Biomarkers of periodontal inflammation in the Australian adult population

Abstract

Background: Several inflammatory biomarkers are implicated in the pathogenesis of periodontitis including interleukin-1b (IL-1b) and C-reactive protein (CRP). This study investigated the presence of these factors in gingival crevicular fluid (GCF) and their relationship to clinical and social determinants of periodontitis in the Australian population. Methods: Equal numbers of periodontitis cases and non-cases were sampled during oral epidemiologic examination in the National Survey of Adult Oral Health. GCF was sampled from four sites where probing pocket depth (PPD) and recession were recorded. From these, IL-1b and CRP were quantified by ELISA and the log amount of GCF IL-1b (pg) per person and the proportion of adults with detectable CRP was computed. Results: Periodontitis cases (n = 511) had significantly higher levels of IL-1b and CRP than non-cases (n = 562). PPD, clinical attachment loss, plaque and gingivitis indices were positively associated with elevated levels of both biomarkers. Levels of both were positively associated with age, low socio-economic position and non-Australian birth. Conclusions: The presence of IL-1b and CRP in GCF are associated with periodontal disease parameters within the Australian population. The levels of both biomarkers are influenced by age, education and eligibility for public dental care.

Interleukin‐1β levels in gingival crevicular fluid and serum under naturally occurring and experimentally induced gingivitis

“…This may be partly due to the limited severity of the plaque‐induced gingival inflammation, which characterized our study population at both N‐O and E‐I gingivitis. Consistently, previous studies have shown that IL‐1 β was found in the serum at extremely low concentrations in periodontally healthy (Mengel et al 2002) and gingivitis (Orozco et al 2006) patients, and the systemic concentrations of IL‐1 β are positively correlated with the degree of gingival inflammation (Liu et al 1996, Ejeil et al 2003, Hou et al 2003, Orozco et al 2006, Fitzsimmons et al 2009).…”

“…When IL‐1 β levels were investigated under naturally occurring (N‐O) plaque‐induced gingival inflammatory conditions, patients with gingivitis showed significantly higher total amounts of IL‐1 β in the gingival crevicular fluid (GCF) compared with periodontally healthy individuals without clinical signs of gingival inflammation (Yücel et al 2008). Moreover, Fitzsimmons et al (2009) reported a significant correlation between the level of IL‐1 β in GCF and clinical indexes to define gingival inflammation. Consistently, the IL‐1 β concentration in the GCF has also been associated with the clinical severity of gingival inflammation in the experimental gingivitis model.…”

Gingival Crevicular Fluid and Plasma Acute‐Phase Cytokine Levels in Different Periodontal Diseases

“…In the present study, elevated GCF IL‐1β and IL‐6 levels in patients with GAgP and CP further confirm the role of these cytokines in periodontal inflammation 31,46,47 . It is well established that periodontal infection may enhance the risk for certain systemic diseases or alter the natural course of the disease 48‐50 .…”

Physical activity, inflammatory biomarkers in gingival crevicular fluid and periodontitis

“…This builds on earlier research relating physical activity to self‐reported periodontal disease (Merchant et al 2003, Joshipura et al 2004) and relating physical fitness with CPITN scores (Wakai et al 1999). Findings also build on evidence of associations between periodontal disease and these inflammatory biomarkers in GCF (Fitzsimmons et al in press). The estimated proportion of subjects reaching recommended levels of physical activity (60%) is similar to a national estimate of 57% obtained by the Australian Institute of Health and Welfare using the same core questions (Armstrong et al 2000).…”

“…GCF was eluted from each pair of paper strips separately, in a two‐step centrifugation procedure described in detail previously (Fitzsimmons et al in press). Eluted samples were pooled before analysis by enzyme linked immunosorbent assays (ELISA).…”