Abstract
Objective: To evaluate local and systemic levels of interleukin-10 (IL-10), IL-33, and tumor necrosis factor alpha (TNF-?) in Thalassemia major (TM) in the presence of gingival inflammation. Material and Methods: 58 patients (TM, n=29 and systemically healthy controls, n=29) were included to the study. IL-10, IL-33, and TNF-? levels were evaluated in gingival crevicular fluid (GCF), saliva and serum. Clinical periodontal measurements were recorded. Results: GCF IL-33 total amounts in TM and gingivitis group were elevated compared to systemically and periodontally healthy group (p=0.01). GCF IL-10, IL-33 and TNF-? concentrations were higher in TM and periodontally healthy group than the systemically healthy and gingivitis group (p=0.02, p=0.008, p=0.003). Serum IL-10 levels were elevated in TM and gingivitis compared to the systemically healthy and gingivitis (p=0.0009) and systemically and periodontally healthy (p=0.0007) groups. Serum IL-10 and TNF-? levels in TM and periodontally healthy group were higher than systemically and periodontally healthy group (p=0.01 and p=0.02). Conclusion: TM may potentially alter circulating levels of IL-33 and IL-10 and therefore, may affect the degree of periodontal inflammation locally or vice versa. Yet, the underlying mechanism linking the hematologic condition is not clear and deserves further investigation. KeywordsGingivitis; Thalassemia major; Interleukin-10; Interleukin-33; Tumor Necrosis Factor-alpha.
Highlights
Thalassemia major (TM) or Cooley anemia, is an autosomal recessive hematologic disorder and characterized by decrease or absence of β-globin chain production [1,2]
plaque index (PI) and bleeding on probing (BOP) scores were similar in the TM and gingivitis and systemically healthy and gingivitis groups (p>0.05) (Table 1)
Elevated PI, BOP scores were found in both TM gingivitis and systemically healthy and gingivitis groups compared to periodontally healthy groups (p
Summary
Thalassemia major (TM) or Cooley anemia, is an autosomal recessive hematologic disorder and characterized by decrease or absence of β-globin chain production [1,2]. Several immunological abnormalities such as functional alterations of T-lymphocytes, polyclonal activation of B-lymphocytes and impaired activity of macrophages and neutrophils have been found in TM patients due to the secondary effects of erythrocyte transfusion and splenectomy [3]. It has been reported that IL1, IL-6 and TNF-α levels are increased over the alterations from gingival health to periodontal disease [5,6]. IL-33 mainly induces T helper 2 (Th2) immune responses [10] and similar to IL-10, it enhances LPS-induced production of TNF-α via its chemoattractant action on Th2 cells [11]
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