitis and is indicative of a stronger systemic proinflammatorystate in disease.