Expression of Inflammatory Mediators in Biofilm Samples and Clinical Association in Multiple Sclerosis Patients in Remission—A Pilot Study

Abstract

Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease of unknown etiology that affects the central nervous system and can lead to neurological impairment. Our aim was to determine whether MS patients also show inflammatory changes in the oral cavity more frequently than healthy individuals. For this purpose, we examined plaque samples for various mediators and their correlation with clinical findings. A study group (MS) and a control group were examined and compared. The plaque samples were analyzed for the expression of interleukins (IL-2, -6, -10), matrix metalloproteinases (MMP-7, MMP-9), and a surface antigen CD90 by quantitative real-time PCR. The clinical parameters examined were the Mombelli plaque index; bleeding on probing (BOP) index; periodontal pocket depth; and decayed, missing, and filled tooth (DMFT) index. The expression of MMP9 was significantly (p = 0.035) higher in the control group. The expression of IL-2 was increased four-fold in the MS group; however, this difference was not statistically significant. The mean PD (p < 0.001) and BOP index (p = 0.029) values were increased in the study group. The clinical parameters of the BOP index and PD were significantly amplified in the MS patients. However, no causal relationship between the investigated inflammatory mediators and the clinical findings could be established in this case series.

A Systematic Literature Review on Inflammatory Markers in the Saliva of Patients with Multiple Sclerosis: A Cause or a Consequence of Periodontal Diseases

“…Our meta-analysis incorporated data from three observational studies, namely Fehlhofer et al [ 30 ], Mirzaii-Dizgah et al [ 45 ], and Koshkzari et al [ 46 ], to determine the relationship between MS and PD or specific changes in biomarkers. The analysis of the combined data showed a strong correlation, with the fixed-effect model producing a combined odds ratio (OR) of 1.76 (95% Contiuous Integration (CI): 1.56–1.99).…”

“…The findings reveal a persistent presence of inflammatory indicators in the saliva of individuals with MS, suggesting a widespread inflammatory reaction throughout the entire body [ 30 , 31 ]. Furthermore, a notable association between MS and PDs has been identified, regardless of whether neuromotor impairments are present or not [ 10 ].…”

“…Multiple studies have examined the existence of inflammatory indicators in the saliva of individuals diagnosed with MS [ 30 , 46 , 50 ]. The markers encompass tau proteins, cytokines, chemokines, matrix metalloproteinases, and various additional compounds implicated in the inflammatory response [ 9 , 51 ].…”

“… Risk of bias summary: ( a ) review authors’ judgements about each risk of bias item for each included study: high risk ; moderate risk ; low risk . ( b ) Summary plot of review authors’ judgments about each risk of bias item presented as percentages across all included studies: high risk ; moderate risk ; low risk [ 9 , 10 , 30 , 45 , 46 ]. …”

“…Research by Schepci [ 9 ], Al Johani [ 22 ], and others has identified MS-specific inflammatory factors like TNF-α, interleukins (IL), C-reactive protein, and TAU proteins in periodontal sulcus fluid and saliva [ 9 , 22 , 30 , 31 , 32 ]. These are found both in the context of MS and in other neurodegenerative conditions, including Alzheimer’s disease, and are also present in both chronic and acute PDs [ 33 ].…”