Зміни цитокінового профілю і вмісту анти-Hsp60 антитіл різної специфічності при генералізованому пародонтиті

Abstract

Сучасні дослідження свідчать, що в основі прогресування генералізованого пародонтиту лежать порушення балансу між мікрофлорою і захисними факторами, які регулюються імунними механізмами. Мета. Дослідити в сироватці крові хворих на генералізований пародонтит зміни цитокінового профілю та його зв'язок із умістом анти-Hsp60 антитіл різної специфічності. Методи дослідження. Обстежено 32 хворих із генералізованим пародонтитом із використанням імунологічних методів. Результати. При генералізованому пародонтиті встановлено підвищення вмісту прозапальних цитокінів (ІЛ-6, ІЛ-8, ІЛ-1β, ФНП) на тлі зростання вмісту антитіл проти прокаріотичного Hsp60 та Hsp60 людини. Висновки. Визначено наявність аутоімунного процесу з ознаками системної запальної відповіді при генералізованому пародонтиті; Современные исследования свидетельствуют, что в основе прогрессирования генерализованного пародонтита лежат нарушения баланса между микрофлорой и защитными факторами, которые регулируются иммунными механизмами. Цель. Определить в сыворотке крови больных генерализованным пародонтитом изменения цитокинового профиля и его связь с содержанием анти-Hsp60 антител разной специфичности. Методы исследования. Обследовано 32 больных с генерализованным пародонтитом с использованием иммунологических методов. Результаты. При генерализованном пародонтите установленно повышение содержания провоспалительных цитокинов (ІЛ-6, ІЛ-8, ІЛ-1β, ФНП) на фоне роста содержания антител против прокариотического Hsp60 и Hsp60 человека. Выводы. Определено наличие аутоиммунного процесса с признаками системного воспалительного ответа при генерализованном пародонтите; Introduction. Periodontitis is considered as a multifactorial disease resulting from a combine impact of local and systemic factors on the background of altered reactivity. The stimulation of the immune system by periodontal bacteria results in the increased production of pro-inflammatory cytokines, which play an important role in the pathogenesis of the disease and is determined by activation of leukocytes, macrophages, fibroblasts and endothelial cells via nonspecific host response to infections, trauma, ischemia etc. The heat shock proteins are considered as an important antigen, which trigger this process. The quantitative characteristics and relationships between pro- and anti-inflammatory cytokines (cytokine balance) reflect the dynamics of inflammation and correlate with activity of certain cardio-vascular diseases, infections and malignant tumors, allowing the objective estimation of the disease severity and prognosis. However the role of blood cytokines in periodontal disease is still a subject of debate in the literature. Aim. To study the cytokine profile changes and their relationship with the content of anti-Hsp60 antibody of different specificity in the blood serum of patients with generalized periodontitis. Materials and methods. The prospective clinical and immunological study was performed in 54 persons aged from 21 to 73 years with mean age 35,8+15 years, which were divided into two groups: the main group - 32 patients with different degrees of periodontitis and control group - 22 patients with intact periodontium. Patients were recruited at the Department of Therapeutic Dentistry in P.L. Shupyk National Medical Academy of Postgraduate Education. All patients were examined according to the standard protocol, which included anamnesis, analysis of current medical data and general health state, clinical periodontal assessment, radiological examination and assay of cytokine profile. For immunological study the samples of venous blood were obtained from all patients in both groups. Assay of interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-4 (IL-4), tumor necrosis factor (TNF-α) and antibodies for human and procariotic heat shock protein Hsp60 in serum of patients was performed using enzyme-linked immunosorbent assay (ELISA). Statistical analysis of received results was carried out using SPSS (SPSS Inc., Chicago, IL, USA) and MS Excel software. Results and discussion. Analysis of the obtained results showed that in patients of the main group the average content of pro-inflammatory cytokines as well as a content of antibodies against prokaryotic Hsp60 and human Hsp60 were significantly higher than in the control group. The average content of IL-6 in patients with periodontitis (the main group) was 17,3±3 pg/ml vs 9,8±2 pg/ml in the control group (p<0.05), the average content of IL-1β in the main group was 53,5±6,6 pg/ml vs 30,4±5,3 pg/ml in the control group (p<0.05), the average content of TNF-α - 23,8±2,6 pg/ml vs 9,7 ± 1,7 pg/ml (p<0.05), the average content of IL-8 in the main group was also higher than in the control (7,9±2,3 pg/ml vs 6,2±1,1 pg/ml), but the differences for this cytokine in studied groups were insignificant (p>0.05). On the contrary, the average content of anti-inflammatory cytokine IL-4 in patients of the main group was lower than in the control: 9,7±1,7 pg/ml vs 16,7±3,5 pg/ml however the differences appeared not significant (p>0.05). Conclusions. The immunological data revealed the significant increase in levels of pro-inflammatory cytokines (IL-6, IL-1β, TNF-α) as well as a growing content of antibodies against prokaryotic Hsp60 and human Hsp60 in patients with periodontitis compared to the control group. The content of anti-inflammatory IL-4 in the control group was higher than in patients with periodontitis; however the differences for this cytokine were insignificant. The increase of pro-inflammatory and decrease in anti-inflammatory cytokines in patients with periodontitis is probably one of the pathogenic mechanisms which determines the course of inflammatory and degenerative processes in periodontal tissues. High concentrations of pro-inflammatory cytokines and antibodies against prokaryotic Hsp60 and human Hsp60 in blood of the patients with periodontitis can be considered as negative prognostic criteria of further disease progression and systemic complication.