IL-1β, TNF-α, and IL-6 levels in gingival fluid and serum of patients with ischemic stroke

Abstract

It has been documented that an increaseof immune cells in periodontitis may stimulate the process of atherosclerosis and lead to ischemic stroke. The aim of this study was to investigate whether there is any significant difference in serum and gingival crevicular fluid (GCF) cytokine concentrations between patients with early ischemic stroke (IS) and a control group. Eighty-six patients were consecutively enrolled for this study, 50 with ischemic stroke and 36 as a control group with no previous stroke. Only dentulous patients were included. In each patient, GCF was collected from the deepest periodontal pocket. Blood serum samples were also taken from all subjects. The collected material was analyzed for cytokine concentrations using the cytometric bead array technique. Cerebral ischemia was found to be correlated with higher serum levels of IL-1β (13.01 ± 13.87 vs. 7.83 ± 2.11) and IL-6 (15.82 ± 16.64 vs. 6.64 ± 2.5) compared to the control group. The levels of IL-1, IL-6 and TNF-α in GCF were higher in patients with ischemic stroke but the difference was not significant. In conclusion, ischemic stroke was found to be associated with higher levels of IL-1β and IL-6 in serum. The cytokine concentrations in GCF did not appear to be directly correlated with those in serum in patients with ischemic stroke. (J Oral Sci 58, 509-513, 2016) Keywords: stroke; periodontal disease; cytokines. IntroductionPeriodontal disease is a form of chronic infection considered to contribute to the development of systemic inflammation. Although it is initiated by bacteria, its pathogenesis and progression are immune-mediated. The host overacts to infectious stimulation by secreting increased amounts of pro-inflammatory cytokines, such as IL-1β, TNF-α and IL-6, and matrix metalloproteinases (MMPs), which are tissue-destructive proteolytic enzymes (1). The locally produced pro-inflammatory mediators may enter the circulation and exert systemic effects. Increases in both the number of peripheral leukocytes and the levels of cytokines and acute-phase proteins have been found in patients with periodontal disease, but are not always significant (2,3). It has also been shown that this increase in leukocytes is aggravated by the severity and extent of the disease. Therapy may lead to a decrease in the number of leukocytes (4,5). Cytokine levels in the healthy systemic circulation are minimal and at times undetectable without the use of hypersensitive methodology (3). Pro-inflammatory mediators circulating in peripheral blood vessels may stimulate atherosclerosis or destabilize atherosclerotic plaque, thus increasing the likelihood of ischemic stroke (IS) (6). The aim of the present study was to compare cytokine concentrations in gingival fluid and serum between patients with IS and a control group matched for age and dental status. Materials and MethodsThe study subjects were 86 patients who were divided into two groups: IS patients and controls. The IS group included 50 randomly selected patients (18 women and 32 men; age range 38...

Systemic inflammatory burden and local inflammation in periodontitis: What is the link between inflammatory biomarkers in serum and gingival crevicular fluid?

“…Other studies also found correlations between the local and the general markers verifying our suggestion for the link between them (Noack et al, ; Zheng, Chen, Shi, Jepsen, & Eberhard, ). There is still, though, great variety in the results in the literature with other studies failing to prove association between GCF and blood biomarkers (Fell et al, ; Fiorini et al, ; Wytrykowska et al, ). Different methodologies, characteristics of the groups, and various selection criteria can justify this great diversity.…”

“…All of them were found higher in the periodontitis groups compared with healthy ones, in both serum and GCF; visfatin, VEGF, oncostatin M, and TNF‐α decreased, in both fluids, after scaling and root planning (Baltacioglu, Akalin, Alver, Deger, & Karabulut, ; Gokul, Faizuddin, & Pradeep, ; Pradeep et al, ; Pradeep, Prapulla, Sharma, & Sujatha, ; Raghavendra et al, ; Thorat, Pradeep, & Garg, ; Turer, Durmus, Balli, & Guven, ). In another study that investigated patients with ischemic stroke, the authors found higher concentrations of some cytokines in the serum in the ischemic patients' group but no correlation between the GCF concentrations and the serum ones (Wytrykowska, Prosba‐Mackiewicz, & Nyka, ). The same results, with no association in serum and GCF, though there were higher concentrations in GCF of periodontitis patients, were also reported for different cytokines in a cohort of pregnant women (Fiorini et al, ).…”

Targeting Oxidative Stress and Inflammation to Prevent Ischemia-Reperfusion Injury

“…However, studies have also shown that IL-6 is involved in the inflammatory response during cerebral ischemia. The detection of IL-6 in patients with acute cerebral infarction found that IL-6 in the cerebrospinal fluid and serum is an independent predictor of cerebral infarction: the greater the volume of cerebral infarction, the higher the level of IL-6, and this was not related to the location of the cerebral infarction (Wytrykowska et al, 2016). IL-6 increases vascular endothelial cell monolayer permeability in vitro, and contributes to ischemia-related bloodbrain barrier dysfunction.…”

Levels of Tumor Necrosis Factor Alpha in Patients With Ischemic Stroke

“…Таким образом, нами в динамике обследования пациентов, страдающих ишемическим инсультом выявлено повышение уровня фактора некроза опухоли-альфа при поступлении и достоверные корреляционные зависимости изменения его уровня в динамике терапии в течение 14 дней наблюдения за пациентами. Несмотря на противоречивость данных литературы, не каждый из источников которой свидетельствует о достоверном изменении концентрации TNFα [29,41], наши данные свидетельствуют о существенном увеличении уровня данного цитокина в сыворотке крови в среднем у наблюдаемых нами лиц. Правда, при этом довольно существенный процент лиц имел показатели TNFα (около 20-24%) в пределах < 10 пг/мл.…”

“…Вместе с тем существуют противоречивые данные об уровнях TNFα в сыворотке и плазме крови при остром ишемическом инсульте. Некоторые исследования показали, что уровни TNFα остаются неизменными после инсульта, в то время как другие сообщают о повышенных уровнях цитокина, хотя и с разными пиковыми периодами [10,25,41].…”