title: The short-term effects of treatment of chronic periodontitis on circulating levels of endotoxin, C-reactive protein, tumor necrosis factor-alpha, and interleukin-6.
abstract: BACKGROUND
  The acute-phase response involves molecules including tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), and C-reactive protein (CRP). This study aimed to determine whether subgingival scaling resulted in rapid changes in plasma concentrations of these molecules.
  
  
  METHODS
  Twenty-three non-smoking adults with chronic periodontitis received subgingival scaling for 60 minutes. Venous blood samples were taken at 0, 15, 30, 60, and 120 minutes. TNF-alpha and IL-6 were assayed from all samples and CRP from the baseline and final samples. Lipopolysaccharide (LPS) was assayed at 0, 15, and 30 minutes using limulus lysate assay (LAL) and EndoCAb Ig assays.
  
  
  RESULTS
  LPS assays were suggestive of a transient low-grade bacteremia, but changes in LPS approaching significance (P=0.061) were seen with LAL only. There was a significant increase in circulating TNF-alpha (P=0.0387) and IL-6 (P<0.0001), and the degree of change in TNF-alpha was correlated with the severity of periodontal breakdown (P=0.001). There was also a significant correlation between levels of IL-6 and TNF-alpha (P<0.001).
  
  
  CONCLUSIONS
  Chronic periodontitis patients undergoing an episode of subgingival scaling show a significant elevation in circulating TNF-alpha and IL-6. This may account for anecdotal reports of pyrexia following treatment and may be significant in terms of the relationship between periodontal disease, bacteremia, and cardiovascular disease.
authors.affiliation: Periodontology and Preventive Dentistry, Guy's, King's and St. Thomas' Dental Institute, King's College, London, UK. mark.ide@kcl.ac.uk
authors.forename: Mark
authors.initials: M
authors.lastname: Ide
authors.forename: Daljit
authors.initials: D
authors.lastname: Jagdev
authors.forename: Paula Y
authors.initials: PY
authors.lastname: Coward
authors.forename: Martin
authors.initials: M
authors.lastname: Crook
authors.forename: G Robin
authors.initials: GR
authors.lastname: Barclay
authors.forename: Ron F
authors.initials: RF
authors.lastname: Wilson
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000906:Antibodies; D002097:C-Reactive Protein / Q000032:analysis*; D002863:Chromogenic Compounds; D002908:Chronic Disease; D003774:Dental Plaque Index; D012534:Dental Scaling; D004731:Endotoxins / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008033:Limulus Test; D008070:Lipopolysaccharides / Q000097:blood; D008297:Male; D010512:Periodontal Index; D010518:Periodontitis / Q000097:blood / Q000628:therapy*; D018709:Statistics, Nonparametric; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
chemical_list: D000906:Antibodies; D002863:Chromogenic Compounds; D004731:Endotoxins; D015850:Interleukin-6; D008070:Lipopolysaccharides; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein