Pro- and anti-inflammatory cytokine dysregulation in the saliva of patients with acromegaly: a cross-sectional study

BACKGROUND: There is evidence to suggest that hormonal dysregulation induced by acromegaly may affect serum cytokine levels. However, to our knowledge, no previous studies have examined the salivary cytokine profile in adults with acromegaly. The aim of this study was to identify the salivary profile of pro- and anti-inflammatory cytokines associated with acromegaly in adults. METHODS: A cross-sectional study was conducted with 25 patients with acromegaly and age-, 25 age- and sex-matched controls. Demographic and general health data were collected. Saliva samples were obtained to quantify the concentrations of IL-1β, IL-4, IL-6, IL-10, IL-17A, IL-22, TGF-α, and TNF-α. Statistical analyses included the Mann-Whitney test, Spearman's correlation, and ROC curve analysis. RESULTS: Patients with acromegaly exhibited significantly higher salivary levels of IL-4, IL-6, IL-10, TGF-α, and TNF-α (p<0.001), as well as IL-17A (p=0.029). No significant differences were observed for isolated IL-1β and IL-22. Comparative analysis showed significantly lower IL-22/IL-4 (p<0.001), IL-1β/IL-10 (p=0.023), and IL-22/IL-10 (p=0.003) ratios in patients with acromegaly compared with controls. Given that IL-1β and IL-22 did not differ significantly between groups, whereas IL-4 and IL-10 were increased in acromegaly, these lower ratios appear to primarily reflect higher levels of the anti-inflammatory cytokines. In multivariate analysis, IL-4, IL-6, IL-17A, IL-22, and TNF-α remained statistically associated with acromegaly. CONCLUSION: The study findings suggest that patients with acromegaly exhibit a significant imbalance in the levels of pro- and anti-inflammatory cytokines in saliva, with emphasis on IL-4, IL-6, IL-17A, IL-22, and TNF-α.