Gingival Crevicular Fluid TNF-α Levels Research Articles

Expression of tight junction proteins in smokers and non-smokers with generalized Stage III periodontitis.

This study aims to evaluate the gingival crevicular fluid (GCF) levels of tumor necrosis factor-α (TNF-α), zonula occludens-1 (ZO-1), occludin (Occ), and tricellulin (Tric) in periodontitis, as well as their alterations due to smoking. Tight junctions (TJ), which consist of transmembrane and cytoplasmic scaffolding proteins, connect the epithelial cells of the periodontium. Occ, claudins, junctional adhesion molecules, and Tric are transmembrane TJ proteins found at the cell membrane. The transmembrane TJ proteins and the intracellular cytoskeleton are directly linked by cytoplasmic scaffolding proteins such as ZO-1. Although the functions and locations of these molecules have been defined, their behavior in periodontal inflammation is unknown. The study included four groups: individuals with periodontal health without smoking (C; n = 31), individuals with generalized Stage III periodontitis without smoking (P; n = 28), individuals with periodontal health while smoking (CS; n = 22), and individuals with generalized Stage III periodontitis while smoking (PS; n = 18). Clinical periodontal parameters were recorded, and enzyme-linked immunosorbent assay (ELISA) was used to examine ZO-1, Occ, Tric, and TNF-α levels in GCF. In the periodontitis groups, clinical parameters were significantly higher (p < .001). The site-specific levels of TNF-α, ZO-1, Tric, and Occ in the P group were statistically higher than those in the other groups (p < .05). TNF-α, probing pocket depth (PPD), and bleeding on probing (BOP) exhibited positive correlations with all TJ proteins (p < .005). Smoking could potentially affect the levels of epithelial TJ proteins in the GCF, thereby potentially playing a significant role in the pathogenesis of the periodontal disease.

Gingival crevicular fluid lipocalin-2 and semaphorin3A in stage III periodontitis: Non-surgical periodontal treatment effects.

Identification of biomarkers to assess individual risk and monitor periodontal health status is important. Research on lipocalin-2 (LCN2) and semaphorin3A (Sema3A) is lacking. This study aimed to evaluate gingival crevicular fluid (GCF) LCN2, Sema3A, and tumor necrosis factor-α (TNF-α) levels in periodontally healthy (H), gingivitis (G), and periodontitis (P) patients, and their changes following non-surgical periodontal therapy. Sixty systemically healthy and non-smoker participants, diagnosed as periodontally healthy, gingivitis, and stage III grade C periodontitis, were recruited (n=20/group). Clinical periodontal parameters were recorded and GCF samples were obtained at baseline from all groups; for group P, these were repeated one and three months following non-surgical periodontal treatment. GCF LCN2, Sema3A, and TNF-α levels were evaluated with enzyme-linked immunosorbent assay. GCF LCN2, Sema3A, and TNF-α total amounts were significantly higher in disease groups than group H (p<.001). Between P and G groups, only TNF-α levels were significantly different (p<.001). Non-surgical periodontal therapy resulted in significant improvement of all clinical parameters and significant decreases of GCF LCN2 and TNF-α levels, at both time points, compared with baseline (p<.001). Sema3A levels remained unchanged following treatment (p>.05). LCN2 and TNF-α levels were significantly positively correlated with clinical parameters. LCN2 (AUC [area under the curve]=0.94) and TNF-α (AUC=0.98) levels were similarly accurate in differentiating between periodontal disease (whether G or P) and healthy controls. LCN2 and TNF-α levels in GCF are correlated with clinical parameters and could prove useful as non-invasive screening tools for periodontitis.

Influence of Ceramic Lumineers on Inflammatory Periodontal Parameters and Gingival Crevicular Fluid IL-6 and TNF-α Levels—A Clinical Trial

The aim was to evaluate the effect of ceramic lumineers on inflammatory periodontal parameters, gingival crevicular fluid (GCF) flow rate and cytokine profile. Patients were provided with lumineers using standardized technique including minimal to no preparation. Ceramic lumineers were etched with hydrofluoric acid and teeth with phosphoric acid followed by adhesive cementation. Periodontal parameters (Plaque index (PI), bleeding on probing (BOP), periodontal pocket depth (PPD), and clinical attachment loss (CAL)) were recorded at baseline and after 4, 12, and 24 weeks of lumineer cementation. Assessment of GCF flow rate and levels of IL-6 and TNF-α was made using enzyme linked immunosorbent assay (ELISA). The statistical significance was determined by the t-test, analysis of variance and post hoc Tukey’s test. It was found that PI, BOP, PPD, and CAL at baseline and 24 weeks were comparable (p &gt; 0.05). The GCF volume at baseline was comparable to the GCF at week 24 (p &gt; 0.05). The IL-6 levels at baseline (5.4 ± 3.6) were similar to those at 24 week (7.4 ± 5.2) (p &gt; 0.05). The TNF-α at week 4 (65.3 ± 16.2), 12 (25 ± 10.2), and 24 (21.3 ± 7.6) was higher than the baseline (13.7 ± 5.8) (p &lt; 0.05). Clinical periodontal parameters and GCF volume among patients treated with ceramic lumineers at baseline and twenty-four week follow-up were comparable. The GCF TNF-α levels significantly increased after ceramic lumineer cementation at 24-week follow-up.

Estimation of Periostin and Tumour Necrosis Factor-α in Type II Diabetics with Chronic Periodontitis: A case-control study.

Background:Periostin, a matricellular protein, is downregulated in chronic inflammatory periodontal disease and is negatively modulated by tumor necrosis factor-α (TNF-α) in human periodontal fibroblast cell culture. The study aimed to estimate the gingival crevicular fluid (GCF) levels of periostin and TNF-α and to discern their relationship in chronic periodontitis (CP) individuals with and without Type II diabetes mellitus (DM).Materials and Methods:A total of 60 participants were divided into three groups, with 20 in each group. Group I – systemically and periodontally healthy, Group II – generalized CP, and Group III – generalized CP with Type II DM. Plaque index, gingival index, sulcular bleeding index, probing depth, and clinical attachment level were recorded. GCF periostin and TNF-α were quantified using the enzyme-linked immunosorbent assay.Results:Intergroup comparison was performed using the one-way ANOVA and Kruskal–Wallis. The relationship between the variables was analyzed using the Pearson's and Kendall's Tau correlation. The GCF periostin levels in Groups I, II, and III was 27.52 ± 2.39 ng/mL, 20.18 ± 1.42 ng/mL, and 16.77 ± 3.29 ng/mL, respectively. The GCF TNF-α levels in Groups I, II, and III was 92.41 ± 19.30 ng/L, 118.53 ± 21.93 ng/L, and 147.67 ± 16.35 ng/L, respectively. Periostin decreased, and TNF-α increased in periodontal disease; moreover, periostin level correlated negatively with all the site-specific clinical parameters whereas TNF-α positively correlated (P < 0.001).Conclusions:TNF-α strongly and negatively downregulates periostin in a chronically inflamed locale leading to compromised integrity of the periodontium.

Evaluation of Level of TNF-α in Chronic Periodontitis Patients with Gestational Diabetes Mellitus after Phase I Periodontal Therapy

Background: There is little number of studies that address the inter-relationship of gestational diabetes mellitus (GDM) and periodontitis during pregnancy. Hence, this study was conducted to provide further evidence in the possible association between chronic periodontitis and GDM by evaluating the level of Tumor necrosis factor-alpha (TNF-α) of chronic periodontitis patients with GDM after phase I periodontal therapy.Subjects and methods: This study was conducted on 40 subjects divided into 2 groups: 20 pregnant females suffering from gestational diabetes mellitus associated with moderate to severe chronic periodontitis and 20 systemically free pregnant females suffering from moderate to severe chronic periodontitis. The periodontal status of the subjects was assessed at baseline before phase I periodontal therapy and 2 months after completion of the treatment: All subjects have been screened by comprehensive periodontal examination and full periodontal charts were obtained. The following clinical parameters were assessed to determine the clinical periodontal status of patients: Plaque Index (PI), Gingival Index (GI), Probing Pocket Depth (PPD), and Clinical Attachment Level (CAL). Gingival crevicular fluid (GCF) and serum samples were collected from both study groups to detect TNF-α levels. Regarding the assessment of TNF-α, Real-time reverse-transcriptase Polymerase Chain Reaction (RT) PCR technique was used.Results: Results of the present study observed statistically significant reduction in TNF-α levels after 2 months from phase I periodontal therapy. The current study showed that, there was a statistically significant positive (direct) correlation between TNF-α level, PI, GI, PPD and CAL measurement at baseline and after 2 months from phase I periodontal therapy.Conclusion: It is shown that the levels of TNF-α in GCF and serum before treatment were higher in GDM group (group 1) than in the control group. Thus, the examination of TNF-α may enhance the understanding of pathogenesis of periodontitis and GDM and its assessment in the treatment process may result in better control of the disease.

Effects of vector ultrasonic system debridement and conventional instrumentation on the levels of TNF-α in gingival crevicular fluid of patients with chronic periodontitis.

Tumor necrosis factor alpha (TNF-α) is an inflammatory mediator whose levels are increased in the gingival crevicular fluid and blood serum in the case of chronic periodontitis. The aim of this study was to determine the effect of vector ultrasonic system (VUS) on the levels of TNF-α in gingival crevicular fluid (GCF) and the clinical parameters in patients with chronic periodontitis. The study protocol was conducted using split-mouth design in 30 patients with chronic periodontitis. VUS and scaling and root planing (S/RP) were applied separately to 2 quadrants, including the upper and the lower jaws. At baseline and after 6 months, clinical parameters including plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL) were recorded, and concentrations of TNF-α in GCF were determined by enzyme-linked immunosorbent assay (ELISA). Intergroup comparisons were evaluated by the independent Students' t-test, and the Pearson correlation was used to determine the relationship between parameters. The level of significance was set at 5%. Both treatment modalities provided statistically significant improvements in clinical periodontal parameters and TNF-α levels after 6 months (p < 0.05). Also, there were no significant correlations between the TNF-α levels in GCF and the clinical parameters in both treatment group at baseline and at the end of 6 months period (p > 0.05). The use of the vector ultrasonic system in the non-surgical treatment of chronic periodontitis presents beneficial improvements for the clinical attachment level and the probing pocket depth as well as TNF-α levels in GCF.

Fetuin-A, serum amyloid A and tumor necrosis factor alpha levels in periodontal health and disease.

This study is evaluating fetuin-A, serum amyloid A (SAA) and tumor necrosis factor alpha (TNF-α) levels in gingival crevicular fluid (GCF) and serum samples in periodontal health and disease. Sixty patients were divided into three groups: Group 1 periodontal health (n=20), Group 2 gingivitis (n=20) and Group 3 chronic periodontitis (CP) (n=20). GCF and serum samples were evaluated using enzyme-linked immunosorbent assay kit. SAA and TNF-α levels in GCF and serum were significantly higher in patients with gingivitis and CP compared with controls (P<0.016). Contrarily, fetuin-A levels in GCF and serum were significantly higher in controls than in patients with gingivitis and CP (P<0.016). In CP group, a significant correlation was observed between GCF-SAA amount and the number of sites with 4≤PPD≤5mm (P<0.05). There was a significant correlation between GCF-fetuin-A levels and the number of sites with PPD≥6mm (P<0.05). GCF-TNF-α was found to have a significant relationship with the number of sites with 4≤PPD≤5mm and PPD≥6mm (P<0.05). In conclusion, serum and total levels of SAA significantly increased, whereas fetuin-A levels significantly decreased, with increasing severity of PD.

Analysis of TNF-α (-308) polymorphism and gingival crevicular fluid TNF-α levels in aggressive and chronic periodontitis: A preliminary report

ObjectivesThe purpose of this study was to determine the differences in the distribution of TNF-α (-308) gene polymorphism among aggressive periodontitis, chronic periodontitis and periodontally healthy individuals and also to investigate whether this polymorphism is associated with gingival crevicular fluid TNF-α levels and periodontal disease severity. Material and methodsA total of 93 individuals were enrolled in the study including 38 aggressive periodontitis, 29 chronic periodontitis patients, and 26 healthy controls. Single nucleotide polymorphism at TNF-α (-308) is analyzed by PCR-RFLP method. Gingival crevicular fluid samples were analyzed for TNF-α, using ELISA. ResultsThe distribution of genotypes and allele frequencies for TNF-α (-308) were similar among the groups. After stratification of patients with respect to attachment level, aggressive periodontitis patients with clinical attachment level ⩾4mm was observed to have a higher frequency of TNF-α (-308) allele 2 compared to the chronic periodontitis patients with clinical attachment level ⩾4mm. No significant differences were found between the TNF-α levels of the different genotypes in spite of an insignificant increase in patient groups carrying TNF-α (-308) allele 2. ConclusionThe results of this study revealed an association between TNF-α (-308) allele 2 frequency and aggressive periodontitis patients with clinical attachment level ⩾4mm in the population studied.

The Effect of Scaling and Root Planing on Glycaemic Control, Periodontal Status and Gingival Crevicular Fluid TNF-α Levels in an Indian Population- To Reveal the Ambivalent Link.

Periodontal disease and diabetes mellitus(DM) share a two - way relationship. It can be hypothesized that successful management of periodontal infection in diabetes will lead not only to reduction of local signs and symptoms of the disease, but also to better control of glucose metabolism. To monitor the effect of Scaling and Root planing (SRP) on glycaemic control in patients with type 2 diabetes mellitus by estimating the HbA1c and GCF TNF-α levels. This Interventional clinicobiochemical study was carried out over a period of 6 months from December 2010-May 2011 in Bengaluru, Karnataka, India. Fifteen well-controlled, 15 moderately controlled and 15 poorly controlled diabetic subjects were enrolled in this study. All participants were subjected to non-surgical periodontal (SRP) therapy. GCF sampling and clinical periodontal parameters assessment were done at baseline and 3 months post-therapy. TNF-α levels in GCF were analyzed by enzyme-linked immunosorbent assay (ELISA) at baseline and 3 months post therapy. The improvement in glycaemic control was assessed using HbA1c levels at 3 months reevaluation. The data obtained were statistically analysed using Kruskal-Wallis test, Mann-Whitney test and Wilcoxon Signed Rank test. Following periodontal treatment, all patients demon- strated a significant improvement in periodontal status. A reduction in TNF-α level and the HbA1c values were also observed. The result indicates that SRP is effective in improving metabolic control in Type 2 Diabetes Mellitus patients possibly through the reduction of TNF-α which in turn might improve the insulin resistance.

Cytokine profile in the gingival crevicular fluid of rheumatoid arthritis patients with chronic periodontitis

The aim was to assess the cytokine profile in the gingival crevicular fluid (GCF) of rheumatoid arthritis (RA) patients with chronic periodontitis (CP). Databases were searched from 1991 to August 2013 using a combination of various keywords. Eight studies were included. The GCF concentrations of interleukin (IL)-1β, IL-4, IL-10, matrix metalloproteinase (MMP)-8, MMP-13 and tumor necrosis factor-alpha (TNF-α) were reported to be higher in patients with RA than in healthy controls (HC) without CP. In one study, TNF-α levels in GCF were significantly higher in HC than in RA patients receiving anti-TNF-α therapy. One study reported no significant difference in GCF TNF-α levels among RA patients and HC regardless of anti-TNF-α therapy. One study reported no difference in IL-1β and prostaglandin E2 levels among RA patients and HC with CP. Raised levels of proinflammatory cytokines are exhibited in the GCF of RA patients with CP.

Periodontal Condition of Patients With Autoimmune Diseases and the Effect of Anti‐Tumor Necrosis Factor‐α Therapy

The aim of this study is to evaluate the effect of autoimmune diseases (AIs), as well as anti-tumor necrosis factor-α (TNF-α) therapy on the clinical and immunologic parameters of the periodontium. Thirty-six AI patients (12 rheumatoid arthritis [RA], 12 psoriatic arthritis, and 12 systemic sclerosis) were recruited together with 12 healthy (H) and 10 RA patients receiving anti-TNF-α therapy (RA+). Periodontal indices including plaque index, gingival index (GI), probing depth (PD), and bleeding on probing (BOP) were measured, and gingival crevicular fluid (GCF) was collected from five deepest pockets using papers strips. The TNF-α level was analyzed using enzyme-linked immunosorbent assay. Analysis of variance test was used for statistical comparison between groups, whereas Pearson linear correlation coefficient test was used to examine the association between TNF-α and periodontal status indices. The three AI subgroups were very similar in clinical and immunologic parameters. GI was greater in the AI patients compared to the H and RA+ groups (1.91 ± 0.54, 1.21 ± 0.67, and 1.45 ± 0.30, respectively, P = 0.0005). AI patients exhibited significantly more BOP than H and RA+ (46.45% ± 17.08%, 30.08% ± 16.86%, and 21.13% ± 9.51%, respectively, P = 0.0002). PD in H and RA+ groups were lower than in the AI (3.47 ± 0.33, 3.22 ± 0.41, and 3.91 ± 0.49 mm, P = 0.0001). Number of sites with PD >4 mm was higher in AI patients compared to H and RA+ (42.44 ± 17.5 versus 24.33 ± 15.62 versus 33.3 ± 6.6, P = 0.0002). GCF TNF-α was higher among the AI patients (1.67 ± 0.58 ng/site) compared to 1.07 ± 0.33 ng/site for the H group and 0.97 ± 0.52 ng/site for the RA+ group (P = 0.0002). A significant positive correlation was found between PD and TNF-α levels in the GCF (r = 0.4672, P = 0.0002), BOP (r = 0.7491, P = 0.0001), and GI (r = 0.5420, P = 0.0001). Patients with AI diseases have higher periodontal indices and higher TNF-α levels in GCF than H controls. Anti-TNF-α treatment appears to reverse this phenomenon.

Human β-defensin 2 and protease activated receptor-2 expression in patients with chronic periodontitis

ObjectiveSome previous studies have shown that gingipains, trypsin-like proteases produced by Porphyromonas gingivalis, up-regulate human β defensin-2 (HBD-2) mRNA expression through protease-activated receptor-2 (PAR2) in gingival epithelial cells. This study aimed at investigating salivary HBD-2 levels and crevicular PAR2 mRNA expression in human chronic periodontitis and evaluating whether periodontal treatment affected this process. MethodsSalivary and gingival crevicular fluid (GCF) samples were collected from periodontally healthy (control) and chronic periodontitis patients at baseline and 50 days after non-surgical periodontal treatment. Salivary HBD-2, and GCF TNF-α levels were analysed by ELISA, and PAR2 mRNA at the GCF was evaluated by RT-PCR. ResultsP. gingivalis was significantly (p<0.05) more prevalent in patients with chronic periodontitis when compared to controls. This prevalence decreased after periodontal therapy (p<0.0001). The control group showed statistically significant lower levels of HBD-2, TNF-α, and PAR2 expression when compared to the chronic periodontitis group. In addition, periodontal treatment significantly reduced PAR2 expression and HBD-2 levels in chronic periodontitis patients (p<0.001). ConclusionsOur results suggest that salivary HBD-2 levels and PAR2 mRNA expression from GCF are higher in subjects with chronic periodontitis than in healthy subjects, and that periodontal treatment decreases both HBD-2 levels and PAR2 expression.

Proinflammatory cytokine levels in hyperlipidemic patients with periodontitis after periodontal treatment

The aim of this study was to evaluate the effects of periodontal treatment on serum and gingival crevicular fluid (GCF) proinflammatory cytokine levels in hyperlipidemic patients with periodontitis. Fifty-two patients with hyperlipidemia and periodontitis and 28 systemically healthy controls with periodontitis (C) were included in the study. Hyperlipidemic groups were divided into two groups as suggested diet (HD) and prescribed statin (HS). The clinical periodontal parameters, fasting venous blood, and GCF samples were obtained, and serum tumor necrosis factor-alpha (TNF-α), interleukin (IL) 1-beta, and IL-6 levels were evaluated at baseline and at 3 months follow-up (3MFU) after the completion of the non-surgical periodontal treatment that included scaling and root planning. Percentage of bleeding on probing was significantly higher in the HS group than both the HD and C groups. In the HD and HS groups, there were significant decreases in serum IL-6 and GCF TNF-α levels between the 3MFU and baseline. A significant decrease was also found in GCF IL-6 at the end of the study period in the HS group. The combination of the periodontal therapy and antilipemic treatment may provide beneficial effects on the metabolic and inflammatory control of hyperlipidemia.

Asociación entre niveles de TNF-α en fluido crevicular gingival de dientes con periodontitis apical asintomática

IntroductionAs a consequence of septic pulp necrosis, the entry of bacterial products into periapical tissues induces the release of pro-inflammatory cytokines, such as the tumor necrosis factor (TNF)-α. This pleiotropic cytokine is involved in the differentiation and activation of osteoclasts to induce bone resorption, a hallmark of asymptomatic apical periodontitis (AAP). Gingival crevicular fluid (GCF) has a great potential as a source of factors associated with osteoclastic activity. The aim of this study was to determine the levels of TNF-α in GCF of teeth with PAA and contralateral healthy controls. MethodsA total of 14 patients with clinical diagnosis of AAP were enrolled from the Clinic of Endodontics, Faculty of Dentistry, Universidad de Chile during 2009 and 30-second GCF samples were obtained with paper strips from AAP teeth and contralateral healthy controls. Total protein concentration and TNF-α levels were determined through bisciconitic acid method and ELISA assay, respectively. Paired t test and StataV11 software were used for statistical analysis. ResultsLevels of TNF-α were significantly higher in GCF from teeth with AAP than controls when standardized by either 30s of sampling and total protein content. ConclusionsThe present study provides preliminary data supporting that TNF-α levels in GCF reflect periapical status. Screening of TNF-α levels in GCF might represent a useful side-diagnostic tool to the monitoring of the apical status.