RESUMO
The aim of the study was to evaluate the diagnostic value of determining the level of hypoxia-inducible factor-1α (HIF-1α) in the gingival fluid in patients with chronic generalized periodontitis (CGP) and exacerbation of inflammatory periodontal diseases in patients with cancer of the oral mucosa (OM). A clinical study was carried out with the participation of 60 patients with CGP (group 1) and 22 patients with cancer of OM (group 2) of the T1-2N0M0 stage, as well as 15 healthy individuals with no revealed periodontal pathology. CGP patients, depending on the depth of periodontal pockets (PC), were divided into two subgroups - with a mild degree (PC depth up to 3.5 mm) and an average degree (PC depth from 4 to 6 mm). Group 2 patients were also divided into two subgroups - with exacerbation of CGP (n=12) and patients with no complications (n=10). The content of HIF-1α in the gingival fluid was determined by enzyme immunoassay. The results of the study made it possible to establish that in patients of group 1, the concentration of HIF-1α in inflammatory exudate increased by 2.4 times (p<0.001) compared with the control group. The concentration of HIF-1α in the contents of periodontal pockets in patients with CGP depended on the severity of the disease: with mild CGP, it did not differ from the control group, and with moderate CGP it was 3.15 times higher (p<0.001). In patients with cancer of OM, the concentration of HIF-1α in the gingival fluid did not depend on the presence of inflammatory periodontal lesions and was determined by a multiple increase in the biomarker level (7.5 times) due to the development of a malignant process in the oral cavity. Therefore, monitoring the concentration of HIF-1α in the gingival fluid is informative in patients with CGP in assessing the severity of periodontal conditions, as well as in differential diagnosis with malignant formations of the oral cavity.
Assuntos
Periodontite Crônica , Periodonto , Líquido do Sulco Gengival , Humanos , Hipóxia , Ligamento Periodontal , Bolsa PeriodontalRESUMO
THE AIM OF THE STUDY: Was to analyze possible correlation between the concentration of the pro-inflammatory cytokine interleukin-6 and the activation marker of osteoclasts cathepsin K in the gingival fluid during osteoresorption of inflammatory (periimplantitis, chronic generalized periodontitis) and malignant oncological origin (malignant neoplasm of gums). MATERIALS AND METHODS: The study comprised 87 individuals of both sexes aged 30 to 60: 20 patients (group 1) with periimplantitis, 30 people with chronic generalized periodontitis (CGP) (group 2), 22 patients with squamous cell carcinoma of the upper and lower alveolar bone gingiva (group 3), 15 healthy individuals without periodontal disease. RESULTS: The concentration of interleukin-6 (IL-6) and cathepsin K was determined in the gingival fluid by enzyme-linked immunosorbent assay. The examination revealed that during CGP and peri-implantitis the accumulation of IL-6 in the contents of periodontal and peri-implantation pockets was a pathogenetic factor for the activation of osteoclasts and their secretion of proteolytic enzymes osteoresorption. In cancer the increase of cathepsin K expression was a lot higher than the accumulation of IL-6 in the gingival fluid reducing the dependence of the activation of osteoclasts on the local accumulation of pro-inflammatory cytokines. Conclusion. To formulate the prognosis of progressive bone loss in patients with peri-implantitis it is necessary to control the concentration of IL-6 and cathepsin K in the peri-implantation pocket, in case of CGP the concentration of IL-6 in the exudate of the periodontal pocket and in patients with cancer of the alveolar processes the content of cathepsin K of gingival fluid.
