ANALYSIS OF CYTOKINE LEVELS IN ORAL FLUID IN PATIENTS WITH GASTROESOPHAGEAL REFLUX DISEASE DEPENDING ON THE PRESENCE OF PERIODONTAL PATHOLOGY

It is known that proinflammatory cytokines produced by activated macrophages and monocytes under the influence of endotoxins from periodontopathogenic bacteria not only initiate but also sustain the inflammatory process in periodontal tissues. The aim was to identify and analyze possible changes in cytokine levels in oral fluid depending on the clinical form of gastroesophageal reflux disease, taking into account the condition of the oral mucosa and periodontal tissues. Materials and methods. Assessment of Cytokine Levels. The content of proand anti-inflammatory cytokines – IL-1β, IL-4, and IL-12 – was measured using enzyme-linked immunosorbent assay (ELISA) kits from Elabscience (USA) on the “Multiskan FC” device. The method was based on a solid-phase “sandwich” ELISA using monoand polyclonal antibodies to IL-1β, IL-4, and IL-12. Samples were obtained from gingival and periodontal pockets. The levels of IL-1β, IL-4, and IL-12 in oral fluid were determined in 65 patients at the time of hospital admission and in 20 individuals from the control group. Results. The results of cytokine concentration analysis in oral fluid of patients with non-erosive GERD confirm that IL-1β plays a key role in initiating and maintaining local inflammatory responses. The hyperproduction of this biologically active mediator in patients with periodontitis and gingivitis is considered a valid indicator of disease activity and progression of periodontal disease in the context of GERD. The data also reveal changes in IL-12 levels, with significantly higher concentrations observed in patients with non-erosive GERD compared to those with the erosive form. Specifically, IL-12 concentrations reached 11.27±0.01 pg/mL in patients with intact periodontium and 11.41±0.03 pg/mL in those with gingivitis, compared to 9.30±0.02 pg/mL (p<0.05) in gingivitis patients with erosive GERD and 9.07±0.02 pg/mL (p<0.05) in those with periodontal tissue damage. Conclusions. Based on the obtained results, it can be summarized that the severity of the inflammatory process in the oral cavity, as indicated by IL-12 levels, was significantly higher in patients with the nonerosive form of GERD, both in those with gingivitis and in those with an intact periodontium. The absence of increased IL-12 levels may suggest a minimal role of this lymphokine in the pathogenesis of periodontal inflammation.