Efeito das alterações metabólicas e gravidade da periodontite sobre níveis séricos de mediadores inflamatórios em pessoas com síndrome de Down

Abstract

Periodontal disease (PD) is among the most prevalent chronic inflammatory diseases in the world, resulting from an imbalance in the interaction between the biofilm microbiotaand innate host factors, provoking a response by the release of inflammatory mediators, including cytokines, prostaglandins and proteinases. Down Syndrome (DS) isan autosomal chromosomal anomaly characterized by the presence of an extra copy on chromosome 21. Individuals with Down syndrome have a high prevalence of PD of earlyonset and destructive course favored by an altered immune response. With the increase in life expectancy of these people, the manifestations of comorbidities arising from the syndromic condition itself, aggravated by the metabolic condition and altered immune response, have been expressed with greater frequency, favoring the involvement of PD. Chapter I of this thesis, Association between serum levels of inflammatory mediators and severity of periodontitisin Down syndrome, is a case-control study that evaluated theserum levels of 6 cytokines, analyzing the relationship of these markers with the severityof periodontitis in individuals with and without DS. The Case group consisted of 43 individuals with DS and the Control group of 20 non-syndromic people who underwent periodontal examination with measurement of probing depth (PS), clinical attachment level (NIC), gingival bleeding index (ISG) and visible plaque index (IPV). The levels ofthe cytokinesIFN-γ, IL-10, IL-17, IL-1β, IL-4 and TNF-α were measured in the collectedserum samples. The severity of periodontitis was categorized according to the criteria ofstages 1 to 4. To assess the severity, the percentage of sites per patient with CIN ≥4mm and PS ≥4mm were calculated, generating their means and prevalence according to the amount of sites present. Serum samples were collected from each participant to analyze the level of quantified cytokines using the Luminex® automatic analyzer system. All analyzes used the resources of GraphPad Prism software version 8 and SPSS version 27.0. Our findings revealed that the severity of periodontitis was not related to the serum levelsof inflammatory mediators (IL-10, IL-17, IL 1β, IL-4 and TNF-α) and that individuals with DS, even without the diagnosis of periodontitis, already have higher serum levels ofinflammatory mediators than their controls with periodontitis (P>0.05). In Chapter II, In Chapter II of this thesis, we set out to confirm the relationship that people with DS have a deficient inflammatory profile associated with altered anthropometric and metabolic parameters. The study was conducted with 43 people with DS. The metabolic condition of the participants was determined by analyzing anthropometric parameters and blood sampling to measure inflammatory mediators. The biochemical assessment included total cholesterol, high-density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides and serum levels of red and white cells. To analyze the serum level of cytokines, samples were collected and quantified using the Luminex® automatic analyzer system. Data analysis was performed using SPSS version 28.0 resources. Our results revealed, in a young sample with DS, the presence of overweight and high levels of HCM, MCV and altered inflammatory markers, in positive and negative correlations with anthropometric and metabolic parameters, already represent risk factors for the future development of systemic diseases or worsening of existing conditions.