title: Coordinate production of PGE2 and IL-1 beta in the gingival crevicular fluid of adults with periodontitis: its relationship to alveolar bone loss and disruption by twice daily treatment with ketorolac tromethamine oral rinse.
abstract: The inflammatory mediators prostaglandin E2 (PGE2) and interleukin-1 beta (IL-1 beta) play critical roles in the inflammatory process leading to alveolar bone and connective tissue loss in periodontal disease. Data from a previously published 6-month clinical study demonstrated that twice daily use of 0.1% ketorolac tromethamine oral rinse prevented alveolar bone loss in adults with periodontitis. We further analyzed data from this study to examine the relationship between PGE2. IL-1 beta and bone loss. Patient mean PGE2 and IL-1 beta levels in gingival crevicular fluid (M-GCF) measured throughout the course of the study were directly compared to the maximum amount of alveolar bone height loss observed at a single study site in each patient. The maximum amount of bone loss measured was chosen for the analysis since the pattern of bone loss was clearly episodic in nature. A statistically significant correlation (r = 0.73, p = 0.001) exists between M-GCF PGE2 concentration and the maximum amount of bone height lost at individual patient study sites. The correlation between M-GCF IL-1 beta concentration and maximum bone height lost is also statistically significant (r = 0.66, p = 0.005). Over the 6-month duration of the study, both PGE2 and IL-1 beta were coordinately expressed in the placebo treatment group as reflected in the significant correlation between M-GCF concentrations of the 2 mediators (r = 0.81, p < 0.001). Treatment of patients with 0.1% ketorolac tromethamine twice daily for 6 months resulted in reductions of PGE2 in GCF and a negligible correlation between M-GCF PGE2 and M-GCF IL-1 beta (r = 0.42, p = 0.088). This lack of a strong association between the 2 mediators in the ketorolac treatment group provides a direct biochemical readout of the anti-inflammatory efficacy of ketorolac tromethamine oral rinse in patients with periodontitis. Further studies are warranted to determine the full diagnostic potential of M-GCF levels of PGE2 and IL-1 beta for predicting risk of alveolar bone loss in patients with periodontitis and monitoring periodontal therapy effectiveness.
authors.affiliation: Procter and Gamble Company, Cincinnati, OH 45242, USA.
authors.forename: P F
authors.initials: PF
authors.lastname: Cavanaugh
authors.forename: M P
authors.initials: MP
authors.lastname: Meredith
authors.forename: W
authors.initials: W
authors.lastname: Buchanan
authors.forename: M J
authors.initials: MJ
authors.lastname: Doyle
authors.forename: M S
authors.initials: MS
authors.lastname: Reddy
authors.forename: M K
authors.initials: MK
authors.lastname: Jeffcoat
mesh_terms: D000328:Adult; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control*; D000704:Analysis of Variance; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D015232:Dinoprostone / Q000032:analysis / Q000096:biosynthesis*; D005260:Female; D005883:Gingival Crevicular Fluid / Q000737:chemistry / Q000378:metabolism; D006801:Humans; D007375:Interleukin-1 / Q000032:analysis / Q000096:biosynthesis*; D020911:Ketorolac Tromethamine; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes / Q000627:therapeutic use; D010518:Periodontitis / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism*; D011857:Radiographic Image Interpretation, Computer-Assisted; D013382:Subtraction Technique; D014046:Tolmetin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014325:Tromethamine / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007375:Interleukin-1; D009067:Mouthwashes; D014325:Tromethamine; D020911:Ketorolac Tromethamine; D014046:Tolmetin; D015232:Dinoprostone