| Summary: | 碩士 === 高雄醫學大學 === 牙醫學研究所碩士班 === 93 === Increase of inflammatory mediators related to periodontal disease is a potential pathway to explain the association between periodontal disease and several systemic diseases, especially preterm low-birth weight (PLBW). Several antioxidative vitamins are considered as protective supplement for pregnancy women through their ability to inhibit the production of these mediators. Hence, in this study, we evaluate the associations among periodontal status and PGE2, IL-1β, TNF-α levels in GCF and Blood first. Then, further compare the relationship of this result with levels of retinol, lycopene, α-, β-carotene and α-, γ-, δ-tocopherol in blood.
We recruited sixty-eight pregnant women, who received a full-mouth clinical periodontal examination at early and late trimesters (1st and 3rd trimester or 2nd and 3rd trimesters). GCF samples were collected at the same time as oral examinations and blood samples were collected within one month after oral examinations. the PGE2, IL-1β, TNF-α in GCF and plasma were assayed using commercial ELISA kits and 48 3rd trimesters plasm sample were additionally sent to HPLC assay for antioxidant vitamins.
We found that the periodontal clinical parameters (mean GI, PD, CAL, BOP%) were associated with the total amount of PGE2, IL-1β and mean CAL with TNF-α (p<0.05). The plasma levels of TNF-α concentration was significant associated with mean PD (r=0.24, p=0.01), mean CAL ( r=0.26, p=0.01)and the total amount of PGE2 (r=0.22, p=0.03). There was no significant relation between clinical parameters, total amount of PGE2, IL-1β and TNF-α in 30-second GCF samples and the concentration of plasma- PGE2 (p > 0.05). For vitamins, we found total amount of PGE2 was negatively associated with plasma levels of retinol (r=-0.34, p=0.02) and total vitamin E (r=-0.34, p=0.02)【α-tocopherol (r=-0.32, p=0.03) and δ-tocopherol (r=-0.32, p=0.03)】. TNF-α concentration in plasma was significantly related to retinol (r=-0.54, p=0.0001).
Conclusion: the results of this study showing that the periodontal status was associated with local level of PGE2, IL-1β, TNF-α and local level of PGE2 were also related to systemic level of TNF-α in blood suggest that chronic inflammatory status might play an important role linking oral health and systemic disease. Retinol and vitamin E might inhibit the production of inflammatory mediators resulting for periodontal status. Further longitudinal studies conducted with large sample size are needed to clarify the causal association.
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