Systemic Diabetic Context-Induced Biochemical Periodontal Alterations in Children

Our studies aimed the eventual correlations of chemokines and interleukins levels (IFN-γ, IL-10, IL-2, IL-4, IL-5 and TNF-α) in serum and gingival crevicular fluid of patients with periodontitis and juvenile insulindependent diabetes mellitus as compared to periodontal healthy subjects (32 vs. 24 children and adolescents, respectively). The diabetic body interferences with microbiological microenvironment imply serious efforts of the first one, resulting in a significant local and systemic secretion of IFN-γ. Thus, we can suggest that measurements of interferon levels in gingival crevicular fluid could be an important parameter in assessing the diabetes progress toward the destructive or inflammatory alterations of periodontal tissues. IL-10 associates an average level of secretion in blood, being decreased in the group with severe periodontal disease (the values in gingival crevicular fluid are inconsistent throughout the studied groups). This reduction in IL-10 secretion could play a role in driving the way for oral tissues toward the degradation in juvenile diabetes population. The levels of IL-2 are very small both in the periphery and in gingival crevicular fluid. These data suggest the possible existence of a local factor that blocks the secretion of this T-cell proliferation factor by lymphocytes and macrophages, especially in diabetic patients with periodontal alteration. We found relatively low IL-4 and IL-5 levels of secretion both in plasma and gingival crevicular fluid for all groups of patients, although a little bit larger in the case of IL-5. The pattern of distribution is quite irregular in all the experimental groups. The values of IL-4 in gingival crevicular fluid of patients with periodontitis were significantly higher than those of controls. The differences of cytokines secretions between groups of diabetic patients with or without periodontal alteration are more apparent in serum.