Changes In Gingival Crevicular Fluid Inflammatory Mediators Of Renal Patients

Objectives: To study the changes in the concentrations of inflammatory mediators, namely interleukin-1-beta(IL-1β), interleukin-6(IL-6), interleukin-8(IL-8), matrixmetalloproteinase-8(MMP-8), tumour-necrosis-factor-α(TNF-α)in gingival crevicular fluid(GCF) of renal patients with periodontitis and to compare this to a control group of non-renal patients with periodontitis.
Methods: 37 patients each were recruited for renal and non-renal groups. The renal group included patients with chronic kidney disease, hemodialysis or peritoneal dialysis with chronic periodontitis (≥1 site with CAL loss>1mm per quadrant). GCF was collected from the deepest pocket of each quadrant with paper points, eluted and analysed for IL-1β, IL-6, IL-8, MMP-8 and TNF-α using ELISA. Scaling and root planing(SRP) was then completed. Parameters was recorded at baseline, 3^rd month and 6^th month. Results were analysed using linear mixed model.
Results: At baseline, compared to non-renal patients, renal patients had significantly higher concentrations of IL-8 in GCF (386.61±493.07pg/μL vs 221.0+245.81pg/μL, p<0.005) but lower levels of MMP-8 (42.80±37.52ng/μL vs 77.94±64.78ng/μL, p<0.005). There was no significant difference between the 2 groups for IL-1β (280.10±316.37pg/μL vs 1009.61±4959.5pg/μL), IL-6 (8.81±18.45pg/μL vs 12.25±26.80pg/μL) & TNF-α (4.40±16.31pg/μL vs 5.95±11.41pg/μL) levels.

After SRP, CKD IL-1β decreased significanlty (118.15± 234.22%, p<0.005), MMP-8 increased significantly(454.19±1423.28%, p<0.005) while IL-6, IL-8 & TNF-α concentrations remained similar; for non-CKD, there was significant decrease for IL-1β (82.51± 510.8%, p<0.005), IL-6 (91.45± 565.77%), MMP-8 (30.24± 275.72%, p<0.005), TNF-α (106.27± 475.20%, p<0.005) while IL-8 levels remained similar.

Overall, compared to non-CKD, CKD has significantly higher IL-6, MMP-8 concentrations whereas IL-1β, IL-8 and TNF-α concentrations were similar.
Conclusions: After SRP, CKD and non-CKD showed improvement of clinical parameters. For the non-CKD group, there was a general decrease of the GCF inflammatory mediators after SRP whereas the changes in CKD were less consistent.