title: Proinflammatory and anti-inflammatory cytokines in gingival crevicular fluid and serum of patients with rheumatoid arthritis and patients with chronic periodontitis.
abstract: BACKGROUND
  The aim of this study is to evaluate proinflammatory and anti-inflammatory cytokine levels in gingival crevicular fluid (GCF) and serum of rheumatoid arthritis (RA) and chronic periodontitis (CP) patients to assess whether cytokine profiles distinguish patients with RA and patients with CP while using healthy patients as background controls.
  
  
  METHODS
  A total of 49 patients, 17 patients with RA (three males and 14 females; mean age: 47.82 ± 10.74 years), 16 patients with CP (10 males and six females; mean age: 44.00 ± 7.00 years), and 16 controls (eight males and eight females; mean age: 28.06 ± 6.18 years) were enrolled. Patients with RA were under the supervision of rheumatologists; 15 of the patients with RA were being treated with methotrexate-sulfasalazine combined therapy, and two of the patients were being treated with leflunomid therapy. Periodontal parameters (plaque index, gingival index, probing depth, and clinical attachment level) were recorded. Interleukin (IL)-1β, IL-4, IL-10, and tumor necrosis factor-α (TNF-α) were determined in GCF and IL-1β and IL-10 in serum by enzyme-linked immunosorbent assay.
  
  
  RESULTS
  There were significant differences found among RA, CP, and control groups for all periodontal parameters (P <0.05). The total amount and concentration of GCF IL-1 β, IL-4, IL-10, and TNF-α were similar in RA and CP patients (P >0.05). Although the total amount and concentration of serum IL-10 was not significantly different among the groups (P >0.05), serum IL-1β was significantly lower in the RA group compared to CP patients and controls and was higher in GCF of the RA group compared to the CP group.
  
  
  CONCLUSIONS
  Although clinical periodontal disease parameters indicated more severe periodontal disease in CP compared to RA patients, immunologic evaluation did not reveal consistent results regarding proinflammatory and anti-inflammatory cytokine levels. This might be a result of the use of non-steroidal anti-inflammatory drugs and rheumatoid agents by patients with RA.
authors.affiliation: Department of Periodontology, Faculty of Dentistry, Baskent University, Ankara, Turkey.
authors.forename: Burcu
authors.initials: B
authors.lastname: Cetinkaya
authors.forename: Esra
authors.initials: E
authors.lastname: Guzeldemir
authors.forename: Ersin
authors.initials: E
authors.lastname: Ogus
authors.forename: Sule
authors.initials: S
authors.lastname: Bulut
mesh_terms: D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000188:drug therapy / Q000276:immunology*; D055113:Chronic Periodontitis / Q000097:blood / Q000276:immunology*; D003430:Cross-Sectional Studies; D016207:Cytokines / Q000032:analysis* / Q000097:blood; D003774:Dental Plaque Index; D005260:Female; D005883:Gingival Crevicular Fluid / Q000276:immunology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D018836:Inflammation Mediators / Q000032:analysis* / Q000097:blood; D016753:Interleukin-10 / Q000032:analysis / Q000097:blood; D053583:Interleukin-1beta / Q000032:analysis / Q000097:blood; D015847:Interleukin-4 / Q000032:analysis; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000145:classification; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000145:classification; D012460:Sulfasalazine / Q000627:therapeutic use; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D016207:Cytokines; D007166:Immunosuppressive Agents; D018836:Inflammation Mediators; D053583:Interleukin-1beta; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D015847:Interleukin-4; D012460:Sulfasalazine; D008727:Methotrexate