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Doctoral Thesis
DOI
https://doi.org/10.11606/T.23.2014.tde-19022015-113701
Document
Author
Full name
Isabella Maria Porto de Araujo
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2014
Supervisor
Committee
Pustiglioni, Francisco Emilio (President)
Garcia, Valdir Gouveia
Nogueira, Fernando Neves
Oliveira, Manuel Herminio de Aguiar
Romito, Giuseppe Alexandre
Title in Portuguese
Doença periodontal em adultos com Deficiência Isolada do Hormônio do Crescimento: aspectos clínicos, microbiológicos e imunológicos
Keywords in Portuguese
Hormônio do Crescimento
Imunologia
Microbiologia
Nanismo
Periodontite
Abstract in Portuguese
Indivíduos com Deficiência Isolada do Hormônio do Crescimento (IGHD), homozigotos para a mutação c.57+1G>A no gene do receptor do hormônio liberador do hormônio de crescimento (GHRH), apresentam maior chance de apresentarem perda de inserção periodontal devido a possível efeito direto da IGHD sobre os tecidos periodontais e/ou a repercussões locais ou sistêmicas da IGHD sobre a resposta imune. Este estudo teve como objetivos avaliar as repercussões locais e sistêmicas da IGHD sobre a resposta imune e comparar os níveis dos patógenos periodontais. Material e Métodos: Foi composto por uma amostra de 19 indivíduos com IGHD e 19 indivíduos no grupo controle, pareados por idade, gênero, condição sócio-econômica, tabagismo e diabetes. Todos foram submetidos a exame periodontal completo, em 6 sítios por dente, e entrevistados por meio de um questionário estruturado. Foi realizada coleta de biofilme subgengival (em sítios rasos e profundos, pareados pela PCS) para verificar os níveis dos microorganismos. Além disso, foram realizadas coletas do fluido gengival (dos mesmos sítios) e do sangue, de ambos os grupos, com a finalidade de analisar o perfil das citocinas inflamatórias. Resultados: Indivíduos com IGHD apresentaram maior quantidade de MMP-8 e CRP (p=0,026 e 0,002) no fluido gengival coletado dos sítios profundos, maior quantidade de IL-17 (p=0,02) no soro e mesmos níveis dos patógenos periodontais, em comparação com os controles (p>0,05). Conclusões: Mesmo com um perfil microbiológico semelhante, indivíduos com a IGHD apresentam alterações imunológicas moderadas (aumento de Interleucina 17 no soro e de metaloproteinase-8 e Proteína C-Reativa no fluido gengival coletado de sítios profundos), comparados aos controles.
Title in English
Periodontal disease in adults with isolated growth hormone deficiency: clinical, microbiological and immunological aspects
Keywords in English
Dwarfism
Growth Hormone
Immunology
Microbiology
Periodontitis
Abstract in English
Isolated Growth Hormone Deficiency (IGHD) subjects, homozygous to a mutation c.57+1G>A in the growth hormone releasing hormone receptor (GHRHR) gene, have a greater chance of having periodontal attachment loss (PAL) due to a possible direct effect of IGHD on the periodontal tissues and/or locals and systemic effects of IGHD on immune response. This aims of this study was evaluate local and systemic effects of IGHD on immune response and compare periodontal pathogens levels. Material and Methods: The sample was composed of 19 IGHD individuals and 19 controls, matched by age, gender, socio-economic condition, smoking and diabetes. Participants were submitted to a clinical full-mouth periodontal examination of six sites per tooth and were interviewed using a structured questionnaire. Subgingival biofilm was collected (in shallow and deep sites matched by probing clinical depth) to check the periodontal pathogens levels. Futhermore, gingival crevicular fluid (same sites) and blood samples were also collected from both groups to analyze inflammatory cytokines profile. Results: IGHD subjects had significantly higher amounts of MMP-8 and CRP (p= 0.026 e 0.002) in the gingival crevicular fluid collected from deep sites, higher amounts of IL-17 (p=0.02) in serum, and same levels of periodontal pathogens, compairing to the control group (p>0.05). Conclusions: Despite the same microorganism profile, IGHD subjects had moderate immunological alterations (increased serum Interleukin 17 and metalloproteinase 8 and C - reactive protein in deep sites gingival fluid), comparing to controls.
 
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Publishing Date
2015-03-25
 
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