Eicosanoids in periodontal diseases: Potential for systemic involvement

Abstract

The potential application of gingival crevicular fluid (GCF) levels of prostaglandin E2 (PGE2) for predicting periodontal disease severity and reflecting disease activity has been described by several investigators. The potential application of GCF levels of PGE2 for predicting amniotic fluid levels of PGE2, and thereby estimating risk of preterm low birth weight, has not been explored until recently. The fact that intraamniotic levels of many inflammatory mediators, such as prostaglandin E2, increase during pregnancy and peak at delivery suggests that these mechanisms play an important role in normal physiologic parturition. There is increasing evidence to suggest that the presence of a subclinical endogenous Gram-negative infection of periodontal disease may present a systemic challenge sufficient to initiate the onset of premature labor, either as a source of lipopolysaccharide (LPS, endotoxin) and/or through stimulation of secondary inflammatory mediators such as PGE2 and interleukin 1 beta (IL-1β). This pilot investigation determines associations among the levels of PGE2 in gingival crevicular fluid, within serum, and within amniotic fluid of 18 women who were undergoing routine amniocentesis during early midtrimester, in an attempt to reveal new baseline data regarding the relationship between periodontal inflammatory mediators and intraamniotic mediators during normal parturition. Full-mouth periodontal examinations were performed and samples of GCF, serum and amniotic fluid were collected from each subject for the quantitative assessment of PGE2 by radioimmunoassay (RIA). Results of a pairwise regression analysis model reveal that PGE2 levels within the GCF are positively associated with intraamniotic PGE2 levels at the P = 0.018 level of significance. Thus, gingival crevicular levels of PGE2 may be used to provide an indirect estimate of the amniotic fluid levels of PGE2.