Evaluation of serum and gingival crevicular fluid C-reactive protein and IL-6 levels in patients with periodontitis and transient ischemic attacks.
BACKGROUND
Recent advances have suggested that periodontitis (PD), the paradigm of chronic infection in dental pathology, shares several pathogenic pathways with cardio- and cerebro-vascular disorders (CVD), based on inflammatory mediators including IL-1, IL-6, TNF-α.


OBJECTIVE
To assess pro-inflammatory biomarkers (C-reactive protein - CRP, IL-6) in serum and gingival crevicular fluid (GCF) in patients with PD and with transient ischemic attacks (TIAs).


METHODS
Prospective observational study on 143 patients classified as follows: 40 healthy subjects (group A), 50 PD patients (group B) and 53 PD-TIAs patients (group C). The predefined assessment protocol has included: current medical data, risk factors for CRP changes, periodontal status (clinical, orthopantomography, Schei Ruler technique), inflammatory biomarkers (CRP, IL-6).


RESULTS
High serum CRP and IL-6 have been reported in both TIAs and PD, while statistically significant increase in GCF CRP only in PD-TIAs (p<0.05). Moreover, both generalized and localized chronic PD may be at higher risk for CVD, since CRP level was higher in these subgroups. However, no significant differences were reported in serum IL-6 between generalized and localized PD. A score function was demonstrated, including bone loss degree, bleeding index, collection site depth, serum and GCF IL-6 and CRP, tooth loss, allowing the classification of PD based on risk for developing TIAs.


CONCLUSIONS
CRP and IL-6 are commonly involved in the pathways of PD and TIAs. Interdisciplinary assessment should be promoted in order to implement the stratification of PD patients according to the risk for TIAs as suggested by the proposed algorithm.
Department of Rheumatology, Grigore T. Popa University of Medicine and Pharmacy, Iassy, Romania.
Danisia
D
Haba
Silvia
S
Teslaru
Didona
D
Ungureanu
Diana
D
Hodorog
C
C
Alecu
Ana Gabriela
AG
Benghiac
L
L
Zetu
Codrina
C
Ancuţa
E
E
Ancuţa
A
A
Nemţoi
Cristina
C
Iordache
D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism*; D005883:Gingival Crevicular Fluid / Q000378:metabolism*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D002546:Ischemic Attack, Transient / Q000097:blood*; D008875:Middle Aged; D010518:Periodontitis / Q000097:blood*; D055815:Young Adult
D015850:Interleukin-6; D002097:C-Reactive Protein