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Background. It is known that the number of polymorphonuclear leukocytes increases with the development of periodontitis. However, their role in the pathogenesis of chronic periodontitis has not been fully defined. Aim. To study the pathogenetic role of polymorphonuclear leukocytes in the development of chronic periodontitis, realized by microvesicles and aggression factors (metalloproteinases, myeloperoxidase, calprotectin, lipocaine 2). Material and methods. 30 patients aged 30 to 50 years with a diagnosis of chronic generalized periodontitis of moderate severity (K05.3) and no severe somatic pathology were under observation. The comparison group included 20 people with no inflammatory diseases in the oral cavity, comparable with the main group in terms of gender, age, nationality, and the presence of bad habits. Using a standard set of indices, the state of periodontal tissues was assessed, and all examined patients underwent X-ray examination. In the oral fluid of the examined, the total number of microvesicles and their phenotype, the concentration of matrix metalloproteinases-2 and -9, myeloperoxidase, calprotectin, lipocaine 2 were determined. The parameters were determined using a flow cytometer. Descriptive statistics are represented by the median and interquartile range (25th and 75th percentiles). Two independent sample sets were compared using the MannWhitney test. Correlation analysis was carried out according to the Spearman method. Results. The total number of microvesicles in the oral fluid in patients with chronic periodontitis was 11 times higher than in healthy volunteers (p=0.00001). More than a third of them had neutrophil markers. The levels of neutrophil aggression factors were also higher in patients with periodontitis and correlated with the value of the periodontal index, the depth of the periodontal pocket, bleeding index, indicators of periodontal health. Thus, a strong positive relationship was found between the total number of microvesicles and the value of the periodontal index (r=0.675), the depth of the periodontal pocket (r=0.763), the bleeding index (r=0.704); the number of neutrophilic microvesicles and indicators of periodontal health r=0.816, r=0.837 and r=0.776, respectively. The content of metalloproteinase-2 correlated with the depth of the periodontal pocket (r=0.754), bleeding index (r=0.811), papillary-marginal-alveolar index (r=0.675). Conclusion. Neutrophils contribute to the pathogenesis of chronic periodontitis through the secretion of aggression factors: metalloproteinases, myeloperoxidase, calprotectin, lipocaine 2, and microvesicles.
Background. It is known that the number of polymorphonuclear leukocytes increases with the development of periodontitis. However, their role in the pathogenesis of chronic periodontitis has not been fully defined. Aim. To study the pathogenetic role of polymorphonuclear leukocytes in the development of chronic periodontitis, realized by microvesicles and aggression factors (metalloproteinases, myeloperoxidase, calprotectin, lipocaine 2). Material and methods. 30 patients aged 30 to 50 years with a diagnosis of chronic generalized periodontitis of moderate severity (K05.3) and no severe somatic pathology were under observation. The comparison group included 20 people with no inflammatory diseases in the oral cavity, comparable with the main group in terms of gender, age, nationality, and the presence of bad habits. Using a standard set of indices, the state of periodontal tissues was assessed, and all examined patients underwent X-ray examination. In the oral fluid of the examined, the total number of microvesicles and their phenotype, the concentration of matrix metalloproteinases-2 and -9, myeloperoxidase, calprotectin, lipocaine 2 were determined. The parameters were determined using a flow cytometer. Descriptive statistics are represented by the median and interquartile range (25th and 75th percentiles). Two independent sample sets were compared using the MannWhitney test. Correlation analysis was carried out according to the Spearman method. Results. The total number of microvesicles in the oral fluid in patients with chronic periodontitis was 11 times higher than in healthy volunteers (p=0.00001). More than a third of them had neutrophil markers. The levels of neutrophil aggression factors were also higher in patients with periodontitis and correlated with the value of the periodontal index, the depth of the periodontal pocket, bleeding index, indicators of periodontal health. Thus, a strong positive relationship was found between the total number of microvesicles and the value of the periodontal index (r=0.675), the depth of the periodontal pocket (r=0.763), the bleeding index (r=0.704); the number of neutrophilic microvesicles and indicators of periodontal health r=0.816, r=0.837 and r=0.776, respectively. The content of metalloproteinase-2 correlated with the depth of the periodontal pocket (r=0.754), bleeding index (r=0.811), papillary-marginal-alveolar index (r=0.675). Conclusion. Neutrophils contribute to the pathogenesis of chronic periodontitis through the secretion of aggression factors: metalloproteinases, myeloperoxidase, calprotectin, lipocaine 2, and microvesicles.
Abstract. The molecular level of physiological processes in the context of studying the pathogenesis of diseases is the basis for their diagnosis and treatment. Thus, the features of the pathogenesis of periodontitis are the direct participation of pro-inflammatory cytokines in the development of alterative inflammation. The study of the cytokine profile is relevant for both diagnostic and therapeutic purposes, since the dynamics of indicators of inflammatory mediators reflects the degree of activity and specificity of pathological reactions present in periodontitis. The purpose of the study Study of cytokine profile indicators in experimental periodontitis. Materials and methods. In an experiment on 50 white non-linear rats weighing 190-280 g, the model of experimental periodontitis proposed by Shkolnaya K.D., Atrushkevich V.G. was reproduced. (Patent RU No. 2625295 dated 07/12/2017). Assessment of the dynamics of the cytokine status of blood serum was carried out by the level of pro-inflammatory (IL-1β, TNF, IL-6, IL-17), anti-inflammatory (IL-4, IL-10) and regulatory (IL-2) cytokines using enzyme-linked immunosorbent assay using reagent kit "Bender MedSystems". Results. The study revealed the presence of an imbalance in the cytokine system, characterized by a violation of the physiological balance between pro-inflammatory and anti-inflammatory cytokines with a predominance of the former. Hyperproduction of cytokines persisted throughout the experiment with an increase in the above uncoupling by day 25, which indicates the formation of an immunoinflammatory process in the periodontium. Conclusion. The data obtained during the study confirm the presence of an imbalance of the cytokine network, which indicates the formation and progression of the inflammatory process of the periodontal complex, and also necessitates the introduction of drugs that inhibit the synthesis of pro-inflammatory mediators into complex therapy.
Determining cytokinemia role in the destructive processes of the periodontal complex gives new opportunities to the development and subsequent implementation of practical methods for chronic periodontitis diagnosis, justifies including pathogenetic drugs that inhibit the secretion of pro-inflammatory mediators in treatment regimens. The aim of the study is to evaluate the dynamics of cytokine profile indicators and identify their correlation with the local status of periodontal tissues in animals with experimental periodontitis. Materials and methods. The study enrolled 65 white outbred rats weighing 180±20 g. The authors reproduced the model of experimental periodontitis according to K.D. Shkolnaya, V.G. Atrushkevich method (patent RU No. 2625295, December 07, 2017). The cytokine profile was assessed by pro-inflammatory and anti-inflammatory cytokine levels, determined by enzyme-linked immunosorbent assay, Bender MedSystems reagent kit. Local status of periodontal tissues was assessed according to the degrees of gingival hemorrhage, dental mobility and depth of periodontal pockets with a button-shaped and modified periodontal probes. Results. During the experimental periodontitis modeling, a high level of cytokinemia was determined. It destructively effects the periodontal connective tissue matrix, which was confirmed by an increase in the depth of periodontal pockets, gingival hemorrhage and dental mobility. A strong correlation between a high level of cytokinemia and local destructive changes in periodontal tissues was determined. This fact emphasized the conjugation of these pathophysiological mechanisms. Conclusion. Defined disorders of physiological balance in the cytokine balance necessitate the use of pathogenic drugs, as they have an inhibitory effect on the synthesis of pro-inflammatory cytokines and prevent further destruction of the periodontal complex. Changes in the cytokine profile indicate inflammation process, and a decrease in the level of cytokinemia indicate the resolution of infection and can be considered a criterion for the effective treatment.
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