The impact of Cortexin on cytokine levels in the treatment of moderate chronic generalized periodontitis in young and middle-aged people

Abstract

Relevance. Chronic generalized periodontitis is one of the most common dental diseases in Russia and worldwide. Periodontitis causes changes in the immune system, cytokines, antioxidant protection, hemostasis and other systems, leading to periodontal microcirculatory and blood supply damage. Interleukins are regulatory molecules that play a part in specific immune reactions: inflammation, regeneration, and microcirculation. They are produced by immune system cells in response to an activating stimulus and regulate the strength and duration of immune and inflammatory reactions. Our study revealed an imbalance of pro- and anti-inflammatory cytokines in patients with moderate chronic generalized periodontitis of different ages.Material and Methods. The study involved 130 patients with moderate chronic generalized periodontitis aged 25 to 60. The control group consisted of 15 practically healthy individuals aged 18 to 24 years without acute and chronic periodontal diseases at the time of the study. The concentration of cytokines in blood serum and oral fluid (IL-1ß, IL-4, IL-8, IL-10) was evaluated in all patients before and after the standard comprehensive treatment and with the inclusion of Cortexin.Results. After the moderate chronic generalized periodontitis treatment, pro-inflammatory and anti-inflammatory cytokines in the blood decreased in the group of 25-44-year-olds. In standard treatment, IL-1ß level decreased by 30%, IL-4 – by two times, IL-8 – by 1.5 times, and IL-10 – by three times; but with Cortexin, IL-1ß became normal, IL-4 decreased by 3.5 times, IL-8 – by 2.5 times, IL-10 became normal. In the oral fluid of patients aged 25-44 years, IL-1ß decreased by 20% after the standard treatment, IL-4 decreased by six times, IL-8 decreased by two times, and the addition of Cortexin to the comprehensive therapy caused a 70% decrease, IL–4 reduced by ten times, IL-8 – by nine times, the concentration of IL-10 remained the same. IL-22 decreased by 1.5 and 2 times based on the treatment methods. The after-treatment assessment of changes in the interleukin content in blood serum in 45-60-year-old patients with chronic generalized periodontitis revealed the same levels of IL-4 after the standard treatment, a decrease of IL-1ß by 1.5 times, IL-8 - by 1.5 times; and the use of Cortexin in the treatment normalized the concentration of IL-4, led to a decrease in IL-1ß by two times, IL-8 - by three times. After the therapy, in the oral fluid of patients aged 45-60 years, IL-1ß decreased by 1.5 times with standard treatment, IL-4 and IL-8 decreased by two times, and IL-10 did not change, IL-22 - by 1.5 times; and using Cortexin, the concentration of IL-1ß decreased by 70%, IL-4 decreased by three times, IL-8 - by four times, IL-10 and IL-22 - by two times.Conclusion. Before treatment, the concentration of cytokines was higher in all groups of patients compared to the control values in blood serum and oral fluid. With standard therapy, the content of interleukins decreases in biological fluids, and the effect is more pronounced if standard treatment and Cortexin are combined. The correlation analysis detects that clinical manifestations of gingival inflammation are directly related to the concentration of pro- and anti-inflammatory interleukins in the blood and oral fluid.