1
|
Mei H, Qi C, Liu J, Yang S, Zhou J, Lu Y, Zheng L, Li J, Zhao L, Xu X. hTAS2R38 polymorphisms modulate oral microbiota and influence the prevalence and treatment outcome of halitosis. MICROBIOME 2025; 13:85. [PMID: 40156025 PMCID: PMC11951550 DOI: 10.1186/s40168-025-02087-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2024] [Accepted: 03/10/2025] [Indexed: 04/01/2025]
Abstract
BACKGROUND The genetic susceptibility of halitosis is unclear, challenging its precise management in high-risk population. Here we investigated the association of hTAS2R38 polymorphisms with the prevalence and treatment outcome of halitosis, with a particular focus on oral microbiota. METHODS A cross-sectional study including 689 participants was conducted to investigate the association between hTAS2R38 polymorphisms and halitosis. A 6-month cohort including 60 halitosis patients was established to explore the relationship between hTAS2R38 polymorphisms and treatment outcome of halitosis. Salivary microbiota was further analyzed and its correlation with hTAS2R38 polymorphisms was investigated. RESULTS In the cross-sectional study, a higher prevalence of halitosis was observed in individuals with AVI/AVI genotype as compared to non-AVI/AVI genotype (PAV/PAV + PAV/AVI) (OR = 2.380, 95% CI = 1.493-3.807). 16S rRNA sequencing revealed the enrichment of Prevotella in the saliva of AVI/AVI individuals. In the prospective study, halitosis patients with AVI/AVI genotype exhibited poor treatment outcome relative to non-AVI/AVI individuals during the 6-month follow-up after halitosis intervention (RR = 2.077, 95% CI = 1.382-3.339). Tannerella, Filifactor, and Mycoplasma were identified to be the major persistent genus in the saliva of AVI/AVI patients over the 6-month period after treatment. Furthermore, the human gingival fibroblasts with AVI/AVI genotype exhibited reduced inhibition against the growth and volatile sulfur compounds production of periodontal pathogens. CONCLUSIONS Our work demonstrates that hTAS2R38 polymorphisms contribute to the development and treatment outcome of halitosis via modulating oral microbiota, providing new insights to the better management of halitosis. Video Abstract.
Collapse
Affiliation(s)
- Hongxiang Mei
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
- Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Cai Qi
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Jinchi Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Sirui Yang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, National Clinical Research Center for Oral Diseases, Air Force Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Jiajia Zhou
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yangyu Lu
- Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Provincial Clinical Research Center of Oral Diseases, Sun Yat-Sen University, Guangzhou, China
| | - Liwei Zheng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
- Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Juan Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
- Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Lei Zhao
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China.
- Department of Periodontology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China.
| | - Xin Xu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China.
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China.
| |
Collapse
|
2
|
Kredig C, Peuckert E, Schmidtmann I, Drechsler T, Erbe C. Oral health in adolescents: periodontal inflammatory biomarkers during orthodontic clear aligner therapy. Clin Oral Investig 2025; 29:168. [PMID: 40042542 PMCID: PMC11882737 DOI: 10.1007/s00784-025-06212-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2024] [Accepted: 02/06/2025] [Indexed: 03/09/2025]
Abstract
OBJECTIVES This prospective study aimed to evaluate periodontal inflammation in adolescents undergoing orthodontic treatment with clear aligners (Invisalign® Teen, Align Technology, San Jose, CA, USA). Key objectives included assessing the presence of 11 periodontitis-associated marker bacteria, active matrix metalloproteinase-8 concentrations in sulcular fluid, and the influence of IL-1 polymorphism genotypes on periodontal health. MATERIALS AND METHODS Fifty adolescent patients (13.3 ± 1.8 years) with mixed and permanent dentition participated. Gingival crevicular fluid samples were analyzed at multiple time points: before, during, and one year after aligner treatment. Periodontal health was assessed using the Gingivitis Index and the Modified Quigley-Hein Index. Genotypic analysis of IL-1 polymorphism was also performed. Statistical analyses included mixed linear models and generalized linear models to explore correlations. RESULTS All combinations of IL-1 polymorphism genotypes were found in the sample. No significant increase in periodontal inflammation or aMMP-8 concentrations was observed over the treatment period. Marker bacteria from the red and orange-associated complexes remained at low levels, while significant changes occurred in the orange and green complexes, particularly Capnocytophaga spp. (p = 0.0042) and Fusobacterium spp. (p = 0.0365). GI correlated significantly with aMMP-8 levels (p = 0.0017), but no genotype effect on GI was observed. MQH showed associations with pathogens from the orange and green complexes, including Capnocytophaga spp. and Fusobacterium spp. CONCLUSIONS Clear aligner treatment in adolescents, including those with an unfavorable genotype, does not increase periodontal inflammation when accompanied by good oral hygiene. CLINICAL RELEVANCE Regular periodontal monitoring and hygiene reinforcement is important during orthodontic treatment, especially in adolescent patients.
Collapse
Affiliation(s)
- Carolin Kredig
- Department of Orthodontics, University Medical Center at the Johannes Gutenberg-University, Mainz, Germany.
| | - Eva Peuckert
- Department of Orthodontics, University Medical Center at the Johannes Gutenberg-University, Mainz, Germany
| | - Irene Schmidtmann
- Institute of Medical Biostatistics, Epidemiology and Informatics, Johannes Gutenberg-University Medical Center, Mainz, Germany
| | | | - Christina Erbe
- Department of Orthodontics, University Medical Center at the Johannes Gutenberg-University, Mainz, Germany
| |
Collapse
|
3
|
Karapetsa D, Consensi A, Castagnoli G, Petrini M, Tonelli M, Gennai S, Bazzichi L, Graziani F. Periodontitis in Italian patients with established rheumatoid arthritis: A cross-sectional study. Oral Dis 2022; 28:1715-1722. [PMID: 33690996 DOI: 10.1111/odi.13842] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 02/21/2021] [Accepted: 03/04/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To assess the prevalence and severity of periodontitis (P) among Italian patients affected by rheumatoid arthritis (RA). MATERIALS AND METHODS A full-mouth periodontal examination and a rheumatologic examination were performed. RA disease activity was scored using the DAS28. Serum analyses investigated levels of rheumatoid factor, anti-citrullinated protein antibodies (ACPAs), C-reactive protein, erythrocyte sedimentation rate and fibrinogen. Information concerning smoking, body mass index and RA medical therapy was collected. Data were analysed by Student's t test, chi-square test, binary logistic regression and Spearman's rank. RESULTS This cross-sectional study included 120 subjects, 77 had both diseases while 43 only had RA. The number of teeth present was statistically lower in the RA-P compared to the RA group (p < .05). There were statistically more subjects seropositive for ACPAs in the RA-P group (62.3% vs. 32.6%, p < .05). RA-P patients had an adjusted OR = 2.9 of presenting a moderate-severe DAS28 score (DAS28 ≥ 3.2). CONCLUSIONS Higher prevalence of severe P was noted among RA subjects. The clinical severity of RA was strongly correlated with the clinical periodontal parameters, and RA subjects also affected by P had an OR of 2.9 for presenting with a moderate-severe RA (DAS28 score ≥ 3.2).
Collapse
Affiliation(s)
- Dimitra Karapetsa
- Section of Dentistry, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy
| | - Arianna Consensi
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giulia Castagnoli
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy
| | - Morena Petrini
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy
- Department of Medical, Oral and Biotechnological Science, University G. D'Annunzio of Chieti, Chieti, Italy
| | - Matteo Tonelli
- Section of Dentistry, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy
| | - Stefano Gennai
- Section of Dentistry, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy
| | - Laura Bazzichi
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Filippo Graziani
- Section of Dentistry, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy
| |
Collapse
|
4
|
Liu X, Li H. A Systematic Review and Meta-Analysis on Multiple Cytokine Gene Polymorphisms in the Pathogenesis of Periodontitis. Front Immunol 2022; 12:713198. [PMID: 35046930 PMCID: PMC8761621 DOI: 10.3389/fimmu.2021.713198] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 08/10/2021] [Indexed: 12/30/2022] Open
Abstract
Aim Periodontitis is an inflammatory disease that destroys both soft and hard periodontal tissues. However, a complex periodontal cytokine network remains unclear. This systematic review explored multiple cytokine gene polymorphisms in the pathogenesis of periodontitis. Material and Methods A systematic search was performed using the databases from previous publications, which indicated the association between cytokine polymorphisms and periodontitis pathogenesis. Meta-analysis was conducted using fixed or randomized models to calculate the significance of multiple cytokine polymorphisms. A total of 147 articles were analyzed with polymorphisms in 12 interleukins [Th1 (IL-2, IFN-γ, and TNF-α), Th2 (IL-4 and IL-13), Th17 (IL-1α, IL-1β, IL-6, and IL-17), and Treg cytokines (IL-10 and TGF-β)]. Doi plot was used to probe the occurrence of publication bias. Results The polymorphisms of IL-2 and TNF-α of Th1 cytokine family may be associated with the pathogenesis or the prevention of periodontitis risk, while the polymorphism of IFN-γ is not related to periodontitis risk. The polymorphisms for IL-4 and IL-13 of Th2 cytokine family are not found to be associated with the pathogenesis of periodontitis. For the polymorphisms of the members of Th17 cytokine family, different IL-1α polymorphisms may have inverse actions in the pathogenesis of periodontitis. IL-1β is a noteworthy cytokine biomarker in periodontitis development and progression. IL-6 may have a protective function in the inflammatory responses of periodontitis, and IL-17 has a weak relationship the inflammatory responses. The polymorphisms for the members of Treg cell cytokines may have a protective function against periodontitis risk. LFK indexes show the major asymmetry due to publication bias. Conclusion IL-1β is a notable cytokine biomarker in periodontitis risk. Treg cytokines favor an anti-inflammatory and protective environment. Further data are needed to confirm the present conclusion due to publication bias.
Collapse
Affiliation(s)
- Xin Liu
- Department of Stomatology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Hui Li
- Department of Stomatology, China-Japan Union Hospital of Jilin University, Changchun, China
| |
Collapse
|
5
|
Kozak M, Dabrowska-Zamojcin E, Mazurek-Mochol M, Pawlik A. Cytokines and Their Genetic Polymorphisms Related to Periodontal Disease. J Clin Med 2020; 9:E4045. [PMID: 33327639 PMCID: PMC7765090 DOI: 10.3390/jcm9124045] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 11/28/2020] [Accepted: 12/10/2020] [Indexed: 12/19/2022] Open
Abstract
Periodontal disease (PD) is a chronic inflammatory disease caused by the accumulation of bacterial plaque biofilm on the teeth and the host immune responses. PD pathogenesis is complex and includes genetic, environmental, and autoimmune factors. Numerous studies have suggested that the connection of genetic and environmental factors induces the disease process leading to a response by both T cells and B cells and the increased synthesis of pro-inflammatory mediators such as cytokines. Many studies have shown that pro-inflammatory cytokines play a significant role in the pathogenesis of PD. The studies have also indicated that single nucleotide polymorphisms (SNPs) in cytokine genes may be associated with risk and severity of PD. In this narrative review, we discuss the role of selected cytokines and their gene polymorphisms in the pathogenesis of periodontal disease.
Collapse
Affiliation(s)
- Małgorzata Kozak
- Chair and Department of Dental Prosthetics, Pomeranian Medical University, Powstańców Wlkp 72, 70-111 Szczecin, Poland;
| | - Ewa Dabrowska-Zamojcin
- Department of Pharmacology, Pomeranian Medical University, Powstańców Wlkp 72, 70-111 Szczecin, Poland;
| | - Małgorzata Mazurek-Mochol
- Department of Periodontology, Pomeranian Medical University, Powstańców Wlkp 72, 70-111 Szczecin, Poland;
| | - Andrzej Pawlik
- Department of Physiology, Pomeranian Medical University, Powstańców Wlkp 72, 70-111 Szczecin, Poland
| |
Collapse
|
6
|
Borilova Linhartova P, Danek Z, Deissova T, Hromcik F, Lipovy B, Szaraz D, Janos J, Fassmann A, Bartova J, Drizhal I, Izakovicova Holla L. Interleukin Gene Variability and Periodontal Bacteria in Patients with Generalized Aggressive Form of Periodontitis. Int J Mol Sci 2020; 21:ijms21134728. [PMID: 32630798 PMCID: PMC7370291 DOI: 10.3390/ijms21134728] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/26/2020] [Accepted: 06/28/2020] [Indexed: 02/07/2023] Open
Abstract
Host genetic predispositions to dysregulated immune response can influence the development of the aggressive form of periodontitis (AgP) through susceptibility to oral dysbiosis and subsequent host-microbe interaction. This case-control study aimed to perform a multilocus analysis of functional variants in selected interleukin (IL) genes in patients with the generalized form of AgP in a homogenous population. Twelve polymorphisms in IL-1 gene cluster, IL-6 and its receptor, IL-10, IL-17A, and IL-18 were determined in 91 AgP patients and 210 controls. Analysis of seven selected periodontal bacteria in subgingival sulci/pockets was performed with a commercial DNA-microarray kit in a subgroup of 76 individuals. The pilot in vitro study included stimulation of peripheral blood monocytes (PBMC) from 20 individuals with periodontal bacteria and measurement of IL-10 levels using the Luminex method. Only the unctional polymorphism IL-10 −1087 A/G (rs1800896) and specific IL-10 haplotypes were associated with the development of the disease (p < 0.05, Pcorr > 0.05). Four bacterial species occurred more frequently in AgP than in controls (p < 0.01, Pcorr < 0.05). Elevated IL-10 levels were found in AgP patients, carriers of IL-10 −1087GG genotype, and PBMCs stimulated by periodontal bacteria (p < 0.05, Pcorr > 0.05). We therefore conclude that a combination of genetic predisposition to the altered expression of IL-10 and the presence of specific periodontal bacteria may contribute to Th1/Th2 balance disruption and AgP development.
Collapse
Affiliation(s)
- Petra Borilova Linhartova
- Clinic of Stomatology, Faculty of Medicine, Masaryk University, Pekarska 664/53, 60200 Brno, Czech Republic; (P.B.L.); (F.H.); (J.J.); (L.I.H.)
- Department of Pathophysiology, Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic; (T.D.); (B.L.)
- Clinic of Maxillofacial Surgery, University Hospital Brno, Jihlavska 20, 62500 Brno, Czech Republic;
| | - Zdenek Danek
- Department of Pathophysiology, Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic; (T.D.); (B.L.)
- Clinic of Maxillofacial Surgery, University Hospital Brno, Jihlavska 20, 62500 Brno, Czech Republic;
- Clinic of Maxillofacial Surgery, Faculty of Medicine, Masaryk University, Jihlavska 20, 62500 Brno, Czech Republic
- Correspondence: ; Tel.: +420-532-232-484
| | - Tereza Deissova
- Department of Pathophysiology, Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic; (T.D.); (B.L.)
| | - Filip Hromcik
- Clinic of Stomatology, Faculty of Medicine, Masaryk University, Pekarska 664/53, 60200 Brno, Czech Republic; (P.B.L.); (F.H.); (J.J.); (L.I.H.)
- Clinic of Stomatology, St. Anne’s University Hospital, Pekarska 664/53, 60200 Brno, Czech Republic;
| | - Bretislav Lipovy
- Department of Pathophysiology, Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic; (T.D.); (B.L.)
- Department of Burns and Plastic Surgery, Faculty of Medicine, Masaryk University, Jihlavska 20, 62500 Brno, Czech Republic
- Department of Burns and Plastic Surgery, University Hospital Brno, Jihlavska 20, 62500 Brno, Czech Republic
| | - David Szaraz
- Clinic of Maxillofacial Surgery, University Hospital Brno, Jihlavska 20, 62500 Brno, Czech Republic;
- Clinic of Maxillofacial Surgery, Faculty of Medicine, Masaryk University, Jihlavska 20, 62500 Brno, Czech Republic
| | - Julius Janos
- Clinic of Stomatology, Faculty of Medicine, Masaryk University, Pekarska 664/53, 60200 Brno, Czech Republic; (P.B.L.); (F.H.); (J.J.); (L.I.H.)
| | - Antonin Fassmann
- Clinic of Stomatology, St. Anne’s University Hospital, Pekarska 664/53, 60200 Brno, Czech Republic;
| | - Jirina Bartova
- Institute of Clinical and Experimental Dental Medicine, First Faculty of Medicine, Charles University, Karlovo nam. 554/32, 12808 Prague, Czech Republic;
- Institute of Clinical and Experimental Dental Medicine, General University Hospital, Karlovo nam. 554/32, 12808 Prague, Czech Republic
| | - Ivo Drizhal
- Department of Dentistry, Faculty of Medicine in Hradec Kralove, Charles University, Simkova 870, 50003 Hradec Kralove, Czech Republic;
| | - Lydie Izakovicova Holla
- Clinic of Stomatology, Faculty of Medicine, Masaryk University, Pekarska 664/53, 60200 Brno, Czech Republic; (P.B.L.); (F.H.); (J.J.); (L.I.H.)
- Department of Pathophysiology, Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic; (T.D.); (B.L.)
- Clinic of Stomatology, St. Anne’s University Hospital, Pekarska 664/53, 60200 Brno, Czech Republic;
| |
Collapse
|
7
|
Debnath P, Dewangan J, Tandon D, Govila V, Sharma M, Kumar V, Govila S, Rath SK. Plasminogen activator inhibitor-1 polymorphisms as a risk factor for chronic periodontitis in North Indian population. J Oral Biol Craniofac Res 2019; 9:226-229. [PMID: 31211041 DOI: 10.1016/j.jobcr.2018.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 04/12/2018] [Indexed: 10/17/2022] Open
Abstract
Objectives Impaired plasminogen activator inhibitor-1 (PAI-1), controlling coagulation and the fibrinolytic system is supposed to be involved in the pathogenesis of periodontitis. This study was performed to examine the association of PAI-1 gene polymorphisms with Chronic Periodontitis (CP) and alveolar bone loss severity involved with the disease and for understanding the role of genetic contributions in disease progression. Methods 87 volunteers were included in the study. Genomic DNA was isolated from peripheral blood, subsequently, DNA samples were subjected to polymerase chain reaction and endonuclease digestion. Direct gene sequencing were performed for all the samples to identify genotype polymorphisms (rs 11560324) in the 3' untranslated region of PAI-1 gene. For bone loss assessment full mouth IOPA was taken. Results Statistical analysis showed that for SNP PAI-I in 3' UTR, genotype CC (homozygous mutant) and allele C (mutant) has a risk associated with CP, although statistically significant association was not found. An increased risk of association of disease severity with CG (heterozygous mutant) and CC (homozygous mutant) genotypes, i.e., an increased carriage rate of genotype CG and CC (homozygous mutant) was evident with the increase in the severity of CP, highlighting an increased susceptibility to CP due to this gene polymorphisms. Conclusion PAI-1 genotype has a risk association with CP and alveolar bone loss severity in North-Indian population.
Collapse
Affiliation(s)
- Puja Debnath
- Department of Periodontics, Babu Banarasi Das College of Dental Sciences, BBD University, Lucknow, Uttar Pradesh, India
| | - Jayant Dewangan
- Genotoxicity Lab, Division of Toxicology & Experimental Medicine, CSIR- Central Drug Research Institute, Lucknow, Uttar Pradesh, India
| | - Divya Tandon
- Genotoxicity Lab, Division of Toxicology & Experimental Medicine, CSIR- Central Drug Research Institute, Lucknow, Uttar Pradesh, India
| | - Vivek Govila
- Department of Periodontics, Babu Banarasi Das College of Dental Sciences, BBD University, Lucknow, Uttar Pradesh, India
| | - Mona Sharma
- Department of Periodontics, Babu Banarasi Das College of Dental Sciences, BBD University, Lucknow, Uttar Pradesh, India
| | - Virendra Kumar
- Department of Dentistry, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India
| | - Smita Govila
- Department of Conservative Dentistry, Babu Banarasi Das College of Dental Sciences, BBD University, Lucknow, Uttar Pradesh, India
| | - Srikanta Kumar Rath
- Genotoxicity Lab, Division of Toxicology & Experimental Medicine, CSIR- Central Drug Research Institute, Lucknow, Uttar Pradesh, India
| |
Collapse
|
8
|
Citterio F, Romano F, Ferrarotti F, Gualini G, Aimetti M. Quality of methods and reporting in association studies of chronic periodontitis and IL1A -889 and IL1B +3953/4 SNPs: A systematic review. J Periodontal Res 2019; 54:457-467. [PMID: 30982982 DOI: 10.1111/jre.12655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 11/30/2018] [Accepted: 12/10/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this systematic review was to evaluate the quality of reporting and methodology in genetic association studies between IL1A -889 and IL1B +3954 polymorphisms and chronic periodontitis. BACKGROUND Evidence provided by periodontal research on genetic risk factors is of uttermost importance in clinical practice as a possible diagnostic and prognostic tool for periodontitis. Inadequate reporting of results as well as high risk of bias due to methodological inconsistency hampers the integration of evidence in terms of clinical applicability. METHODS This review includes case-control studies in humans published between 1997 and July 2017. Searching was conducted through MEDLINE, EMBASE, and search handing. Specific scoring systems have been developed to evaluate the quality of methods and reporting. Each article was scored according to its adequacy, and then, the total number and the percentage of items positively qualified for both methods and reporting were calculated. The quality of methods in studies scoring 0-6, 7-12, and 13-16 was, respectively, considered poor, moderate, and good. For reporting, scores of 0-9, 10-18, and 19-26 were deemed of poor, moderate, and good quality, respectively. Pearson's correlation coefficient was calculated to explore the correlation between the year of publication and the quality in terms of methods and reporting. RESULTS From the 531 screened studies, 52 met the inclusion criteria and were thus included in the study. The quality of methods and reporting of published genetic association papers on IL1 and chronic periodontitis is moderate. On a scale from 0 to 16, the mean score for methods of the reviewed studies was 8.19 ± 1.93. The items more frequently considered inadequate concerned the handling of confounders in statistical analysis, especially oral hygiene habits, socioeconomic status, subgingival colonization of specific periodontal pathogens, and stress. A significant positive correlation was found between the year of publication and the quality scores in terms of method (r = 0.401, P = 0.003). In terms of reporting, the mean score was 14.83 ± 3.04 on a scale from 0 to 26 and it was considered overall moderate. No statistically significant correlation was found between the year of publication and the quality of reporting (P = 0.266). CONCLUSIONS The association between IL1A -889 and IL1B +3954 polymorphisms and chronic periodontitis is questionable due to methodological inconsistency. Evidence arising from meta-analysis is unreliable due to high risk of bias and moderate quality in terms of reporting.
Collapse
Affiliation(s)
- Filippo Citterio
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Federica Romano
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Francesco Ferrarotti
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Giacomo Gualini
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Mario Aimetti
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| |
Collapse
|
9
|
Heidari Z, Moudi B, Mahmoudzadeh-Sagheb H. Immunomodulatory factors gene polymorphisms in chronic periodontitis: an overview. BMC Oral Health 2019; 19:29. [PMID: 30755190 PMCID: PMC6373099 DOI: 10.1186/s12903-019-0715-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 01/14/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Chronic periodontitis (CP), defines as destruction of the supporting tissues of the teeth and resorption of the alveolar bone. It is widespread in human populations and represent an important problem for public health. CP results from inflammatory mechanisms created by the interaction between environmental and host genetic factors that confer the individual susceptibility to the disease. AIM The aim of the current study was to explore and summarize some functional biomarkers that are associated with CP susceptibility. METHODS CP is considered to be a multifactorial disease. The pathogenesis of multifactorial diseases is characterized by various biological pathways. The studies revealed that polymorphisms were associated with susceptibility to periodontal diseases. In other word, genetic variations can change the development of CP. However, there are some conflicting results, because there are different variations in frequency of some alleles in any populations. Therefore, we conducted the current review to completely understanding the special biomarkers for CP. RESULTS There is some evidence that SNPs in the IL-1α, IL-1β, IL1RN, IL-6, IL-10, TNF-α, TGF-β1, IFN-γ and VDR may be associated with CP susceptibility. CONCLUSION In conclusion, numerous studies have reported the host genetic factors associated with CP susceptibility and related traits. Therefore, it is prevail to study the multiple SNPs and their effects to find the useful diagnosis methods. The current study will investigate the relationship between polymorphisms in cytokine genes and the susceptibility to the chronic periodontitis.
Collapse
Affiliation(s)
- Zahra Heidari
- Infectious Diseases and Tropical Medicine Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
- Department of Histology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, 98167-43175 Iran
| | - Bita Moudi
- Infectious Diseases and Tropical Medicine Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
- Department of Histology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, 98167-43175 Iran
| | - Hamidreza Mahmoudzadeh-Sagheb
- Infectious Diseases and Tropical Medicine Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
- Department of Histology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, 98167-43175 Iran
| |
Collapse
|
10
|
Interleukin-1 Gene Variability and Plasma Levels in Czech Patients with Chronic Periodontitis and Diabetes Mellitus. Int J Dent 2019; 2019:6802349. [PMID: 30755772 PMCID: PMC6348895 DOI: 10.1155/2019/6802349] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 12/19/2018] [Indexed: 12/28/2022] Open
Abstract
Recent studies have suggested a bidirectional relationship between chronic periodontitis (CP) and diabetes mellitus (DM). Immunoregulatory factors such as cytokines play an important role in etiopathogenesis of both diseases. The aim of this study was to analyze variability in interleukin-1 (IL-1) gene cluster and IL-1β plasma levels in patients with CP, DM, and a combination of both diseases. A total of 1016 individuals participating in this case-control study—225 healthy controls, 264 patients with CP, 132 with type 1 diabetes (T1DM), and 395 patients with type 2 diabetes (T2DM)—were genotyped using methods based on polymerase chain reaction for IL-1 gene polymorphisms (IL-1A (−889C/T, rs1800587), IL-1B (+3953C/T, rs1143634), and IL-1RN (gene for IL-1 receptor antagonist, IL-1RA, 86 bp tandem repeats in intron 2)). Levels of IL-1β were measured by Luminex methods in subgroups of controls, CP, T1DM + CP, and T2DM + CP subjects. Although no significant associations were found in the genotype and allele frequencies of IL-1A (−889C/T), significant differences in the allele frequencies of IL-1B (+3953C/T) were observed between controls and CP patients (P < 0.05). In T1DM patients, IL-1RN∗S “short” allele and IL-1RN 12 genotype were significantly less frequent than those in controls (P < 0.01). In haplotype analysis, TTL haplotype decreased the risk of CP development (P < 0.01), whereas CCS and CTL haplotypes (P < 0.01 and P < 0.05) were associated with T1DM. Although IL-1β levels were measured significantly higher in mononuclear cells after stimulation by mitogens, HSP70, or selected periodontal bacteria than in unstimulated cells, IL-1 genotypes did not correlate with circulating IL-1β levels. In the Czech population, significant associations between the IL-1B polymorphism with CP and the IL-1RN variant with T1DM were found. Haplotype analysis suggests that variability in IL-1 gene cluster may be one of the factors in the CP and T1DM pathogenesis, although single variants of these polymorphisms are not substantial for protein production.
Collapse
|
11
|
Wong HC, Ooi Y, Pulikkotil SJ, Naing C. The role of three interleukin 10 gene polymorphisms (- 1082 A > G, - 819 C > T, - 592 A > C) in the risk of chronic and aggressive periodontitis: a meta-analysis and trial sequential analysis. BMC Oral Health 2018; 18:171. [PMID: 30348144 PMCID: PMC6198364 DOI: 10.1186/s12903-018-0637-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 10/11/2018] [Indexed: 12/01/2022] Open
Abstract
Background Periodontitis is a major oral health problem and it is considered as one of the reasons for tooth loss in developing and developed nations. The objective of the current review was to investigate the association between IL10 polymorphisms − 1082 A > G (rs1800896), -819C > T (rs1800871), − 592 A > C (rs1800872) and the risk of either chronic periodontitis or aggressive periodontitis. Methods This is a meta- analysis study, following the preferred reporting items for systematic reviews and meta- analyses (PRISMA). Relevant studies were searched in the health related electronic databases. Methodological quality of the included studies were assessed using the Newcastle-Ottawa Scale. For individual studies, odds ratio (OR) and its 95%confidence interval (CI) were calculated to assess the strength of association between IL10 polymorphisms (− 1082 A > G, -819C > T, − 592 A > C) and the risk of periodontitis. For pooling of the estimates across studies included, the summary OR and its 95% CIs were calculated with random-effects model. The pooled estimates were done under four genetic models such as the allelic contrast model, the recessive model, the dominant model and the additive model. Trial sequential analysis (TSA) was done for estimation of the required information size for this meta-analysis study. Results Sixteen studies were identified for this review. The included studies were assessed to be of moderate to good methodological quality. A significant association between polymorphism of IL10–1082 A > G polymorphism and the risk of chronic periodontitis in the non-Asian populations was observed only in the recessive model (OR,1.42; 95% CI:1.11, 1.8,I2: 43%). The significant associations between − 592 A > C polymorphism and the risk of aggressive periodontitis in the non-Asian populations were observed in particular genetic models such as allele contrast (OR, 4.34; 95%CI:1.87,10.07,I2: 65%) and recessive models (OR, 2.1; 95% CI:1.16, 3.82,I2: 0%). The TSA plot revealed that the required information size for evidence of effect was sufficient to draw a conclusion. Conclusions This meta-analysis suggested that the IL10–1082 A > G polymorphism was associated with chronic periodontitis CP risk in non-Asians. Thus, in order to further establish the associations between IL10 (− 819 C > T, − 592 A > C) in Asian populations, future studies should include larger sample sizes with multi-ethnic groups. Electronic supplementary material The online version of this article (10.1186/s12903-018-0637-9) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Hey Chiann Wong
- School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Yuxuan Ooi
- School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | | | - Cho Naing
- Institute for Research, Development and Innovation (IRDI), International Medical University, 5700, Kuala Lumpur, Malaysia. .,Division of Tropical Heath and Medicine, James Cook University, Townsville, Australia.
| |
Collapse
|
12
|
Association between the rs1143634 polymorphism in interleukin-1B and chronic periodontitis: Results from a meta-analysis composed by 54 case/control studies. Gene 2018; 668:97-106. [DOI: 10.1016/j.gene.2018.05.067] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 05/15/2018] [Indexed: 12/22/2022]
|
13
|
Application of Interleukin-1 Genes and Proteins to Monitor the Status of Chronic Periodontitis. Int J Biol Markers 2018; 28:92-9. [PMID: 23592003 DOI: 10.5301/jbm.5000013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2013] [Indexed: 02/05/2023]
Abstract
It has been widely reported that periodontitis may lead to bone tissue and teeth loss and result in failure of prosthodontics or implants. Interleukin-1 (IL-1) is a potent proinflammatory cytokine that plays an essential role during the pathogenesis of periodontitis. However, the gene polymorphisms of IL-1α, IL-1β and IL-1RN and the relationship between these protein expressions in healthy people and patients with chronic periodontitis (CP) in China have not been fully elucidated. We investigated the gene polymorphisms and protein expression of IL-1α, IL-1β and IL-1RN in healthy subjects and CP patients, and our data suggest that these gene polymorphisms are associated with CP. The frequency of the C/C genotype of IL-1α was 55% in CP patients, while in the control group it was 20% (p<0.0001). The C/C genotype of IL-1β was also higher in CP patients (51%) than in controls (21%) (p<0.0001). For the 2/2 genotype of IL-1RN, CP patients showed a 30% frequency, while in controls this was 15% (p<0.0001). Protein levels evaluated by enzyme-linked immunosorbent assay demonstrated a significant difference in secretion between patients and controls for IL-1α and IL-1β. These results indicate that genotype and protein production of IL-1α, IL-1β and IL-1RN are associated with CP in a Chinese population, and might be putative risk indicators for chronic periodontitis.
Collapse
|
14
|
Shibata K. Historical aspects of studies on roles of the inflammasome in the pathogenesis of periodontal diseases. Mol Oral Microbiol 2018; 33:203-211. [DOI: 10.1111/omi.12217] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2018] [Indexed: 12/15/2022]
Affiliation(s)
- K. Shibata
- Department of Oral Molecular Microbiology; Faculty of Dental Medicine and Graduate School of Dental Medicine; Hokkaido University; Hokkaido Japan
| |
Collapse
|
15
|
Mesa F, Lanza E, García L, Marfil-Alvarez R, Magan-Fernandez A. Polymorphism IL-1RN rs419598 reduces the susceptibility to generalized periodontitis in a population of European descent. PLoS One 2017; 12:e0186366. [PMID: 29023524 PMCID: PMC5638498 DOI: 10.1371/journal.pone.0186366] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 10/01/2017] [Indexed: 11/21/2022] Open
Abstract
Interleukin (IL) 1-ra is a potent endogenous competitive inhibitor of IL-α and β and has an anti-inflammatory role. Study objectives were: 1) to assess the associations of IL-1RN genetic single nucleotide polymorphism (SNP) (rs419598) with generalized chronic periodontitis (GCP), generalized aggressive periodontitis (GAgP), and absence of periodontitis and 2) to assess its association with the load of five periodontopathogenic bacteria and periodontal clinical variables. A cross-sectional analytic study was conducted in 123 patients with GCP, 60 patients with GAgP, and 20 controls. Reverse hybridization PCR was used for genotyping analysis to detect SNPs in IL-1A (rs1800587), IL-1B (rs1143634), and IL-1RN (rs419598) genes and for determination of the load of five periodontopathogenic bacteria. The severity and extension of periodontitis were assessed. Multinomial logistic regression and mediated regression analyses were performed. Considering results for GCP and GAgP patients together, the presence of polymorphism in IL-1A and/or IL-1B gene was associated with a higher likelihood of periodontitis, (OR = 8.11; 95%CI [1.85–35.48]), but this likelihood was reduced when IL-1RN polymorphism was also present, (OR = 5.91; 95%CI [1.08–32.27]). IL-1RN polymorphism was significantly associated with lower counts of red complex bacteria, specifically Porphyromona gingivalis, Tannerella forsythia, and Prevotella intermedia, which were associated with improved clinical outcomes. The polymorphic expression of IL-1RN (rs419598) gene may be associated with a reduced susceptibility to GAgP and GCP in populations of European descent. This effect may be mediated by a decreased load of Porphyromona gingivalis, Tannerella forsythia, and Prevotella intermedia.
Collapse
Affiliation(s)
- Francisco Mesa
- Periodontology Department, School of Dentistry, University of Granada, Granada, Spain
- * E-mail:
| | | | - Llenalia García
- SEPLIN Statistical Solutions, Spin-Off University of Granada, Granada, Spain
| | - Rafael Marfil-Alvarez
- Periodontology Department, School of Dentistry, University of Granada, Granada, Spain
| | | |
Collapse
|
16
|
Domínguez-Pérez RA, Loyola-Rodriguez JP, Abud-Mendoza C, Alpuche-Solis AG, Ayala-Herrera JL, Martínez-Martínez RE. Association of cytokines polymorphisms with chronic peridontitis and rheumatoid arthritis in a Mexican population. Acta Odontol Scand 2017; 75:243-248. [PMID: 28358286 DOI: 10.1080/00016357.2017.1280846] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Historically, it has been shown that rheumatoid arthritis (RA) and periodontitis (PE) share pathophysiological similarities and possibly a genetic background. In order to elucidate the genetic background between both diseases, we evaluated the distributions of five SNPs genotypes and all the possible haplotypes composed in subjects with isolated RA, PE, combined diseases and healthy controls. MATERIALS AND METHODS The study population consisted of 280 Mexican subjects. Genomic DNA was isolated from buccal epithelial cells collected by cheek scrapings and analyzed for the determination of the following SNPs: IL-1α + 4845 (rs17561), IL-1α -889 (rs1800587), IL-1β + 3954 (rs1143634), IL-1β -511(rs16944) and TNF-α -308 (rs1800629). RESULTS After adjustment for age, sex and smoking status, multiple logistic regression analysis revealed a no significant association in the genotype frequencies of TNF-α -308 and IL-1α + 4845 SNPs. Otherwise a significant association was observed in IL-1β + 3954 and IL-1β -511 (p < 0.05) while IL-1α -889 was of borderline statistical significance (p = 0.054). Also, we found three negative associated haplotypes with PE: IL-1α + 4845 G/IL-1β -511 A, IL-1β + 3954 C/IL-1β -511 A and interestingly IL-1α -889 C/IL-1β -511 A also with a positive association with RA. CONCLUSIONS Some genotypes and haplotypes are associated with the diseases. But it seems that the genetic background of the association between RA and PE needs to be explored deeper.
Collapse
Affiliation(s)
- Rubén Abraham Domínguez-Pérez
- Doctorado en Ciencias Biomedicas Basicas, Facultad de Medicina, Universidad Autonoma de San Luis Potosi, San Luis Potosi, Mexico
- Advanced Education in General Dentistry, Master Degree Program at San Luis Potosi University, San Luis Potosi University, San Luis Potosi, Mexico
| | - Juan Pablo Loyola-Rodriguez
- Doctorado en Ciencias Biomedicas Basicas, Facultad de Medicina, Universidad Autonoma de San Luis Potosi, San Luis Potosi, Mexico
- Advanced Education in General Dentistry, Master Degree Program at San Luis Potosi University, San Luis Potosi University, San Luis Potosi, Mexico
| | - Carlos Abud-Mendoza
- Regional Unit of Rheumathology and Osteoporosis at Central Hospital “Dr. Ignacio Morones Prieto”, Faculty of Medicine, San Luis Potosi University, San Luis Potosi, Mexico
| | | | - José Luis Ayala-Herrera
- Doctorado en Ciencias Biomedicas Basicas, Facultad de Medicina, Universidad Autonoma de San Luis Potosi, San Luis Potosi, Mexico
- Advanced Education in General Dentistry, Master Degree Program at San Luis Potosi University, San Luis Potosi University, San Luis Potosi, Mexico
| | - Rita Elizabeth Martínez-Martínez
- Doctorado en Ciencias Biomedicas Basicas, Facultad de Medicina, Universidad Autonoma de San Luis Potosi, San Luis Potosi, Mexico
- Advanced Education in General Dentistry, Master Degree Program at San Luis Potosi University, San Luis Potosi University, San Luis Potosi, Mexico
| |
Collapse
|
17
|
Anovazzi G, de Medeiros MC, Pigossi SC, Finoti LS, Mayer MPA, Rossa C, Scarel-Caminaga RM. Functional Haplotypes in Interleukin 4 Gene Associated with Periodontitis. PLoS One 2017; 12:e0169870. [PMID: 28114408 PMCID: PMC5256924 DOI: 10.1371/journal.pone.0169870] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 12/23/2016] [Indexed: 12/25/2022] Open
Abstract
Chronic periodontitis (CP) is an infectious inflammatory disease that affects tooth-supporting structures and in which dental plaque bacteria, immune mechanisms and genetic predisposition play important roles. Interleukin 4 (IL-4) is a key anti-inflammatory cytokine with relevant action in imbalances in inflamed periodontal tissue. Individuals carrying the TCI/CCI genotype (S-haplotype) of the IL-4 gene are 5 times more susceptible to CP, whereas the CTI/TTD genotype (P-haplotype) confers protection against CP. Compared with the S-haplotype, subjects with the P-haplotype produce higher levels of the IL-4 protein after non-surgical periodontal therapy. The present in vitro study aimed to investigate the functionality of IL-4 haplotypes in immune cells to obtain insight into the influence of these genetic variations in regulating immune responses to CP-associated bacteria. Peripheral blood was collected from 6 subjects carrying each haplotype, and their immune cells were challenged with periodontopathogens to compare responses of the different haplotypes with regard to gene expression, protein secretion and the immunophenotype of T helper responses. We found higher IL-4 mRNA and protein levels in the P-haplotype, which also presented higher levels of anti-inflammatory cytokines. In contrast, cells from S-haplotype subjects responded with higher levels of pro-inflammatory cytokines. S-haplotype individuals exhibited significantly greater polarization toward the Th1 phenotype, whereas the P-haplotype was associated with an attenuated response to periodontopathogens, with suggestive skewing toward Th2/M2 phenotypes. In conclusion, IL-4 genetic variations associated with susceptibility to or protection against chronic periodontitis are directly associated with influencing the response of immune cells to periodontopathogens.
Collapse
Affiliation(s)
- Giovana Anovazzi
- Department of Oral Diagnosis and Surgery, School of Dentistry at Araraquara, UNESP- Univ Estadual Paulista, Araraquara, São Paulo, Brazil
- Department of Morphology, School of Dentistry at Araraquara, UNESP- Univ Estadual Paulista, Araraquara, São Paulo, Brazil
| | - Marcell Costa de Medeiros
- Department of Oral Diagnosis and Surgery, School of Dentistry at Araraquara, UNESP- Univ Estadual Paulista, Araraquara, São Paulo, Brazil
| | - Suzane Cristina Pigossi
- Department of Oral Diagnosis and Surgery, School of Dentistry at Araraquara, UNESP- Univ Estadual Paulista, Araraquara, São Paulo, Brazil
- Department of Morphology, School of Dentistry at Araraquara, UNESP- Univ Estadual Paulista, Araraquara, São Paulo, Brazil
| | - Livia Sertori Finoti
- Department of Oral Diagnosis and Surgery, School of Dentistry at Araraquara, UNESP- Univ Estadual Paulista, Araraquara, São Paulo, Brazil
- Department of Morphology, School of Dentistry at Araraquara, UNESP- Univ Estadual Paulista, Araraquara, São Paulo, Brazil
| | - Marcia Pinto Alves Mayer
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Carlos Rossa
- Department of Oral Diagnosis and Surgery, School of Dentistry at Araraquara, UNESP- Univ Estadual Paulista, Araraquara, São Paulo, Brazil
| | | |
Collapse
|
18
|
da Silva FRP, Guimarães-Vasconcelos ACC, de-Carvalho-França LF, di-Lenardo D, Rodrigues LS, Barreto-do-Nascimento MLL, Vasconcelos DFP. Relationship between -889 C/T polymorphism in interleukin-1A gene and risk of chronic periodontitis: Evidence from a meta-analysis with new published findings. Med Oral Patol Oral Cir Bucal 2017; 22:e7-e14. [PMID: 27918732 PMCID: PMC5217499 DOI: 10.4317/medoral.21233] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 06/08/2016] [Indexed: 12/13/2022] Open
Abstract
Background Periodontitis results from an inflammatory response caused by accumulative microorganisms in periodontal sites. Several factors are involved in pathogenesis of periodontitis, for example the -889 C/T polymorphism in interleukin-1A gene. This study aimed to evaluate the relationship between this polymorphism and risk of development of chronic periodontitis by a meta-analysis based in new published findings. Material and Methods Thereunto a review in literature was performed in the electronic biomedical and education databases (Cochrane Library, Google Scholar, MEDLINE and PubMed) to studies published before August 2, 2015, the abstracts were evaluated and the data extraction performed by two calibrated examiners. The calculations of the meta-analysis were obtained through statistical software Review Manager version 5.2 with calculation of Odds Ratio (OR), heterogeneity (I²) and Funnel plots with P <0.05. Results In overall, twenty-one case/control studies were selected with 2,174 patients with chronic periodontitis and 1, 756 controls. The meta-analysis showed T allele was associated with chronic periodontitis (OR = 1.22, 95% CI: 1.09, 1.36, P = 0.0004) with decreased value to heterogeneity (I² = 15%, P = 0.28). TT genotype was associated to patients with chronic periodontitis (OR = 1.40, 95% CI: 1.07, 1.83, P = 0.01). No publication bias was found in this meta-analysis by asymmetry in Funnel plots. Conclusions This meta-analysis with 2,174 patients with chronic periodontitis and 1, 756 controls evidenced the -889 C/T polymorphism is associated to risk of development of chronic periodontitis with no significant value to heterogeneity to allelic evaluation. Key words:Alleles, odds ratio, periodontal disease, cytokines.
Collapse
Affiliation(s)
- F-R-P da Silva
- Universidade Federal do Piauí- UFPI, Campus Ministro Reis Veloso, Colegiado de Biomedicina, Av. São Sebastião, 2819, Reis Veloso, Parnaíba - PI - Brasil, 64204-035,
| | | | | | | | | | | | | |
Collapse
|
19
|
Laine ML, Morré SA, Murillo LS, van Winkelhoff AJ, Peña AS. CD14 and TLR4 Gene Polymorphisms in Adult Periodontitis. J Dent Res 2016; 84:1042-6. [PMID: 16246938 DOI: 10.1177/154405910508401114] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Bacterial deposits, smoking, and host genetic factors play a major role in an individual’s predisposition to periodontitis. Bacterial components are recognized by CD14 and toll-like receptor 4 (TLR4), resulting in a NF-κB-based inflammatory response. We hypothesized that functional CD14 and TLR4 polymorphisms contribute to periodontitis susceptibility. We aimed to investigate the occurrence of CD14-260C>T, TLR4 299Asp>Gly, and 399Thr>Ile gene polymorphisms in adult periodontititis. DNA was collected from 100 patients with severe periodontitis and from 99 periodontally healthy controls. The gene polymorphisms were determined by the PCR technique. The presence of the periodontal pathogens Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans, and whether the subjects smoked, was included in the analyses. The CD14-260T/T genotype was found in 34.0% of periodontitis patients and in 20.2% of controls. Logistic regression analysis adjusted for gender, age, smoking, and prevalence of P. gingivalis and A. actinomycetemcomitans showed an association between the CD14-260T/T genotype and periodontitis (P = 0.004, OR 3.0, 95% CI 1.4–6.9). We conclude that the CD14-260T/T genotype contributes to the susceptibility to severe periodontitis in Dutch Caucasians.
Collapse
Affiliation(s)
- M L Laine
- Department of Periodontology, Section of Oral Microbiology, Academic Centre for Dentistry Amsterdam, Van der Boechorsstraat 7, 1081 BT Amsterdam, The Netherlands.
| | | | | | | | | |
Collapse
|
20
|
Ribeiro MSM, Pacheco RBA, Fischer RG, Macedo JMB. Interaction of IL1B and IL1RN polymorphisms, smoking habit, gender, and ethnicity with aggressive and chronic periodontitis susceptibility. Contemp Clin Dent 2016; 7:349-56. [PMID: 27630500 PMCID: PMC5004549 DOI: 10.4103/0976-237x.188560] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background: Although the interleukin-1 (IL-1) plays a critical role in the pathogenesis of periodontitis, associations between IL1 gene cluster polymorphisms and the disease remains unclear. Aims: To investigate the importance of IL1B-511C>T (rs16944), IL1B +3954C>T (rs1143634), and IL1RN intron 2 variable number tandem repeat (VNTR) (rs2234663) polymorphisms, individually or in combination, as the risk factors of periodontitis in a Southeastern Brazilian population with a high degree of miscegenation. Subjects and Methods: A total of 145 individuals, with aggressive (aggressive periodontitis [AgP], n = 43) and chronic (chronic periodontitis [CP], n = 52) periodontitis, and controls (n = 50) were genotyped by polymerase chain reaction (PCR) (IL1RN intron 2 VNTR) or PCR-restriction fragment length polymorphism (PCR-RFLP) (IL1B-511 C>T and IL1B + 3954C>T) techniques. Statistical Analysis: The independent t-test, Chi-square, and Fisher's exact tests were used. The SNPStats program was used for haplotype estimation and multiplicative interaction analyses. Results: The IL1B +3954T allele represented risk for CP (odds ratio [OR] = 2.84), particularly in smokers (OR = 4.43) and females (OR = 6.00). The minor alleles IL1RN*2 and *3 increased the risk of AgP (OR = 2.18), especially the IL1RN*2*2 genotype among white Brazilians (OR = 7.80). Individuals with the combinations of the IL1B + 3954T and IL1RN*2 or *3-containing genotypes were at increased risk of developing CP (OR = 4.50). Considering the three polymorphisms (rs16944, rs1143634, and rs2234663), the haplotypes TC2 and CT1 represented risk for AgP (OR = 3.41) and CP (OR = 6.39), respectively. Conclusions: Our data suggest that the IL1B +3954C>T and IL1RN intron 2 VNTR polymorphisms are potential candidates for genetic biomarkers of periodontitis, particularly in specific groups of individuals.
Collapse
|
21
|
Boukortt KN, Saidi-Ouahrani N, Boukerzaza B, Ouhaibi-Djellouli H, Hachmaoui K, Benaissa FZ, Taleb L, Drabla-Ouahrani H, Deba T, Ouledhamou SA, Mehtar N, Boudjema A. Association analysis of the IL-1 gene cluster polymorphisms with aggressive and chronic periodontitis in the Algerian population. Arch Oral Biol 2015; 60:1463-70. [DOI: 10.1016/j.archoralbio.2015.06.018] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 03/08/2015] [Accepted: 06/15/2015] [Indexed: 12/01/2022]
|
22
|
Kayar NA, Alptekin NÖ, Erdal ME. Interleukin-1 receptor antagonist gene polymorphism, adverse pregnancy outcome and periodontitis in Turkish women. Arch Oral Biol 2015; 60:1777-83. [PMID: 26445016 DOI: 10.1016/j.archoralbio.2015.09.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 09/14/2015] [Accepted: 09/16/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of this study was to determine associations between interleukin (IL)-1A (+4845), IL-1B (+3954), and IL-1 receptor antagonist (RN) variable number tandem repeat polymorphisms and adverse pregnancy outcomes and periodontitis in a Turkish women. DESIGN A total of 156 patients, including 64 women with normal birth outcome (NB) and 92 women with preterm/low birth weight outcome (PLBW) were included in this case-control study. Within 24h after labor, maternal demographic characteristics and clinical periodontal parameters were recorded. The distribution and genotype frequencies of IL-1 were analyzed with polymerase chain reaction-restriction fragment length polymorphism assay. Statistical analyses were carried out for clinical periodontal parameters, genotype frequencies, and to identify explanatory variables for PLBW. RESULTS PLBW was associated with maternal age (p<0.05), irregular prenatal care (p<0.001), previous PLBW (p<0.05), and antibiotic use during pregnancy (p<0.05). Measurements of probing depth and clinical attachment level (CAL) were significantly higher in the PLBW group than in the NB group (p<0.001). PLBW was associated with IL-1RN allele 2 (p<0.001). Moreover, stepwise logistic regression analysis showed that CAL (OR 1.39, 95% CI: 1.04-1.85) and IL-1RN polymorphism (OR 7.92, 95% CI: 2.76-22.79), previous PLBW (OR 5.01, 95% CI: 1.08-23.17), age (OR 1.22, 95% CI: 1.04-1.44) were predictors found to increase the risk of PLBW (p<0.05). There was a negative association between PLBW and regular prenatal care, total number of births, use an antibiotic during pregnancy period (p<0.05). CONCLUSION Our study showed that, IL-1RN allele 2, periodontal disease characterized with clinical attachment loss, previous PLBW and age could be an important risk factors for PLBW.
Collapse
Affiliation(s)
- Nezahat Arzu Kayar
- The Ministry Health of Turkey, Oral and Dental Health Center, Antalya, Turkey
| | - Nilgün Özlem Alptekin
- Baskent University, Faculty of Dentistry, Department of Periodontology, Ankara, Turkey.
| | - Mehmet Emin Erdal
- Mersin University, Faculty of Medicine, Department of Medical Biology and Genetics, Mersin, Turkey
| |
Collapse
|
23
|
HLA Haplotypes and Genotypes Frequencies in Brazilian Chronic Periodontitis Patients. Mediators Inflamm 2015; 2015:481656. [PMID: 26339134 PMCID: PMC4539106 DOI: 10.1155/2015/481656] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 05/24/2015] [Accepted: 05/30/2015] [Indexed: 01/22/2023] Open
Abstract
Human leukocyte antigens (HLA) have a pivotal role in immune response and may be involved in antigen recognition of periodontal pathogens. However, the associations of HLA with chronic periodontitis (CP) have not been previously studied in the Brazilian population. In an attempt to clarify the issue of genetic predisposition to CP, we examined the distribution of HLA alleles, genotypes, and haplotypes in patients from Southern Brazil. One hundred and eight CP patients and 151 healthy and unrelated controls with age-, gender-, and ethnicity-matched were HLA investigated by polymerase chain reaction with sequence specific oligonucleotides. To exclude smoking as a predisposing factor, statistical analyses were performed in the total sample and in nonsmoking individuals. The significant results showed a positive association of the A∗ 02/HLA-B∗ 40 haplotype with CP (total samples: 4.2% versus 0%, Pc = 0.03; nonsmokers: 4.3% versus 0%, Pc = 0.23) and a lower frequency of HLA-B∗ 15/HLA-DRB1∗ 11 haplotype in CP compared to controls (total samples: 0.0% versus 4.3%, Pc = 0.04; nonsmokers: 0 versus 5.1%, P = 1.0). In conclusion, the HLA-A∗ 02/B∗ 40 haplotype may contribute to the development of CP, while HLA-B∗ 15/DRB1∗ 11 haplotype might indicate resistance to disease among Brazilians.
Collapse
|
24
|
Armingohar Z, Jørgensen JJ, Kristoffersen AK, Schenck K, Dembic Z. Polymorphisms in the Interleukin-1 Gene Locus and Chronic Periodontitis in Patients with Atherosclerotic and Aortic Aneurysmal Vascular Diseases. Scand J Immunol 2014; 79:338-45. [DOI: 10.1111/sji.12166] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 02/14/2014] [Indexed: 02/07/2023]
Affiliation(s)
- Z. Armingohar
- Department of Oral Biology; Faculty of Dentistry; University of Oslo; Oslo Norway
| | - J. J. Jørgensen
- Department of Vascular Surgery; Oslo University Hospital; Aker and University of Oslo; Oslo Norway
| | - A. K. Kristoffersen
- Department of Oral Biology; Faculty of Dentistry; University of Oslo; Oslo Norway
| | - K. Schenck
- Department of Oral Biology; Faculty of Dentistry; University of Oslo; Oslo Norway
| | - Z. Dembic
- Department of Oral Biology; Faculty of Dentistry; University of Oslo; Oslo Norway
| |
Collapse
|
25
|
Mao M, Zeng XT, Ma T, He W, Zhang C, Zhou J. Interleukin-1α − 899 (+ 4845) C→T polymorphism increases the risk of chronic periodontitis: Evidence from a meta-analysis of 23 case–control studies. Gene 2013; 532:114-9. [DOI: 10.1016/j.gene.2013.09.043] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 09/07/2013] [Accepted: 09/11/2013] [Indexed: 11/25/2022]
|
26
|
Li ZG, Li JJ, Sun CA, Jin Y, Wu WW. Interleukin-18 promoter polymorphisms and plasma levels are associated with increased risk of periodontitis: a meta-analysis. Inflamm Res 2013; 63:45-52. [DOI: 10.1007/s00011-013-0669-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Accepted: 09/27/2013] [Indexed: 12/23/2022] Open
|
27
|
Kayal RA. The role of osteoimmunology in periodontal disease. BIOMED RESEARCH INTERNATIONAL 2013; 2013:639368. [PMID: 24151615 PMCID: PMC3789307 DOI: 10.1155/2013/639368] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 08/15/2013] [Accepted: 08/17/2013] [Indexed: 12/26/2022]
Abstract
Periodontal disease is a pathological condition that involves inflammation of the tooth supporting structures. It occurs in response to the presence of bacterial plaque on the tooth structure. The host defense system, including innate and adaptive immunity, is responsible for combating the pathologic bacteria invading the periodontal tissue. Failure to eradicate the invading pathogens will result in a continuous state of inflammation where inflammatory cells such as lymphocytes, PMNs, and macrophages will continue to produce inflammatory mediators in an effort to destroy the invaders. Unfortunately, these inflammatory mediators have a deleterious effect on the host tissue as well as foreign microbes. One of the effects of these mediators on the host is the induction of matrix degradation and bone resorption through activation of proteases and other inflammatory mediators that activate osteoclasts.
Collapse
Affiliation(s)
- Rayyan A. Kayal
- Department of Oral Basic and Clinical Science, King Abdulaziz University Faculty of Dentistry, P.O. Box 3738, Jeddah 21481, Saudi Arabia
| |
Collapse
|
28
|
The Role of Interleukin-1 Genotype in the Association between Coronary Heart Disease and Periodontitis in a Syrian Population. ISRN DENTISTRY 2013; 2013:195678. [PMID: 23691333 PMCID: PMC3649497 DOI: 10.1155/2013/195678] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 03/17/2013] [Indexed: 12/17/2022]
Abstract
Objective. To determine whether differences exist between periodontitis subjects with and without Coronary Heart Disease (CHD) in a Syrian population in the distribution of IL-1 alleles at positions IL-1α+4845, IL-1β+3954, IL-1β−511, and IL-1RN VNTR. Background. The role of Interleukin-1 genes in the association between periodontitis and CHD has been demonstrated in previous studies. No study has been carried out on the Syrian population to asses for such a role. Methods. 200 Syrian Arab periodontitis patients (184 males, 16 females; mean age 52.61) were divided into two groups: cases group 100 subjects with CHD (92 males, 8 females; mean age 52.06); controls group 100 subjects without CHD (92 males, 8 females; mean age 53.16). Probing depth (PD), clinical attachment loss (CAL), and alveolar bone loss (ABL) were performed for patients. Blood samples were collected for genotyping analysis of IL-1α+4845, IL-1β+3954, and IL-1β−511 using PCR-RFLP technique and IL-1RN VNTR using normal PCR. Results. An association between both (CAL and ABL) and CHD was shown after adjustment for other confounders (OR: 7.659, P = 0.001; OR: 3.645, P = 0.006, resp.). Also, an association between allele 2 of IL-1α+4845, IL-1β+3954, and IL-1β−511 and ABL was shown. Allele 2 of IL-1α+4845 and IL-1β−511 was associated with ABL among individuals with and without CHD. But after adjustment for other confounders, the association remained only between allele 2 of IL-11α+4845 and both CHD and severe ABL (OR: 0.189, P < 0.001). Conclusion. Allele 2 of IL-11α+4845 may be considered a risk indicator for having both CHD and severe ABL in the investigated Syrian population.
Collapse
|
29
|
Deng JS, Qin P, Li XX, Du YH. Association between interleukin-1β C (3953/4)T polymorphism and chronic periodontitis: evidence from a meta-analysis. Hum Immunol 2012; 74:371-8. [PMID: 23220433 DOI: 10.1016/j.humimm.2012.11.018] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2012] [Revised: 11/18/2012] [Accepted: 11/27/2012] [Indexed: 01/01/2023]
Abstract
The aim of this study was to perform a meta-analysis to evaluated the association between interleukin-1β (IL-1β) C(3953/4)T polymorphism and chronic periodontitis (CP). Systematic searches of electronic databases and hand searching of references were performed, including PubMed, Embase and Web of Science. The pooled odds ratios (ORs) with 95% confidence intervals (95%CIs) were calculated. Publication bias was tested by Begg's funnel plot and Egger's regression test. Sensitivity analysis was conducted by limiting the meta-analysis studies conforming to Hardy-Weinberg equilibrium (HWE) or high quality (score ≥ 7). Data analyses were carried out by Stata 11.0. There were significant associations between IL-1β C(3953/4)T polymorphism and CP (for T allele vs. C allele: OR = 1.30, 95%CI = 1.05-1.60, p = 0.02; for T/T vs. C/C: OR = 1.66, 95%CI = 1.12-2.45, p = 0.01; for C/T+T/T vs. C/C: OR = 1.28, 95%CI = 0.99-1.65; and for T/T vs. C/T+C/C: OR = 1.62, 95%CI = 1.15-2.29, p = 0.006). When stratified by ethnicity, statistically significantly elevated risk was found for Caucasians, but not for Asians. When stratified by study design, evidences of significant association was observed between IL-1β C(3953/4)T polymorphism and CP in both population-based studies and hospital-based studies. This meta-analysis indicates that there is strong evidence for association between IL-1β C(3953/4)T polymorphism and CP.
Collapse
Affiliation(s)
- Jia-Shu Deng
- The Affiliated hospital of Stomatology, Chongqing Medical University, Chongqing 400012, China
| | | | | | | |
Collapse
|
30
|
Laine ML, Crielaard W. Functional foods/ingredients and periodontal diseases. Eur J Nutr 2012; 51 Suppl 2:S27-30. [PMID: 22535144 DOI: 10.1007/s00394-012-0325-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Marja L Laine
- Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | | |
Collapse
|
31
|
Laine M, Moustakis V, Koumakis L, Potamias G, Loos B. Modeling Susceptibility to Periodontitis. J Dent Res 2012; 92:45-50. [DOI: 10.1177/0022034512465435] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Chronic inflammatory diseases like periodontitis have a complex pathogenesis and a multifactorial etiology, involving complex interactions between multiple genetic loci and infectious agents. We aimed to investigate the influence of genetic polymorphisms and bacteria on chronic periodontitis risk. We determined the prevalence of 12 single-nucleotide polymorphisms (SNPs) in immune response candidate genes and 7 bacterial species of potential relevance to periodontitis etiology, in chronic periodontitis patients and non-periodontitis control individuals (N = 385). Using decision tree analysis, we identified the presence of bacterial species Tannerella forsythia, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and SNPs TNF -857 and IL-1A -889 as discriminators between periodontitis and non-periodontitis. The model reached an accuracy of 80%, sensitivity of 85%, specificity of 73%, and AUC of 73%. This pilot study shows that, on the basis of 3 periodontal pathogens and SNPs, patterns may be recognized to identify patients at risk for periodontitis. Modern bioinformatics tools are valuable in modeling the multifactorial and complex nature of periodontitis.
Collapse
Affiliation(s)
- M.L. Laine
- Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, and VU University Amsterdam, Department of Periodontology, The Netherlands
| | - V. Moustakis
- Foundation for Research and Technology – Hellas (FORTH), Institute of Computer Science, Bioinformatics Laboratory, Science and Technology Park of Crete, Heraklion 71110, Greece
- Technical University of Crete, Department of Production Engineering and Management, Chania, Greece
| | - L. Koumakis
- Foundation for Research and Technology – Hellas (FORTH), Institute of Computer Science, Bioinformatics Laboratory, Science and Technology Park of Crete, Heraklion 71110, Greece
| | - G. Potamias
- Foundation for Research and Technology – Hellas (FORTH), Institute of Computer Science, Bioinformatics Laboratory, Science and Technology Park of Crete, Heraklion 71110, Greece
| | - B.G. Loos
- Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, and VU University Amsterdam, Department of Periodontology, The Netherlands
| |
Collapse
|
32
|
Loo WTY, Fan CB, Bai LJ, Yue Y, Dou YD, Wang M, Liang H, Cheung MNB, Chow LWC, Li JL, Tian Y, Qing L. Gene polymorphism and protein of human pro- and anti-inflammatory cytokines in Chinese healthy subjects and chronic periodontitis patients. J Transl Med 2012; 10 Suppl 1:S8. [PMID: 23046796 PMCID: PMC3445856 DOI: 10.1186/1479-5876-10-s1-s8] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Periodontal disease is thought to arise from the interaction of various factors, including the susceptibility of the host, the presence of pathogenic organisms, and the absence of beneficial species. The genetic factors may play a significant role in the risk of periodontal diseases. Cytokines initiate, mediate and control immune and inflammatory responses. The aim of this study is to compare genotypes and soluble protein of pro and anti-inflammatory cytokines (IL-1α, IL-1β, IL-6, IFN-γ, IL-10, TNF-α and IL-4) in subjects with or free of chronic periodontitis. METHODS A total of 1,290 Chinese subjects were recruited to this clinical trial: 850 periodontally healthy controls and 440 periodontal patients. All subjects were free of systemic diseases. Oral examinations were performed, and the following parameters were recorded for each subject: supragingival/subgingival calculus, gingival recession, bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL), gingival recession and tooth mobility. The peripheral blood samples were collected for genetic and enzyme linked immunosorbent assay (ELISA) analysis. Restriction enzymes were used for digestion of amplified fragments of IL-1α, IL-1β, IL-6, IFN-γ, IL-10, TNF-α and IL-4. RESULTS The protein expressions of patient and control samples for IL-1α, IL-1β, IL-6, TNF-α, IFN-γ, IL-10, and IL-4 measured by ELISA confirmed a statistically significant difference (p < 0.001). The digestion of fragments of various genes showed that the pro-inflammatory cytokines IL-1α and TNF-α, and the anti-inflammatory cytokines IL-4 and IL-10 demonstrated a correlation with chronic inflammation in patients (X2: p < 0.001). The remaining genes investigated in patients and healthy subjects (IL-1β, IL-6, IFN-γ and IL-10) did not show any significant difference. CONCLUSIONS The cytokine gene polymorphisms may be used as a marker for periodontitis susceptibility, clinical behaviour and severity. This detection offers early diagnosis and induction of prophylaxis to other family members against disease progression.
Collapse
Affiliation(s)
- Wings TY Loo
- UNIMED Medical Institute, Hong Kong SAR
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
| | - Chang-bin Fan
- Stomatological Hospital of Guangzhou Medical College, Guangzhou, PRC
| | - Lan-jun Bai
- Department of Stomatology, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, No.32, Section 2,1st Ring Road (West), Chengdu, Sichuan, PRC
| | - Yuan Yue
- State Key Laboratory for Oral Diseases and Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, PRC
| | - Yi-ding Dou
- Jin Hua Dentistry, Chengdu, 610041, Sichuan, PRC
| | - Min Wang
- State Key Laboratory for Oral Diseases and Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, PRC
| | - Hao Liang
- State Key Laboratory for Oral Diseases and Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, PRC
| | | | | | - Jin-le Li
- State Key Laboratory for Oral Diseases and Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, PRC
| | - Ye Tian
- State Key Laboratory for Oral Diseases and Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, PRC
| | - Liu Qing
- UNIMED Medical Institute, Hong Kong SAR
| |
Collapse
|
33
|
Interleukin-1 receptor antagonist polymorphism (rs2234663) and periodontitis susceptibility: A meta-analysis. Arch Oral Biol 2012; 57:585-93. [DOI: 10.1016/j.archoralbio.2012.01.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Revised: 01/09/2012] [Accepted: 01/31/2012] [Indexed: 11/19/2022]
|
34
|
|
35
|
|
36
|
Hart R, Doherty DA, Pennell CE, Newnham IA, Newnham JP. Periodontal disease: a potential modifiable risk factor limiting conception. Hum Reprod 2012; 27:1332-42. [DOI: 10.1093/humrep/des034] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
|
37
|
Karimbux NY, Saraiya VM, Elangovan S, Allareddy V, Kinnunen T, Kornman KS, Duff GW. Interleukin-1 gene polymorphisms and chronic periodontitis in adult whites: a systematic review and meta-analysis. J Periodontol 2012; 83:1407-19. [PMID: 22348697 DOI: 10.1902/jop.2012.110655] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Interleukin-1 (IL-1) gene polymorphisms have been associated with increased levels of inflammatory mediators and several inflammatory diseases. Periodontitis is a bacterially induced chronic inflammatory disease that destroys the connective tissues and bone that support the teeth, affects substantial numbers of adults, and has been implicated as a contributing factor in systemic diseases. IL-1 gene polymorphisms, most prominently IL1A (-889), IL1A (+4845), and IL1B (+3954), have been associated with chronic periodontitis (CP) in whites. Since the first report, ≥125 studies have examined IL-1 gene variation in relation to periodontal disease. These studies have produced mixed findings in diverse periodontal phenotypes and in different ethnic groups. One previous meta-analysis has been published on this topic and supported an association between IL-1 genes and periodontitis, but considerable doubt remains about the patient populations in which the association may be of clinical relevance. METHODS A systematic review and meta-analysis was conducted in an attempt to clarify whether IL-1 gene variants were associated with well-defined clinical phenotypes of CP in white patients. Study inclusion criteria focused on the analytic framework originally proposed for the IL-1 genetic effect in which overexpression of inflammatory mediators is hypothesized to result in more severe periodontitis in response to a bacterial challenge. RESULTS Twenty-seven studies were included in the qualitative analysis. Nineteen studies yielded significant associations between carriage of the minor IL-1 alleles and periodontitis. The meta-analysis, based on 13 qualifying studies, found significant effects for the two individual gene variations (IL1A odds ratio [OR] = 1.48; IL1B OR = 1.54) and for a composite genotype that combines minor alleles at each locus (OR = 1.51). Statistically significant heterogeneity was found that could not be explained, but there was no indication of publication bias. CONCLUSION This review and meta-analysis show that IL1A and IL1B genetic variations are significant contributors to CP in whites.
Collapse
Affiliation(s)
- Nadeem Y Karimbux
- Department of Oral Medicine Infection and Immunity, Harvard University School of Dental Medicine, Boston, MA.
| | | | | | | | | | | | | |
Collapse
|
38
|
Pretzl B, El Sayed N, Cosgarea R, Kaltschmitt J, Kim TS, Eickholz P, Nickles K, Bäumer A. IL-1-polymorphism and severity of periodontal disease. Acta Odontol Scand 2012; 70:1-6. [PMID: 21449691 DOI: 10.3109/00016357.2011.572562] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To determine the association between the interleukin (IL)-1-polymorphism and the severity of periodontal disease prior to active periodontal therapy. MATERIALS AND METHODS Two hundred and six patients with obtained baseline x-rays were tested for IL-1-polymorphism. Relative bone loss before active periodontal treatment was measured with a Schei ruler and classified in five groups. Descriptive statistics and backward stepwise linear regression analyses were performed. RESULTS Forty-nine patients with moderate (mChP), 79 with severe chronic (sChP) and 78 with aggressive periodontitis (AgP) were included. Age correlated significantly with bone loss and number of teeth at baseline. Gender, smoking and IL-1-polymorphism were neither associated with bone loss nor with number of teeth prior to treatment. After adjusting for age as well as gender, AgP was significantly associated with more severe bone loss in untreated periodontal disease (p = 0.036). In non-smokers, mean number of teeth prior to active periodontal therapy correlated significantly with presence of IL-1 polymorphism. CONCLUSION The IL-1-polymorphism is associated with lower number of teeth in non-smokers with untreated periodontal disease. Untreated AgP is associated with more severe bone loss than untreated ChP.
Collapse
Affiliation(s)
- Bernadette Pretzl
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
39
|
Ricci M, Garoia F, Tabarroni C, Marchisio O, Barone A, Genovesi A, Covani U. Association between genetic risk score and periodontitis onset and progression: a pilot study. Arch Oral Biol 2011; 56:1499-505. [PMID: 21846573 DOI: 10.1016/j.archoralbio.2011.07.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Revised: 06/12/2011] [Accepted: 07/05/2011] [Indexed: 01/30/2023]
Abstract
AIM Recent research has focused attention on the single nucleotide polymorphisms (SNPs) involved in the host response in periodontitis. However, so as to combine the relatively small effects of individual genes the use of multi locus genetic risk (GRS) has been proposed. This study aims to evaluate whether the genetic risk score may predict periodontitis onset and progression. MATERIALS AND METHODS Fifty patients were divided into various groups according to periodontal status. Total DNA was isolated from epithelial oral cells by a masked operator and the selected SNPs were analysed. A GRS was calculated using an additive model. RESULTS We found a strong association only between TNF rs1800629 and diffused forms of periodontitis. Data show that GRS is able to discriminate diffused forms of periodontitis from localized ones. Finally, a progressive increase of the GRS is evident in advanced periodontitis in comparison with early forms. DISCUSSION In recent years, research on genetic polymorphism has had limited success in predicting the susceptibility to periodontal disease. However, our results indicate that the use of the genetic risk score could be promising. Further studies are necessary to include data from multiple genes so as to confirm our result.
Collapse
Affiliation(s)
- M Ricci
- Istituto Stomatologico Tirreno, Versilia Hospital, Camaiore (Lu), Italy.
| | | | | | | | | | | | | |
Collapse
|
40
|
Türkoğlu O, Berdeli A, Emingil G, Atilla G. A novel p.S34N mutation of CAMP gene in patients with periodontal disease. Arch Oral Biol 2011; 56:573-9. [DOI: 10.1016/j.archoralbio.2010.11.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Revised: 11/07/2010] [Accepted: 11/15/2010] [Indexed: 11/30/2022]
|
41
|
Hamdy AAEMM, Ebrahem MAEM. The Effect of Interleukin-1 Allele 2 Genotype (IL-1a−889 and IL-1b+3954) on the Individual's Susceptibility to Peri-Implantitis: Case-Control Study. J ORAL IMPLANTOL 2011; 37:325-334. [DOI: 10.1563/aaid-joi-d-09-00117.1] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Abstract
Individuals bearing the combination of interleukin (IL)-1 allele 2 at IL-1A−889 and IL-1B+3954 are referred to as being genotype positive and are susceptible to increased periodontal tissue destruction. The aim of this study was to assess the possible association of IL-1 allele 2 (IL-1A−889 and IL-B+3954) genotypes with the severity of peri-implantitis progression and the effect of this combination on treatment outcomes. Fifty patients with International Team for Implantology implants were studied; patients ranged in age from 35–55 years, and each patient had 1 implant. According to peri-implant tissue status, patients were divided into 2 groups: group I consisted of 25 patients with peri-implantitis, and group II comprised 25 patients with healthy peri-implant tissue. Clinical parameters were assessed at baseline and after 3 and 6 months. Epithelial cells were collected from the oral mucosa by plastic spatula and were used for IL-1 genotyping by the polymerase chain reaction technique. Group I patients were subjected to a peri-implantitis treatment and maintenance program. In all, 17 patients from group I and 5 patients from group II were genotype positive, with a statistically significant difference noted between the 2 groups. Group I genotype-positive patients presented with higher scores and measurements of clinical parameters with increased suppuration from peri-implant tissues compared with group II; differences were statistically significant (P < .05). In terms of response to treatment, genotype-negative patients demonstrated better response than genotype-positive patients. The combination of IL-1 allele 2 (IL-1A−889 and IL-1B+3954) in patients with inflamed periodontal or peri-implant tissues acts as a risk factor that leads to greater tissue destruction. IL-1 gene polymorphism at IL-1A−889 and IL-1B+3954 may affect outcomes of treatment for peri-implantitis in genotype-positive individuals.
Collapse
|
42
|
|
43
|
de Smit MJ, Brouwer E, Vissink A, van Winkelhoff AJ. Rheumatoid arthritis and periodontitis; a possible link via citrullination. Anaerobe 2011; 17:196-200. [PMID: 21515392 DOI: 10.1016/j.anaerobe.2011.03.019] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2010] [Revised: 03/02/2011] [Accepted: 03/29/2011] [Indexed: 12/26/2022]
Abstract
Rheumatoid Arthritis (RA) and chronic and aggressive periodontitis are chronic inflammatory disorders characterized by deregulation of the host inflammatory response. Increased secretion of pro-inflammatory mediators results in soft and hard tissue destruction of the synovium and periodontium respectively. Both diseases share risk factors and have pathological pathways in common, resulting in loss of function and disability as a final clinical outcome. This article discusses possible interactions, particularly related to the periodontal pathogen Porphyromonas gingivalis, which could explain the observed association between these two prevalent diseases.
Collapse
Affiliation(s)
- M J de Smit
- Center for Dentistry and Oral Hygiene, Department of Periodontology, University Medical Center Groningen, University of Groningen, The Netherlands.
| | | | | | | |
Collapse
|
44
|
Fan WH, Liu DL, Xiao LM, Xie CJ, Sun SY, Zhang JC. Coronary heart disease and chronic periodontitis: is polymorphism of interleukin-6 gene the common risk factor in a Chinese population? Oral Dis 2010; 17:270-6. [DOI: 10.1111/j.1601-0825.2010.01736.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
45
|
Borges MAT, Figueiredo LCD, Brito RBD, Faveri M, Feres M. Microbiological composition associated with vitamin D receptor gene polymorphism in chronic periodontitis. Braz Oral Res 2010; 23:203-8. [PMID: 19684957 DOI: 10.1590/s1806-83242009000200018] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2008] [Accepted: 06/27/2008] [Indexed: 11/21/2022] Open
Abstract
The aim of this cross-sectional study was to examine the relationship between the composition of the subgingival microbiota and the vitamin D receptor (VDR) gene polymorphism in Brazilian adults with chronic periodontitis. The clinical parameters of probing depth, clinical attachment level, bleeding on probing, plaque accumulation and suppuration were measured in 60 Caucasian adults who were divided into two groups: 30 healthy individuals (control) and 30 with chronic periodontitis (ChP). Subgingival plaque samples were collected from 6 sites per subject and analyzed for 38 bacterial species using the Checkerboard DNA-DNA Hybridization. DNA was obtained from the subjects' epithelial cells by scraping the buccal mucosa and using a mouthwash containing 3% of glucose. Polymorphism in the VDR gene was analyzed by the polymerase chain reaction (PCR), followed by Taql digestion (RFLP). The healthy subjects presented significantly lower levels (0.3 x 10(7) +/- 0.7 x 10(7)) of total microbial counts in comparison with subjects with chronic periodontitis (4.5 x 10(7) +/- 2.9 x 10(7)). Regarding the occurrence of VDR polymorphism, it was observed that the Tt genotype was more prevalent in the Periodontitis group (60%) than in the Healthy group (30%), while the prevalences of the TT genotype were 23.3% and 53.3%, respectively (Chi-square test, p < 0.05). No difference was found in the composition of subgingival microbiota among the VDR genotypes evaluated for the Healthy and Periodontitis groups. In conclusion, the Tt genotype was associated with periodontal disease; however, no association with the subgingival microbiota was observed.
Collapse
|
46
|
Shete AR, Joseph R, Vijayan NN, Srinivas L, Banerjee M. Association of single nucleotide gene polymorphism at interleukin-1beta +3954, -511, and -31 in chronic periodontitis and aggressive periodontitis in Dravidian ethnicity. J Periodontol 2010; 81:62-9. [PMID: 20059418 DOI: 10.1902/jop.2009.090256] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Interleukin (IL)-1beta gene polymorphisms are considered a potential risk factor for periodontal disease. The aim of this study is to identify the association of IL-1beta gene polymorphisms with chronic periodontitis and aggressive periodontitis in a Malayalam-speaking Dravidian population from South India. METHODS The case-control study consisted of 43 patients with chronic periodontitis and 54 patients with aggressive periodontitis as cases, and the control group consisted of 101 healthy subjects. All subjects were genotyped for IL-1beta +3954, -511, and -31 loci by polymerase chain reaction amplification followed by restriction enzyme digestion and gel electrophoresis. Genotype, allele, and haplotype analyses were done. RESULTS Analyses for allele and genotypes showed a high frequency of the C allele and CC genotype for single nucleotide polymorphism IL-1beta +3954 in the group with chronic periodontitis and no difference for patients with aggressive periodontitis compared to controls (P <0.05). Haplotype analysis showed that IL-1beta -31 and -511 were in strong linkage disequilibrium in all groups. The IL-1beta -31 allele T was in linkage with allele T of IL-1beta +3954 in the control group. CONCLUSIONS In the Malayalam-speaking Dravidian population, allele C of IL-1beta +3954 appeared to be an important risk factor for chronic periodontitis. The IL-1beta -31 allele T was in linkage with allele T of IL-1beta +3954 in the control group. No gene polymorphisms were found in patients with aggressive periodontitis. More studies with a larger sample size involving the entire cluster of the IL-1beta gene are necessary to determine the exact role of IL-1beta gene polymorphisms in periodontal disease.
Collapse
Affiliation(s)
- Abhijeet Rajendra Shete
- Department of Periodontics, Government Dental College, Medical College, Post Office, Calicut, Kerala 673008, India.
| | | | | | | | | |
Collapse
|
47
|
Gene polymorphisms in chronic periodontitis. Int J Dent 2010; 2010:324719. [PMID: 20339487 PMCID: PMC2844543 DOI: 10.1155/2010/324719] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2009] [Revised: 11/09/2009] [Accepted: 01/06/2010] [Indexed: 02/06/2023] Open
Abstract
We aimed to conduct a review of the literature for gene polymorphisms associated with chronic periodontitis (CP) susceptibility. A comprehensive search of the literature in English was performed using the keywords: periodontitis, periodontal disease, combined with the words genes, mutation, or polymorphism. Candidate gene polymorphism studies with a case-control design and reported genotype frequencies in CP patients were searched and reviewed. There is growing evidence that polymorphisms in the IL1, IL6, IL10, vitamin D receptor, and CD14 genes may be associated with CP in certain populations. However, carriage rates of the rare (R)-allele of any polymorphism varied considerably among studies and most of the studies appeared under-powered and did not correct for other risk factors. Larger cohorts, well-defined phenotypes, control for other risk factors, and analysis of multiple genes and polymorphisms within the same pathway are needed to get a more comprehensive insight into the contribution of gene polymorphisms in CP.
Collapse
|
48
|
López NJ, Valenzuela CY, Jara L. Interleukin-1 Gene Cluster Polymorphisms Associated With Periodontal Disease in Type 2 Diabetes. J Periodontol 2009; 80:1590-8. [DOI: 10.1902/jop.2009.090134] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
49
|
Relationship Between Fcγ Receptor and Interleukin-1 Gene Polymorphisms and Post-treatment Apical Periodontitis. J Endod 2009; 35:1186-92. [DOI: 10.1016/j.joen.2009.05.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2009] [Revised: 05/10/2009] [Accepted: 05/10/2009] [Indexed: 12/20/2022]
|
50
|
Raunio T, Knuuttila M, Hiltunen L, Karttunen R, Vainio O, Tervonen T. IL-6−174genotype associated with the extent of periodontal disease in type 1 diabetic subjects. J Clin Periodontol 2009; 36:11-7. [DOI: 10.1111/j.1600-051x.2008.01344.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|