Adriana Monea, Lia Yero Eremie, Csilla Bukhari, Gabriela Beresescu, Carmen Biris
University of medicine and pharmacy Tirgu-Mures, Romania
Our objective was to investigate immunological changes that occur in saliva of subjects with type 2 diabetes mellitus (T2DM) without signs of periodontal disease and to establish if salivary inflammatory cytokines are a possible link between diabetes mellitus and periodontal breakdown. Material and methods. Twenty T2DM subjects with no periodontal disease and twenty healthy controls were registered for the present study. TNF-α and IL-6 level from saliva and serum were measured. Periodontal tissue samples were histologically examined.
Results: TNF-α and IL-6 levels were higher in T2DM subjects compared to controls, with an extremely significant difference in saliva (p<0.001). Significant inflammation, affecting both epithelial and connective tissues was present in periodontal biopsies. Conclusions: The subjects showed an increased TNF-α and IL-6 levels, both in serum and -mostly in -saliva of diabetics without signs of periodontal disease, confirming the hypothesis of immunological implication, as a correlation between periodontal disease incidence and diabetes mellitus. Histologic alterations, suggesting a local inflammatory state, were present in periodontal tissue of diabetics, confirming the above hypothesis. The study reveals that saliva analysis is a quite efficient method in testing the periodontal breakdown progression in the subjects with T2DM.
1 Department of Nephrology, University of Medicine and Pharmacy of Targu Mures, Romania
2 Department of Internal Medicine, County Clinical Hospital Targu- Mures, Romania
3 Department of Internal Medicine, University of Medicine and Pharmacy of Targu Mures, Romania
4 CCAMF of University of Medicine and Pharmacy of Targu Mureș, Romania
5 Department of Laboratory Medicine, University of Medicine and Pharmacy of Targu Mureș, Romania
6 Department of Pharmacology, University of Medicine and Pharmacy of Targu Mureș, Romania
Introduction: Hepcidin is a regulatory protein in iron metabolism; we do not know the role in chronic kidney disease anemia.
Methods: 22 patients with CKD anemia and 15 patients with CKD without anemia were investigated. CKD anemia-inclusion criteria: over 18 years, hemoglobin ≤12 g/dl for women and ≤13 g/dl for men, no treatment for anemia 6 months before enrollment, glomerular filtration rate (eGFR) <60 ml/min/1.73m² and stable creatinine three months before enrollment. Exclusion criteria: infection, bleeding, malignancy, systemic or liver disease, immunosuppression, renal replacement therapy. CKD without anemia-inclusion criteria: over 18 years, no anemia or treatment for anemia, CKD with stable creatinine values three months before enrollment. Exclusion criteria: medical conditions known to have a role in the development of polycythemia. Hepcidin-25 and ferritin were measured by ELISA method. Erythropoietin (EPO), tumor necrosis factor (TNF)-α, interleukin (IL)-6 were evaluated using chemiluminescent enzyme immunometric assays. Unpaired T test, Pearson correlation and multiple regression were used for statistical analysis.
Results: Hemoglobin values were significantly lower in anemia group. There were no differences in terms of eGFR, age, body mass index, serum hepcidin, erythropoietin, fibrinogen, IL-6, and TNF-α between CKD patients with and without anemia. Serum hepcidin correlated positively with ferritin (r=0.45 p<0.05), TNF-α (r=0.54, p<0.05) and negatively with erythropoietin (r=-0.51, p<0.05). Multiple linear regression analysis demonstrated that TNF-α is an independent predictor of serum hepcidin in our patients (p=0.003, R=0.71).
Conclusion: We found no differences in serum hepcidin, erythropoietin and inflammatory markers in non-dialysis CKD patients with and without anemia.
Russu OM1, Gergely I1, Zazgyva Ancuţa1, Zuh SGy1, Nagy E2, Nagy Ö1, Pop TS1
1 Department of Orthopaedics and Traumatology, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
2 Department of Pharmaceutical Biochemistry, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
Objective: To analyse the correlations between the levels of Tumor Necrosis Factor α, Matrix Metalloproteinase 8, Interleukin 6 and the presence of cartilage lesions in the knee.
Methods: We studied 79 individuals divided in three groups – a group with cartilage lesions, a group with meniscal lesions and a control group. All patients underwent arthroscopic surgical interventions – either diagnostic or therapeutic. Venous blood samples and synovial fluid samples were obtained and we determined the levels of TNF-α, MMP-8 and IL-6 respectively. All study participants filled out the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Score questionnaire, based on which the IKDC score was calculated.
Results: we found higher levels of MMP-8 in both serum and synovial fluid for groups 1 and 2 compared to the control group, but no correlation between the serum and synovial fluid levels of MMP-8. The serum MMP-8 levels showed a significant negative correlation with the highest level of activity without pain and significant giving way. The synovial MMP-8 could be correlated to the IKDC score. Serum levels and synovial levels of TNF-α were in strong correlation. We found no association between serum and/or synovial TNF-α and MMP-8 levels.
Conclusions: We found that synovial MMP-8 concentrations showed a reverse correlation with the IKDC scores (an activity-based score) – thus MMP-8 might be a diagnostic and prognostic marker in knee osteoarthritis.
Yero Ieremie Lia Maria, Lazăr Luminița*, Ciurba Adriana
University of Medicine and Pharmacy of Tirgu Mures, Romania
Periodontal disease can have significant effects by increasing the circulating levels of TNF-α, therefore its prevention and treatment is important in maintaining the overall health of the body. Objective: The aim of our research was to assess the differences in the salivary concentration of TNF-α between patients with periodontal disease and those free of the disease and to studz whether it can represent an indicator of the evolution of periodontal disease. We also aimed to assess the practical applicability of the method for the determination of this cytokine in the saliva.
Materials and methods: Our study included two groups of subjects, the first group consisting in patients diagnosed with periodontal disease, while the control group included subjects free of periodontal disease. TNF-α concentration was determined with the ELISA test for human TNF-α and the results were expressed in pg/ mL. The data were statistically processed with GraphPad software and the statistical nonparametric Mann-Whitney test was applied.
Results: We observe nearly double values of the TNF-α salivary level in the group of patients suffering from periodontal disease compared to the subjects free of periodontal disease, which allows us to notice that saliva analysis is a useful and safely enough method for the diagnosis and follow-up in the development of periodontal disease.
Conclusion: The salivary level of TNF-α in patients with periodontal disease is not only an indicator of periodontal disease progression, but also a reflection of the pathogen potential that periodontal disease may have on the overall health of the body.
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