Non-Surgical Periodontal Therapy Could Improve the Periodontal Inflammatory Status in Patients with Periodontitis and Chronic Hepatitis C

Non-surgical periodontal therapy (NSPT) is the first essential step for the management of any periodontitis patient. This study aims to evaluate the impact of NSPT on pro-inflammatory mediators’ regulation and on clinical parameters in periodontitis patients who suffer from chronic hepatitis C. At baseline, selected patients were clinically evaluated for their periodontal status. A subsequent quantitative assessment of C-reactive protein and pentraxin-3 in samples of gingival fluid was performed by Enzyme-Linked Immunosorbent Assay (ELISA). Afterwards, NSPT was performed. Three months after NSPT, the clinical and ELISA assessments were repeated. The results show an improvement of the clinical parameters in periodontitis patients at the three-month recall. In chronic hepatitis C patients with periodontitis, the gingival fluid levels of pro-inflammatory markers reduced significantly. The targeted markers also expressed significant correlations with the clinical parameters used for the assessment of periodontitis’ severity. The results suggest that, while chronic hepatitis C patients exhibited a more negative periodontal status at baseline as compared to non-hepatitis ones, NSPT is effective in decreasing the local periodontal inflammatory reaction and in proving the periodontal status of this type of patients. Given the limitation of the study, periodontal screening and NSPT should be included in the integrated therapeutical approach of chronic hepatitis C patients, for its impact on the local inflammatory response.

Laboratory control of the osteoresorptive effects of glucorcorticoids in patients with purpose colitis

The aim of the work was to develop an informative method for laboratory monitoring of osteoresorbent action during systemic administration of glucocorticoids in patients with ulcerative colitis. The study included 54 patients with ulcerative colitis aged 18 to 44 years: 35 (64,8%) men and 19 (35,2%) women. In patients of the clinical group before and after the first, second, third courses of glucocorticosteroids, as well as during the formation of steroid dependence, the concentration of the osteoresorption marker cathepsin K was determined simultaneously in the blood serum and gingival fluid by enzyme immunoassay. The concentration of the osteomarker was compared with the parameters of the densitometric density of the lumbar vertebrae L1-L4 during X-ray examination. It was found that with the systemic use of glucocorticoids in patients with ulcerative colitis, the concentration of cathepsin K in the gingival fluid increased earlier than in the blood serum. It was found that with an increase in the concentration of cathepsin K in the gingival fluid of more than 2,6 pmol/l in conditions of systemic administration of glucocorticosteroids, the risk of osteoporosis increased with a diagnostic sensitivity of 81,8% and a specificity of 74,4% (p=0,0001).The diagnostic accuracy was 78,1%. With an increase in the concentration of cathepsin K in the gingival fluid above the differential separation level (2,6 pmol/l), the risk of developing osteoporosis increased 3,2 times (p= 0,0001). The study developed a methodological and informational algorithm has been developed for the non-invasive control of steroidal osteoporosis in patients with ulcerative colitis with systemic use of glucocorticoids by assessing the concentration of cathepsin K in the gingival fluid.

Influence of rs6667202 SNP on Interleukin-10 levels in the gingival fluid of patients with periodontitis grade C

Grade C periodontitis in youngers is characterized by a severe form of periodontitis, and IL10 rs6667202 single nucleotide polymorphism (SNP) has been described as an important feature in this disease etiology. Aim: This study aimed to evaluate, in vivo, the functionality of IL10 rs6667202 SNP on IL-10 gingival fluid levels. Methods: Thirty patients with Perio4C were selected, 15 with the IL10 AA genotype (rs6667202) and 15 with AC/CC genotypes. The gingival fluid was collected from two sites with probing depth ≥ 7 mm and bleeding on probing, and two healthy sites. The IL-10 concentration was determined by Luminex/MAGpix platform. Results: In deep pockets, the IL10 AA genotype presented a lower concentration of IL-10 when compared with AC or CC genotypes (p<0.05). In shallow pockets, no difference between groups was seen (p>0.05). Conclusion: IL10 rs6667202 SNP decreases the production of IL-10 in crevicular fluid, potentially affecting this disease progression.

Expression of MicroRNAs in Periodontal Disease: A Systematic Review

Introduction. Periodontal disease (PD) is a chronic inflammation of the soft tissues that support the structure of the tooth, and miRNAs are highly dynamic molecules that participate in the regulation of gene expression interfering with multiple genetic targets. The dysregulation of the expression of miRNAs has been associated with different types of pathologies; therefore, they are excellent molecules to be studied as biomarkers. Material and Methods. A search was made in the electronic databases of PubMed, Scopus, and Science Direct. The following key words were used: “microRNAs,” “miRNAs,” “periodontal disease,” “periodontitis,” and “biomarker”; employee independent search strategies with the Boolean operators “OR” and “AND”; a further search of the references of the selected studies was performed to detect potential studies that met the selection criteria. The data recollected from each article were author, country, year of publication, sample size, type of sample used to identify miRNAs, methodology used to identify miRNAs, type of periodontal disease, and miRNAs identified. Results. Of the 13 selected studies, 6 used gingival tissue as a sample for the identification of miRNAs, 3 used gingival fluid, 2 used saliva, 1 used serum, and another used periodontal tissue. Chronic periodontitis was the most studied periodontal disease in 9 of the 13 selected articles; 7 used microarrays as the main technique for the identification of miRNAs. qRT-PCR was the assay choice to validate the identified miRNAs. Conclusion. The main type of periodontal disease on which most studies are focused is chronic periodontitis, with the main miRNAs being hsa-miR-146a, hsa-miR-146b, hsa-miR-155, and hsa-miR-200. This systematic review is one of the first to carry out an analysis of the current role of miRNAs in PD as biomarkers.

Follow-up Study of Microflora Changes in Crevicular Gingival Fluid in Obese Subjects After Bariatric Surgery

The objective of our study was to investigate the effect of weight loss on the crevicular microflora following bariatric surgery. Crevicular fluid samples were taken from 57 subjects: 22 were in the normal control group; 18 in the obese control group; and 17 patients had had bariatric surgery, who underwent a repeat sampling 6 to 12 months after the operation. Crevicular fluid samples were analyzed by MALDI-TOF MS analysis. After surgery and weight loss, the mean germ count increased, albeit not significantly. Also, Candida albicans and non-albicans Candida species: C. dubliniensis, C. kefyr, and C. lusitaniae appeared after surgery (p < 0.05) in subjects where Neisseria was either absent throughout or eliminated after surgery. However, periodontitis did not develop during this time in our subjects.

Information Algorithm for Non-Invasive Evaluation of Osteoresorbable Side Effects of Glucocorticosteroids in Patients with Ulcerative Colitis

A study involving 45 patients with ulcerative colitis found that the activity of the Cathepsin K bone resorption marker measured by an enzyme-linked immunosorbent assay in gingival fluid could be used as a non-invasive control over the development of steroid osteoporosis caused by systemic use of glucocorticoids. When the concentration of Cathepsin K in the gingival fluid exceeded 3.7 pmol/L, the risk of developing osteoporosis in patients with ulcerative colitis taking glucocorticosteroids on a regular basis increased by 7.9 times with a diagnostic accuracy of 82.6% (p=0.002). As a result of the study, an effective method for non-invasive assessment of osteoresorbable side effects of glucocorticosteroids in autoimmune diseases was proposed.

Clinical and immunological monitoring of gingival fluid cytokines in patients with perimplantitis during photodynamic therapy

The effect of FDT on the processes of mucosal immunity, in particular, the cytokine profile, remains practically unstudied.Objective: clinical and immunological assessment of the effectiveness of FDT in the complex treatment of periimplantitis at the initial stage of the relief of the inflammatory process.Materials and research methods. The study included patients who contacted the dental institutions of the Republic of Dagestan and the clinic of the Department of Surgical Dentistry of Moscow State Medical University aged 20 to 49 years with a diagnosis of periimplantitis, a total of 61 people. 33 patients received the ABT (the main group 1), 28 patients received the PDT (the main group 2). The control group consisted of 76 patients with stable implants without signs of inflammation or periodontitis (intact periodontium). The concentration of cytokines TNF, IL-1β, IL-6, and IL-17A in the oral fluid was determined by ELISA twice using the INFINITE F50 analyzer (TECAN, Austria) and test systems (Vector-Best, Novosibirsk, Russia). Results. Differences in the state of the cytokine profile in ABT (amoxicillin / sodium clavulanate at 825/125 mg 2 times a day for 7 days) and PDT (FotoSan 350 apparatus, photosensitizer toluidine blue: 4 sessions every 1 day for 40 sec) were found. The maximum cytokine response was observed in the evaluation of IL-1β (137–139 pg/ml) and IL-17A (161–172 pg/ml). After 1 month, statistically significant differences were revealed between the groups of patients with periimplantitis receiving different treatment options. The level of TNF-α decreased by 2.5 times and corresponded to the norm in the case of PDT, but with ABT it remained significantly higher, although we also observed a downward trend. The level of IL-17A showed a statistically significant decrease in PDT, while in ABT, the decrease was not significant. 3 months after treatment, complete normalization of the levels of TNF-α, IL-6 and IL-17A was observed in both compared groups, with the exception of IL-1β, which remained elevated: 8.6 times with PDT and 25 times with ABT.Conclusion. The cytokine profile of gingival fluid in periimplantitis is an important diagnostic marker for the severity of inflammation, which can confirm the presence of periimplantitis and predict the course. The content of IL-1β and IL-17 A reflects the severity of the process. Restoring normal levels of IL-1β is slower than IL-17 A.