IL-6 levels in gingival crevicular fluid (GCF) from patients with non-insulin dependent diabetes mellitus (NIDDM), adult periodontitis and healthy subjects.

Cytokines play an important role in the pathology associated with chronic inflammatory diseases. One of these cytokines, interleukin 6 (IL-6) is a major mediator of the host response to tissue injury, infection and bone resorption. In the present study, gingival crevicular fluid (GCF) level of IL-6 was determined in patients with non-insulin dependent diabetes mellitus (NIDDM) with periodontitis, adult periodontitis, and healthy controls by use of an enzyme linked immunosorbent assay (ELISA). Twenty-four NIDDM patients with periodontitis, twenty-four adult periodontitis and twenty-four healthy controls were selected for the study. GCF sampling was performed on the vestibular aspects of maxillary incisors and canine teeth. Plaque index (PI), gingival index (GI), gingival bleeding time index (GBTI), probing depth (PD) and probing attachment levels (PAL) were recorded from each sampling area and also the entire dentition. NIDDM and adult periodontitis patients had numerous sites with radiographic evidence of alveolar bone resorption, loss of attachment and pocket depth greater than 3 mm. The mean GCF IL-6 level was 2.43 +/- 0.97 ng/ml in NIDDM patients, 1.31 +/- 0.92 ng/ml in adult periodontitis and 0.62 +/- 0.58 ng/ml in healthy subjects, respectively (p < 0.05). GCF IL-6 levels were markedly higher in NIDDM and adult periodontitis groups compared to the healthy controls. No correlation was found between GCF IL-6 levels and all clinical parameters. These findings suggested that GCF IL-6 levels were significantly higher in the area of inflammation and periodontal destruction locally. The high IL-6 levels in NIDDM patients might be due to different microbial flora in periodontal pockets and altered immune system. Future studies are needed to evaluate the complex interaction among IL-6 GCF levels, host response and local microbial environment in the NIDDM patients.

[1]  D. Fine,et al.  Indicators of periodontal disease activity: an evaluation. , 1986, Journal of clinical periodontology.

[2]  H Löe,et al.  The Gingival Index, the Plaque Index and the Retention Index Systems. , 1967, Journal of periodontology.

[3]  M. Grower,et al.  A comparison of the glucose and protein content of gingival fluid from diabetics and nondiabetics. , 1975, Journal of periodontal research.

[4]  P. Remani,et al.  Cell-mediated and humoral immune response in diabetic patients with periodontitis. , 1990, Oral surgery, oral medicine, and oral pathology.

[5]  P. Bartold,et al.  Interleukin-6 production by human gingival fibroblasts. , 1991, Journal of periodontal research.

[6]  M. Geivelis,et al.  Measurements of interleukin-6 in gingival crevicular fluid from adults with destructive periodontal disease. , 1993, Journal of periodontology.

[7]  G. Seymour.  Importance of the host response in the periodontium. , 1991, Journal of clinical periodontology.

[8]  T. Hirano,et al.  IL-6 is produced by osteoblasts and induces bone resorption. , 1990, Journal of immunology.

[9]  Y. Ohno,et al.  In vitro production of interleukin-1, interleukin-6, and tumor necrosis factor-alpha in insulin-dependent diabetes mellitus. , 1993, The Journal of clinical endocrinology and metabolism.

[10]  WHO Expert Committee on Diabetes Mellitus: second report. , 1980, World Health Organization technical report series.

[11]  S. Pollock,et al.  Gingival interleukin-6 concentration following phase I therapy. , 1995, Journal of periodontology.

[12]  T. Hirano,et al.  B cell stimulating factor 2/interleukin 6 is a costimulant for human thymocytes and T lymphocytes , 1988, The Journal of experimental medicine.

[13]  M. Deasy,et al.  The gingival bleeding time index. , 1981, Journal of periodontology.

[14]  A. Allison,et al.  Gingival fluid IL-1 beta and IL-6 levels in menopause. , 1994, Journal of clinical periodontology.

[15]  S. Takashiba,et al.  Assessment of interleukin-6 in the pathogenesis of periodontal disease. , 1994, Journal of periodontology.

[16]  J. G. Fisher,et al.  Microbiological and immunological studies of adult periodontitis in patients with noninsulin-dependent diabetes mellitus. , 1988, Journal of periodontology.

[17]  R. Genco,et al.  Periodontal disease in non-insulin-dependent diabetes mellitus. , 1991, Journal of periodontology.

[18]  T. Kishimoto,et al.  The biology of interleukin-6. , 1989, Blood.

[19]  K. Federlin,et al.  Impairment of Polymorphonuclear Leukocyte Function and Metabolic Control of Diabetes , 1992, Diabetes Care.

[20]  T. Tervonen,et al.  Diabetes--a risk factor for periodontitis in adults? , 1994, Journal of periodontology.

[21]  J. Ainamo,et al.  Periodontal conditions in insulin-dependent diabetes mellitus. , 1992, Journal of clinical periodontology.

[22]  Rüdin Hj,et al.  Correlation between sulcus fluid rate and clinical and histological inflammation of the marginal gingiva. , 1970, Helvetica odontologica acta.

[23]  F. Ersoy,et al.  The gingival crevicular fluid Interleukin‐1β and tumour necrosis factor‐α levels in patients with rapidly progressive periodontitis , 1995 .

[24]  W. Knowler,et al.  Non-insulin dependent diabetes mellitus and alveolar bone loss progression over 2 years. , 1998, Journal of periodontology.

[25]  S. Socransky,et al.  Tissue levels of bone resorptive cytokines in periodontal disease. , 1991, Journal of periodontology.

[26]  K. Rateitschak,et al.  Correlation between sulcus fluid rate and clinical and histological inflammation of the marginal gingiva. , 1970, Helvetica odontologica acta.

[27]  K. Kalkwarf,et al.  Gingival fluid IL-1 and IL-6 levels in refractory periodontitis. , 1993, Journal of clinical periodontology.

[28]  R. Arnold,et al.  Inflammatory mediator response as a potential risk marker for periodontal diseases in insulin-dependent diabetes mellitus patients. , 1997, Journal of periodontology.