Inflammatory cytokines in saliva: early signs of metabolic disorders in chronic kidney disease. A controlled cross-sectional study.
OBJECTIVE
The aim of this study was to evaluate correlations between levels of cytokines in secreted stimulated saliva in patients with chronic kidney disease (CKD) and hyposalivation.


METHODS
Seventy patients with clearance <20 mL/min/1.73 m(2) were evaluated; 40 were predialysis, 21 hemodialysis, and 9 peritoneal dialysis, and they were matched with 70 control subjects. Salivary flow rate was measured and submandibular/sublingual saliva collected. Analyses were performed for whole protein content using a protein assay, and levels of tumor necrosis factor (TNF) α, interleukin (IL) 1β, γ-interferon (γ-INF), IL-6, IL-8, IL-10, monocyte chemotactic protein (MCP) 1, and soluble intercellular adhesion molecule (sICAM) 1, by using Luminex technology.


RESULTS
Patients with CKD had lower (P = .03) stimulated salivary secretion rate and higher salivary whole protein concentration (P = .002) than control subjects. Concentrations of IL-8 (P = .03) and MCP-1 (P = .002) were decreased and TNF-α/IL-10 (P = .05) and IL-8/IL10 (P = .03) ratios were decreased in CKD patients. CKD patients with low secretion levels of stimulated saliva expressed decreased levels of TNF-α (P = .04), IL-1β (P = .02), γ-INF (P = .03), IL-6 (P = .003), IL-8 (P = .005), MCP-1 (P = .006), and sICAM-1 (P = .02).


CONCLUSIONS
Salivary cytokines and secretion rates are significantly decreased in CKD patients. Further research is necessary to understand operating mechanisms and clinical implications of the down-regulation of inflammatory markers in saliva.
Thorman
Royne
R
Department of Dental Medicine, Public Dental Service, Karolinska University Hospital, Karolinska Institutet, Solna, Sweden. royne.thorman@ki.se
Lundahl
Joachim
J
Yucel-Lindberg
Tülay
T
Hylander
Britta
B
D016022:Case-Control Studies; D018932:Chemokine CCL2 / Q000032:analysis; D003430:Cross-Sectional Studies; D016207:Cytokines / Q000032:analysis*; D003731:Dental Caries / Q000378:metabolism; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000032:analysis*; D018799:Intercellular Adhesion Molecule-1 / Q000032:analysis; D007371:Interferon-gamma / Q000032:analysis; D016753:Interleukin-10 / Q000032:analysis; D053583:Interleukin-1beta / Q000032:analysis; D015850:Interleukin-6 / Q000032:analysis; D016209:Interleukin-8 / Q000032:analysis; D008297:Male; D008875:Middle Aged; D010483:Periapical Diseases / Q000378:metabolism; D010518:Periodontitis / Q000378:metabolism; D010530:Peritoneal Dialysis; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000378:metabolism* / Q000628:therapy; D012463:Saliva / Q000737:chemistry* / Q000276:immunology / Q000378:metabolism; D012471:Salivary Proteins and Peptides / Q000032:analysis; D012636:Secretory Rate / Q000502:physiology; D013361:Sublingual Gland / Q000378:metabolism; D013363:Submandibular Gland / Q000378:metabolism; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D014987:Xerostomia / Q000378:metabolism
D018932:Chemokine CCL2; D016207:Cytokines; D018836:Inflammation Mediators; D053583:Interleukin-1beta; D015850:Interleukin-6; D016209:Interleukin-8; D012471:Salivary Proteins and Peptides; D014409:Tumor Necrosis Factor-alpha; D018799:Intercellular Adhesion Molecule-1; D016753:Interleukin-10; D007371:Interferon-gamma