The Journal of Contemporary Dental Practice

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 18 , ISSUE 6 ( June, 2017 ) > List of Articles

RESEARCH ARTICLE

Assessment of C-reactive Proteins, Cytokines, and Plasma Protein Levels in Hypertensive Patients with Apical Periodontitis

Pallavi Goel, Kiran Kulkarni, N Rashmi, Vineet Galhotra, Jagadish P Rajguru, Satyendra K Jha

Citation Information : Goel P, Kulkarni K, Rashmi N, Galhotra V, Rajguru JP, Jha SK. Assessment of C-reactive Proteins, Cytokines, and Plasma Protein Levels in Hypertensive Patients with Apical Periodontitis. J Contemp Dent Pract 2017; 18 (6):516-521.

DOI: 10.5005/jp-journals-10024-2076

Published Online: 00-06-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction

Chronic apical periodontitis (CAP) manifests mostly as periapical radiolucency. Various inflammatory mediators play a significant role in the pathogenesis of apical periodontitis. In acute inflammatory conditions, C-reactive proteins (CRP) and fibrinogen show a rise in their concentrations. In chronic diseases with high inflammatory components, an increased prevalence of hypertension has been observed. Hence, we assessed the association of CAP and plasma levels of various inflammatory markers (CRP, interleukin 6 [IL-6], and fibrinogen) in severely hypertensive patients.

Materials and methods

This study was conducted in the conservative wing of the institute and included assessment of 250 hypertensive patients with apical periodontitis. With the help of periapical radiographs and clinical examination, the assessment of following parameters was done: Amount of teeth present, visible plaque index, periodontal pocket probing depth, clinical attachment level, bleeding on probing, presence/absence of carious lesions, which included assessment of caries in crown portion, in the root portion, and residual tooth roots (RR), presence of CAP from each patient; 8 mm of venous blood was collected in the morning for the assessment of plasma levels of IL-6, CRP, and fibrinogen levels. Immediate collection and processing of the samples were done in the hospital laboratory. All the results were analyzed by Statistical Package for the Social Sciences software.

Results

Out of 250, 155 patients were females. Mean plasma levels of CRP observed in our study were 0.8 mg/dL. Mean plasma levels of IL-6 and fibrinogen were found to be 3.3 and 337.1 mg/dL respectively. A significant correlation was observed while comparing mean body mass index (BMI), RR, and CAP in hypertensive patients. While comparing the mean plasma IL-6 levels, mean BMI, and CAP in the patients, significant results were obtained. Significant correlation was observed while comparing the mean BMI and CAP in hypertensive patients.

Conclusion

Systemic levels of CRP, IL-6, and fibrinogen levels are influenced by the presence of CAP in hypertensive patients.

Clinical significance

In hypertensive patients, CAP alters the systemic levels of various inflammatory markers.

How to cite this article

Rashmi N, Galhotra V, Goel P, Rajguru JP, Jha SK, Kulkarni K. Assessment of C-reactive Proteins, Cytokines, and Plasma Protein Levels in Hypertensive Patients with Apical Periodontitis. J Contemp Dent Pract 2017;18(6):516-521.


PDF Share
  1. Proinflammatory and immunoregulatory mechanisms in periapical lesions. Mol Immunol 2009 Nov;47(1):101-113.
  2. Treatments of endodontic infections. Rio de Janeiro: Quintessence; 2011. p. 403.
  3. Immunolocalization of interleukin 4, interleukin 6, and lymphotoxin alpha in dental granulomas. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003 Sep;96(3):356-360.
  4. Pathogenesis of apical periodontitis and the causes of endodontic failures. Crit Rev Oral Biol Med 2004 Nov;15(6):348-381.
  5. Immunoexpression of interleukin 17 in apical periodontitis lesions. J Endod 2014 Sep;40(9):1400-1403.
  6. Properties of four acute phase proteins: C-reactive protein, serum amyloid a protein, alpha 1-acid glycoprotein, and fibrinogen. Semin Arthritis Rheum 1990 Dec;20(3):129-147.
  7. Determinants of C-reactive protein concentration in blood. Ital Heart J 2001 Mar;2(3):189-195.
  8. Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. JAMA 2003 May;289(19):2560-2572.
  9. Resistant hypertension: Diagnosis, evaluation, and treatment. A scientific statement from the American Heart Association Professional Education Committee of the Council for high blood pressure research. Circulation 2008 Jun;117(25):e510-e526.
  10. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement. Circulation 2005 Oct;112(17):2735-2752.
  11. Association between apical periodontitis lesions and plasmatic levels of C-reactive protein, interleukin 6 and fibrinogen in hypertensive patients. Int Endod J 2016 Dec;49(12):1107-1115.
  12. The effects of surgical exposures of dental pulps in germ-free and conventional laboratory rats. Oral Surg Oral Med Oral Pathol 1965 Sep;20:340-349.
  13. Interleukin-25: Key regulator of inflammatory and autoimmune diseases. Curr Pharm Des 2011 Nov;17(34):3781-3785.
  14. Granulocyte chemotactic protein 2 (gcp-2/cxcl6) complements interleukin-8 in periodontal disease. J Periodontal Res 2009 Aug;44(4):465-471.
  15. Granulocyte chemotactic protein-2 and related CXC chemokines: from gene regulation to receptor usage. J Leukoc Biol 1997 Nov;62(5):563-569.
  16. Cardiovascular disease, inflammation, and periodontal infection. Periodontology 2000 2007 Jun;44(1):113-126.
  17. Influence of surgical treatment of periapical lesions on serum and blood levels of inflammatory mediators. Int Endod J 1992 Sep;25(5):229-233.
  18. Association of endodontic infection with detection of an initial lesion to the cardiovascular system. J Endod 2011 Dec;37(12):1624-1629.
  19. Examination of the relation between periodontal health status and cardiovascular risk factors: serum total and high density lipoprotein cholesterol, C-reactive protein, and plasma fibrinogen. Am J Epidemiol 2000 Feb;151(3):273-282.
  20. Can apical periodon-titis modify systemic levels of inflammatory markers? A systematic review and meta-analysis. J Endod 2013 Oct;39(10):1205-1217.
  21. Is the severity of periodontitis related to gingival crevicular fluid and serum high-sensitivity C-reactive protein concentrations? Clin Lab 2014 Jan;60(10):1653-1658.
  22. Periodontal therapy reduces plasma levels of interleukin-6, C-reactive protein, and fibrinogen in patients with severe periodontitis and refractory arterial hypertension. J Periodontol 2009 May;80(5):786-791.
  23. C-reactive protein expression is up-regulated in apical lesions of endodontic origin in association with interleukin-6. J Endod 2015 Apr;41(4):464-469.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.