Abstract

BackgroundSince chronic apical periodontitis (CAP) appears to be a risk factor for coronary heart disease, the aim of the study was to determine the relationship between the size of CAP lesion and inflammatory markers (hsCRP, IL-6, TNF-α), as well as lipids and lipoproteins (LpPLA2, apoAI, apoB level) in blood serum of patients with CAP.MethodsThe patients studied (n = 43) were divided into groups: patients under 50 and over 50 years of age, and a separate subgroup of the oldest age with the largest size of CAP lesions. Apolipoprotein AI (apoAI) above 150 mg/dL and below 150 mg/dL was used as an important criterion for the division of patients into groups. The CAP lesion size was measured using the Kodak digital imaging system software. The control group consisted of clinically healthy volunteers (n = 20) without CAP. Lipids were measured on a Siemens analyzer (Germany), apoAI, apoB, hsCRP levels were determined by immunonephelometric method, using the Health Care Diagnostic Product (Siemens GmbH, Germany), and IL-6, TNF-α and LpPLAG7 assay kits (ELISA, R&D Systems) were used.ResultsThe findings suggested that in patients with CAP and their age increase, the CAP lesion size, the concentration of inflammatory markers and LpPLA2 mass increased. Correlations between the CAP lesion size and LpPLA2 mass and between the CAP lesion size and TG level in patients with apoAI 150 ≤ mg/dL showed increase TG in atherogenic apoB-containing triglyceride-rich lipoprotein and TC in cholesterol-rich lipoprotein. The patients with a low apoAI and high LpPLA2 level can have a higher risk of odontogenic disease and progression of atherosclerosis and coronary heart disease.ConclusionWe have found a positive correlation between apoAI level and the CAP lesion size and a negative correlation between LpPLA2 level and the CAP lesion size. The results suggest that apoAI and LpPLA2 in HDL particles have antiinflammatory action and together can limit the CAP lesion size in patient with a higher apoAI level. The literature data on the distribution of lipoprotein particles in subjects are still insufficient, so this problem requires further studies.

Highlights

  • Since chronic apical periodontitis (CAP) appears to be a risk factor for coronary heart disease, the aim of the study was to determine the relationship between the size of CAP lesion and inflammatory markers, as well as lipids and lipoproteins (LpPLA2, Apolipoprotein AI (apoAI), apoB level) in blood serum of patients with CAP

  • The studies showed that in patients under 50 years of age there was no statistically significant increase in the IL-6 and TNF-α concentration as compared to controls, but there was a significant difference between the concentration of hsCRP and LpPLA2 (Table 2)

  • The results showed that the concentration of inflammatory markers, and LpPLA2 and the size of CAP lesion were significantly the lowest in patients under 50 years of age, increased with age, and were the highest in relation to the control group, and patients ≤ 50 years of age as well as the oldest with largest CAP lesion size

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Summary

Introduction

Since chronic apical periodontitis (CAP) appears to be a risk factor for coronary heart disease, the aim of the study was to determine the relationship between the size of CAP lesion and inflammatory markers (hsCRP, IL-6, TNF-α), as well as lipids and lipoproteins (LpPLA2, apoAI, apoB level) in blood serum of patients with CAP. The role of serum lipids and lipoproteins is significant in this inflammatory process [2, 3]. Interleukin-6 (IL-6) is a cytokine, which plays an important role in many chronic inflammatory diseases [5]. The author’s previous findings had shown that serum and gingival crevicular fluid (GCF) proinflammatory cytokines such as TNF-α, IL-1b, and IL-6 levels may play an important role in association with a periodontal disease and hyperlipidemia [3].

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