Periodontal health related–inflammatory and metabolic profiles of patients with end-stage renal disease: potential strategy for predictive, preventive, and personalized medicine

Abstract

Objectives To compare the periodontal health related–inflammatory and metabolic differences between patients with end-stage renal disease (ESRD) and healthy controls (HC), and to identify potential biomarkers in gingival crevicular fluid (GCF) and serum of ESRD patients for predictive, preventive, and personalized medicine (PPPM). Methods Patients with ESRD (ESRD group; n = 52) and healthy controls (HC group; n = 44) were recruited. Clinical periodontal parameters were recorded. The differential metabolites in the GCF and serum were identified by liquid chromatography/mass spectrometry (LC/MS). Inflammatory markers including interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), and C-reactive protein (CRP) were also assessed. Results In the ESRD group, IL-8 and CRP were significantly higher in GCF, whereas IL-6 and CRP were significantly higher in serum, compared with HC group (all P < 0.05). In the case of GCF, taurine levels were positively correlated with IL-8 levels in both groups (all P < 0.05). In the case of serum, l-phenylalanine and p-hydroxyphenylacetic acid levels were positively correlated with CRP levels in both groups (all P < 0.05). Significant positive correlations were observed between metabolites (including pseudouridine, l-phenylalanine, and p-hydroxyphenylacetic acid) and IL-6 levels only in ESRD group. Conclusions IL-8 and CRP are potential inflammatory makers that reflect the periodontal health of ESRD individual, which may be considered the valuable predictive diagnostics in the agreement with PPPM philosophy. Besides, metabolites of taurine in GCF as well as l-phenylalanine and p-hydroxyphenylacetic acid in serum are possible biomarkers correlated with inflammatory markers. All these biomarkers may also be highly recommended as a novel predictive/diagnostic tool for the assessment of inflammatory status from the perspectives of PPPM in view of susceptible population and individual screening.

TNF-α, IL-1β, MMP-8 Crevicular Profile in Patients with Chronic Kidney Disease and Periodontitis

“…Hence, our results acknowledge higher GCF mean levels of IL-1β in hemodialysis patients with periodontitis, compared to patients with periodontitis without kidney impairment. This pattern represents evidence suggesting the role of cytokines in the immune inflammatory mechanism that characterizes the two pathological entities, in contrast to the data from Ma et al, who report a higher mean IL-1β level in the control group [65]. In our opinion, these contradictory results may be explained by the small sized group used by Ma et al, in his study (15 subjects per group).…”

“…The results indicate the absence of statistic significant differences between the levels of crevicular fluid IL-1β of both groups [65]. Mean values of crevicular IL-1β were 0.26 ng/mL in the CKD group and 0.34 ng/mL in the healthy control group [65]. However, the study was limited by the small study population.…”

“…The literature review points only one study that analyses crevicular IL-1β in end stage kidney failure. This recent investigation [65] evaluates together with IL-1β also IL-6, IL-8 and C reactive protein (CRP) in serum and GCF, in patients with end stage CKD, compared to a healthy control group. The results indicate the absence of statistic significant differences between the levels of crevicular fluid IL-1β of both groups [65].…”

“…This recent investigation [65] evaluates together with IL-1β also IL-6, IL-8 and C reactive protein (CRP) in serum and GCF, in patients with end stage CKD, compared to a healthy control group. The results indicate the absence of statistic significant differences between the levels of crevicular fluid IL-1β of both groups [65]. Mean values of crevicular IL-1β were 0.26 ng/mL in the CKD group and 0.34 ng/mL in the healthy control group [65].…”

Association of Periodontitis and Atopic Dermatitis with the Levels of IL-13, IL-31, and TSLP in the Gingival Crevicular Fluid

“…A study suggested that molecules from systemic diseases can travel to the oral gingiva, modifying the immune composition of the GCF [29]. Prior studies using multiplex-bead immunoassays and ELISA methods have uncovered distinct GCF profiles between systemically healthy subjects and those with acute myocardial infarction, diabetes, rheumatoid arthritis, and psoriasis [29][30][31][32][33][34]. However, this aspect has yet to be comprehensively evaluated in AD.…”