title: The Association Between Thalassemia Major and Periodontal Health.
abstract: BACKGROUND
  The aim of this cross-sectional study is to compare the local and systemic levels of soluble receptor activator of nuclear factor-κB ligand (sRANKL), osteoprotegerin (OPG), a proliferation-inducing ligand (APRIL), B-cell activating factor (BAFF), interleukin (IL)-6, and IL-8 in biofluids of patients with thalassemia major (TM) with or without gingivitis.
  
  
  METHODS
  Seventy-seven patients are included in this study (TM, n = 29; systemically healthy, n = 48). Gingival crevicular fluid (GCF), saliva, and serum levels of IL-6, IL-8, sRANKL, OPG, BAFF, and APRIL were determined by enzyme-linked immunosorbent assay. Data were analyzed by appropriate non-parametric or parametric statistical tests.
  
  
  RESULTS
  Median GCF, serum, and saliva levels for BAFF (P <0.001) and IL-6 and IL-8 (P <0.005) were higher in TM gingivitis than in systemically healthy gingivitis (P <0.001). GCF, serum, and saliva levels for APRIL, sRANKL, IL-6, and IL-8 were higher in TM than in systemically and periodontally healthy comparison groups (P <0.05). Positive correlations were found between bleeding on probing (BOP), plaque index (PI) scores, and GCF APRIL, serum sRANKL, serum OPG, and sRANKL concentrations in TM groups (P <0.05). Several significant positive correlations were found between BOP, PI scores, and biofluid parameters also in systemically healthy groups.
  
  
  CONCLUSIONS
  TM may have a role in the underlying systemic hematologic condition and potentially affect gingival inflammation via dysregulation of lymphocytes and increased activation of osteoclasts.
authors.affiliation: Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey.
authors.forename: Aliye
authors.initials: A
authors.lastname: Akcalı
authors.affiliation: Department of Haematology, School of Medicine, Aydın Government Hospital, Aydın, Turkey.
authors.forename: Selda
authors.initials: S
authors.lastname: Kahraman Çeneli
authors.affiliation: Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey.
authors.forename: Pınar
authors.initials: P
authors.lastname: Gümüş
authors.affiliation: Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey.
authors.forename: Nurcan
authors.initials: N
authors.lastname: Buduneli
authors.affiliation: Infection and Immunity Group; Dental Hospital and School; School of Medicine; College of Medical, Veterinary and Life Sciences; University of Glasgow; Glasgow, Scotland, UK.
authors.forename: David F
authors.initials: DF
authors.lastname: Lappin
authors.affiliation: Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey.
authors.forename: Özgün
authors.initials: Ö
authors.lastname: Özçaka
mesh_terms: D000293:Adolescent; D000328:Adult; D053264:B-Cell Activating Factor / Q000032:analysis / Q000097:blood; D003430:Cross-Sectional Studies; D003774:Dental Plaque Index; D005260:Female; D005883:Gingival Crevicular Fluid / Q000737:chemistry; D005891:Gingivitis / Q000097:blood / Q000150:complications; D006801:Humans; D015850:Interleukin-6 / Q000032:analysis / Q000097:blood; D016209:Interleukin-8 / Q000032:analysis / Q000097:blood; D008297:Male; D008875:Middle Aged; D053244:Osteoprotegerin / Q000032:analysis / Q000097:blood; D010512:Periodontal Index; D053245:RANK Ligand / Q000032:analysis / Q000097:blood; D012463:Saliva / Q000737:chemistry; D053300:Tumor Necrosis Factor Ligand Superfamily Member 13 / Q000032:analysis / Q000097:blood; D055815:Young Adult; D017086:beta-Thalassemia / Q000097:blood / Q000150:complications*
chemical_list: D053264:B-Cell Activating Factor; C508606:CXCL8 protein, human; C508600:IL6 protein, human; D015850:Interleukin-6; D016209:Interleukin-8; D053244:Osteoprotegerin; D053245:RANK Ligand; C505688:TNFSF11 protein, human; D053300:Tumor Necrosis Factor Ligand Superfamily Member 13
keywords: Beta-thalassemia; cytokines; gingivitis; interleukins; lymphocytes; osteoclasts