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 inflammatory process that leads to destruction of teeth supporting tissues. There is a complex network of pro- and anti-inflammatory cytokines acting in the inflamed periodontal tissues. This study was designed to detect the serum levels of pro-and anti-inflammatory cytokines in chronic periodontitis patients and determine its correlation with different clinical parameters of the periodontal status, as well as study the correlation among these cytokines and to evaluate the ratio between pro-and anti-inflammatory cytokines. Subjects and Methods: A total of 50 patients with chronic periodontitis were studied, their ages range from 23-60 years with a mean age of 40.1±7.6 years. Apparently healthy volunteers consisted of 25 individuals who were their age range (21-50) years with a mean age of 33.4±9.1 years considered as control. Periodontal parameters used in this study were plaque index, gingival index, probing pocket depth, clinical attachment level and bleeding on probing. Blood samples were collected from CP patients and healthy control groups to assess serum concentrations of 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) were significantly higher in CP patients than in healthy control groups (p 0.05). In contrast serum levels of anti-inflammatory cytokines (IL-10) was significantly low in patients when compared to control (p<0.001). On the other hand, the ratios of IL-1β\IL-10 and TNF-α\IL-10 were significantly higher in patients when compared with the ratios in control group. Regarding correlation between serum cytokines and clinical periodontal parameters, serum IL-1β level was showed significant positive correlation with each of plaque index, gingival index, probing pocket depth and clinical attachment level. On the otherhand no association between serum IL-2 levels and clinical parameters of chronic periodontitis were found. Moreover; IL-6 was showed significant positive correlation with probing pocket depth, while TNF-α revealed significant positive association with each of gingival index, probing pocket depth and clinical attachment level. Conversely, serum IL-10 levels had negative significant correlation with plaque index, probing pocket 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 in periodontitis, and suggests that cytokines may play an important role in pro-inflammatory response in serum of patients with chronic periodontitis. Moreover imbalance between pro and anti-inflammatory cytokines could be involved in the initiation and progression of chronic periodontitis and is indicative of a stronger systemic pro-inflammatory state in disease.