Heterogeneity of systemic inflammatory responses to periodontal therapy

被引:91
作者
Behle, Jan H. [1 ]
Sedaghatfar, Michael H. [1 ]
Demmer, Ryan T. [2 ]
Wolf, Dana L. [1 ]
Celenti, Romanita [1 ]
Kebschull, Moritz [1 ]
Belusko, Paul B. [1 ]
Herrera-Abreu, Miriam [1 ]
Lalla, Evanthia [1 ]
Papapanou, Panos N. [1 ]
机构
[1] Columbia Univ, Coll Dent Med, Sect Oral & Diagnost Sci, Div Periodont, New York, NY 10032 USA
[2] Columbia Univ, Mailman Sch Publ Hlth, Dept Epidemiol, New York, NY 10032 USA
基金
美国国家卫生研究院;
关键词
atherosclerotic vascular disease; inflammatory mediators; periodontal therapy; systemic inflammation; C-REACTIVE PROTEIN; ADHESION MOLECULE EXPRESSION; NECROSIS-FACTOR-ALPHA; CARDIOVASCULAR-DISEASE; PERIPHERAL-BLOOD; AGGRESSIVE PERIODONTITIS; ENDOTHELIAL-CELLS; SERUM ANTIBODY; MARKERS; INFECTION;
D O I
10.1111/j.1600-051X.2009.01382.x
中图分类号
R78 [口腔科学];
学科分类号
1003 ;
摘要
Behle JH, Sedaghatfar MH, Demmer RT, Wolf DL, Celenti R, Kebschull M, Belusko PB, Herrera-Abreu M, Lalla E, Papapanou PN. Heterogeneity of systemic inflammatory responses to periodontal therapy. J Clin Periodontol 2009; 36: 287-294. doi: 10.1111/j.1600-051X.2009.01382.x. We investigated the effect of comprehensive periodontal therapy on the levels of multiple systemic inflammatory biomarkers. Thirty patients with severe periodontitis received comprehensive periodontal therapy within a 6-week period. Blood samples were obtained at: 1-week pre-therapy (T1), therapy initiation (T2), treatment completion (T3), and 4 weeks thereafter (T4). We assessed the plasma concentrations of 19 biomarkers using multiplex assays, and serum IgG antibodies to periodontal bacteria using checkerboard immunoblotting. At T2 and T4, dental plaque samples were analysed using checkerboard hybridizations. At T3, PAI-1, sE-selectin, sVCAM-1, MMP-9, myeloperoxidase, and a composite summary inflammatory score (SIS) were significantly reduced. However, only sE-selectin, sICAM, and serum amyloid P sustained a reduction at T4. Responses were highly variable: analyses of SIS slopes between baseline and T4 showed that approximately 1/3 and 1/4 of the patients experienced a marked reduction and a pronounced increase in systemic inflammation, respectively, while the remainder were seemingly unchanged. Changes in inflammatory markers correlated poorly with clinical, microbiological and serological markers of periodontitis. Periodontal therapy resulted in an overall reduction of systemic inflammation, but the responses were inconsistent across subjects and largely not sustainable. The determinants of this substantial heterogeneity need to be explored further.
引用
收藏
页码:287 / 294
页数:8
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