중증 치주염환자의 치은열구액에서 전신 급성감염인자인 C-reactive protein의 검출

Abstract

Some research has indicated that inflammation in the target area for dental surgery decreases the success rate of orofacial surgery and oral implant surgery. Inflammation can arise from resident bacteria and other flora or the presence of a foreign body during surgery. (Turvey et al., 2011) To avoid this disadvantage, most surgeons perform blood tests to assess acute systemic inflammation before surgery. This test typically evaluates C-reactive protein (CRP) and interleukin (IL)-6 levels because these are common markers of acute inflammation. Although this information aids in determining the prognosis for recovery, performing the blood test regularly is often untenable because of needle phobia on the part of the patient and turnaround time for results. For these reasons, some researchers have turned to IL-6 detection in saliva instead of serum due to their easy approach.(Tishler et al., 1999) But evidence has suggested no significant association between IL-6 levels in serum and in saliva under baseline conditions because IL-6 is not only under systemic regulation but also is under local regulation.(Sjogren et al., 2006) Recently, CRP, a common marker of systemic acute inflammation secreted by liver cells under the transcriptional control of IL-6,(Pepys and Hirschfield, 2003) became another target for measurement in saliva for association with serum CRP levels.(Ouellet-Morin et al., 2011) Saliva arises mostly from the salivary gland, but it also contains some gingival crevicular fluid (GCF). Cytokines in GCF are not easily diluted while cytokines in saliva can be diluted by salivary gland stimulation. Therefore, in some studies, GCF instead of saliva has been used for detecting inflammation-related molecules and cytokines.(Dutzan et al., 2009; Shaddox et al., 2011) Periodontitis is an inflammatory disease well-known in dental departments. Periodontal pathogens affect both local and systemic immune and inflammatory responses, and cytokines from systemic immune and inflammatory responses against periodontitis are involved in destruction of both periodontal connective tissue and alveolar bone.(Noack et al., 2001) One of the cytokines that initiates a systemic acute-phase response is CRP. Recent cross-sectional studies have shown that plasma CRP in periodontitis is elevated compared with controls. (Paraskevas et al., 2008) Therefore, the aims of this study were to confirm the presence of CRP in mouth fluid, which consists of saliva and GCF, in severe chronic periodontitis patients and to assess differences in CRP concentrations in these two fluids and between healthy people and severe chronic periodontitis patients.