Detection of IL-4, IL-6, and IL-12 Serum Levels in Generalized Aggressive Periodontitis
Summary
In September of 2011, experimenters Robati, Ranjbari, Boroujerdnia, and Chinipardaz measured how periodontitis is related to the immune system's function, and compared the roles of cytokine networks, which regulate inflammation, immunity function, and the specific cytokines under study (IL-4, IL-6, and IL-12) are growth and activation factors for B cells, T cells, and natural killer cells. The experimenters observed the cytokines' specific involvement in cases of periodontal disease. The researchers noted that chronic periodontitis is caused by the oral cavity's defense system trying to fight off dental plaque antigens that want to infect the mouth and specifically the gums. The researchers also discussed how T cells are extensively involved in periodontitis, since they regulate immunity and can be measured in cases of periodontal disease. Robati et al. (2011) sought to measure patients with aggressive periodontitis versus a control group in order to measure the presence or absence of the specified cytokines IL-4, IL-6, and IL-12, since previous studies had proven that IL-4 has been known to suddenly cause periodontal disease.
The researchers selected twenty-five Iranian patients from ages 20 to 36 that were referred to the Periodontal Clinic of Ahvaz Jundishapur University of Medical Sciences. The control group included 25 healthy patients who were undergoing crown lengthening procedures by a licensed dentist prior to the study. The medical and dental histories of both cases and controls were collected, including information on HIV infections, pregnancy, medications that affect cytokine function, and smoking habits. The attachment of gum tissue to teeth was measured in at least 3 affected teeth, and all patients had 5 or 6 teeth with greater than 5 mm of periodontal disease-related gum tissue recession. Surgical techniques were used, including restorative crown lengthening, pocket reduction of gum tissue where gum flaps were contoured properly, fracture lines in teeth were corrected, and crown lengthening helped alleviate gum and bone loss associated with cavities. Blood samples of the patients were collected during periodontal pocket reduction surgery, and control groups' blood samples were taken before extractions in noninflammatory areas, in order to assess white blood cell count. The cytokine assay used to test for IL-4, IL-6, and IL-12 presence included an enzyme-linked immunosorbent assay which tests for antibody presence to locate a particular antigen, and absorbance readings at 450 nm from a spectrophotometer measured cytokine presence. T-tests were used to quantify the data collected.
The researchers found that cytokines were present in all of the sample population in differing amounts; however, IL-4 levels were higher in the control group than the case group, while IL-6 was found more abundantly in the case group. There was a non-significant decrease in IL-12 in the case group versus the control group. Cytokines are definitely involved in the process of regulating tissue regrowth, immune response, and inflammation related to periodontitis. The findings reaffirmed previous findings of how cytokine IL-4 was found in decreased amounts in periodontitis patients versus people without periodontitis. In addition, IL-6 levels were increased in the periodontitis patients versus the control group, and the findings are supported by previous findings that indicate how IL-6 is necessary in bone recovery. Although no significant different in the levels of IL-12 between periodontitis patients and the control group population, IL-12 levels were lower in patients affected by periodontitis, which was supported by previous findings connecting IL-12 levels to periodontal inflammation. There is a protective affect offered by IL-4 levels that are high.
Here are the findings tabulated from the experimenters:
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| Image from http://www.iji.ir/september2011/4thiji_vol8_no3_2011.pdf |
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| Image from http://www.iji.ir/september2011/4thiji_vol8_no3_2011.pdf |
Recommendations for Future Research
In order to further investigate if IL-12 levels truly play a significant role in inflammation related to periodontitis, researchers should do another ELISA analysis with patients who have elevated levels of IL-12, and measure only patients who have aggressive periodontitis to see how their personal factors affect the production of IL-12 related to periodontitis. In addition, samples from different hospitals should be included to show a more generalized picture of the population that has periodontitis. In addition, the activity of bacteria associated with periodontitis should be measured more thoroughly through microscopic methods in patients who had decreased IL-4 levels and generalized aggressive periodontitis. Another study could also assess how cytokines are related to different stages of periodontitis and not just the severe stage, in order to generalize the activity of cytokines across the spectrum of less severe to severe periodontitis infections.
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