Hipovitaminose D, catelicidina e doença periodontal: associações na doença renal crônica

Abstract

Introduction: The prevalence of chronic periodontitis (CP), in its severe form, in patients with chronic kidney disease (CKD) has been reported over the years. Deficiency of vitamin D (25 (OH) D) and cathelicidin (LL-37) appears to play an important role in the pathogenesis of CP, and inadequate levels of vitamin D and LL- 37 have been observed in patients with CKD. Aim: to examine the association between serum 25 (OH) D, LL-37 and IL-6 in plasma and gingival crevicular fluid in patients with CKD and CP. Method: This was a cross-sectional study where four groups were formed: Group 1, 15 systemically healthy individuals (SS) and without CP (SS/CP-), Group 2, 15 patients with CP and SS (SS / CP +) and Group 3, 15 patients with CKD and without PC (DRC/CP-), and 15 patients with CKD and CP (DRC / CP +). Demographic data, physical examination and laboratory data were obtained on the day of the exam. CKD was defined and staged according to the NKF QDOKITM. Serum 25 (OH) D levels were measured by chemiluminescence. CP was characterized according to the American Academy of Periodontology (1999). LL-37 and IL-6 in plasma and gingival crevicular fluid were measured by ELISA. Results: the results of 25 (OH) D were stratified deficient (≤ 14 ƞg / mL), insufficient (15-29 ƞg / mL) and sufficiency (≥ 30 ƞg / ml). Patients with CKD and CP had a more severe CP and lower levels of 25(OH)D and LL-37 in plasma. It has been observed an association between lower levels of 25(OH)D and LL-37 in plasma. Moreover, statistically higher levels of LL-37 and IL-6 were found in gingival fluid of patients with CP (SS / CP + and CKD / CP +) compared to those without periodontal disease (CKD /CP- and SS/CP-) . Conclusion: In patients with CKD, inadequate levels of 25(OH)D and LL-37 can possibly affect the innate immune response, predisposing individuals to infection. Increased levels of IL-6 and the LL-37 in the gingival crevicular fluid featuring an increase of inflammatory responses, which could explain a worse CP in these patients.