Clinico-pathogenetic value of some cytokines in periodontitis

Most authors ascribe pathogenesis of parodontitis to alterations of oral microbiota and mechanisms of local immunity. One may therefore assume that of the concepts of pathogenesis, diagnosis and treatment of the disease may be successfully developed when implementing immunological studies of oral fluid. The aim of present study was to characterize cytokine status of the oral fluid in patients with chronic periodontitis. The study included 101 subjects who were divided into two groups, according to results of retrospective analysis, i.e., study group (69 patients) with moderate or severe periodontitis, and control group (32 virtually healthy volunteers).In control group of patients, cytokine levels corresponded to normal values. In the patients with periodontitis, we have revealed increased IL-2, IL-4 levels. This finding suggests that the cytokine balance in periodontitis is characterized by predominance of Th2 produced factors, i.e., activation of “anti-inflammatory” immunemediated mechanisms. We have also determined VEGF levels in oral fluid, since disturbances of microcirculatory bed seem to be important in evolving periodontitis, along with immune shifts. The VEGF content in oral fluid also tended to increase in the patients. We have found that the IL-4 level in the oral fluid is of high diagnostic value in periodontitis, with diagnostic sensitivity of 88%, and diagnostic specificity of 99% (AUC = 0.95).In our study, we have obtained data corresponding to general view on altered local immune mechanisms in developing chronic periodontitis. This shift manifests as imbalance in cytokine production, especially, by activated IL-4 production. One may assume that this cytokine exerts both pathogenetic effect (immunomediated destruction of tissues) and protective action (stimulation of antimicrobial immunity) in periodontitis.Prevalence and ratio of these effects seems to determine progression rates and development of complications in the disease. Determination of IL-4 content in oral fluid can be considered a potential quantitative tool for laboratory diagnosis of periodontal tissue diseases, being a marker of activity in this pathological process.