Publication: Generalize agresif periodontitisli bireylerde periodontal tedavi öncesi ve sonrasında nötrofil fonksiyonlarının incelenmesi
Abstract
Bu çalışmada generalize agresif periodontitis (AgP) ve kronik periodontitis (KP) hastalarında başlangıç periodontal tedavi öncesinde ve sonrasında klinik parametreler ve nötrofillere ait fagositoz ve oksidatif patlama fonksiyonları incelendi. Çalışmaya yaş ortalaması 30.6±2.88 olan 4 erkek, 6 kadın generalize AgP’li 10 hasta, yaş ortalaması 33.7±4.14 olan 5 erkek, 5 kadın KP’li 10 hasta ve yaş ortalaması 29.8±4.61 olan periodontal ve sistemik olarak sağlıklı 10 birey dahil edildi. Her iki hasta grubunda 0. ve 49. günlerde nötrofillerin fagositoz ve oksidatif patlama fonksiyonlarını içeren kan testleri ve tüm ağız plak indeks (Pİ), dişeti oluğu kanama indeksi (DOKİ), sondalanabilir cep derinliği (SCD) ve rölatif ataşman seviyesi (RAS) ölçümleri yapıldı. Fagositoz ve oksidatif patlama fonksiyonlarının incelenmesi flow cytometry yöntemiyle gerçekleştirildi. Klinik değerlendirmede, her iki hasta grubunda tedavi öncesi ve tedavi sonrası, KP’te RAS değişimi haricinde tüm klinik indeks ve ölçümlerde, anlamlı grup içi değişimler saptandı (p0.01). Gruplar arası karşılaştırmada ise grup içi değişimlere ait fark ortalamalarında istatistiksel olarak anlamlı farklılık bulunmadı (p>0.05). İmmünolojik değerlendirmede, generalize AgP, KP ve sağlıklı bireylerden oluşan 3 grubun % fagositoz ve oksidatif patlama ile ilgili başlangıç (0. gün), tedavi sonrası (49. gün) ile tedavi öncesi ve sonrası değişim (0.-49. gün) değerleri arasında anlamlı farklılık bulunmadı (p>0.05). Parlaklık göstergesine göre alınan ortalama fagositoz derecesi değerlerinin, generalize AgP’te tedavi öncesinde (0. gün), sağlıklı ve KP grubuna göre yüksek olduğu, tedavi sonrasında düşerek sağlıklı grubun ve KP grubunun tedavi sonrası değerlerine yaklaştığı görüldü. Fagositoz derecesi ile ilgili veriler bireysel hasta bazında sağlıklı grup ortalamasına göre değerlendirildiğinde ise, AgP’li hasta grubunda sağlıklı gruba kıyasla 0. günde hastaların hepsinde yüksek değerler (Generalize AgP: 10 hasta) olduğu, 0.-49. gün değişiminde ise generalize AgP’te değerlerin azalma gösterirken, KP’te yükseldiği izlendi. Bu bulguların ve ilgili literatürün ışığında, nötrofil fonksiyonlarının pek çok faktörün etkisi altında olduğunu, sadece kronik enflamasyon ile ilişkilendirilemeyeceğini, bu sistemde yer alan hücresel yolun yanı sıra serumla ilişkili defektlerin olabileceğini ve fonksiyonları etkileyebilecek farklı mikroorganizma ve virülans faktörlerinin mevcut olduğunu söyleyebiliriz. Bu konuda daha geniş hasta gruplarında mikrobiyal ajanların ve genetik faktörlerin tespitiyle birlikte yapılacak çalışmalara ihtiyaç vardır.
The objective of this study was to evaluate clinical parameters, phagocytosis and oxidative burst functions of neutrophils in generalized aggressive periodontitis (AgP) and chronic periodontitis (CP) patients, before and 6 weeks after initial periodontal therapy. 10 generalized AgP patients (4 male, 6 female, mean age of 30.6±2.88), 10 CP patients (5 male, 5 female, mean age of 33.7±4.14) and 10 periodontally and systemically healthy individuals were included in the study. At 0. and 49. days, peripheral blood analyses including phagocytosis and oxidative burst functions have been perfomed. At the same days plaque index (PI), bleeding on probing (BOP), probing depth (PD) and relative attachment level (RAL) have been measured in both patient groups. Phagocytosis and oxidative burst functions have been evaluated by flow cytometric analysis. At the end of the observation period, statistically significant improvements in clinical parameters were observed in the patient groups (p0.01) compared to their respective baseline values only with the exception of RAS changes in CP (p>0.05). Intergroup comparisons revealed no significant differences. Regarding to the immunological evaluations, pre-treatment and post-treatment levels of neutrophil % phagocytosis and oxidative burst functions demonstrated no statistical significant differences (p>0.05) between 3 groups. The differences between pre- and post-treatment neutrophil % phagocytosis and oxidative burst functions in intergroup comparisons did not reveal any statistical significance (p>0.05). The mean fluorescence intensity considered as the degree of phagocytosis, was found to be much higher in generalized AgP patients than in CP and healthy group before the initial periodontal treatment but reached almost similar levels for both groups after the treatment. Evaluation of degree of phagocytosis in generalized AgP group at pre-treatment (0. day) on individual base, revealed higher values (Generalized AgP: 10 patients) when compared with the healthy group. The difference between pre- and post-treatment levels (0.-49. day) showed increased degree of phagocytosis in generalized AgP group while CP patients exhibited depression. In the light of the related literature, these results indicate that neutrophil functions cannot be associated only with chronic inflammation and suggest that cell-associated as well as serum- associated defects may play role in this system. Further studies on larger group of patients are needed to investigate these functions together with microbiological parameters and genetic factors.
The objective of this study was to evaluate clinical parameters, phagocytosis and oxidative burst functions of neutrophils in generalized aggressive periodontitis (AgP) and chronic periodontitis (CP) patients, before and 6 weeks after initial periodontal therapy. 10 generalized AgP patients (4 male, 6 female, mean age of 30.6±2.88), 10 CP patients (5 male, 5 female, mean age of 33.7±4.14) and 10 periodontally and systemically healthy individuals were included in the study. At 0. and 49. days, peripheral blood analyses including phagocytosis and oxidative burst functions have been perfomed. At the same days plaque index (PI), bleeding on probing (BOP), probing depth (PD) and relative attachment level (RAL) have been measured in both patient groups. Phagocytosis and oxidative burst functions have been evaluated by flow cytometric analysis. At the end of the observation period, statistically significant improvements in clinical parameters were observed in the patient groups (p0.01) compared to their respective baseline values only with the exception of RAS changes in CP (p>0.05). Intergroup comparisons revealed no significant differences. Regarding to the immunological evaluations, pre-treatment and post-treatment levels of neutrophil % phagocytosis and oxidative burst functions demonstrated no statistical significant differences (p>0.05) between 3 groups. The differences between pre- and post-treatment neutrophil % phagocytosis and oxidative burst functions in intergroup comparisons did not reveal any statistical significance (p>0.05). The mean fluorescence intensity considered as the degree of phagocytosis, was found to be much higher in generalized AgP patients than in CP and healthy group before the initial periodontal treatment but reached almost similar levels for both groups after the treatment. Evaluation of degree of phagocytosis in generalized AgP group at pre-treatment (0. day) on individual base, revealed higher values (Generalized AgP: 10 patients) when compared with the healthy group. The difference between pre- and post-treatment levels (0.-49. day) showed increased degree of phagocytosis in generalized AgP group while CP patients exhibited depression. In the light of the related literature, these results indicate that neutrophil functions cannot be associated only with chronic inflammation and suggest that cell-associated as well as serum- associated defects may play role in this system. Further studies on larger group of patients are needed to investigate these functions together with microbiological parameters and genetic factors.