Multiple Apical Periodontitis Influences Serum Levels of Cytokines and Nitric Oxide

J Endod. 2016 May;42(5):747-51. doi: 10.1016/j.joen.2016.01.022. Epub 2016 Apr 5.

Abstract

Introduction: This study evaluated whether apical periodontitis (AP) in a single tooth or in multiple teeth affected serum levels of inflammatory mediators and influenced blood homeostasis.

Methods: Thirty male Wistar rats were divided into 3 groups of 10 rats each: control group, healthy rats; 1AP group, rats with AP in 1 tooth; and 4AP group, rats with AP in 4 teeth. After 30 days, the rats were anesthetized, and their blood was collected through cardiac puncture to quantify tumor necrosis factor alpha (TNF-α), interferon gamma (IFN-γ), interleukin (IL)-6, IL-17, IL-23, and nitric oxide (NO) levels. The rats were then sacrificed by administering an anesthetic overdose. Their maxillary and mandibular molars were collected and processed for histologic analysis with hematoxylin-eosin and for immunohistochemical staining of the cytokines and NO-producing enzyme nitric oxide synthase. Results of these analyses were statistically analyzed; P < .05 was considered statistically significant.

Results: Rats in the 1AP and 4AP groups showed increased IL-6, IL-17, IL-23, TNF-α, IFN-γ, and NO synthase expression; inflammatory cell infiltration; and moderate bone resorption in affected teeth. Serum TNF-α, IL-6, IL-17, and IL-23 levels were higher in rats in the 4AP group than in those in the control group (P < .05). Serum NO levels were significantly lower in rats in the 1AP and 4AP groups than in those in the control group (P < .05). Serum IFN-γ levels were not different among rats in the 3 groups (P > .05).

Conclusions: These results suggested that AP affected blood homeostasis by altering the serum levels of inflammatory cytokines and NO.

Keywords: Apical periodontitis; cytokines; nitric oxide.

MeSH terms

  • Animals
  • Bone Resorption
  • Cytokines / blood*
  • Interferon-gamma / blood
  • Interleukin-17
  • Interleukin-23
  • Interleukin-6
  • Male
  • Mandible
  • Maxilla
  • Molar
  • Nitric Oxide / blood*
  • Periapical Periodontitis / blood*
  • Periapical Periodontitis / diagnostic imaging
  • Periapical Periodontitis / metabolism*
  • Periapical Tissue / diagnostic imaging
  • Periapical Tissue / pathology
  • Rats
  • Rats, Wistar
  • Serum / chemistry*
  • Tumor Necrosis Factor-alpha / blood

Substances

  • Cytokines
  • Interleukin-17
  • Interleukin-23
  • Interleukin-6
  • Tumor Necrosis Factor-alpha
  • Nitric Oxide
  • Interferon-gamma