Track Gum Disease With Cytokine Score in Saliva

A single score is developed to describe the level of cytokines in the saliva, and this score is linked with the severity of clinical gum inflammation, according to a study published in the journal PLOS ONE. While more research is needed to test the “cytokine score,” it could hold promise for measuring how well a patient responds to treatment for gum disease, predicting gum disease recurrence, or detecting ongoing inflammation related to systemic diseases.

Looking into Salivary Cytokines Gives Picture of Gum Disease

Periodontal (or gum) disease is a chronic, inflammatory condition that affects roughly half of the adults. Marked by inflamed gums, which can bleed and detach from the tooth. Periodontal disease results from the complex interaction between an imbalance of healthy and unhealthy bacteria under the gum line and the immune system’s response.

This response produces high levels of cytokines—small proteins that signal the immune system—in the inflamed gums, especially pro-inflammatory cytokines such as IL-8, IL-1β, IL-6, and TNFα. Periodontal disease is also associated with systemic conditions including cardiovascular disease, diabetes, and Alzheimer’s.

Scientists believe that gum inflammation contributes to these conditions through both indirect pathways (cytokines boosting systemic inflammation) and direct pathways (cytokines traveling to a specific organ like the heart or brain), but studying this is difficult due to the challenge of measuring cytokines in the fluid found deep in the pockets in the gums.

Fortunately, cytokines are also found in the saliva, which is easier to collect. In this study, the researchers wanted to know if clinically detected gum inflammation could predict the level of cytokines found in saliva.

Salivary Cytokines: Window to Molecular Make-up of the Oral Environment

Researchers evaluated the gums and saliva of 67 adults, ages 45 and older, who had some degree of periodontal disease but were otherwise healthy. To measure their clinical gum inflammation, the researchers used a formula called the Periodontal Inflamed Surface Area (PISA).

This formula is calculated using measurements of the depth of pockets in the gums and bleeding upon probing. PISA provides a single measure of periodontal inflammation; a higher PISA score indicates worse inflammation.

Participants were also asked to spit into sterile tubes to capture saliva samples, which were then analyzed to measure a range of both pro- and anti-inflammatory cytokines: IL-1β, IL-6, IL-8, IL-13, TNF-α, and IL-10. Researchers used two different ways (the Cytokine Component Index and Composite Inflammatory Index) to combine these cytokines into a single score.

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They found that PISA scores were significantly associated with the new cytokine scores, independent of other factors including age, gender, smoking, and body mass index (BMI). The higher the cytokine score, the greater the periodontal inflammation. This demonstrates that a single score encompassing several salivary cytokines correlates with the severity of periodontal inflammation.

But more research is needed to validate the cytokine score in patients with different health conditions, as well as those with all levels of periodontal disease, including healthy gums and early-stage gum disease.

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However, if the cytokine score is validated in larger and more diverse patient populations, it could be used to better understand periodontal disease progression and recurrence, as well as the potential connection to other systemic conditions.



Source-Eurekalert