背景:与牙周组织直接和持续接触的多微生物生物失调膜的存在引发了宿主免疫应答。白细胞介素18(IL-18)触发上调其他促炎细胞因子(TNF-α,IL-1β,IL-6),形成一个恶性循环,扩大牙周组织的炎症和破坏性过程。进行了系统评价和荟萃分析,主要目的是研究慢性牙周炎受试者不同生物样本中IL-18的表达。
方法:该协议遵循PRISMA指南,并在OpenScienceFramework(OSF)中注册:https://doi.org/10.17605/OSF。IO/BS9GM。在PubMed数据库中进行了数字搜索,ScienceDirect,谷歌学者,从3月15日开始查阅了WebofScience和牙科与口腔科学源数据库,2005年2月10日,2023年。使用JBI工具进行横断面研究和临床试验评估研究质量。使用随机/固定效应模型进行荟萃分析,以评估血清中IL-18的浓度,等离子体,唾液,与对照组相比,暴露组的牙龈组织和GCF。
结果:搜索策略共提供了3,156篇文章,其中18项调查符合纳入标准,15篇文章进行了定量分析。研究的患者总数为1,275例(682例和593例对照)。荟萃分析显示血清IL-18水平显著升高,与健康受试者相比,患有慢性牙周炎的受试者的唾液和GCF(血清:SMD=62.73,95CI:25.43-100.03,Z=3.29,p=0.001*;唾液:SMD=243.63,95CI:8.68-478.59,Z=2.03,p=0.042*;GCF:SMD=150.26,95CI:56.86-243.66,p=3.66
结论:血清IL-18水平,唾液和GCF有可能作为牙周炎患者临床和影像学参数的补充诊断工具。
BACKGROUND: The presence of a polymicrobial dysbiotic film in direct and constant contact with periodontal tissues initiates the host immune response. Interleukin 18 (IL-18) triggers up-regulates the production of other proinflammatory cytokines (TNF-α, IL-1β, IL-6), creating a vicious cycle that expands the inflammatory and destructive process in the periodontal tissue. A systematic
review and meta-analysis was carried out with the main propose to investigate IL-18 expression in different biological samples from subjects with chronic periodontitis.
METHODS: The protocol followed PRISMA guidelines and was registered in Open Science Framework (OSF): https://doi.org/10.17605/OSF.IO/BS9GM . A digital search was conducted in the databases PubMed, ScienceDirect, Google Scholar, Web of Science and Dentistry & Oral Sciences Source databases were consulted from March 15th, 2005 to February 10th, 2023. Study quality was assessed using the JBI tool for cross-sectional studies and clinical trials. A meta-analysis was performed using a random/fixed effects model to evaluate the concentration of IL-18 in serum, plasma, saliva, gingival tissue and GCF of exposure group compared to control group.
RESULTS: The search strategy provided a total of 3,156 articles, of which 18 investigations met the inclusion criteria and 15 articles were quantitatively analyzed. The total number of patients studied was 1,275 (682 cases and 593 controls). The meta-analysis revealed significantly elevated IL-18 levels of serum, saliva and GCF of subjects with chronic periodontitis compared to healthy subjects (Serum: SMD = 62.73, 95%CI: 25.43-100.03, Z = 3.29, p = 0.001*; Saliva: SMD = 243.63, 95%CI: 8.68-478.59, Z = 2.03, p = 0.042*; GCF: SMD = 150.26, 95%CI: 56.86-243.66, Z = 3.15, p = 0.02*).
CONCLUSIONS: IL-18 levels in serum, saliva and GCF could have the potential to be used as complementary diagnostic tools to the clinical and radiographic parameters in subjects with periodontitis.