The importance of inflammatory biomarkers, IL-6 and PAPP-A, in the evaluation of asymptomatic apical periodontitis

Şirin, Dursun Ali; Özçeli̇k, Fatih; Erşahan, Şeyda; Pençe, Halime Hanım

doi:10.1007/s10266-020-00534-8

Cited by 10 publications

(18 citation statements)

References 35 publications

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“…Among the final 17 studies, the majority were case–control studies which included ten articles ( 6 , 32 , 34 , 35 , 38 , 40 – 44 ). Five cross-sectional studies ( 30 , 31 , 33 , 36 , 39 ). Finally, two cohort searches ( 6 , 37 ), as shown in Figure 2 .…”

Section: Resultsmentioning

confidence: 99%

Is there any association between the presence of biomarkers and apical periodontitis? A systematic review

Matos-Sousa,

Chemelo,

Frazão

et al. 2024

Front. Immunol.

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This systematic review aimed to verify whether there is evidence of an association between apical periodontitis and the presence of systemic biomarkers. This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - PRISMA. For this, the acronym PECO was used; population (P) of adult humans exposed (E) to the presence of apical periodontitis, compared (C) to adult humans without apical periodontitis, and the outcome (O) of the presence of biomarkers was observed. The articles were searched in PubMed, Scopus, Web of Science, LILACS, Cochrane Library, OpenGray, and Google Scholar grey databases. Subsequently, studies were excluded based on title, abstract, and full article reading, following the eligibility criteria. The methodological quality of the selected studies was evaluated using the Newcastle-Ottawa qualifier. After exclusion, 656 studies were identified, resulting in 17 final articles that were divided into case-control, cross-sectional, and cohort studies. Eight studies were considered to have a low risk of bias, one had a medium risk of bias, and eight had a high risk of bias. In addition, 12 articles evaluated biomarkers in blood plasma, four evaluated them in saliva, and only one evaluated them in gingival crevicular fluid. The results of these studies indicated an association between apical periodontitis and the systemic presence of biomarkers. These markers are mainly related to inflammation, such as interleukins IL-1, IL-2, and IL-6, oxidative markers, such as nitric oxide and superoxide anions, and immunoglobulins IgG and IgM.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier (CRD42023493959).

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Section: Resultsmentioning

confidence: 99%

Is there any association between the presence of biomarkers and apical periodontitis? A systematic review

Matos-Sousa,

Chemelo,

Frazão

et al. 2024

Front. Immunol.

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“…Many research studies have focused on investigating biomarkers associated with periapical injury and their relationship with systemic diseases ( Inchingolo et al, 2013 ; Kimak et al, 2015 ; Gomes et al, 2018 ; Sirin et al, 2021 ). Interleukins and tumor necrosis factors have been found to play a role in the pathogenesis of chronic inflammatory diseases like pulpitis and apical periodontitis ( Tani‐Ishii et al, 1995 ).…”

Section: Discussionmentioning

confidence: 99%

“…In addition to its local effects, apical periodontitis may contribute to the systemic immune response through a variety of pathways, including changes in interleukin expression ( Baeza et al, 2016 ; Garrido et al, 2019 ; Haug and Marthinussen, 2019 ; Sirin et al, 2021 ), immunoglobulins ( Garrido et al, 2019 ; Sirin et al, 2021 ), C-reactive protein ( Garrido et al, 2019 ; Sirin et al, 2019 ), and biochemical factors ( Chen et al, 2021 ; Bakhsh et al, 2022 ). Consequently, there is evidence suggesting that AP contributes to increased systemic inflammation ( Inchingolo et al, 2013 ; Zhang et al, 2016 ; Hernández-Ríos et al, 2017 ; Georgiou et al, 2021 ; Poornima et al, 2021 ; Bakhsh et al, 2022 ; Niazi and Bakhsh, 2022 ) as chronic infections activate inflammatory mediators that exert systemic effects ( Gomes et al, 2013 ; Niazi and Bakhsh, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Modulation of blood redox status by the progression of induced apical periodontitis in rats

Frazão,

Santos Mendes,

Baia-da-Silva

et al. 2023

Front. Physiol.

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This study aimed to investigate if apical periodontitis in different periods changes systemic levels of the antioxidant and pro-oxidant parameters in Wistar rats. Twenty-four rats were randomly allocated into healthy animals, apical periodontitis at 14 days (AP14) and apical periodontitis at 28 days (AP28). The first mandibular molars were accessed in the AP groups, and the pulp chamber was exposed to the oral environment, inducing the apical lesion. After 14 and 28 days, the animals were anesthetized, euthanized, and hemimandibles were collected for micro-computed tomography (micro-CT) analysis to measure lesion volume, bone volume (BV), percent of bone to total tissue volume (BV/TV), trabecular thickness (Tb.Th), trabecular number (Tb.N), and trabecular space (Tb.Sp). A histological examination of the remaining bone was also performed. Finally, blood samples were collected for oxidative biochemistry analysis, investigating glutathione (GSH), Trolox equivalent antioxidant capacity (TEAC), and lipid peroxidation (TBARS). The lesion volume was greater at 28 than at 14 days, as shown by micro-CT. AP14 and AP28 had decreased BV and Tb.Th, but only AP28 showed a reduction in BV/TV. Tb.N and Tb. Sp were increased in apical periodontitis at 28 days. In the histopathological analysis, AP14 had focal regions of moderate mononuclear inflammatory infiltrate, and AP28 had an intense inflammatory infiltrate with bacterial colonies. In the biochemical evaluation, GSH, TEAC, and TBARS were increased after 14 days. However, GSH returned to control levels, TEAC was similar to AP14, and TBARS increased significantly after 28 days. Therefore, the oxidative biochemistry response was modulated according to the progression of periapical damage. After 14 days, the organism could still react to the injury. However, at 28 days, the antioxidant response decreased, associated with an increase in TBARS.

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“…Our results showed that the E and ETF2 formulations suppressed IL-6 production in LPS-induced BMDMs. Elevated IL-6 levels are associated with periodontal tissue degradation [ 69 ], chronic apical periodontitis [ 70 ], and early childhood caries [ 71 ]. The IL-6 content in saliva is reportedly higher in patients with periodontitis than in healthy patients [ 72 ] and is positively correlated with periodontal lesion severity [ 73 ].…”

Section: Discussionmentioning

confidence: 99%

Pomegranate Extract Potentiates the Anti-Demineralizing, Anti-Biofilm, and Anti-Inflammatory Actions of Non-Alcoholic Mouthwash When Associated with Sodium-Fluoride Trimetaphosphate

et al. 2022

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This study investigated the anti-caries and anti-inflammatory effects of mouthwash formulations containing Punica granatum (pomegranate) peel extract (PPE), sodium-trimetaphosphate, and low concentrations of fluoride. PPE was characterized using high-performance liquid chromatography (ellagic acid and punicalagin). Total phenolics were quantified among formulations, and their stability was analyzed for 28 days. The formulation effects were evaluated as follows: (1) inorganic component concentration and reduced demineralization on bovine enamel blocks subjected to pH cycling; (2) anti-biofilm effect on dual-biofilms of Streptococcus mutans ATCC 25175 and Candida albicans ATCC 10231 treated for 1 and 10 min, respectively; and (3) cytotoxicity and production of inflammatory mediators (interleukin-6 and tumor necrosis factor-alpha). The formulation containing 3% PPE, 0.3% sodium-trimetaphosphate, and 225 ppm of fluoride resulted in a 34.5% surface hardness loss; a 13% (treated for 1 min) and 36% (treated for 10 min) biofilm reduction in S. mutans; a 26% (1 min) and 36% (10 min) biofilm reduction in C. albicans; absence of cytotoxicity; and anti-inflammatory activity confirmed by decreased interleukin-6 production in mouse macrophages. Thus, our results provide a promising prospect for the development of an alcohol-free commercial dental product with the health benefits of P. granatum that have been recognized for a millennium.

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The importance of inflammatory biomarkers, IL-6 and PAPP-A, in the evaluation of asymptomatic apical periodontitis

Cited by 10 publications

References 35 publications

Is there any association between the presence of biomarkers and apical periodontitis? A systematic review

Is there any association between the presence of biomarkers and apical periodontitis? A systematic review

Modulation of blood redox status by the progression of induced apical periodontitis in rats

Pomegranate Extract Potentiates the Anti-Demineralizing, Anti-Biofilm, and Anti-Inflammatory Actions of Non-Alcoholic Mouthwash When Associated with Sodium-Fluoride Trimetaphosphate

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