CYTOKINE COMPOSITION OF GINGIVAL CREVICULAR FLUID IN PATIENTS WITH DIFFERENT PATHOGENETIC VARIANTS OF GENERALIZED PERIODONTITIS

Abstract

Generalized periodontitis (GP) is characterized by heterogeneous pathogenetic mechanisms, which may be reflected in differences in the local cytokine response in periodontal tissues. Objective. To assess and compare the cytokine composition of gingival crevicular fluid in patients with different pathogenetic variants of generalized periodontitis. Materials and methods. A cross-sectional study involving 120 individuals diagnosed with stage I–II generalized periodontitis was conducted. Participants were divided into three groups according to the pathogenetic profile of the disease course. The concentrations of IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-17, and TNF-α in gingival crevicular fluid were determined by enzyme-linked immunosorbent assay. Statistical differences were assessed between groups with different pathogenetic profiles and between male and female participants. Results. In patients with the infectious-inflammatory profile of GP, gingival crevicular fluid levels of IL-1β and IL-8 were significantly higher (p<0.05) than in the other groups; the mean concentrations of these cytokines were 176.8±26.3 pg/mL and 171.0±33.6 pg/mL, respectively. In the metabolic profile, the predominant cytokines were IL-6, IL-17, and TNF-α, with mean concentrations of 144.1±24.8 pg/mL, 116.7±20.6 pg/mL, and 84.8±15.7 pg/mL, respectively. The neuroimmune profile was characterized by reduced concentrations of all cytokines studied, particularly the anti-inflammatory cytokines IL-4 and IL-10, with mean values of 22.6±5.2 pg/mL and 36.4±8.2 pg/mL, respectively. Analysis of sex-related differences showed that the mean IL-1β level in men was 138.5±45.2 pg/mL and was significantly higher (p=0.007) than the corresponding value in women (118.2±34.8 pg/mL). Women had significantly higher mean concentrations of IL-6 (110.4±31.2 pg/mL; p=0.045) and IL-17 (94.1±24.9 pg/mL; p<0.001), whereas the corresponding values in men were 98.6±32.8 pg/mL and 78.9±23.9 pg/mL, respectively. Conclusions. Significant differences in the cytokine composition of gingival crevicular fluid were found among patients with different pathogenetic variants of generalized periodontitis. The infectious-inflammatory variant was characterized by predominance of IL-1β and IL-8; the metabolic profile, by IL-6, IL-17, and TNF-α; and the neuroimmune variant, by reduced concentrations of all cytokines studied, especially the anti-inflammatory cytokines IL-4 and IL-10. Sex-related differences included higher IL-1β levels in men and higher IL-6 and IL-17 levels in women.