Perfil clínico, microbiológico e resposta imune da periodontite e seu impacto em mulheres com câncer de mama

• Ano de defesa: 2021
• Autor(a) principal: Gomes, Maria da Conceição Machado
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal do Espírito Santo; BR; Doutorado em Biotecnologia; Centro de Ciências da Saúde; UFES; Programa de Pós-Graduação em Biotecnologia Rede Nordeste de Biotecnologia (Renorbio)
• Palavras-chave em Português: Periodontite; câncer de mama; fluido crevicular gengival; citocinas; subject.br-rjbn; Biotecnologia
• Link de acesso: http://repositorio.ufes.br/handle/10/15800

The main objective this study was to evaluate the subgingival microbial profile and levels of inflammatory markers of periodontitis associated with breast cancer (BC) and the impact of periodontal therapy on these findings. This study evaluated in 2 phases (before and during chemoterapy), the sociodemographic profile of the studied population, the characterization by bacterial count of subgingival microbiota, the correlation between the subgingival microbiota with the tooth loss, clinical attachment level (CAL≥4mm) and age, the PD immune response by the secretion of inflammatory cytokines, CPP and their relationship with molecular subtype for the BC and the tumor grade with tooth loss and CAL≥4mm in the groups. Basic periodontal therapy occurred twice in each phase within 14 days after a crevicular gingival fluid and biofilm collection during clinical care. One hundred patients were managed through a longitudinal case control study where 50 of them with BC (Group 1) and 50 without BC (group 2) and subdivided according to the presence of periodontitis with probing depth (PD) and clinical attachment level (CAL) ≥4mm (A); or without periodontitis with PD≤3mm and CAL≤4mm. Bacterial counting was performed by the checkerboard DNA-DNA Hybridization method, the scretion of cytokines IL8, TNFα, IL¨6 and IL1β by Enzyme Linked Immuno Sorbent Assay (ELISA) method, the CPP such as: tooth loss, visible plaque (VP), gingival bleeding (GB), bleeding on probing (BOP), probing depth (PD) and clinical attachment level (CAL), but one periodontal site with PD≥4mm for patients with periodontitis and PD ≤3mm for patients without periodontitis by gingival crevicular fluid and biofilm collections. 60% of the patients were 51 years old or older, 16% were smokers and 34% were alcoholics in group 1. In comparisons between groups: bacterial count presented proportions >105 in almost all assessment in group 1A and 1B compared to groups 2A and 2B in phase 2 mainly for the species complexes that had more aggressive. In phase 1, when group 1B was evaluated, there was a significant association of CAL≥4mm with the species Capnocytophaga ochracea (r=0.514), Eikenella corrodens (r=0.516) e Leptotrichia buccalis (r=0.481). For group 1A, it was observed that there was a significant association between CAL≥4mm and A. actinomycetencomytans (r=0.468), Eikenella corrodens (r=0.437) e Streptococcus anginosus (r=0.411). In phase 2, for group 1A there was a significant correlation of CAL≥4mm with Streptococcus mitis (r=0.455) e Actinomyces naeslundi I (r= 0.506). In phase 1, age was significantly correlated with Streptococcus anginosus (r=0.463) and Propionybacterium acnes (r=0.496) in group1B and Fusobacterium periodonticum (r=0.539) in group 1A. In phase 2 with Actinomyces naeslundi I (r= 0.528) in group 1A, Porphyromonas gingivalis (r=0.438), Actinomyces naeslundi I (r=0.433), Veillonela parvula (r=0,439) and Actinomyces israelli (r=0.405) in group 1B. The tooth loss in phase 1 presented association with species Actinomyces gerencseriae (r=0.564), Actinomyces odontolyticus (r=0.550), Capnocytophaga gingivalis (r=0.549) and Neisseria mucosa (r=0,515), where these were moderate and strong correlations for species Treponema socranskii (r=0.664), Streptococcus anginosus (r=0.668) and Prevotella melaninogenica (r=0.731) in group 1B. The tooth loss was significative to Veillonela parvula (r=0.441), Eubacterium saburreum (r=0.496) and Prevotella melaninogenica (r=0.526) in group 1A and phase 2, presented correlation significative with Streptococcus intermedius (r=0.432), Actinomyces israelli (r=0.419) and Capnocytophaga ochracea (r=0.497) in group 1B. In P2 compared with P1, the citokines IL-8 (p=0.007) and TNFα (p=0.004) were higher in group 1B compared with group 2B. The groups 1A and 1B presented higher significance for IL-1β (p<0.001), TNFα in group 1A (p<0.001) and 1B (p=0.004) and IL6 in group 1A (p=0,002) and 1B (p<0.001) compared with group 2A and 2B. VP, GB, BOP, PD≥ 4mm and CAL>4mm (p<0,001) were highest in groups 1B and 1A compared with groups 2A and 2B. The levels of proportion were highest for tooth loss, PD=4mm and CAL>4mm (p<0.001) to TNBC subtype compared to luminal B. Regarding tumor grade, tooth loss had a significant relationship with tumor grade II (p=0.003) and III (p= 0.006) in group 1B compared to group 1A and CAL≥4mm with tumor grade II (p= 0.005) and III (p= 0.000) in group 1B compared to group 1A. It can be concluded that basic periodontal therapy significantly improved bacterial, inflammatory and peridontal indices in patients without cancer, which did not occur in the cancer group that had increased levels.