The Effect of Long-Term Heavy Smoking on Gingival Crevicular Fluid IL-4 levels

Yıl 2012, Cilt: 3 Sayı: 2, 69 - 76, 22.10.2012

Prof. Dr. Fatma Kırzıoğlu , Doç. Dr. Zuhal Yetkin Ay , Yrd. Doç. Dr. Medine Cumhur Cüre Doç. Dr. Recep Sütçü , Doç. Dr. Reha Demirel

Öz

Aim: The aim of this study was to evaluate the influence of long-term and heavy smoking on the gingival crevicular fluid (GCF) interleukin–4 (IL-4) levels in chronic periodontitis patients.
Methods: The study population included 126 non-smoker (NS) and long-term and heavy smoker (S) chronic periodontitis patients and 17 non-smoker healthy controls (C). The NS and S groups were divided into three subgroups according to the probing depth (PD) categories: a: PD ≤ 3 mm, b: PD= 4-5 mm, c: PD > 5 mm. For each individual, clinical data were recorded.
Results: All of the NS subgroups had higher IL–4 concentrations than the C group (p<0.05). But in the S a- and b-subgroups, lower IL–4 levels were found than that in the C group (p<0.05). The NS a- and b-subgroups showed significant negative correlations between IL–4 and gingival inflammation symptoms (p<0.05).
Conclusion: Our study has supported that long-term and heavy smoking impairs the immune response in periodontitis patients.

Anahtar Kelimeler

Interleukin–4, gingival crevicular fluid, periodontitis, smoking

Uzun dönem aşırı sigara kullanımının kronik periodontitisli bireylerde dişeti oluğu sıvısı interlökin 4 düzeylerine etkisi

Öz

Amaç: Bu çalışmanın amacı uzun dönem aşırı sigara kullanımının kronik periodontitis hastalarında dişeti oluğu sıvısı (DOS) interlökin (IL)-4 düzeylerine etkisini belirlemekti. Yöntem ve Gereç: Çalışma popülasyonu sigara içmeyen (S-), uzun dönem aşırı sigara içen (S+) 126 kronik periodontitisli ve 17 sağlıklı kontrol (K) bireyden oluştu. Sigara içen ve içmeyen gruplar cep derinliği (CD) kategorilerine göre üçer alt gruba (a: CD ≤ 3 mm, b: CD= 4-5 mm, c: CD > 5 mm) ayrıldı. Bireylerden klinik ölçümler kaydedildi.
Bulgular: Sigara içmeyen tüm S- alt gruplarında K grubuna göre DOS IL–4 düzeyleri yüksekti (p<0.05). Ancak DOS IL–4 düzeyleri S+a ve S+b alt gruplarında K grubuna göre anlamlı derecede düşük bulundu (p<0.05). Dişeti inflamasyon belirteçleri ve IL–4 düzeyleri arasındaki korelasyonlar S-a ve S-b alt gruplarında istatistiksel olarak anlamlı ve negatifti (p<0.05).
Sonuçlar: Çalışmamızın sonuçları uzun dönemli aşırı sigara kullanımının periodontitisli bireylerde immün cevapta bazı bozulmalara yol açabileceğini desteklemektedir.

Anahtar Kelimeler

İnterlökin–4, dişeti oluğu sıvısı, periodontitis, sigara kullanımı

Kaynakça

• Birkedal–Hansen H. Role of cytokines and inflammatory mediators in tissue destruction. J Periodontal Res 1993; 28: 500–510.
• Offenbacher S. Periodontal diseases: Pathogenesis. Ann Periodontol 1996; 1: 821–878.
• Käαer UR, Gleissner C, Dehne F, Michel A, Willershausen–Zonnchen B, Bolten WW. Risk for periodontal disease in patients with longstanding rheumatoid arthritis. Arthritis Rheum 1997; 40: 2248–2251.
• Bozkurt FY, Berker E, Akkuş S, Bulut Ş. Relationship between IL–6 levels in gingival crevicular fluid and periodontal status in patients with rheumatoid arthritis and adult periodontitis. J Periodontol 2000; 71: 1756–1760.
• Coffman RL, Mosmann TR. CD4+ T–cell subsets: regulation of differentiation and function. Res Immun 1991; 142: 7–9.
• Fujihashi K, Kono Y, Beagley KW, Yamamoto M, McGhee JR, Mestecky J, Kiyono H. Cytokines and periodontal disease: Immunopathological role of interleukins for B cell responses in chronic inflamed gingival tissues. J Periodontol 1993; 64: 400–406.
• Taubman MA, Kawai T. Involvement of T– lymphocytes in periodontal disease and in direct and indirect induction of bone resorption. Crit Rev Oral Biol Med 2001; 12: 125–126.
• Mosmann TR, Cherwinski H, Bond MV, Giedlen MA, Coffman RL. Two types of helper T cells clones. J Immunol 1986; 136: 2348–2356.
• Zelante T, De Luca A, Bonifazi P, Montagnoli C, Bozza S, Moretti S, Belladonna ML, Vacca C, Conte C, Mosci P, Bistoni F, Puccetti P, Kastelein RA, Kopf M, Romani L. IL–23 and the Th17 pathway promote inflammation and impair antifungal immune resistance. Eur J Immunol 2007; 37: 2680–2682.
• Lexberg MH, Taubner A, Forster A, Albrecht I, Richter A, Kamradt T, Radbruch A, Chang HD. Th memory for interleukin–17 expression is stable in vivo. Eur J Immunol 2008; 38: 2654–2664.
• O’Garra A. Cytokines induce the development of functionally heterogeneous T helper cell subsets. Immunity 1998; 8: 275–283.
• Belardelli F, Ferrantini M. Cytokines as a link between innate and adaptive antitumor immunity. Trends Immunol 2002; 23:201–208.
• Mangan DF, Robertson B, Wahl SM. IL–4 enhances programmed cell death (apoptosis) in stimulated human monocytes. J Immunol 1992; 148: 1812–1816.
• Corcoran ML, Stetler–Stevenson WG, Brown PD, Wahl LM IL–4 inhibition of PGE synthesis 2 block interstitial collagenase and 92Kd type IV collagenase/gelatinase production of human monocytes. J Biol Chem 1992; 267: 515–519.
• Shapira L, van Dyke TE, Hart TC. A localized absence of interleukin–4 triggers periodontal disease activity: a novel hypothesis. Med Hypotheses 1992; 39: 319–322.
• Kabashima H, Nagata K, Hashiguchi I, Toriya Y, Iijima T, Maki K, Maeda K. Interleukin–1 receptor antagonist and interleukin–4 in gingival crevicular fluid of patients with inflammatory periodontal disease. J Oral Pathol Med 1996; 25: 449–455.
• Boström L, Linder LE, Bergstrom J. Smoking and GCF levels of IL–1beta and IL–1ra in periodontal disease. J Clin Periodontol 2000; 27: 250–255.
• Darby IB, Hodge PJ, Riggio MP, Kinane DF. Microbial comparison of smoker and non–smoker adult and early–onset periodontitis patients by polymerase chain reaction. J Clin Periodontol 2000; 27: 417–424.
• Erdemir EO, Duran I, Haliloglu S. Effects of smoking on clinical parameters and the gingival crevicular fluid levels of IL–6 and TNF–α in patients with chronic periodontitis. J Clin Periodontol 2004; 31: 99–104.
• Bergström J. Tobacco smoking and risk for periodontal disease. J Clin Periodontol 2003; 30: 107–113.
• Feldman RS, Alman JE, Chauncey HH. Periodontal disease indexes and tobacco smoking in healthy aging men. Gerodontics 1987; 1: 43–46.
• Bergström J. Cigarette smoking as risk factor in chronic periodontal disease. Community Dent Oral Epidemiol 1989; 17: 245–247.
• Goultschin J, Cohen, H.D, Donchin M, Brayer L. Soskolne W.A. Association of smoking with periodontal treatment needs. J Periodontol 1990; 61: 364–367.
• Preber H, Kant T. Bergström J. Cigarette smoking oral hygiene and periodontal health in Swedish army conscripts. J Clin Periodontol 1980; 7: 106–113.
• Osterberg T, Mellstrom D. Tobacco smoking: a major risk factor for loss of teeth in three 70–year– old cohorts. Communityity Dent Oral Epidemiol 1986; 14: 367–370.
• Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann Periodontol 1999; 4: 1–6.
• Löe H, Silness J. Periodontal disease in pregnancy. I. Prevalance and severity. Acta Odont Scand 1963; 21: 533–551.
• Silness J, Löe H. Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condition. Acta Odont Scand 1964; 22: 121–135.
• Nowicki D, Vogel RI, Melcher S, Deasy MJ. The gingival bleeding time index. J Clin Periodontol 1981; 52: 260–262.
• Genco RJ. Host responses in periodontal diseases current concepts. J Periodontol 1992; 63: 338–355.
• Mehindate K, al–Daccak R, Aoudjit F, Damdoumi F, Fortier M, Borgeat P, Mourad W. Interleukin–4, transforming growth factor beta 1, and dexamethasone inhibit superantigen– induced prostaglandin E2–dependent collagenase gene expression through their action on cyclooxygenase–2 and cytosolic phospholipase A2. Lab Invest 1996; 75: 529–538.
• Choi Y, Kim JJ. B cells activated in the presence of Th1 cytokines inhibit osteoclastogenesis. ExpMol Med 2003; 35: 385–392.
• Ejeil AL, Gaultier F, Igondjo–Tchen S, Senni K, Pellat B, Godeau G, Gogly B. Are cytokines linked to collagen breakdown during periodontal disease progression? J Periodontol 2003; 74: 196–201.
• Gorska R, Gregorek H, Kowalski J, Laskus–Perendyk A, Syczewska M, Madalinski K. Relationship between clinical parameters and cytokine profiles in inflamed gingival tissue and serum samples from patients with chronic periodontitis. J Clin Periodontol 2003; 30: 1046–1052.
• Pradeep AR, Roopa Y, Swati PP. Interleukin–4,a T–helper 2 cell cytokine,is associated with the remission of periodontal disease. J Periodontal Res. 2008; 43: 712–716.
• 36. Tsai Chi–Cheng, Chia–Hsin Ku, Ya–Ping Ho, Kun–Yen Ho, Yi–Min Wu, Chun–Cheng Hung. Changes in Gingival Crevicular Fluid Interleukin–4 and Interferon–gamma in Patients with Chronic Periodontitis Before and After Periodontal Initial Therapy. Kaoh J Med Sci 2007; 23: 1–7.
• Hagiwara E, Takahashi KI, Okubo T, Ohno S, Ueda A, Aoki A, Odagiri S, Ishigatsubo Y. Cigarette smoking depletes cells spontaneously secreting Th(1) cytokines in the human airway. Cytokine 2001; 14: 121–126.
• Bergström J, Eliasson S, Preber H. Cigarette smoking and periodontal bone loss. J Periodontol 1991; 62: 242–246.
• Grossi SG, Zambon JL, Ho AW, Koch G, Dunford RG, Machtei EE, Norderyd OM, Genco RJ. Assessment of risk for periodontal disease I. Risk indicators for attachment loss. J Periodontol 1994; 65: 260–267.
• Giannopoulou C, Kamma JJ, Mombelli A. Effect of inflammation, smoking and stress on gingival crevicular fluid cytokine level. J Clin Periodontol. 2003; 30:145–153.
• Bergström J. Short–term investigation on the influence of cigarette smoking upon plaque accumulation. Scand J Dent Res 1981; 89: 235– 238.
• Bergström J, Eliasson S, Dock J. A 10–year prospective study of tobacco smoking and periodontal health. J Periodontol 2000; 71: 1338– 1347.
• Machuca G, Rosales I, Lacalle JR, Machuca C, Bullon P. Effect of cigarette smoking on periodontal status of healthy young adults. J Periodontol 2000; 71: 73–78.
• Zambon JJ, Grossi SG, Machtei EE, Ho AW, Dunford R, Genco RJ. Cigarette smoking increases the risk for subgingival infection with periodontal pathogens. J Periodontol 1996; 67: 1050–1054.
• Giannopoulou C, Cappuyns I, Mombelli A. Effect of smoking on gingival crevicular fluid cytokine profile during experimental gingivitis. J Clin Periodontol 2003; 30: 996–1002.
• Haber J, Wattles J, Crowley M, Mandell R. Evidence for cigarette smoking as a major risk factor for periodontitis. J Periodontol 1993; 64: 16–23.
• Axelsson P, Paulander J, Lindhe J. Relationship between smoking and dental status in 35– 50– 65– and 75–year old individuals. J Clin Periodontol 1998; 25: 297–305.
• van der Weijden GA, De Slegte C, Timmerman MF, van der Velden U. Periodontitis in smokers and non–smokers: intra–oral distribution of pockets. J Clin Periodontol 2001; 28: 955–960.
• Danielsen B, Manji F, Nagelkerke N, Fejerskov O, Baelum V. Effect of cigarette smoking on the transition dynamics in experimental gingivitis. J Clin Periodontol 1990; 17: 159–164.