Effects of periodontal therapy on GCF cytokines in generalized aggressive periodontitis subjects

Abstract

Aim: To examine changes in levels of gingival crevicular fluid (GCF) cytokines, after periodontal therapy of generalized aggressive periodontitis (GAgP).

Materials and methods: Twenty-five periodontally healthy and 24 GAgP subjects had periodontal clinical parameters measured and gingival crevicular fluid (GCF) samples collected from up to 14 sites/subject. GCF samples were analysed using multiplex bead immunoassay for: GM-CSF, IFN-γ, IL-10, IL-1β, IL-2, IL-6 and TNF-α. Aggressive periodontitis subjects were randomly assigned to either scaling and root planing (SRP) alone or SRP plus systemic amoxicillin (500 mg) and metronidazole (400 mg) 3 times a day for 14 days. Clinical parameters and GCF cytokines were re-measured 6 months after treatment. Differences over time were analysed using the Wilcoxon test and between groups using the Mann-Whitney test.

Results: Significant reductions in GCF GM-CSF, IL-1β and the ratio IL-1β/IL-10 and increases in GCF IL-6 were detected after therapy. The mean change in GCF cytokines did not differ significantly between groups.

Conclusions: Periodontal therapy improved GCF cytokine profiles by lowering IL-1β and increasing IL-10 levels. The reduction in GCF GM-CSF after therapy implicates this cytokine in the pathogenesis of GAgP. There was no difference between therapies in changes of GCF cytokines.

Figure 1

Plots of GCF cytokine levels (pg/ml) for each site sampled in the GAgP subjects at baseline and 6 months post-therapy. The green circles represent the baseline GCF levels and have been ordered in each panel from the site with the lowest GCF value to the highest value pre-therapy. The red and purple circles represent the 6 month GCF levels for each site. The red circles indicate increase, while the purple circles indicate a decrease after treatment in the site levels of GCF cytokines.

Figure 2

Plots of mean GCF cytokine levels (pg/ml) at baseline and 6 months post-therapy in generalized aggressive periodontitis subjects in the placebo (white panels) and systemic antibiotic (grey panels) groups. The green circles represent the mean baseline GCF levels (measured at up to 14 sites per subject) and have been ordered in each panel from the subject with the lowest GCF value to the highest value pre-therapy. The red and purple circles represent the 6 month mean GCF data for each subject. The red circles indicate a mean increase, while the purple circles indicate a mean decrease in GCF cytokine levels after treatment.