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Clinical Oral Investigations

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01-07-2013 | Review

The potential association between gingival crevicular fluid inflammatory mediators and adverse pregnancy outcomes: a systematic review

Authors: Pascale Stadelmann, Regina Alessandri, Sigrun Eick, Giovanni E. Salvi, Daniel Surbek, Anton Sculean

Published in: Clinical Oral Investigations | Issue 6/2013

Abstract

Objectives

The association between periodontal disease and adverse pregnancy outcomes (APO), primarily preterm birth (PTB), is still controversially discussed in the literature. Therefore, the aim of the present systematic review was to analyze the existing literature on the potential association between inflammatory mediators detected in gingival crevicular fluid (GCF) and APO.

Materials and methods

MEDLINE (PubMed) and EMBASE databases were searched for entries up to April 2012 and studies were selected by two independent reviewers.

Results

The majority of the eight studies included confirmed a positive association between GCF mediators, such as interleukin-1β, prostaglandin E₂, and tumor necrosis factor-alpha, and APO. Due to the heterogeneity and variability of the available studies, no meta-analysis could be performed.

Conclusions

A positive association between GCF inflammatory mediator levels and APO/PTB might be present but the results need to be considered with great caution because of the heterogeneity and variability among the studies. Further studies with an adequate number of patients allowing for an appropriate analysis are warranted to definitely confirm this association.

Clinical relevance

The present findings suggest that an association between GCF inflammatory mediator levels and APO might exist.

Taylor GW, Burt BA, Becker MP, Genco RJ, Shlossman M, Knowler WC, Pettitt DJ (1996) Severe periodontitis and risk for poor glycemic control in patients with non-insulin-dependent diabetes mellitus. J Periodontol 67(10 Suppl):1085–1093PubMedCrossRef

Kebschull M, Demmer RT, Papapanou PN (2010) “Gum bug, leave my heart alone!”—epidemiologic and mechanistic evidence linking periodontal infections and atherosclerosis. J Dent Res 89(9):879–902PubMedCrossRef

Chambrone L, Guglielmetti MR, Pannuti CM, Chambrone LA (2011) Evidence grade associating periodontitis to preterm birth and/or low birth weight: I. A systematic review of prospective cohort studies. J Clin Periodontol 38(9):795–808PubMedCrossRef

Offenbacher S, Farr DH, Goodson JM (1981) Measurement of prostaglandin E in crevicular fluid. J Clin Periodontol 8(4):359–367PubMedCrossRef

Heasman PA, Collins JG, Offenbacher S (1993) Changes in crevicular fluid levels of interleukin-1 beta, leukotriene B4, prostaglandin E2, thromboxane B2 and tumour necrosis factor alpha in experimental gingivitis in humans. J Periodontal Res 28(4):241–247PubMedCrossRef

Graves D (2008) Cytokines that promote periodontal tissue destruction. J Periodontol 79(8 Suppl):1585–1591PubMedCrossRef

Collins JG, Smith MA, Arnold RR, Offenbacher S (1994) Effects of Escherichia coli and Porphyromonas gingivalis lipopolysaccharide on pregnancy outcome in the golden hamster. Infect Immun 62(10):4652–4655PubMed

Collins JG, Windley HW 3rd, Arnold RR, Offenbacher S (1994) Effects of a Porphyromonas gingivalis infection on inflammatory mediator response and pregnancy outcome in hamsters. Infect Immun 62(10):4356–4361PubMed

Offenbacher S, Katz V, Fertik G, Collins J, Boyd D, Maynor G, McKaig R, Beck J (1996) Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol 67(10 Suppl):1103–1113PubMed

10.

Conde-Agudelo A, Papageorghiou AT, Kennedy SH, Villar J (2011) Novel biomarkers for the prediction of the spontaneous preterm birth phenotype: a systematic review and meta-analysis. BJOG 118(9):1042–1054PubMedCrossRef

11.

Wang TJ, Gona P, Larson MG, Tofler GH, Levy D, Newton-Cheh C, Jacques PF, Rifai N, Selhub J, Robins SJ, Benjamin EJ, D’Agostino RB, Vasan RS (2006) Multiple biomarkers for the prediction of first major cardiovascular events and death. N Engl J Med 355(25):2631–2639PubMedCrossRef

12.

Beck S, Wojdyla D, Say L, Betran AP, Merialdi M, Requejo JH, Rubens C, Menon R, Van Look PF (2010) The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bull World Health Organ 88(1):31–38PubMedCrossRef

13.

Smith GC, Fretts RC (2007) Stillbirth. Lancet 370(9600):1715–1725PubMedCrossRef

14.

Lawn JE, Cousens S, Zupan J (2005) 4 million neonatal deaths: when? Where? Why? Lancet 365(9462):891–900PubMedCrossRef

15.

Callaghan WM, MacDorman MF, Rasmussen SA, Qin C, Lackritz EM (2006) The contribution of preterm birth to infant mortality rates in the United States. Pediatrics 118(4):1566–1573PubMedCrossRef

16.

Wimmer G, Pihlstrom BL (2008) A critical assessment of adverse pregnancy outcome and periodontal disease. J Clin Periodontol 35(8 Suppl):380–397PubMedCrossRef

17.

Chambrone L, Pannuti CM, Guglielmetti MR, Chambrone LA (2011) Evidence grade associating periodontitis with preterm birth and/or low birth weight: II: a systematic review of randomized trials evaluating the effects of periodontal treatment. J Clin Periodontol 38(10):902–914PubMedCrossRef

18.

McGaw T (2002) Periodontal disease and preterm delivery of low-birth-weight infants. J Can Dent Assoc 68(3):165–169PubMed

19.

Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J clin epidemiol 62(10):1006–1012PubMedCrossRef

20.

Needleman IG (2002) A guide to systematic reviews. J Clin Periodontol 29(3):6–9, discussion 37–38PubMedCrossRef

21.

Offenbacher S, Lin D, Strauss R, McKaig R, Irving J, Barros SP, Moss K, Barrow DA, Hefti A, Beck JD (2006) Effects of periodontal therapy during pregnancy on periodontal status, biologic parameters, and pregnancy outcomes: a pilot study. J Periodontol 77(12):2011–2024PubMedCrossRef

22.

Oettinger-Barak O, Barak S, Ohel G, Oettinger M, Kreutzer H, Peled M, Machtei EE (2005) Severe pregnancy complication (preeclampsia) is associated with greater periodontal destruction. J Periodontol 76(1):134–137PubMedCrossRef

23.

Tarannum F, Faizuddin M, Madaiah H (2011) Gingival crevicular fluid prostaglandin E2 level as a predictor of preterm low birth weight: a pilot investigation. J Oral Sci 53(3):293–300PubMedCrossRef

24.

Offenbacher S, Jared HL, O’Reilly PG, Wells SR, Salvi GE, Lawrence HP, Socransky SS, Beck JD (1998) Potential pathogenic mechanisms of periodontitis associated pregnancy complications. Ann Periodontol 3(1):233–250PubMedCrossRef

25.

Canakci V, Canakci CF, Yildirim A, Ingec M, Eltas A, Erturk A (2007) Periodontal disease increases the risk of severe pre-eclampsia among pregnant women. J Clin Periodontol 34(8):639–645PubMedCrossRef

26.

Carta G, Persia G, Falciglia K, Iovenitti P (2004) Periodontal disease and poor obstetrical outcome. Clin Exp Obstet Gynecol 31(1):47–49PubMed

27.

Konopka T, Rutkowska M, Hirnle L, Kopec W, Karolewska E (2003) The secretion of prostaglandin E2 and interleukin 1-beta in women with periodontal diseases and preterm low-birth-weight. Bull Group Int Rech Sci Stomatol Odontol 45(1):18–28PubMed

28.

Noack B, Klingenberg J, Weigelt J, Hoffmann T (2005) Periodontal status and preterm low birth weight: a case control study. J Periodontal Res 40(4):339–345PubMedCrossRef

29.

Romero R, Baumann P, Gonzalez R, Gomez R, Rittenhouse L, Behnke E, Mitchell MD (1994) Amniotic fluid prostanoid concentrations increase early during the course of spontaneous labor at term. Am J Obstet Gynecol 171(6):1613–1620PubMedCrossRef

30.

Romero R, Baumann P, Gomez R, Salafia C, Rittenhouse L, Barberio D, Behnke E, Cotton DB, Mitchell MD (1993) The relationship between spontaneous rupture of membranes, labor, and microbial invasion of the amniotic cavity and amniotic fluid concentrations of prostaglandins and thromboxane B2 in term pregnancy. Am J Obstet Gynecol 168(6 Pt 1):1654–1664, discussion 1664–1658PubMedCrossRef

31.

Romero R, Brody DT, Oyarzun E, Mazor M, Wu YK, Hobbins JC, Durum SK (1989) Infection and labor. III. Interleukin-1: a signal for the onset of parturition. Am J Obstet Gynecol 160(5 Pt 1):1117–1123PubMedCrossRef

32.

Romero R, Durum S, Dinarello CA, Oyarzun E, Hobbins JC, Mitchell MD (1989) Interleukin-1 stimulates prostaglandin biosynthesis by human amnion. Prostaglandins 37(1):13–22PubMed

33.

Tamatani T, Tsunoda H, Iwasaki H, Kaneko M, Hashimoto T, Onozaki K (1988) Existence of both IL-1 alpha and beta in normal human amniotic fluid: unique high molecular weight form of IL-1 beta. Immunology 65(3):337–342PubMed

34.

Flynn A, Finke JH, Hilfiker ML (1982) Placental mononuclear phagocytes as a source of interleukin-1. Science 218(4571):475–477PubMedCrossRef

35.

Opsjln SL, Wathen NC, Tingulstad S, Wiedswang G, Sundan A, Waage A, Austgulen R (1993) Tumor necrosis factor, interleukin-1, and interleukin-6 in normal human pregnancy. Am J Obstet Gynecol 169(2 Pt 1):397–404PubMedCrossRef

36.

Lopez Bernal A, Hansell DJ, Canete Soler R, Keeling JW, Turnbull AC (1987) Prostaglandins, chorioamnionitis and preterm labour. Br J Obstet Gynaecol 94(12):1156–1158PubMedCrossRef

37.

Romero R, Wu YK, Mazor M, Hobbins JC, Mitchell MD (1988) Amniotic fluid prostaglandin E2 in preterm labor. Prostaglandins Leukot Essent Fatty Acids 34(3):141–145PubMedCrossRef

38.

Offenbacher S (1996) Periodontal diseases: pathogenesis. Ann Periodontol 1(1):821–878PubMedCrossRef

39.

Beck JD, Offenbacher S, Williams R, Gibbs P, Garcia R (1998) Periodontitis: a risk factor for coronary heart disease? Ann Periodontol 3(1):127–141PubMedCrossRef

40.

Damare SM, Wells S, Offenbacher S (1997) Eicosanoids in periodontal diseases: potential for systemic involvement. Adv Exp Med Biol 433:23–35PubMed

41.

Fiorini T, Vianna P, Weidlich P, Musskopf ML, Moreira CH, Chies JA, Rosing CK, Oppermann RV, Susin C (2012) Relationship between cytokine levels in serum and gingival crevicular fluid (GCF) in pregnant women. Cytokine 58(1):34–39PubMedCrossRef

42.

Orozco A, Gemmell E, Bickel M, Seymour GJ (2006) Interleukin-1beta, interleukin-12 and interleukin-18 levels in gingival fluid and serum of patients with gingivitis and periodontitis. Oral Microbiol Immunol 21(4):256–260PubMedCrossRef

43.

Trombelli L, Scapoli C, Carrieri A, Giovannini G, Calura G, Farina R (2010) Interleukin-1 beta levels in gingival crevicular fluid and serum under naturally occurring and experimentally induced gingivitis. J Clin Periodontol 37(8):697–704PubMed

44.

Fentoglu O, Kirzioglu FY, Ozdem M, Kocak H, Sutcu R, Sert T (2012) Proinflammatory cytokine levels in hyperlipidemic patients with periodontitis after periodontal treatment. Oral Dis 18(3):299–306PubMedCrossRef

45.

Yalcin F, Basegmez C, Isik G, Berber L, Eskinazi E, Soydinc M, Issever H, Onan U (2002) The effects of periodontal therapy on intracrevicular prostaglandin E2 concentrations and clinical parameters in pregnancy. J Periodontol 73(2):173–177PubMedCrossRef

46.

Thunell DH, Tymkiw KD, Johnson GK, Joly S, Burnell KK, Cavanaugh JE, Brogden KA, Guthmiller JM (2010) A multiplex immunoassay demonstrates reductions in gingival crevicular fluid cytokines following initial periodontal therapy. J Periodontal Res 45(1):148–152PubMedCrossRef

47.

Michalowicz BS, Hodges JS, DiAngelis AJ, Lupo VR, Novak MJ, Ferguson JE, Buchanan W, Bofill J, Papapanou PN, Mitchell DA, Matseoane S, Tschida PA (2006) Treatment of periodontal disease and the risk of preterm birth. N Engl J Med 355(18):1885–1894PubMedCrossRef

48.

Offenbacher S, Beck JD, Jared HL, Mauriello SM, Mendoza LC, Couper DJ, Stewart DD, Murtha AP, Cochran DL, Dudley DJ, Reddy MS, Geurs NC, Hauth JC (2009) Effects of periodontal therapy on rate of preterm delivery: a randomized controlled trial. Obstet Gynecol 114(3):551–559PubMedCrossRef

Title: The potential association between gingival crevicular fluid inflammatory mediators and adverse pregnancy outcomes: a systematic review
Authors: Pascale Stadelmann
Regina Alessandri
Sigrun Eick
Giovanni E. Salvi
Daniel Surbek
Anton Sculean
Publication date: 01-07-2013
Publisher: Springer-Verlag
Published in: Clinical Oral Investigations / Issue 6/2013
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-013-0952-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The potential association between gingival crevicular fluid inflammatory mediators and adverse pregnancy outcomes: a systematic review

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

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