IL-4及IFN-γ於慢性牙周炎之探討

IL-4 and IFN-γ in Chronic Periodontitis

古家欣(Chia-Hsin Ku)

指導教授 ： 蔡吉政

高雄醫學大學/口腔醫學院/牙醫學研究所/碩士(2005年)

摘要

近來的研究顯示出細胞激素對慢性牙周炎的免疫反應的重要性，尤其是由T細胞所製造的細胞激素，將來或許可以作為診斷的指標。
我們研究的主要目的是針對中度以及重度慢性牙周炎的患者，探討牙齦溝液中IL-4和IFN-γ的表現與臨床牙周指數和吸菸之關係，以及其對牙周非手術性治療的反應。研究包括了17位慢性牙周炎患者口腔中共70個病灶，利用Periopaper®，分別在非手術性牙周治療前以及非手術性牙周治療後一個月，收集選定病灶中的牙齦溝液。利用R&D公司所生產的ELISA (enzyme-linked immunosorbent assays)套件測定治療前後共140個樣本中IL-4和IFN-γ的總量與濃度。
研究發現，在牙周非手術治療前，沒有探測出血的部位其IL-4的總量與濃度顯著高於有探測出血的部位；在吸菸的影響方面，治療前吸菸患者IL-4的總量與濃度在PD、PAL<6的部位明顯高於PD、PAL≧6的部位。另外，治療前在PD、PAL≧6的部位，非吸菸患者IL-4的總量與濃度顯著高於吸菸患者。經過牙周非手術治療，臨床牙周指數有顯著的改善，IFN-γ的總量會顯著下降，而IL-4/IFN-γ比值則會顯著增加。另外，吸菸與非吸菸患者對於牙周非手術治療的反應則無顯著的差異。
因此我們推論，Th1的代表性細胞激素IFN-γ在牙周病灶區是佔優勢的，而Th2的代表性細胞激素IL-4則是和牙周發炎的緩解有關，IL-4 / IFN-γ的高比值則意味著牙周狀況的改善。另外，吸菸患者牙周病灶區的IL-4表現可能會受到抑制，吸菸與否對於牙周非手術治療的反應則無差異。

關鍵字

IFN-γ ； 牙齦溝液 ； 細胞激素 ； IL-4 ； 吸菸

並列摘要

Recent studies have shown that cytokines, especially those produced by T cells, are pivotal to the immune response of chronic periodontitis and may be used as markers in diagnosis.
The aim of present study was to determine the level of interleukin (IL)-4 and interferon (IFN)-γ in gingival crevicular fluid (GCF) of individuals with moderate and advanced chronic periodontitis and to study their association with clinical periodontal parameters, smoking, and the response to non-surgical periodontal treatment.
A total of 70 sites of 17 patients with chronic periodontitis were included in the study. GCF was collected by means of Periopaper® at baseline and one month after non-surgical periodontal treatment. The contents of IL-4 and IFN-γwere measured in 140 samples by use of commercially available sandwich enzyme-linked immunosorbent assays produced by R&D company.
In sites without bleeding on probing (BOP), the level of IL-4 was significantly higher as compared to sites with BOP before non-surgical periodontal treatment. In sites with probing depth (PD)<6 and sites with probing attachment level (PAL)<6, the level of IL-4 was significantly higher as compared to sites with PD≧6 and PAL≧6 before non-surgical periodontal treatment in smokers. Furthermore, in sites with PD≧6 and PAL≧6, the level of IL-4 in nonsmokers was significantly higher than those in smokers before non-surgical periodontal treatment. After non-surgical periodontal therapy, the clinical periodontal parameters was significantly reduced, while the total amount of crevicular IFN-γwas significantly lower and the crevicular IL-4/IFN-γratio was significantly higher compared to those before non-surgical periodontal therapy. The response to non-surgical periodontal therapy in smoking population was similar to that in non-smoking population.
The present data suggest that IFN-γ,the Th1 cytokine may be predominant in diseased sites, whereas IL-4, the Th2 cytokine may reduces local inflammation. The high ratio of IL-4/IFN-γmay be related to reduced clinical periodontal parameters. The crevicular IL-4 seemed to be suppressed in smoking population.

並列關鍵字

IL-4 ； IFN-γ ； smoking. ； gingival crevicular fluid ； cytokine

參考文獻

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