Avaliação da influência do tabagismo no desenvolvimento da periodontite apical em ratos wistar / Evaluation of smoking influence on the development of apical periodontitis in wistar rats

A infecção endodôntica ocorre a após contaminação do tecido pulpar levando à uma colonização bacteriana dos canais radiculares resultando em uma resposta inflamatória dos tecidos periapicais e formação de uma lesão periapical, a periodontite apical (PA). O tabagismo, por sua vez, tem impactos prejudiciais à saúde oral e sistêmica sendo considerado um importante fator de risco para as doenças periodontais. Este trabalho tem por finalidade investigar a influência do tabagismo no desenvolvimento da periodontite apical em ratos. Trinta e dois ratos machos Wistar foram divididos em 4 grupos experimentais (n=8): Controle (sem periodontite apical induzida e sem inalação da fumaça do cigarro); FU (com inalação a fumaça do cigarro); PA (com periodontite apical induzida); FU+PA (com inalação a fumaça do cigarro e periodontite apical induzida). Para a inalar a fumaça do cigarro, grupo de cinco animais permaneceram em uma câmara de tabagismo inalando a fumaça de 10 cigarros por 8 minutos, três vezes ao dia, durante 50 dias. Decorridos 20 dias de inalação de fumaça do cigarro, foi realizada a cirurgia para indução da periodontite apical nos animais do grupo PA e FU+PA, no primeiro molar inferior direto, o qual permaneceu aberto na cavidade bucal por 30 dias. Nesses 30 dias subsequentes da indução da PA, os animais do grupo FU+PA e FU continuaram com a inalação a fumaça do cigarro. No 50º dia, os animais foram eutanasiados e coletados amostras de tecido hematológico para avalição dos níveis séricos de nicotina, cotinina, fosfatase alcalina, cálcio, fósforo, série vermelha e série branca. As hemimandibula removidas foram escaneadas em microtomógrafo para avaliar o volume da destruição óssea e processadas histologicamente para avaliação do perfil inflamatório e expressão das citocinas IL-6, IL-1ß, TNF-α e dos marcadores do metabolismo ósseo RANKL e OPG. Os dados foram tabulados e aplicados os testes estatísticos de Mann-Whitney para os dados não paramétricos e teste t para os dados paramétricos, a um nível de significância de P< 0.05. Com relação a análise histológica o grupo FU+PA apresentou infiltrado inflamatório mais intenso em relação aos demais grupos (P< 0,05). As citocinas pró-inflamatórias IL-6, IL-1ß, TNF-α apresentaram alto padrão de imunomarcação para o grupo FU+PA (P< 0,05). A análise histométrica mostrou maior área de reabsorção óssea no grupo FU+PA, assim como na análise microtomográfica (P< 0,05). As citocinas RANKL esteve mais expressa no grupo FU+PA (P< 0,05) e OPG teve maior expressão no grupo PA (P< 0,05). Na análise hematológica houve um aumento na concentração de hemácias, hemoglobina e leucócitos para o FU+PA (P< 0,05). Os níveis séricos de cálcio foram menores no FU+PA (P> 0,05), a fosfatase alcalina e o cálcio se manteve constante em todos os grupos experimentais (P> 0,05). A concentração sérica de nicotina e cotinina no grupo FU e FU+PA foram compatíveis com fumante humano(AU)

Endodontic infection occurs mainly after pulp tissue contamination by a carious process, leading to bacterial colonization of root canal system and inflammatory response of periapical tissues, followed by formation of apical periodontitis (AP). It is widely known that smoking has harmful impacts on oral and systemic health and is considered a risk factor for periodontal diseases. The objective of this research was to investigate the influence of smoking on the development of AP in rats. Thirty-two male Wistar rats were divided into 4 experimental groups (n = 8): C - Control (no induced AP and no cigarette smoke inhalation); CSI (cigarette smoke inhalation); AP (induced apical periodontitis); CSI + AP (cigarette smoke inhalation and induced apical periodontitis). To inhale cigarette smoke, group with five animals remained in a smoking chamber inhaling smoke from 10 cigarettes for 8 minutes, three times daily, for 50 days. After 20 days of cigarette smoke inhalation, pulp chamber access was performed to induce apical periodontitis in the first mandibular right molar, which remained with pulp chamber exposed to oral cavity for 30 days in animals in the AP and CSI + AP group. During these 30 days after the AP induction, animals in the CSI + AP and CSI group continued to inhale cigarette smoke. On the 50th day, animals were euthanized and blood sample collected to assess serum levels of nicotine, cotinine, alkaline phosphatase, calcium, phosphorus, red series and white series. The hemimandibles were removed and scanned in microtomograph to assess bone volume and histologically processed to assess inflammatory profile and expression of cytokines IL-6, IL-1ß, TNF-α and bone metabolism markers RANKL and OPG. Data were tabulated and statistically analyzed using Mann-Whitney tests for nonparametric data and analysis of variation test for parametric data, with a significance level of P< 0.05. Regarding histological analysis, CSI+AP group showed more intense inflammatory infiltrate compared to other groups (P < 0.05). Histometric analysis showed a larger area of bone resorption in the CSI + AP group, also observed in the microtomographic analysis (P< 0.05). Group CSI+AP had elevated pro-inflammatory cytokines IL-6, IL-1ß, TNF-α expression (P< 0.05). The RANKL cytokines were also more expressed in the CSI+AP group (P< 0.05), while OPG was more expressed in the AP group (P< 0.05). The hematological analysis revealed an increase in the concentration of red blood cells, hemoglobin, and leukocytes for CSI+AP (P< 0.05). Serum calcium levels were lower in CSI+AP (P> 0.05), and alkaline phosphatase and calcium remained constant in all experimental groups (P> 0.05). The serum concentrations of nicotine and cotinine in the CSI and CSI+AP group were compatible with human smokers(AU)

Cytotoxicity, inflammation, biomineralization, and immunoexpression of IL-1β and TNF-α promoted by a new bioceramic cement

Abstract Aim To evaluate the cytotoxicity, biocompatibility and mineralization capacity of BIO-C PULPO, and MTA. Methodology L929 fibroblasts were cultured and MTT assay was used to determine the material cytotoxicity on 6, 24, and 48 h. A total of 30 male rats (Wistar) aged between 4 and 6 months, weighing between 250 and 300 g were used. Polyethylene tubes containing BIO-C PULPO, MTA, and empty tubes were implanted into dorsal connective tissue. After the experimental periods (7, 15, 30, 60, and 90 days) the tubes were histologically analyzed using hematoxylin-eosin (H&E), immunolabeling of IL-1β and TNF-α, and von Kossa staining, or without staining for polarized light analysis. The average number of inflammatory cells was quantified; the mineralization assessment was determined by the area marked in μm2 and semiquantitative immunolabeling analyses of IL-1β and TNF-α were performed. Then, data underwent statistical analysis with a 5% significance level. Results It was observed that BIO-C PULPO and MTA presented cytocompatibility at 6, 24, and 48 similar or higher than control for all evaluated period. On periods 7 and 15 days, BIO-C PULPO was the material with the highest number of inflammatory cells (p<0.05). On periods 30, 60, and 90 days, BIO-C PULPO and MTA presented similar inflammatory reactions (p>0.05). No statistical differences were found between Control, BIO-C PULPO, and MTA for immunolabeling of IL-1β and TNF-α in the different periods of analysis (p<0.05). Positive von Kossa staining and birefringent structures under polarized light were observed in all analyzed periods in contact with both materials, but larger mineralization area was found with BIO-C PULPO on day 90 (p<0.05). Conclusion BIO-C PULPO was biocompatible and induced mineralization similar to MTA.

Efeito da fibrose hepática sobre a severidade da periodontite apical: análise histológica e imunoistoquímica em ratos / Effect of liver fibrosis on the severity of apical periodontitis: histological and immunohistochemical analysis in rats

A inter-relação das alterações sistêmicas com o desenvolvimento e progressão de infecções orais como a periodontite apical tem sido objeto de intensos estudos nos últimos anos. O objetivo deste trabalho foi verificar a influência da fibrose hepática (FH) na severidade da periodontite apical (PA) em ratos Wistar. Quarenta ratos foram divididos em 4 grupos (n=10): Grupo C - ratos controle; Grupo PA - ratos portadores de PA; Grupo FH - ratos portadores de FH; Grupo PA+FH - ratos portadores de PA e FH. A FH foi induzida pelos métodos químico e cirúrgico associados. Foi administrado Tetracloreto de Carbono (CCl4) na dosagem de 0,2ml/100g de peso corporal, 2 vezes por semana, via intraperitoneal, e durante todo o experimento (60 dias). Após 30 dias do início da administração da droga, os animais foram submetidos à cirurgia de ligadura do ducto biliar. Em seguida, as a polpa dentária dos primeiros e segundos molares superiores e inferiores direito foram expostas pelo período de 30 dias para desenvolvimento da PA. Ao final do experimento os animais foram eutanaziados e as maxilas, assim como os fígados, coletados para análise em microscopia de luz. O tecido hepático foi analisado em coloração de hematoxilina e eosina (H&E) e Picrosírius red para comprovar a fibrose hepática e as maxilas processadas para análise histológica, histométrica e imunoistoquímica para IL-1ß, IL-6, e TNFα. Os resultados obtidos foram analisados e comparados por testes estatísticos específicos para cada caso com nível de significância de 5% (p < 0.05). A FH foi confirmada pela análise histológica dos fígados nos grupos FH e PA+FH que apresentaram hepatócitos necrosados, desorganização vascular e intensa deposição de colágeno no parênquima hepático, formando pontes de fibrose. Quanto à periodontite apical observou-se infiltrado inflamatório moderado no grupo PA e intenso no PA+FH (p < 0.05). A análise histométrica mostrou maiores áreas de reabsorção óssea periapical no grupo PA+FH em comparação ao grupo PA (p < 0.05). A análise imunoistoquímica revelou maior imunomarcação para citocinas IL-1ß, IL-6 e TNF-α no grupo PA+FH quando comparado ao grupo PA (p < 0.05). Conclui-se que a FH influencia na severidade da periodontite apical, exacerbando o infiltrado inflamatório, por meio do aumento das citocinas IL-1ß, IL-6 e TNF-α, e aumentando a reabsorção óssea periapical(AU)

The interrelationship between systemic disorders and oral infections such as apical periodontitis has been the subject of intense studies in recent years. The aim of this study was to evaluate the influence of liver fibrosis (LF) on the severity of apical periodontitis (AP) in Wistar rats. Forty rats were divided into 4 groups (n=10): Group C - control rats; AP group - rats with AP; LF Group - rats with LF; AP+LF Group - rats with AP and LF. LF was induced by the association of chemical and surgical methods. Carbon tetrachloride (CCl4) was administered at a dosage of 0.2ml/100g of body weight, twice a week, intraperitoneally, and throughout the experiment (60 days). After 30 days from the beginning of the drug administration, the animals were submitted to bile duct ligation surgery and the dental pulps of the first and second right maxillary and mandibular molars were exposed to induce AP in a period of 30 days. At the end of the experiment, the animals were killed and the jaws, as well as the livers, were collected for analysis under light microscopy. The liver tissue was analyzed in Hematoxilin and Eosin (H&E) and Picrosírius red staining to confirm the liver fibrosis. The jaws were processed for histological, histometric and immunohistochemical analysis for IL1ß, IL-6, and TNF-α. The results obtained were analyzed and compared by specific statistical tests (p < 0.05). LF was confirmed by histological analysis of the liver in the LF and AP+LF groups, which presented necrotic hepatocytes, vascular disorganization and intense collagen deposition in the liver parenchyma, forming fibrosis bridges. A moderate inflammatory infiltrate was observed, in the AP group and intense in the AP+LF (p < 0.05). Histometric analysis showed greater areas of periapical bone resorption in the AP+LF group compared to the AP group (p < 0.05). The immunohistochemical analysis revealed greater immunolabeling for cytokines IL-1ß, IL-6 and TNF-α in the AP+LF group when compared to the AP group (p < 0.05). It is concluded that LF influences on the severity of apical periodontitis, exacerbating the inflammatory infiltrate, by increasing the cytokines IL-1ß, IL-6 and TNF-α, and intensifying the periapical bone resorption(AU)

Effects of MTA and Brazilian propolis on the biological properties of dental pulp cells

Abstract: The aim of this study was to evaluate the effect of mineral trioxide aggregate (MTA) and Brazilian propolis on the cell viability, mineralization, anti-inflammatory ability, and migration of human dental pulp cells (hDPCs). The cell viability was evaluated with CCK-8 kit after 1, 5, 7, and 9 days. The deposition of calcified matrix and the expression of osteogenesis-related genes were evaluated by Alizarin Red staining and real-time PCR after incubation in osteogenic medium for 21 days. The expression of inflammation-related genes in cells was determined after exposure to 1 μg/mL LPS for 3 h. Finally, the numbers of cells that migrated through the permeable membranes were compared during 15 h. Propolis and MTA significantly increased the viability of hDPCscompared to the control group on days 7 and 9. In the propolis group, significant enhancement of osteogenic potential and suppressed expression of IL-1β and IL-6 was observed after LPS exposure compared to the MTA and control groups. The number of migration cells in the propolis group was similar to that of the control group, while MTA significantly promoted cell migration. Propolis showed comparable cell viability to that of MTA and exhibited significantly higher anti-inflammatory and mineralization promotion effects on hDPCs.

Gliclazide reduced oxidative stress, inflammation, and bone loss in an experimental periodontal disease model

Abstract Objective The aim of this study was to evaluate the effects of gliclazide on oxidative stress, inflammation, and bone loss in an experimental periodontal disease model. Material and Methods Male albino Wistar rats were divided into no ligature, ligature, and ligature with 1, 5, and 10 mg/kg gliclazide groups. Maxillae were fixed and scanned using micro-computed tomography to quantify linear and bone volume/tissue volume (BV/TV) and volumetric bone loss. Histopathological, immunohistochemical and immunofluorescence analyses were conducted to examine matrix metalloproteinase-2 (MMP-2), cyclooxygenase 2 (COX-2), cathepsin K, members of the receptor activator of the nuclear factor kappa-Β ligand (RANKL), receptor activator of nuclear factor kappa-Β (RANK), osteoprotegerin (OPG) pathway, macrophage migration inhibitory factor (MIF), superoxide dismutase-1 (SOD-1), glutathione peroxidase-1 (GPx-1), NFKB p 50 (Cytoplasm), NFKB p50 NLS (nuclear localization signal), PI3 kinase and AKT staining. Myeloperoxidase activity, malondialdehyde and glutathione levels, while interleukin-1 beta (IL-1β) and tumor necrosis factor-alpha (TNF-α) levels were evaluated by spectroscopic ultraviolet-visible analysis. A quantitative reverse transcription polymerase chain reaction was used to quantify the gene expression of the nuclear factor kappa B p50 subunit (NF-κB p50), phosphoinositide 3-kinase (PI3k), protein kinase B (AKT), and F4/80. Results Micro-computed tomography showed that the 1 mg/kg gliclazide treatment reduced linear bone loss compared to the ligature, 5 mg/kg gliclazide, and 10 mg/kg gliclazide treatments. All concentrations of gliclazide increased bone volume/tissue volume (BV/TV) compared to the ligature group. Treatment with 1 mg/kg gliclazide reduced myeloperoxidase activity, malondialdehyde, IL-1β, and TNF-α levels (p≤0.05), and resulted in weak staining for COX-2, cathepsin k, MMP-2, RANK, RANKL, SOD-1, GPx-1,MIF and PI3k. In addition, down-regulation of NF-κB p50, PI3k, AKT, and F4/80 were observed, and OPG staining was strong after the 1 mg/kg gliclazide treatment. Conclusions This treatment decreased neutrophil and macrophage migration, decreased the inflammatory response, and decreased bone loss in rats with ligature-induced periodontitis.

Effects of 1, 25-dihydroxyvitamin D3 on experimental periodontitis and AhR/NF-κB/NLRP3 inflammasome pathway in a mouse model

Abstract Vitamin D has been known to have important regulatory functions in inflammation and immune response and shows inhibitory effects on experimental periodontitis in animal models. However, the potential mechanism has yet to be clarified. Recent studies have highlighted Aryl hydrocarbon receptor (AhR) and its downstream signaling as a crucial regulator of immune homeostasis and inflammatory regulation. Objective: This study aimed to clarify the effect of 1,25-dihydroxyvitamin D3 (VD3) on experimental periodontitis and AhR/nuclear factor-κB (NF-κB)/NLR pyrin domain-containing 3 (NLRP3) inflammasome pathway in the gingival epithelium in a murine model. Methodology: We induced periodontitis in male C57BL/6 wild-type mice by oral inoculation of Porphyromonas gingivalis (P. gingivalis), and subsequently gave intraperitoneal VD3 injection to the mice every other day for 8 weeks. Afterwards, we examined the alveolar bone using scanning electron microscopy (SEM) and detected the gingival epithelial protein using western blot analysis and immunohistochemical staining. Results: SEM images demonstrated that alveolar bone loss was reduced in the periodontitis mouse model after VD3 supplementation. Western blot analyses and immunohistochemical staining of the gingival epithelium showed that the expression of vitamin D receptor, AhR and its downstream cytochrome P450 1A1 were enhanced upon VD3 application. Additionally, VD3 decreased NF-κB p65 phosphorylation, and NLRP3, apoptosis-associated speck-like protein, caspase-1, interleukin-1β (IL-1β) and IL-6 protein expression. Conclusions: These results implicate the alleviation of periodontitis and the alteration of AhR/NF-κB/NLRP3 inflammasome pathway by VD3 in the mouse model. The attenuation of this periodontal disease may correlate with the regulation of AhR/NF-κB/NLRP3 inflammasome pathway by VD3.

Análise da associação entre a periodontite e polimorfismos de nucleotídeo único da interleucina-1beta / Analysis of the association between periodontitis and interleukin-1beta single nucleotide polymorphisms

A periodontite é uma doença inflamatória, que pode ser classificada em Periodontite Crônica (PC) ou Periodontite Agressiva (PA), desencadeada por um desequilíbrio na microbiota subgengival, que pode ser influenciado por diversos fatores, como polimorfismos genéticos. Dessa forma, o objetivo deste trabalho foi analisar, através de uma revisão da literatura, se há ou não associação entre a periodontite e polimorfismos genéticos de nucleotídeo único (SNPs). Os genes IL1B +3954(3), -511, -31 foram os alvos desta pesquisa, por serem os mais estudados e apresentarem boa plausibilidade biológica. Foi realizada uma busca no PubMed e ao final 24 artigos de estudos casos-controle foram selecionados. Na maioria dos estudos não foi encontrada associação positiva entre os SNPs +3954(3), -511, -31 da IL1B e a PA ou PC. Dessa forma, é possível concluir que não há associação positiva entre a periodontite e os SNPs IL1B +3954(3), -511, -31 e PA e PC. Todavia os resultados devem ser analisados com cautela, pois os estudos apresentam limitações. (AU)

Periodontitis is an inflammatory disease which is classified as chronic periodontitis (PC) or aggressive periodontitis (PA) and is initiated by an unbalance in subgengival microbiota which for their part can be influenced by a lot of factors, such as genetic polymorphism. Therefore, the aim of this study was to analyse if there is an association between periodontitis and single nucleotide polymorphisms (SNPs). The genes IL1B +3954(3), -511, -31 were chosen as the targets of this literature review, because they have good biologic plausibility and are the most studied in literature. A search was conducted on PubMed and the results analysed and 24 case-controls articles were chosen.Most of the studies did not find a positive association between the ILB1 SNPs +3954(3), -511, -31 and PA e PC. Therefore, the case-controls studies indicated that there is no positive association between SNPs IL1B +3954(3), -511, -31 and PA or PC. However, the results of this work must be analysed carefully as the studies used have limitations. (AU)

In-office tooth bleaching with 38% hydrogen peroxide promotes moderate/severe pulp inflammation and production of ll-1ß, TNF-ß, GPX, FGF-2 and osteocalcin in rats

Abstract Objectives: To study the intensity of inflammatory infiltrate and production of interleukin-1β (ll-1β), tumor necrosis factor-β (TNF-β), fibroblast growth factor-2 (FGF-2), glutathione peroxidase (GPX), and osteocalcin in response to in-office tooth bleaching in rats. Material and Methods: Twenty male Wistar rats were randomized into four groups (n=5) according to the received treatment (tooth bleaching or no treatment - control) and the period of euthanasia after treatment (24 h or 10 days). We performed tooth bleaching using a 38% hydrogen peroxide gel on maxillary and mandibular incisors. After euthanasia, incisors (20 per group) were processed for histological analysis, immunohistochemistry staining of ll-1β, TNF-β, FGF-2 and GPX and osteocalcin by immunofluorescence. We analyzed data using the Mann-Whitney and Kruskal-Wallis/Dunn tests (p<0.05). Results: The bleached groups presented statistically significant differences regarding the pulp inflammation stage compared with the control groups. Bleached teeth showed moderate/severe inflammatory infiltrate and control groups presented absent inflammatory cells or a negligible number of mononuclear cells (p<0.001) at two times (24 h and 10 days). There was strong staining for ll-1β, TNF-β, and GPX in bleached groups at 24 h and strong staining for ll-1β, TNF-β, GPX and FGF-2 at 10 days. After 10 days of tooth bleaching, the bleached group showed a statistically superior amount of osteocalcin than the other groups (p<0.01). Conclusions: Tooth bleaching with 38% hydrogen peroxide causes severe pulp inflammation, but characteristics of tissue repair after 10 days.

Effect of non-surgical periodontal therapy on the degree of gingival inflammation and stress markers related to pregnancy

Abstract Objectives The purpose of this study was to determine the impact of nonsurgical periodontal therapy considering the salivary stress-related hormone and cytokine levels in the gingival crevicular fluid (GCF) on pregnant and nonpregnant women. Material and Methods Thirty non-pregnant (control group) and 30 pregnant women (test group) that met the study inclusion criteria were chosen. Only participants with gingivitis were included. Clinical data and samples of GCF and saliva were collected at baseline and after periodontal therapy. The levels of interleukin-1 beta (Κ-1β) and IL-10, and concentration of salivary chromogranin A (CgA) hormone were analyzed by enzyme-linked immunosorbent assay (ELISA). The repeated measures analysis of variance was used for intragroup and intergroup analyses. Results A major decrease in the gingival inflammation was observed in both groups after periodontal therapy (p<0.05). Periodontal treatment decreased the level of IL-1β in GCF (p<0.05) in control group, but no statistical difference was determined for GCF IL-1β in the test group. However, after periodontal therapy, the CgA hormone concentration was reduced in both groups (p<0.05). However, there was no difference in salivary CgA concentration, GCF IL-10 levels, and perceived stress scale (PSS)-10 between the groups (p>0.05). Conclusions Within the limitations of this study, periodontal therapy significantly improved the periodontal status and stress level. In addition, the severity of the gingival inflammation during pregnancy was related to stress. However, further studies will be needed to substantiate these early findings.

Microbiological, lipid and immunological profiles in children with gingivitis and type 1 diabetes mellitus

Abstract Objective The aim of this study was to compare the prevalence of periodontal pathogens, systemic inflammatory mediators and lipid profiles in type 1 diabetes children (DM) with those observed in children without diabetes (NDM), both with gingivitis. Material and methods Twenty-four DM children and twenty-seven NDM controls were evaluated. The periodontal status, glycemic and lipid profiles were determined for both groups. Subgingival samples of periodontal sites were collected to determine the prevalence of periodontal microorganisms by PCR. Blood samples were collected for IL-1-β, TNF-α and IL-6 analysis using ELISA kits. Results Periodontal conditions of DM and NDM patients were similar, without statistical differences in periodontal indices. When considering patients with gingivitis, all lipid parameters evaluated were highest in the DM group; Capnocytophaga sputigena and Capnocytophaga ochracea were more prevalent in the periodontal sites of DM children. “Red complex” bacteria were detected in few sites of DM and NDM groups. Fusobacterium nucleatum and Campylobacter rectus were frequently found in both groups. Similar levels of IL-1-β, TNF-α and IL-6 were detected in DM and NDM children. Conclusion Clinical and immunological profiles are similar between DM and NDM children. The presence of Capnocytophaga sputigena and Capnocytophaga ochracea were associated with gingivitis in DM children.

Verificação genotípica do polimorfismo rs1143634 do gene il1b em indivíduos com a doença periodontal crônica / Genotypic Verification rs1143634 polymorphism IL1B gene in Individuals with Chronic Periodontal Disease

O objetivo desta pesquisa foi verificar a frequência do polimorfismo rs1143634 do gene IL1B em indivíduos com a doença periodontal crônica (DPC) e a relação do mesmo com o risco de afecção. Foram analisadas 39 amostras de um grupo de indivíduos diagnosticados com DPC, sendo 77% com nível leve, 21% com o nível moderado e 3% com o nível severo, apresentando uma média de idade de 43,26. Durante o estudo foram utilizadas as técnicas de PCR e RFLP para o rastreamento do SNP (Do Inglês, Single nucleotide polymorphism - Polimorfismo de Núcleotídeo Único) rs1143634, verificando-se diferenças significativas (p<0,0001) e uma redução absoluta de risco de 53,8% referente à presença do alelo C, indicando o alelo T como um fator de risco. No entanto, este resultado também sugere a possibilidade da participação de outros fatores, uma vez que a redução obtida foi pouco acima de 50%, e deste modo, poderia apontar para o envolvimento de elementos relacionados aos hábitos de vida (higiene bucal, tabagismo e etilismo) e/ou outros aspectos genéticos, considerando que o gene IL1B entre outros mediadores implicados com a patogênese da DPC possuem várias regiões polimórficas.(AU)

The current work aimed to determine the allelic frequency regarding the SNP rs1143634 in the IL1B gene of individuals with chronic periodontal disease (CPD) and the potential to predict the relative risk for the condition. Thus, 39 patients, with a mean age of 43.26, diagnosed with CPD were clinically distributed according the level of disease in low level (77%), moderate (21%), and severe (3%). In order to genotype the SNP, PCR and RFLP methodologies were used. Allele C in rs1143634 was related to an absolute relative risk reduction of 53.8%, showing statistically significant difference (p<0,0001) On the other hand, the presence of T in rs1143634 can be considered a risk factor for CPD. Additional to the results from the current study, the participation of other factors, since reduction obtained was slightly above 50%, suggested to involvement others elements including and life style (oral hygiene, smoking, and alcoholism) and the genetic risk when considering the roll of IL1B gene in the pathogenesis of CPD.(AU)

The effect of hippophae rhamnoides extract on oral mucositis induced in rats with methotrexate

ABSTRACT Objective: To investigate the effect of HRE (Hippophae rhamnoides extract) on oral mucositis induced in rats with MTX. Material and Methods: Experimental animals were divided into groups as healthy (HG), HRE+MTX (HMTX), and control group, which received MTX (MTXC). HMTX group received 50 mg/kg HRE while MTXC and HG groups received equivolume distilled water with gavage once a day. After one hour of HRE and distilled water administration, HMTX and MTXC groups received a single dose of oral MTX 5 mg/ kg. This procedure was repeated for one month. Results: The levels of MDA, IL-1β, and TNF-α were found to be significantly higher in the cheek, lower lip, and tongue tissue of the animals receiving MTX, compared with HG and HMTX groups; however, these parameters were lower in the cheek and low lip tissue, and a milder damage ocurred in these tissues, compared with the tongue tissue in MTXC group. No histopathologic damage was observed in the cheek, lower lip, and tongue tissues of the rats treated with HRE. Conclusion: This findings indicate that HRE as a natural product is an important advantage compared with synthetic drugs for prophylaxis of oral mucositis developed due to MTX.

Avaliação dos eixos ECA / ANG II / AT1 e ECA-2 / ANG (1-7) / MAS em fibroblastos de gengiva e ligamento periodontal humanos estimulados por IL-1ß e sua contribuição na produção e regulação de citocinas e quimiocinas / Evaluation ACE /ANG II /AT1 and ACE-2 /ANG (1-7) /MAS axis in gingival and periodontal ligament human fibroblasts stimulated with IL-1ß and its contribution in the production of cytokines and chemokines

O Sistema renina-angiotensina (SRA) tem sido relatado como um importante modulador de processos inflamatórios e imunológicos, incluindo a doença periodontal (DP). Estudos sugerem neste sistema um eixo alternativo (ECA-2 /ANG(1-7) /MAS) que atuaria como um contra-regulador de efeitos mediados pelo clássico eixo (ECA /ANGII /AT1). Sabe-se que bactérias periodontopatogênicas, como a Porphyromonas gingivalis (Pg), possuem componentes bioativos de membrana (ex. lipopolissacarídeos-LPS) capazes de induzir uma forte resposta imune no hospedeiro devido à liberação de citocinas nas células, entre elas Interleucina (IL)- 1ß. Neste contexto, fibroblastos são as células mais abundantes nos tecidos periodontais e possuem em sua superfície celular receptores necessários para o reconhecimento da invasão bacteriana, ativando cascatas intracelulares, que levam à produção de citocinas. O objetivo deste estudo foi verificar se os eixos ECA/ ANGII/ AT1 e ECA-2/ ANG(1-7)/ MAS contribuem para a produção e/ ou regulação de citocinas inflamatórias (CI) por fibroblastos de gengiva humana (HGF) e ligamento periodontal humano (HPLF) estimulados por IL-1ß. Após o pré-tratamento com Losartan e Ang (1-7) ou silenciamento mediado por RNA de interferência (RNAi) de AT1, HGF e HPLF foram estimulados por IL-1ß por 3 horas (RNAm) ou 24 horas (proteína). Expressão de RNAm para AT1, MAS, ECA, ECA-2, IL-1ß, TNF-α, IL-6, IL-8, IL-10, TGF-ß, CXCL12, RANK-L e OPG foram avaliados por RT-qPCR e das proteínas IL-6, IL-8, ECA e ECA-2 por ELISA. Foi realizado também Western Blot para detecção de AT1 e ECA nos extratos celulares e dosagem de nitrito no sobrenadante das culturas. Ambos os subtipos de fibroblastos mostraram aumento da expressão de RNAm para AT1, IL-1ß, IL-6, IL-8, TNF-α e OPG, quando estimulados por IL-1ß. No entanto, apenas em HPLF foi observado aumento para MAS, ECA e TGF-ß. Losartan e Ang (1-7) não modularam o transcrito, a secreção de CI e nem a produção de nitrito no sobrenadante das culturas, tanto em HGF como em HPLF. O silenciamento do receptor AT1 reduziu a secreção de IL-6 e IL-8 induzida por IL-1ß em cultura de HGF e HPLF e aumentou a expressão gênica de OPG somente em HGF. Estes resultados sugerem que o silenciamento de AT1, mas não o bloqueio farmacológico deste receptor pelo antagonista Losartan, em HGF e HPLF, pode controlar a produção de IL-6 e IL-8, que por sua vez contribuem para a patogênese periodontal.(AU)

The renin-angiotensin system (RAS) has been reported as an important modulator of inflammatory and immune responses, including periodontal disease (PD). Studies suggest an alternative axis as part of this system (ACE-2 / ANG (1-7) / MAS) that would act as counter-regulatory to the classical axis (ECA / ANGII / AT1). It is known that periodontal bacteria such as Porphyromonas gingivalis (Pg) have bioactive components in their membrane (such as lipopolysaccharide-LPS) capable of inducing a strong immune response in the host due to the release of cytokines in cells, including interleukin (IL) - 1ß. In this regard, fibroblasts are the most abundant cells in periodontal tissues and receptors needed for the recognition of bacterial invasion by activating intracellular cascades that lead to cytokine production. The aim of this study was to determine whether the axes ACE / ANGII / AT1 and ACE-2 / ANG (1-7) / MAS contribute to the production and / or regulation of inflammatory cytokines (IC) by fibroblasts of human gingiva (HGF) and human periodontal ligament (HPLF) stimulated IL-1ß. After pre-treatment with Losartan, Ang (1-7) or silencing mediated by RNA interference (RNAi) of AT1, HGF and HPLF were stimulated by IL-1ß for 3 hours (RNAm) or 24 hours (protein). Expression mRNA for AT1, MAS, ACE, ACE-2, IL-1ß, TNF-α, IL-6, IL-8, IL-10, TGF-ß, CXCL12, RANK-L and OPG was assessed by RT- qPCR and proteins IL-6, IL-8, ACE and ACE-2 by ELISA. Western Blot for the detection of AT1 and ECA and dosage of nitrite was also performed. Experiments stimulated by IL-1ß showed a positive control for gene expression AT1, IL-1ß, IL-6, IL-8, TNF-α and OPG in HGF and HPLF and MAS, ACE and TGF-ß only HPLF. Losartan and Ang (1-7) did not modulate the transcription and secretion of IC and no nitrite production in the culture supernatant of HGF and HPLF. The silencing AT1 reduced IL-6 secretion and IL-8 induced by IL- ß in cultured HGF and HPLF and increased OPG gene expression only HGF. These results suggest that silencing AT1, but not pharmacological blockade of this receptor by Losartan in HPLF and HGF, can control the production of IL-6 and IL-8, which in turn contribute to the pathogenesis of periodontal disease.(AU)

Parâmetros clínicos e moleculares podem ser usados como biomarcadores das doenças peri-implantares e periodontais? / Can clinical and molecular parameters be used as biomarker of peri-implant and periodontally affected sites? - a literature review

O objetivo deste trabalho foi realizar uma revisão da literatura sobre os parâmetros clínicos e moleculares como marcadores de doenças peri-implantares e periodontais. Uma busca eletrônica foi realizada entre os anos de 2000 e 2014, apenas em periódicos de língua inglesa, utilizando-se as palavras-chave “dental implants”, “interleukin-1” e “peri-implantitis” no site Medline/PubMed. Parâmetros clínicos – sangramento (SS), profundidade de sondagem (PS), índice gengival (IG) e índice de placa (IP) –, bem como as diversas citocinas pró-inflamatórias, foram analisados em estudos com seres humanos com mucosite e, ou peri-implantite. Foram recuperados 325 artigos com 45 destes inicialmente selecionados e, após a avaliação dos textos completos, foram incluídos 20 trabalhos. Pôde-se concluir que: 1) As citocinas pró-inflamatórias são utilizadas como marcadores das doenças peri-implantar e periodontal; 2) Os trabalhos apresentam diversos parâmetros clínicos e moleculares como meio de diagnóstico; 3) Estes achados clínicos mostram a doença peri-implantar apenas em seu estágio atual; 4) Os resultados são variados pela natureza transversal dos estudos e das populações; e 5) Novas avaliações deverão ser feitas com o intuito de reforçar estas informações e torná-las úteis à prática clínica diária.

The aim of this paper was to make a literature review on the clinical and molecular parameters as biomarkers of the peri-implant and periodontal diseases. An electronic search was made between the 2000 and 2014 in the English language journals at the Medline/PubMed site. Clinical parameters - bleeding on probing (BoP), pocket depth (PD), gingival index (GI), and the plaque index (PI), as well as proinfl ammatory cytokines were analyzed in human models with mucositis and peri-implantitis. Overall, 325 references were retrieved, 45 initially selected, but only 20 papers included. it can be concluded that: 1) the proinfl ammatory cytokines are used as markers of peri-implant and periodontal diseases; 2) several clinical and molecular parameters were used for diagnostic purposes; 3) The clinical fi ndings show the peri-implant disease on its early stages; 4) The results varied due to its cross-sectional nature and targeted populations; and 5) New evaluations need to be made with the aim to reinforce these information and make them useful at the clinical practice.

Biocompatibilidade da terapia fotodinâmica: estudo in vitro e in vivo / Biocompatibility of photodynamic therapy: a study in vitro and in vivo

Introdução: A terapia fotodinâmica (TFD) se baseia em um conjunto de processos biológicos, físicos e químicos que ocorre por meio da ativação de um fotossensibilizador (FS) com luz (laser ou LED) para destruir as células alvo. O objetivo deste estudo foi avaliar a citotoxicidade e a resposta tecidual da TFD incluindo a produção de citocinas (IL - 1β e IL - 6). Métodos: 1) Para o teste de citotoxicidade os grupos foram divididos em: hipoclorito de sódio 5%; hipoclorito de sódio 2,5%; clorexidina 2%; solução salina; TFD (curcumina + luz Led azul); e controle (meio de cultura). As soluções foram diluídas em meio de cultura DMEM (1x104 células) e colocadas em placas de 24 poços, com linhagem de fibroblastos de camundongos (L-929). Depois de 6, 24 e 48 horas, o ensaio de MTT foi utilizado para avaliar a viabilidade celular e o ensaio de ELISA foi utilizado para avaliação de citocinas no sobrenadante. 2) Para o teste de resposta tecidual, os grupos foram divididos em: controle (solução salina); hipoclorito de sódio 2,5%; hipoclorito de sódio 5%; clorexidina 2%; TFD (curcumina + luz Led Azul). As soluções foram colocadas em tubos de polietileno e foram implantadas no tecido conjuntivo dorsal de ratos Wistar por 7, 15, 30, 60, e 90 dias. Os tubos com tecido circundante foram removidos e divididos ao meio e uma das metades foi corada com hematoxilina e eosina e a outra metade utilizada para avaliação das citocinas por ELISA. A análise estatística foi realizada utilizando ANOVA, Kruskal Wallis ou teste de Tukey (p < 0,05). Resultados: Quanto ao estudo in vitro, a TFD e a solução salina apresentaram baixa citotoxicidade semelhante ao do grupo controle (p> 0,05), menor que o hipoclorito de sódio (2,5% e 5%) e a clorexidina 2% (p < 0,05) em todos os períodos de tempo. Todas as soluções liberaram citocinas em quantidade similar ao controle (p>0,05). Quanto ao estudo in vivo, todas as soluções provocaram reação inflamatória severa após 7 dias, que diminuiu com o tempo. Não...

Introduction: Photodynamic therapy (PDT) is based on a set of biological, physical and chemical processes that occurs through the activation of a photosensitizer (PS) with light (laser or LED) to destroy target cells. The aim of this study was to evaluate the cytotoxicity and tissue response of PDT including the production of cytokines (IL - 1β and IL – 6). Methods: 1) For the cytotoxicity test groups were divided into: 5% sodium hypochlorite; 2.5% sodium hypochlorite; 2% chlorhexidine; saline; PDT (curcumin + Led blue light); and control (culture medium). The solutions were diluted in DMEM culture medium (1x104 cells) and placed in 24 -well plates with mouse fibroblast line (L929). After 6, 24 and 48 hours, the MTT assay was used to assess cell viability and ELISA assay was used to assess cytokine in the supernatant. 2) To test the tissue response, the groups were divided into: control (saline); 2.5%; sodium hypochlorite, 5% sodium hypochlorite; 2% chlorhexidine; TFD (curcumin + Led blue light). The solutions were placed into polyethylene tubes and implanted in the dorsal tissue of Wistar rats for 7, 15, 30, 60, and 90 days. The tubes were removed with surrounding tissue and divided in half and one half was stained with hematoxylin and eosin and the other half used to assess cytokine by ELISA. Statistical analysis was performed using ANOVA, Kruskal Wallis or Tukey test (p < 0.05). Results: For the in vitro study, PDT and saline showed low cytotoxicity similar to the control group (p > 0.05) , less than sodium hypochlorite (2.5% and 5%) and 2% chlorhexidine (p < 0.05) at all time periods. All solutions released cytokines similar to control (p > 0.05) amount. As for the in vivo study, all solutions caused severe inflammatory reaction after 7 days, which decreased with time. No inflammation was observed at 90 days in the PDT group similar to the control (p > 0.05) . All materials induced release of IL - 6 and IL - 1β but the amount was not statistically...

Expressão de citocinas na saliva e fluido periimplantar de pacientes com periimplantite / Cytokives expression in saliva and peri-implant crevicular fluid in patients with peri-implant disease

O objetivo desse estudo foi avaliar os níveis de GM-CSF,IL-1ß, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12, IFN-γ e TNF-α na saliva e fluido periimplantar (FPi) de pacientes que apresentam periimplantite comparados com indivíduos que apresentammucosite periimplantar. Vinte e dois pacientes foram divididos em 2 grupos: mucosite (MU n=12, média de idade de 65±9.4, sendo 2 homens e 10 mulheres) totalizando 36 implantes de hexágono externo e plataforma regular em mandíbula e periimplantite (PI n=10, média de idade de 59.4±11.8, sendo 4 homens e 6 mulheres) totalizando 30 implantes de hexágono externo e plataforma regular em mandíbula.Os parâmetros clínicos avaliados foram: profundidade de bolsa, índice de placa e sangramento a sondagem. Foi realizada a coleta de fluido periimplantar, saliva não estimulada, e saliva do ducto da parótida. As amostras foram submetidas à análise imunológica e os níveis de GM-CSF,IL-1ß, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12, IFN-γ e TNF-α foram mensurados através da técnica de multianálise. Os resultados clínicos demonstraram que os pacientes com PI apresentaram maior índice de placa em relação aos com MU (100% e80% respectivamente; p=0,02). Os pacientes com MU apresentaram menor profundidade de bolsa em relação aos sítios rasos e profundos dos pacientes com PI (2.2±0.5 e2.5±0.9; p=0,001; 5.1±0.8; p≤0,001respectivamente). No FPi, os níveis de IL-1ß nos sítios rasos dos pacientes com PI foram significativamente maiores quando comparados aos níveis nos sítios dos pacientes com MU (p=0.03). Na saliva do ducto da parótida, os níveis de IL-8 foram significativamente mais altos nos pacientes com PI em relação aos com MU (p=0.04). Níveis elevados de IL-1ß parece ser uma característica do paciente com periimplantite, independente do grau de destruição ao sítio. A saliva do ducto da parótida apresentou níveis significativamente maiores na expressão da IL-8 e IL-12, não detectado na saliva total.

This study aimed to measure the level of GM-CSF,IL-1ß, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12, IFN-γ and TNF-α in periimplantcrevicular fluid (PICF), whole saliva and salivafrom parotid gland from patients with Mucosites (MU) and periimlantitis (PI) who uses implants exclusively. Twelve patients with mucositis (MU; 2 men and 10 woman; mean age 65±9,4) and ten patients with periimplantitis (PI 4 men and 6 woman; mean age 59.4±11,8)participated in the study. The clinical parameters evaluated were, pocket depth, bleeding on probing and percentage of plaque.Samples were collected and citokines were meansured by a multiplexed bead immunoassay (Luminex). Significance statistical differences in the levels of citokines between groups was determined using non-parametric Mann-Whitney U test, and between sample from the same group theWilcoxon signed rank test. Among the clinical parameters, patients with PI had a higher percentage of plaque compared with the MU (p = 0.02). The MU patients had lower pocket depth compared to shallow sites in patients with PI (p = 0.001), and to the deep sites (p ≤ 0.00). In PICF, the levels of IL-1ß was significantly higher in shallow sites in patients with PI in relation to the sites of patients with MU (p = 0.03). In the saliva from parotid, the levels of IL-8 and IL-12 were significantly higher in patients with PI (p = 0.04). Elevated levels of IL-1ß seem to be a characteristic of patients with peri-implantitis, regardless of the degree of destruction to the site. The saliva of the parotid duct showed a significant increase in expression of IL-8 and IL-12 not detected in the saliva.

Perfil imunológico e microbiológico de pacientes com periodontites crônica e agressiva / Immunological and microbiological profiles of chronic and agressive periodontitis subjects

O objetivo deste estudo foi determinar os níveis de interleucina-1β (IL-1 β), IL-2, IL-4, IL-8, interferon-γ (IFN-γ) e a atividade de elastase no fluido gengival (FG) de pacientes com periodontite crônica generalizada (PCG) e periodontite agressiva generalizada (PAgG), e correlacionar com indivíduos de um grupo controle com gengivite apenas. Um objetivo secundário foi analisar o perfil microbiológico subgengival destes indivíduos. Dados clínicos transversais foram obtidos de 20 pacientes com PCG, 17 pacientes com PAgG e 10 indivíduos com gengivite. Amostras de FG foram coletadas com tiras de papel e os níveis de: IL-1β, IL-2, IL-4, IL-8 e IFN-γ foram medidos, utilizando um imunoensaio do tipo multiplex (Luminex). Atividade da elastase foi avaliada por um ensaio enzimático. Amostras de placa subgengival foram analisadas através do checkerboard DNA-DNA hybridization. As diferenças de significância entre os grupos para dados imunológicos e microbiológicos foram realizadas utilizando o teste Kruskal-Wallis, ajustando para múltiplas comparações. As médias dos parâmetros clínicos e os volumes de FG foram maiores nos pacientes com PCG e PAgG comparados ao grupo gengivite. Níveis mais elevados de IL-1β e atividade de elastase foram encontrados em sítios profundos quando comparado a sítios rasos em ambos os grupos com periodontite (p <0,05). Os dados microbiológicos apresentaram níveis significativamente mais elevados das espécies do complexo vermelho em pacientes com PCG e PAgG, quando comparados aos indivíduos com gengivite (p <0,05). Não houve diferença estatisticamente significante nos níveis de biomarcadores no FG e nos níveis de espécies bacterianas subgengivais entre pacientes com PCG e pacientes com PAgG. Sendo assim, concluímos que os dados do presente estudo não mostraram diferença estatisticamente significante nos parâmetros imunológicos e microbiológicos medidos entre indivíduos com PCG e PAgG

The goal of this study was to determine the gingival crevicular fluid (GCF) levels of interleukin-1β (IL-1β), IL-2, IL-4, IL-8 and interferon-γ (IFN-γ) and elastase activity from patients with generalized chronic (GCP) and generalized aggressive periodontitis (GAgP) and to compare with a control group with gingivitis subjects. A secondary aim was to analyze the microbiological profile of these subjects. Cross-sectional clinical data were obtained from 20 GCP, 17 GAgP and 10 gingivitis subjects. GCF samples were collected with paper strips and the levels of: IL-1β, IL-2, IL-4, IL-8, and IFN-γ measured using a multiplexed bead immunoassay (Luminex). Elastase activity was assessed by an enzymatic assay. Subgingival plaque samples were analyzed using checkerboard DNA-DNA hybridization. Significance of differences among groups for immunological and microbiological data was examined using Kruskal-Wallis adjusting for multiple comparisons. Mean clinical parameters and GCF volumes were higher in GCP and GAgP patients compared to controls. Higher levels of IL-1β and higher elastase activity were found in deep sites compared to shallow sites in both periodontitis groups (p<0.05). The microbiological data showed significantly higher levels of the Red complex species in GCP and GAgP patients compared to controls (p<0.05). There were no statistically significant differences in levels of GCF biomarkers and in levels of subgingival bacterial species between GCP and GAgP subjects. In conclusion, there were no statistically significant differences in the measured immunological and microbiological parameters between GCP and GAgP subjects

Efeito do tratamento periodontal não cirúrgico em pacientes com periodontite crônica e agressiva: achados microbiológicos e imunológicos / Effect of non surgical periodontal treatment in chronic and aggressive subjects: microbiological and immunological findings

O objetivo do presente estudo foi comparar a expressão de IL-1β, IL-4, IL-8, interferon-γ, atividade de elastase e a composição do perfil microbiano subgengival antes e depois do tratamento periodontal não cirúrgico em pacientes com doença peridontal crônica generalizada (PC) e agressiva generalizada (PA). Vinte pacientes com PC e quatorze com PA foram avaliados. Dados clínicos, fluido gengival e biofilme subgengival foram analisados na visita inicial (VI) e 3 meses (3M) após o tratamento periodontal não cirúrgico. Amostras de fluido gengival (FG) foram coletadas com tiras de papel e os níveis de: IL-1β, IL-4, IL-8 e INF-γ foram medidos, utilizando um tipo de imunoensaio multiplexado (Luminex). Atividade da elastase foi avaliada por um ensaio enzimático. Amostras de placa subgengival foram analisadas através do checkerboard DNA-DNA hybridization. Na avaliação de 3 meses após terapia periodontal foi encontrado melhora significativa para todos os parâmetros clínicos em ambos os grupos. Foram encontradas reduções significativas na atividade de elastase nos sítios rasos e profundos dos pacientes do grupo PA e nos sítios profundos do grupo PC, também foi achado um aumento significativo de INF-γ nos sítios rasos do grupo PA. Os dados microbiológicos, mostraram reduções significativas para os níveis dos membros do complexo vermelho (P. gingivalis, T. forsythia, T.denticola), e para as espécies E.nodatum e P.micra no grupo PC. No grupo PA, ocorreram reduções significativas no níveis de P. gingivalis, T. forsythia, Fusobacterium nucleatum ss polymorphum e Fusobacterium periodonticum. Quando as respostas clínica e imunológica 3M após terapia foram comparadas entre os grupos, apenas diferenças sutis foram observadas. Nenhuma diferença microbiológica foi encontrada entre os grupos após a terapia. Em conclusão, os achados suportam nossa hipótese de que as periodontites cronica e agressiva respondem de forma semelhante ao tratamento periodontal nao cirúrgico.

Our aim was to compare the expression of IL1β, IL-4, IL-8, INF-γ, elastase activity and the composition of the subgingival microbiota profile before and after non-surgical periodontal treatment in patients with untreated generalized chronic (GCP) and aggressive periodontitis (GAgP). Twenty patients with GCP and 14 with GAgP were evaluated. Clinical data, GCF and plaque were analyzed at baseline and 3 months after non-surgical periodontal treatment. IL-1β, IL-4, IL-8 and INFγ were analyzed in a luminex assay. Elastase activity was assessed by an enzymatic assay. Subgingival plaque samples were analyzed using checkerboard DNA-DNA hybridization. Three months after periodontal therapy significant improvement for all clinical parameters in both groups were found. We have found significant reductions in the elastase activity in shallow and deep sites from GAgP and in deep sites from GCP group. A significant increase in INF-γ in the shallow sites from GAgP group were also found. Microbiological data showed significant reductions in the levels of members of the red complex (P. gingivalis, T. forsythia, T. denticola), and for the species E.nodatum and P.micra on GCP group. In the GAgP group, there were significant reductions in levels of P. gingivalis, T. forsythia, Fusobacterium nucleatum and Fusobacterium polymorphum ss periodonticum. When the clinical and immunological responses after therapy were compared between groups, only slight differences were found. No microbiological difference was found between groups after therapy. In conclusion, the findings support our hypothesis that the chronic and aggressive periodontitis respond equally well to non-surgical periodontal treatment.

Condições periodontais em pacientes com lúpus eritematoso sistêmico juvenil / Periodontal conditions in patients with juvenile systemic lupus erythematosus

Periodontite e lúpus eritematoso sistêmico (LES) apresentam processos de destruição tecidual semelhantes. Pouca evidência é disponível sobre as possíveis relações entre as doenças periodontais e as formas de lúpus que afetam crianças e adolescentes, conhecida como lúpus eritematoso sistêmico juvenil (LESJ). Esta tese é baseada na hipótese de que adolescentes com LESJ podem apresentar condições periodontais diferenciadas devido a mecanismos inflamatórios e destrutivos alterados em comum. Dessa forma, os objetivos foram: (1) avaliar as condições clínicas periodontais de um grupo de adolescentes com LESJ e de um grupo de controles saudáveis sistemicamente; (2) verificar a atividade neutrofílica (elastase) e os níveis de IL-1 β e IL-18 no fluido crevicular gengival (FCG), bem como os níveis séricos de IL-18. A porcentagem média de placa visível, sangramento marginal e sítios com perda de inserção clínica ≥2 foi similar em ambos os grupos. A porcentagem média de sítios com profundidade de sondagem ≥3 mm foi significantemente maior nos controles que nos pacientes com LESJ (30% versus 16,9% - P=0,03). Os pacientes com LESJ ativos apresentaram maiores níveis de placa (P=0,01) e sangramento marginal (P=0,05) quando comparados aos inativos. Não foram encontradas diferenças na profundidade de sondagem e perda de inserção clínica entre os pacientes ativos e inativos. Quando comparados aos controles, os pacientes com LESJ tinham maiores níveis de elastase livre (427 versus 45 - P=0,03), mas níveis menores de Eα2MG (97,5 versus 295 -P=0,001), IL-1 β (13,4 versus 27 - P=0,05) e IL-18 (16,2 versus 41 - P=0,04). Na divisão por atividade só foram encontradas diferenças nos níveis de elastase, maiores no grupo ativo (601 versus 208,5 - P=0, 05). Os pacientes com LESJ apresentaram maiores níveis séricos de IL-18 (369,5 versus 331,19 - P=0,04) e VHS (20 versus 2,2 - P=0,03) quando comparados aos controles...

Periodontitis and systemic lupus erythematosus (SLE) share similar mechanisms of tissue destruction. Little is known about the possible association between periodontal diseases and the the forms of lupus that affect children and adolescents, i.e. juvenile systemic lupus erythematosus (JSLE). This thesis is based on the hypothesis that JSLE adolescents might have a different periodontal condition due to common altered inflammatory and destructive mechanisms. Thus, the aims were: (1) evaluate the periodontal conditions in adolescents with JSLE compared to those of a control group of healthy adolescents; (2) analyse markers of neutrophil activity (elastase), levels of IL-1 β and IL-18 in the gingival crevicular fluid as well as serum levels of IL-18. The mean percentages of visible plaque, marginal bleeding and sites with attachment loss (AL) ≥ 2 were similar in both groups. The mean percentage of sites with pocket depth (PD) ≥ 3 mm was significantIy higher in control than in JSLE patients (30% versus 16,9% - P=0,03). There were significant difference in plaque (P=0,01) and marginal bleeding (P=0,05) levels between JSLE patients with active and inactive disease. There were no significant differences in PD and AL in these subgroups. When compared to controls, JSLE patients showed higher levels of free elastase (427 versus 45 - P=0, 03), but lower levels of Eα2MG (97,5 versus 295 -P=0,001), IL1- β (13,4 versus 27 - P=0,05) and IL-18 (16,2 versus 41 - P=0,04). There were significant differences in the JSLE subgroups in the total amount of elastase, higher in the active subgroup (601 versus 208,5 - P=0,05). The levels of IL β and IL-18 did not differ between the subgroups. In serum, JSLE patients had higher 1evels of IL-18 (369,5 versus 331,19 - P=0,04) and ESR (20 versus 2,2 - P=0,03) when compared to controls...