Análise de citocinas na saliva de indivíduos com lúpus eritematoso sistêmico e periodontite crônica

• Ano de defesa: 2017
• Autor(a) principal: Santuza Maria Souza de Mendonça
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Minas Gerais; Brasil; FAO - DEPARTAMENTO DE CLÍNICA; Programa de Pós-Graduação em Odontologia; UFMG
• Palavras-chave em Português: Lúpus eritematoso sistêmico; Periodontite crônica; Citocinas; Saliva; Glândulas salivares
• Link de acesso: http://hdl.handle.net/1843/44749; https://orcid.org/0000-0002-3033-6301

Systemic lupus erythematosus (SLE), a chronic connective tissue disease that may present with oral manifestations, has environmental, genetic, hormonal and infectious factors in its etiopathogesis. It is characterized by the lack of control of immunoregulation and consequently target organ damage. Chronic periodontitis (CP) is a chronic bacterial infection of the tooth-supporting tissues that triggers, in susceptible patients, a series of immunological processes dependent on the host-infectious agent interaction. These processes culminate in the destruction of affected tissues, clinical attachment loss and alveolar bone. The immune system has an important role in the development of CP and SLE. Altered cytokines levels characterize both diseases and contributes to periodontal tissue damage in CP and to macrocomplexes deposition with connective tissue destruction in SLE. The aim of this cross-sectional study was to analyze the production of salivary cytokines in SLE patients and its relationship with CP. Clinical and salivary parameters of inflammation and periodontal damage were associated with activity (Systemic Lupus Erythematosus Disease Activity Index 2000, SLEDAI-2K) and damage (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index, SDI) indexes and to other indicators such as levels of C-reactive protein and cumulative dose of corticoids. The sample comprised of 70 SLE patients under in treatment at the Rheumatology Outpatient Clinic of the Hospital das Clínicas of the Federal University of Minas Gerais, and 70 individuals without SLE (controls). The two groups were paired by age, gender, color, educational level and monthly income. All subjects were classified as without CP and with CP. Salivary concentrations of interleukin 33 (IL-33), matrix metalloproteinase-2/tissue inhibitor of metalloproteinase-2 (MMP2/TIMP2), receptor activator of nuclear factor kappa B (RANK) and osteoprotegerin (OPG) were measured by Enzyme-Linked Immunosorbent Assay (ELISA), while interleukin 2 (IL-2), Interferon gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), interleukin 4 (IL-4), interleukin 6 (IL-6), interleukin 10 (IL-10) and interleukin 17A (IL-17A) concentrations were determined by Cytometric Bead Array (CBA). IL-6 and IL-17A salivary levels were higher in SLE patients with CP than controls with CP. IL-6, IL-17A and IL-33 were increased in SLE individuals with CP when compared to SLE patients without CP. Bivariate analysis revealed that SLE duration correlated with probing depth (PD), clinical attachment loss (CAL), concomitant sites (CS) and missing teeth. Cumulative dose of corticoids correlated with PD and CS, while SLE damage correlated with CAL and missing teeth. The multivariate model indicated an association between cumulative dose of corticoid and periodontal damage and between salivary concentration of IL-33 and SLE activity. Our results suggest that the corticoids long-term therapy may contribute to periodontal destruction in SLE. Moreover, the increased levels of IL-6, IL-17A and IL-33 in saliva of SLE/CP subjects suggest possible pro-inflammatory pathways amplification in this group of patients.