【作者】 谭春；

【导师】 吴亚菲；

【作者基本信息】 四川大学 ， 口腔临床医学， 2003， 硕士

【摘要】 白细胞介素-1(IL-1)是一种多功能的细胞因子，与牙周炎的发生发展关系密切。IL-1受体拮抗剂(IL-1ra)能特异性地与IL-1受体结合但不诱导靶细胞产生相应的生物学效应，从而抑制了IL-1的多种生物学活性。本研究通过检测牙周健康牙与牙周炎患牙龈沟液(GCF)中IL-1β和IL-1ra的含量，探讨两者与牙周炎的关系以及两者的相互关系。共10名非牙周炎患者的15颗牙周健康牙和33名慢性牙周炎患者的15颗牙周健康牙，43颗牙周炎患牙(其中包括15颗BOP阴性患牙和28颗BOP阳性患牙)纳入本研究。采集观察牙的GCF样本，随后记录牙龈指数(GI)，牙周袋探诊深度(PPD)和临床附着丧失(CAL)。应用双抗体夹心ELISA法测定样本中IL-1β和IL-1ra的含量。结果显示：(1)临床牙周健康牙组GCF中IL-1β的含量为61.891±20.719pg／ml；IL-1ra的含量为739.410±249.121ng／ml；10000IL-1β／IL-1ra的值为0.857±0.375。其中临床牙周健康者和慢性牙周炎患者的样本各占一半，两组样本中IL-1β和IL-1ra的含量和10000IL-1β／IL-1ra的值均无统计学差异。(2)慢性牙周炎患牙组GCF中IL-1β的含量为224.402±87.416pg／ml，10000IL-1β／IL-1ra的值为6.813±0.375，明显高于临床牙周健康牙组(P＜0.0001)，患牙组IL-1ra的含量为366.722±104.188ng／ml，明显低于临床牙周健康牙组(P＜0.0001)；经相关分析，GCF中IL-1β的含量与IL-1ra的含量呈负相关关系(r=-0.730，P＜0.01)。(3)慢性牙周炎BOP阳性患牙组GCF中IL-1β的含量为262.387±79.116pg／ml，10000IL-1β／IL-1ra的值为8.510+4.478，明显高于BOP阴性组(平均值分别为153.497±50.800pg／ml和3.647±0.992)(P＜0.0001)，四川大学七年制学位论文而BOP阳性组IL一lra的含量为334.450士90.090ng/ml，明显低于BOP阴性组(平均值为426.962士IO2.918n留ml)(p<001)。(4)经相关分析，慢性牙周炎患牙GCF中IL一lp的含量与GL PPD和CAL均呈正相关关系 (二0.741，p<0.01;r=0.366，P<005;。0.620，P<0.01)，IL一lra的含量与Gl呈负相关关系(。一0.303，p<0.05)，10o00IL一lp/IL一lra的值IOO00IL一lp/IL一lra的值与Gl、pPD和CAL均呈正相关关系(r=0.797，P<O·01;二0·392，P<0.05;。0.535，P<0.01)。表明:牙周组织局部IL一lp的产生增加和IL一lra的生成不足使1 O000IL一lp江L一lra的值明显增大，IL一lp活性增高，可能与牙周炎发生和病变活动期有关。牙周炎患牙雌沟液中IL一lp的水平和I000OIL一lp/IL一lra的值，尤其是后者，反映了牙周炎症的严重程度，可以尝试作为判断牙周病变程度以及牙周炎活动性的一个指征。更多还原

【Abstract】 Aim: Interleukin-1β (IL-1β), a multifunctional proinflammatory cytokine, has been involved in the pathogenesis of periodontal destruction. IL-1 receptor antagonist(IL-1ra), another member of IL-1 family, binds to the IL-1 receptor but fails to activate cells, thus inhibiting the biologic activities of IL-1 β . The aim of this study are to investigate: (1)IL-1β and IL-1ra concentrations in gingival crevicular fluid(GCF) of periodontally healthy and chronic periodontitis sites; (2)the relationship between GCF IL-1β and IL-lra levels. Method: 15 GCF samples were harvested from non-inflamed sites of 10 periodontally healthy subjects, 15 GCF samples from non-inflamed sites and 43 GCF samples from chronic periodontitis sites (including 28 GCF samples from BOP positive sites and 15 GCF samples from BOP negative sites) of 33 patients with chronic periodontitis. Clinical measurements(GI, PPD and CAL) were recorded for each tooth after obtaining a GCF sample. The concentrations of IL-1β and IL-lra in GCF were quantified by sensitive enzyme linked immunosorbent assay(ELISA). Results: (1) The mean concentrations of IL-1 β and IL-lra and the average value of 10000IL-1β/IL-lra for non-inflamed sites were 61.891 ±20.719pg/ml, 739.410±249.121ng/ml and 0.857±0.375, respectively. They were all of no difference for the non-inflamed sites betweenthe periodontally healthy subjects and the patients with chronic periodontitis(P >0.05). (2) The mean concentration of IL-1β (224.402±87.416pg/ml)and the average value of 10000IL-lβ /IL-1ra(6.813±0.375) for periodontitis sites were much greater than that for healthy sites (P< 0.0001) and in contrast the mean concentration of IL-lra for periodontitis sites(366.722 ± 104.188ng/ml) was lower than that for healthy sites (P< 0.0001). For all sites, a strong inverse relationship was found between IL-1β and IL-lra levels in GCF (r=-0.730, P <0.01) . (3) The mean concentration of IL-1β and the average value of 10000IL-1β /IL-lra for BOP positive periodontitis sites were greater than that for BOP negative sites(P< 0.0001) and the mean concentration of IL-lra was in contrast (P<0.01). (4)Both of IL-1β and 10000IL-1β /IL-1ra value had the positive correlations with GI, PPD and CAL(P<0.01). And the negative correlation was found between GI and IL-1ra(P<0.05, P<0.01). Conclusions: The increasing production of IL-1β and decreasing production of IL-lra result in the increase of the 10000IL-1β /IL-1ra value and the corresponding enhancement of IL-1β activity which may play an important role in the initiation of periodontitis and in the intensified inflammatory response of active stage of periodontitis. Furthermore, the GCF level of IL-1β and the value of 10000IL-1β /IL-1ra, especially the latter one, are closely associated with the severity of chronic periodontitis and may also be valuable indicators of the clinical activity of periodontitis.更多还原