CXCL8/CCL2 ratio regulates inflammatory cell dynamics and reflects C-reactive protein levels in gingivitis

Gingivitis is a common inflammatory condition of the gingiva initiated by dental plaque biofilm. The progression from health to early and acute gingivitis involves activation of local immune responses, particularly, chemokines that regulate leukocyte recruitment. CXCL8 (IL-8) plays a key role in neutrophil attraction, while CCL2 is important for monocyte/macrophage recruitment. However, the relationship between these local mediators and systemic inflammatory marker C-reactive protein (CRP) remains unclear. The aim of this study was to evaluate the levels of CXCL8, CCL2, and CRP in gingival crevicular fluid (GCF) and serum across health, early gingivitis, and acute gingivitis, and to analyze their correlations during disease progression. A case-control study was conducted on 90 participants divided into three groups: healthy, early gingivitis, and acute gingivitis. Gingival crevicular fluid samples were collected to measure CXCL8 and CCL2 levels, while serum CRP was assessed as a systemic marker. Statistical analysis included comparison between groups and correlation analysis among biomarkers. CXCL8 levels showed a significant increase from healthy state to acute gingivitis (approximately 1.8-fold increase, p < 0.05). CCL2 demonstrated a marked elevation, reaching nearly 15-fold higher levels in acute gingivitis compared to healthy subjects (p < 0.001). In contrast, CRP levels did not show a significant difference between healthy and gingivitis groups (p = 0.588). Correlation analysis revealed weak, non-significant associations among biomarkers in early gingivitis. In acute gingivitis, a significant negative correlation was observed between CXCL8 and CRP (r = -0.381, p = 0.038). The findings suggest that gingivitis progression is characterized by increased local chemokine production, reflecting neutrophil and monocyte recruitment, without significant systemic CRP elevation. Local inflammatory regulation appears more prominent than systemic involvement in gingivitis.