Inflammatory mediators in saliva and gingival fluid of children with congenital heart defect

Abstract

Objectives (a) To compare levels of pro‐ and anti‐inflammatory mediators in saliva and gingival crevicular fluid (GCF) in children with and without congenital heart defects (CHD cases and controls) and to test whether a systemic component exists in CHD cases by controlling for gingivitis and plaque scores. (b) To correlate the levels of pro‐ and anti‐inflammatory mediators in GCF and saliva with plaque bacterial composition among CHD cases and controls. Materials and Methods Whole un‐stimulated saliva and GCF samples were collected (60 CHD cases, 60 controls [Sudan]) and were analysed for levels of prostaglandin E2 (PGE2), interleukin‐1β (IL‐1β), tumour necrosis factor‐α (TNF‐α), interleukin‐1ra (IL‐1ra) and interleukin‐10 (IL‐10) levels. These levels were correlated with the previously reported levels of four red complex bacteria. Results Significantly elevated levels of PGE2 and IL‐1β in GCF and IL‐1β and TNF‐α in saliva were detected among CHD cases compared with controls. General linear model (GLM) analyses revealed that PGE2 and IL‐1β levels remained significantly higher in GCF and saliva samples, respectively, among CHD cases after controlling for gingivitis and plaque score, whereas TNF‐α and IL‐10 levels were significantly lower in their GCF samples. Additionally, IL‐1β level was significantly positively correlated to the counts of the four red complex species in their GCF. Conclusion In addition to higher levels of some pro‐inflammatory mediators in saliva and GCF corresponding to more gingivitis in CHD cases, also a systemic inflammatory component exists and is reflected in these two oral fluids.

The Evaluation of Oral Health Condition and Oral and Dental Care in Children with Congenital Heart Disease

“…Oral health and risk factors are often neglected as parents focus on chronic diseases [1]. It has been reported that children with CHD had more carious lesions [1,2], more dental plaque and gingivitis [4] and therefore had worse oral health than healthy children. Identifying and eliminating dental problems in children with CHD or preventing the emergence of these problems with preventive health services is very important in increasing patients' quality of life.…”

Infective endocarditis in children-pattern, diagnosis, management and short term outcome in Sudan

“…Previous studies from Ahmed Gasim hospital showed that Sudanese children with CHD are at increased risk of severe gingivitis and caries compared to the children without CHD. 9,10 There was almost equal number of males to females with a ratio of 1:0.9, and most of the patients were over five years old (Figure 1). 34% of patients with IE had no structural heart disease, the diagnosis of IE in structurally normal heart in children can be delayed, as the indexof suspension will be very low; this figure is similar to studies from Africa.…”

Congenital Heart Diseases and Periodontal Diseases—Is There a Link?

“…Conversely, in both saliva and gingival crevicular fluid samples, the levels of IL-1β and PGE2 were considerably higher in patients with CHD compared with controls ( 43 ). Furthermore, greater levels of red complex bacterial counts were correlated with higher amounts of IL-1β in gingival crevicular fluid ( 43 ).…”

“…Conversely, in both saliva and gingival crevicular fluid samples, the levels of IL-1β and PGE2 were considerably higher in patients with CHD compared with controls ( 43 ). Furthermore, greater levels of red complex bacterial counts were correlated with higher amounts of IL-1β in gingival crevicular fluid ( 43 ). PGE2 and IL-1β remained elevated in patients with CHD after correcting for gingivitis and plaque scores, indicating a systemic inflammatory component in both gingival crevicular fluid and saliva responsible for the maintenance of an inflammatory state in the periodontium of subjects with CHD ( 43 ).…”

“…Furthermore, greater levels of red complex bacterial counts were correlated with higher amounts of IL-1β in gingival crevicular fluid ( 43 ). PGE2 and IL-1β remained elevated in patients with CHD after correcting for gingivitis and plaque scores, indicating a systemic inflammatory component in both gingival crevicular fluid and saliva responsible for the maintenance of an inflammatory state in the periodontium of subjects with CHD ( 43 ). Hence, it can be understood that individuals with CHD have a greater systemic inflammation, which can be reflected in their oral fluids thereby linking periodontal and systemic inflammation ( Figure 1 ).…”