Increased Interleukin‐18 in Patients With Juvenile Idiopathic Arthritis and Early Attachment Loss

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Abstract
Background: Patients with juvenile idiopathic arthritis (JIA) have been shown to have incipient attachment loss (AL) more frequently than systemically healthy individuals. This study investigated neutrophil activity and proinflammatory cytokines in these patients and aged‐matched controls.Methods: Elastase activity, measured with a low molecular weight substrate (S‐2484), and interleukin‐1β (IL‐1β), measured with the enzyme‐linked immunosorbent assay (ELISA), were analyzed in the gingival fluid of 38 patients with JIA and 29 controls. IL‐1β and interleukin‐18 (IL‐18) were measured with ELISA in the serum of the same groups. Subgingival plaque was analyzed by DNA probes to detect 12 bacteria.Results: Significantly elevated serum levels of IL‐1β and IL‐18 were found in the JIA group. No differences were found in the gingival fluid levels of elastase and IL‐1β between groups, or in the frequency of subjects positive to most of the bacteria analyzed, except F. nucleatum, C. rectus, P. micros, and S. intermedius, which were significantly more frequent in the control group. When the JIA group was subdivided according to the presence/absence of AL, IL‐18 was significantly increased in the JIA subgroup with AL compared to those without it. There were no differences in the subgingival microbiota between the subgroups.Conclusion: The findings of increased serum IL‐18 and IL‐1β in patients with JIA accompanied by a similar subgingival microbiota suggest that the increased frequency of incipient attachment loss observed in these patients might be due to their altered systemic inflammatory response, making them more susceptible to periodontal disease. J Periodontol 2005;76:75‐82.

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