Relationship between Chronic Periodontitis and Inflammatory Cytokines in Patients Undergoing Maintenance Hemodialysis

Abstract

Background: Systemic inflammation has been proposed as one of the main mechanisms underlying the association between End-stage renal disease (ESRD) and periodontitis. However, the available data regarding this mechanism are limited. This study aimed to investigate the correlation between serum and gingival crevicular fluid (GCF) levels of inflammatory cytokines and the association with periodontal parameters in patients undergoing maintenance hemodialysis (MHD). Methods: Patients who were undergoing MHD were enrolled as the HD group. Healthy individuals who underwent oral examination were selected as the control group. All participants underwent a full-mouth periodontal evaluation, and the levels of eight inflammatory cytokines, including IL-1β, IL-17, IL-6, IL-8, and TNF-α, MCP-1, MMP-8, and CRP, in the GCF and serum were measured. Results: A total of 63 MHD patients and 75 healthy persons were included. The prevalence of moderate/severe periodontitis was significantly higher in the HD group than in the control group (88.9 vs. 66.7%, P<0.05). The levels of GCF and serum C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), monocyte chemoattractant protein-1 (MCP-1), and matrix metalloproteinase-8 (MMP-8) were higher in patients in the HD group with moderate/severe periodontitis than in the control group. The GCF and serum CRP levels were positively correlated with the periodontal clinical parameters. Serum CRP, MCP-1, TNF-α, and MMP-8 levels were positively correlated with the GCF CRP levels. Interpretation: Periodontitis was more prevalent among patients undergoing MHD than among healthy controls, and CRP may contribute to the association between End-stage renal disease (ESRD) and periodontitis. Funding: CAMS Innovation Fund for Medical Sciences (2019-I2M-5-037), Shanghai Clinical Research Center for Oral Diseases (19MC1910600), and Clinical Research Program of ninth People's Hospital, Shanghai JiaoTong University School of Medicine (201918069), and the General Project of the Shanghai Municipal Health Committee (Project No. 201940041). Declaration of Interest: The authors report no conflict of interests related to this study. Ethical Approval: This study was approved by the Research Ethics Committee of the Ninth People's Hospital before its initiation. The participants were informed of the objectives of the study and provided written informed consent.