Background: Chronic periodontitis is a multifactorial polymicrobial infection characterized by an inflammatory
process that leads to destruction of teeth supporting tissues. There is a complex network of pro- and antiinflammatory
cytokines acting in the inflamed periodontal tissues. This study was designed to detect the serum levels
of pro-and anti-inflammatory cytokines in chronic periodontitis patients and determine its correlation with different
clinical parameters of the periodontal status, as well as study the correlation among these cytokines and to evaluate
the ratio between pro-and anti-inflammatory cytokines.
Subjects and Methods: A total of 50 patients with chronic periodontitis were studied, their ages range from 23-60
years with a mean age of 40.1±7.6 years. Apparently healthy volunteers consisted of 25 individuals who were their
age range (21-50) years with a mean age of 33.4±9.1 years considered as control. Periodontal parameters used in
this study were plaque index, gingival index, probing pocket depth, clinical attachment level and bleeding on
probing. Blood samples were collected from CP patients and healthy control groups to assess serum concentrations
of IL-1β, IL-2, IL-6, TNF-α and IL-10 by means of enzyme-linked immune-sorbent assay.
Results: The current results revealed that median serum levels of pro-inflammatory cytokines (IL-1β and TNF-α) were
significantly higher in CP patients than in healthy control groups (p<0.001), whereas the serum levels of IL-2and IL-6
were not observed any significant differences between two groups (p>0.05). In contrast serum levels of antiinflammatory
cytokines (IL-10) was significantly low in patients when compared to control (p<0.001). On the other
hand, the ratios of IL-1βIL-10 and TNF-αIL-10 were significantly higher in patients when compared with the ratios in
control group.
Regarding correlation between serum cytokines and clinical periodontal parameters, serum IL-1β level was showed
significant positive correlation with each of plaque index, gingival index, probing pocket depth and clinical
attachment level. On the otherhand no association between serum IL-2 levels and clinical parameters of chronic
periodontitis were found. Moreover; IL-6 was showed significant positive correlation with probing pocket depth, while
TNF-α revealed significant positive association with each of gingival index, probing pocket depth and clinical
attachment level. Conversely, serum IL-10 levels had negative significant correlation with plaque index, probing
pocket depth and bleeding on probing. Interestingly strong linear positive correlation was found among each of (IL-
1β, IL-6 and TNF-α,).While strong negative correlation was noticed between IL-10 and each of (IL-1β and TNF-α).
Conclusion: The present results may provide direct evidence for the systemic activation of immune cells in
periodontitis, and suggests that cytokines may play an important role in pro-inflammatory response in serum of
patients with chronic periodontitis. Moreover imbalance between pro and anti-inflammatory cytokines could be
involved in the initiation and progression of chronic periodontitis and is indicative of a stronger systemic proinflammatory
state in disease. |