Interactions between stress, interleukin-1beta, interleukin-6 and cortisol in periodontally diseased patients.
Interactions between stress, interleukin-1beta, interleukin-6 and cortisol in periodontally diseased patients.
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牙周病患者压力、白细胞介素 1β、白细胞介素 6 和皮质醇之间的相互作用。
DOI：
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发表时间：
2002
影响因子：
6.7
通讯作者：
L. Flores
中科院分区：
文献类型：
--
作者：
R. Mengel;M. Bacher;L. Flores
背景/目的
本研究的目的是测量牙周病患者外周血中的白细胞介素-1 β、白细胞介素-6和皮质醇水平，以记录与心理社会应激的任何相互作用。
材料和方法
试验组包括16例未经治疗的患者和14例治疗的侵袭性泛发性牙周炎（AGP），5例未经治疗的侵袭性局限性牙周炎（ALP）和5例慢性泛发性牙周炎（CGP）。对照组包括40名牙周健康先证者。在同一时间（上午8点）从所有患者和对照组的头静脉采集血液。每一天.然后用灵敏的ELISA“Quantikine HS免疫测定试剂盒”（Biermann Diagnostica，Bad瑙海姆，FRG）测量IL-1 β、IL-6和皮质醇水平。临床检查包括探诊深度、牙龈退缩、牙龈指数、菌斑指数和临床附着水平。采用问卷调查的方法，询问患者和对照组的生活态度和工作及家庭压力。还记录了以前和现在的烟草消费水平。统计学评价基于Mann-Whitney U-Wilcoxon检验（用于比较患者和对照组之间的血清值和临床参数）和Kruskal-Wallis检验（用于组间比较）。所有数据均通过斯皮尔曼等级相关系数进行相关分析，并通过卡方检验确定与压力和吸烟相关的显著性水平。
结果
关于皮质醇，结果显示，无论是在患者组之间还是与对照组相比，都没有显著差异。IL-1 β仅在AGP患者及其对照组中检测到，但无显著差异。IL-6在几乎所有患者和对照组中均被检测到，但无显著差异。IL-6仅在未经治疗的AGP患者中显著升高（P < 0.05），并与记录的附着丧失轻微相关。在所有AGP患者中，记录到IL-1 β和IL-6之间的轻微相关性。评估问卷显示，未经治疗的AGP患者的比例高于对照组的悲观的生活态度。在所有AGP患者中，家庭引起的压力和吸烟被发现与依恋丧失相关。在未经治疗的AGP患者中，吸烟与IL-1 β蛋白含量相关，而在对照组中，吸烟与IL-6水平之间存在中度相关性。
结论
本研究发现，免疫介质（IL-1 β，IL-6），糖皮质激素（皮质醇）和登记的压力值之间没有相关性。然而，未经治疗的AGP患者表现出悲观的生活态度，外周血中IL-6水平升高。作为一个限制性因素，应当铭记的是，所调查的病人人数太少，无法得出充分的结论。
BACKGROUND/AIMS
The aim of the present study was to measure interleukin-1beta, interleukin-6 and cortisol levels in the peripheral blood of periodontally diseased patients in order to record any interactions with psychosocial stress.
MATERIAL AND METHODS
The test group comprised 16 patients with untreated and 14 with treated aggressive generalized periodontitis (AGP), five patients with untreated aggressive localized periodontitis (ALP) and five with chronic generalized periodontitis (CGP). The control group comprised 40 periodontally healthy probands. Blood was taken from the cephalic vein of all patients and controls at the same time (8 a.m.) each day. IL-1beta, IL-6 and cortisol levels were then measured with a sensitive ELISA, the 'Quantikine HS Immunoassay Kit' (Biermann Diagnostica, Bad Nauheim, FRG). The clinical examination covered probing depth, gingival recession, gingival index, plaque index and clinical attachment level. A questionnaire was used to ask the patients and controls about their attitude to life and the stress induced by their jobs and their families. Previous and current levels of tobacco consumption were also recorded. Statistical evaluation was based on the Mann-Whitney U-Wilcoxon test for comparison of blood serum values and clinical parameters between patients and controls, and the Kruskal-Wallis test for intergroup comparison. All data were correlated by means of Spearman's rank correlation coefficient, and significance levels relating to stress and smoking were determined with the chi-square test.
RESULTS
With respect to cortisol, the results showed no significant differences either between the patient groups or in comparison with the controls. IL-1beta was detected only in the AGP patients and their controls, but with no significant differences. IL-6 was detected in virtually all patients and controls, but with no significant differences. Only in the untreated AGP patients was IL-6 significantly elevated (P < 0.05) and a slight correlation with attachment loss recorded. In all AGP patients a slight correlation between IL-1beta and IL-6 was recorded. Evaluation of the questionnaire revealed a higher proportion of untreated AGP patients than of controls with a pessimistic attitude to life. In all AGP patients, family-induced stress and smoking were found to correlate with attachment loss. In the untreated AGP patients, smoking correlated with IL-1beta protein content, and in the controls there was a moderate correlation between smoking and IL-6 levels.
CONCLUSIONS
The present study found no correlation between the immunological mediators (IL-1beta, IL-6), glucocorticoids (cortisol) and the registered stress values. However, the patients with untreated AGP showed signs of a pessimistic attitude to life, and an elevated IL-6 level was recorded in the peripheral blood. As a restrictive factor it should be borne in mind that the number of patients investigated was too small for adequate conclusions to be drawn.
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