Interleukin‐6 and granulocyte‐macrophage colony‐stimulating factor in apical periodontitis: correlation with clinical and histologic findings of the involved teeth

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Abstract
Apical periodontitis is characterized by the presence of immunocompetent cells producing a wide variety of inflammatory mediators. Releasing cytokines with long‐range action, such as interleukin‐6 (IL‐6) and granulocyte‐macrophage colony‐stimulating factor (GM‐CSF), apical periodontitis may induce changes in remote organs of the host. This study quantified the levels of IL‐6 and GM‐CSF in symptomatic and asymptomatic human periradicular lesions. Lesions were also characterized by size and histologic findings. Tissue samples were homogenized and supernatants were assayed using an enzyme‐linked immunosorbent assay (ELISA). Correlations between cytokine levels and characteristic features (as single variables) of the lesions were analysed. There was a trend for higher levels of IL‐6 and GM‐CSF in symptomatic than in asymptomatic lesions, but the difference was not significant. Levels also tended to be higher in large than in small lesions, in polymorphonuclear (PMN) cell‐rich than in PMN cell‐poor samples, and in epithelialized than in non‐epithelialized lesions. Significantly higher levels of IL‐6 (778.1 ± 220.5 pg/μg) and GM‐CSF (363.3 ± 98.4 pg/μg) were found in samples coincidentally possessing symptomatic and epithelialized features than in asymptomatic, small, PMN cell‐poor, non‐epithelialized lesions (IL‐6: 45.2 ± 13.1 pg/μg and GM‐CSF: 135.1 ± 26.4 pg/μg). These results suggest that symptomatic lesions containing epithelial cells represent an immunologically active stage of apical periodontitis, whereas asymptomatic, small, PMN cell‐poor, non‐epithelialized lesions represent healing apical lesions.

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