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Journal of Peking University (Health Sciences) ›› 2025, Vol. 57 ›› Issue (4): 772-778. doi: 10.19723/j.issn.1671-167X.2025.04.023

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Application of combined detection of inflammatory indexes and cytokines in chronic periodontitis

Zhenying BAO1, Yajie WANG2,*()   

  1. 1. Department of Clinical Laboratory, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
    2. Department of Clinical Laboratory, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
  • Received:2022-10-25 Online:2025-08-18 Published:2025-08-02
  • Contact: Yajie WANG

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Abstract:

Objective: To analyze the inflammatory indexes and cytokines levels in serum and saliva of patients with chronic periodontitis (CP), and to explore the value of single index or multiple indexes combined detection in the clinical diagnosis and treatment of CP. Methods: The serum and saliva specimens of 42 CP patients and 38 periodontal healthy people admitted to the Department of Periodontology in Peking University Hospital of Stomatology were detected by inflammatory indexes and cytokines. According to clinical periodontal parameters, CP patients were performed by clinical staging, and the correlation between inflammatory indexes and cytokines levels and the severity of CP was analyzed. To evaluate the levels of inflammatory indexes and cytokines in serum and saliva samples in the periodontal health group and CP group. Three inflammatory indexes were involved in this study: C-reactive protein (CRP), serum amyloid A (SAA), procalcitonin (PCT); and 12 cytokines: Interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12P70, IL-17, interferon (IFN)-α, IFN-γ, and tumor necrosis factor α (TNF-α). The Spearman correlation statistical method was used to analyze the correlation between the levels of inflammatory indexes and cytokines and the severity of chronic periodontitis. Mann-Whitney U test was used to identify the indicators with differences between the groups, the optimal indicators were identified through binary Logistic regression analysis with stepwise selection, and the area under the curve (AUC) of receiver operating characteristic (ROC) was used to evaluate the diagnostic efficiency. Results: By testing the levels of inflammatory markers and cytokines in patients with chronic periodontitis with dif-ferent clinical stages, it was found that CRP, SAA, IL-8 in serum and IL-1β, IL-6, IL-8, IL-12P70, IL-17, TNF-α in saliva were significantly positively correlated with the severity of chronic periodontitis. Compared with the periodontal healthy group, the serum levels of CRP, SAA, IL-2, IL-5, IL-8, IL-12P70, IL-17 and IFN-α in the CP group were significantly increased (All P < 0.05). The AUC of SAA, IL-2, IL-8, IL-12P70, IL-17, IFN-α, combination 1 (IL-2+IL-8) and combination 2 (CRP+SAA+IL-12P70) were >0.7, and the AUC of combination 2 (0.998) was the highest, with high sensitivity (97.6%) and specificity (97.4%). The levels of IL-1β, IL-6, IL-8 and IL-12P70 in the saliva of the CP group were significantly higher than those in the periodontal healthy group, while the levels of IL-4 in the saliva were significantly lower than those in the periodontal healthy group (All P < 0.05). The AUC of IL-6, IL-8 and combination 3 (IL-4+IL-6+IL-8) were >0.7, and the AUC of combination 3 (0.852) was the highest. In the comparative analysis of diagnostic efficacy between single index and multi-index combined, combination 2, combination 1, and serum IL-8 demonstrated the highest AUC values (ranked top 3), with multi-index combinations exhibiting superior discriminative power over single index. Conclusion: Serum levels of IL-8, CRP, SAA, and salivary levels of IL-1β, IL-6, IL-8, and other indicators may be helpful for the clinical diagnosis and treatment of CP. Serum IL-8 and multiple indicators may be used as an auxiliary diagnostic indice to identify CP.

Key words: Chronic periodontitis, Inflammatory index, Cytokines, Serum, Saliva

CLC Number: 

  • R781.42

Table 1

Serum inflammatory indexes and cytokines levels in both groups"

Items Healthy controls (n=38) Chronic periodontitis (n=42) P
CRP/(mg/L) 0.60 (0.36, 1.62) 1.49 (0.34, 4.78) 0.035
SAA/(mg/L) 1.16 (0.92, 1.69) 2.18 (1.73, 7.18) < 0.001
PCT/(ng/L) 6.50 (2.75, 13.30) 12.00 (3.00, 21.00) 0.128
IL-1β/(ng/L) 1.04 (0.51, 1.65) 0.50 (0.00, 2.52) 0.285
IL-2/(ng/L) 1.42 (1.05, 2.16) 2.46 (1.71, 3.75) < 0.001
IL-4/(ng/L) 1.40 (0.75, 2.11) 1.26 (0.67, 1.95) 0.491
IL-5/(ng/L) 1.24 (0.73, 1.74) 1.84 (0.91, 3.93) 0.031
IL-6/(ng/L) 0.72 (0.45, 1.02) 0.24 (0.00, 1.61) 0.095
IL-8/(ng/L) 4.27 (3.31, 5.77) 47.25 (28.59, 76.37) < 0.001
IL-10/(ng/L) 1.44 (0.72, 1.98) 1.51 (1.33, 1.98) 0.116
IL-12P70/(ng/L) 0.99 (0.78, 1.73) 1.99 (1.45, 2.35) < 0.001
IL-17/(ng/L) 2.01 (1.36, 2.47) 3.33(2.39, 4.44) < 0.001
IFN-α/(ng/L) 1.53 (0.92, 2.61) 2.42(1.53, 4.30) 0.002
IFN-γ/(ng/L) 3.69 (2.56, 5.23) 4.16 (2.80, 5.54) 0.784
TNF-α/(ng/L) 2.15 (1.63, 2.59) 1.49 (0.51, 3.17) 0.158

Figure 1

Forest plot of serum inflammatory indexes and cytokines screened by binary Logistic regression CRP, C-reactive protein; SAA, serum amyloid A; IL, interleukin; IFN, interferon."

Figure 2

Receiver operating characteristic curve evaluated the diagnostic efficacy of serum inflammatory indexes and cytokines CRP, C-reactive protein; SAA, serum amyloid A; IL, interleukin; IFN, interferon; AUC, area under curve. Combination 1, IL-2+IL-8; Combination 2, CRP+SAA+IL-12P70."

Table 2

Saliva cytokines levels in both groups"

Items Healthy controls (n=38) Chronic periodontitis (n=42) P
IL-1β/(ng/L) 231.53 (124.49, 587.13) 427.51 (171.01, 805.16) 0.025
IL-2/(ng/L) 2.42 (1.65, 3.49) 2.71 (2.19, 3.49) 0.075
IL-4/(ng/L) 1.35 (0.74, 1.86) 0.98 (0.70, 1.22) 0.019
IL-5/(ng/L) 2.42 (0.97, 7.15) 1.87 (1.26, 2.41) 0.336
IL-6/(ng/L) 16.46 (7.85, 31.68) 41.55 (20.84, 55.25) 0.002
IL-8/(ng/L) 343.02 (253.26, 798.46) 932.71 (671.42, 1 467.16) < 0.001
IL-10/(ng/L) 2.54 (1.65, 4.25) 1.92 (1.51, 3.29) 0.401
IL-12P70/(ng/L) 1.77 (1.38, 2.84) 2.18 (1.87, 2.72) 0.032
IL-17/(ng/L) 2.92 (1.92, 4.73) 2.57 (1.68, 4.75) 0.919
IFN-α/(ng/L) 2.04 (1.53, 2.81) 2.36 (1.25, 3.03) 0.612
IFN-γ/(ng/L) 2.69 (1.62, 5.47) 2.42 (1.44, 5.02) 0.771
TNF-α/(ng/L) 6.95 (4.37, 9.18) 4.74 (1.38, 7.93) 0.066

Figure 3

Forest plot of saliva cytokines screened by binary Logistic regression IL, interleukin."

Figure 4

Receiver operating characteristic curve evaluated the diagnostic efficacy of saliva cytokines IL, interleukin; AUC, area under curve; Combination 3, IL-4+IL-6+IL-8."

Table 3

Correlation of inflammatory indexes and cytokines with severity of chronic periodontitis"

Index ρ P
Serum
  CRP 0.450 0.003
  SAA 0.368 0.017
  IL-8 0.460 0.002
Saliva
  IL-1β 0.523 < 0.001
  IL-6 0.470 0.002
  IL-8 0.732 < 0.001
  IL-12P70 0.484 0.001
  IL-17 0.439 0.004
  TNF-α 0.334 0.030
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