Endodontic infections increase leukocyte and lymphocyte levels in the blood
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The aim of this study was to determine whether the presence of single or multiple apical periodontitis (AP) alters blood cell counts and cytokine production.
Material and methods
Thirty rats were divided into three groups: a control group comprising rats without AP, a group called 1AP comprising rats with AP in one tooth, and a group called 4AP comprising rats with AP in four teeth. Endodontic infection was induced by pulp exposure of the first right maxillary molar in the 1AP group or by exposing the first and second right maxillary and mandibular molars in the 4AP group. A blood count and cytokine levels were obtained 30 days after infection by collecting blood by cardiac puncture. The maxillae were dissected and stained with hematoxylin and eosin to evaluate the inflammatory infiltrate. The data were tabulated and subjected to statistical analysis (P < 0.05).
Histological analysis showed a predominance of mononuclear inflammatory cells. In blood, significant increase of leukocytes, lymphocytes, and tumor necrosis factor alpha (TNF-α) in 4AP compared with the control and 1AP groups (P < 0.05) was observed. In addition, significant decrease of interleukin-4 (IL-4) in 1AP and 4AP groups compared with the control was observed (P < 0.05).
In the rat model, the presence of multiple AP can affect health by increasing lymphocyte and TNF-α levels in the blood.
The presence of endodontic infections can interfere with the blood profile, altering systemic health.
KeywordsApical periodontitis Leukocytes Lymphocytes Blood count
This study was supported by a grant (2013/23358-8) from the São Paulo Research Foundation (FAPESP), São Paulo, SP, Brazil.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
This article does not contain any studies with human participants performed by any authors. The animal study was approved by the Institutional Ethics Committee (CEUA 2014-00108) of Universidade Estadual Paulista, São Paulo, Brazil and conducted in accordance with ethical standards.
For this type of study, formal consent is not required.
- 3.Cintra LT, Samuel RO, Azuma MM, Ribeiro CP, Narciso LG, de Lima VM, Sumida DH, Coclete GA, Dezan-Júnior E, Gomes-Filho JE (2014) Apical periodontitis and periodontal disease increase serum IL-17 levels in normoglycemic and diabetic rats. Clin Oral Investig 18:2123–2128. https://doi.org/10.1007/s00784-014-1192-7 CrossRefPubMedGoogle Scholar
- 4.Cintra LT, Samuel RO, Facundo AC, Prieto AK, Sumida DH, Bomfim SR, Souza JC, Dezan-Júnior E, Gomes-Filho JE (2014) Relationships between oral infections and blood glucose concentrations or HbA1c levels in normal and diabetic rats. Int Endod J 47:228–237. https://doi.org/10.1111/iej.12136 CrossRefPubMedGoogle Scholar
- 5.Marçal JR, Samuel RO, Fernandes D, de Araujo MS, Napimoga MH, Pereira SA, Clemente-Napimoga JT, Alves PM, Mattar R, Rodrigues V Jr, Rodrigues DB (2010) T-helper cell type 17/regulatory T-cell immunoregulatory balance in human radicular cysts and periapical granulomas. J Endod 36:995–999. https://doi.org/10.1016/j.joen.2010.03.020 CrossRefPubMedGoogle Scholar
- 13.Cintra LT, da Silva Facundo AC, Prieto AK, Sumida DH, Narciso LG, Mogami Bomfim SR, Oliveira e Silva C, Dezan-Júnior E, Gomes-Filho JE (2014) Blood profile and histology in oral infections associated with diabetes. J Endod 40:1139–1144. https://doi.org/10.1016/j.joen.2014.01.034 CrossRefPubMedGoogle Scholar
- 15.Pereira RF, de Oliveira da Mota MS, de Lima Coutinho Mattera MS, Tsosura TV, Chiba FY, Garbin CA, Ervolino E, Cintra LT, Okamoto MM, Machado UF, Sumida DH (2016) Periapical lesions decrease Akt serine phosphorylation and plasma membrane GLUT4 content in rat skeletal muscle. Clin Oral Investig 20:1625–1630. https://doi.org/10.1007/s00784-015-1664-4 CrossRefPubMedGoogle Scholar
- 18.Musalaiah SV, Anupama M, Nagasree M, Krishna CM, Kumar A, Kumar PM (2014) Evaluation of nonsurgical periodontal therapy in chronic periodontitis patients with anemia by estimating hematological parameters and high-sensitivity C-reactive protein levels. J Pharm Bioallied Sci 6:S64–S69. https://doi.org/10.4103/0975-7406.137390 CrossRefPubMedPubMedCentralGoogle Scholar
- 19.Gaddale R, Mudda JA, Karthikeyan I, Desai SR, Shinde H, Deshpande P (2014) Changes in cellular and molecular components of peripheral blood in patients with generalized aggressive periodontitis. J Investig Clin Dent. https://doi.org/10.1111/jicd.12127
- 21.Stein NC, Kreutzmann C, Zimmermann SP, Niebergall U, Hellmeyer L, Goettsch C, Schoppet M, Hofbauer LC (2008) Interleukin-4 and interleukin-13 stimulate the osteoclast inhibitor osteoprotegerin by human endothelial cells through the STAT6 pathway. J Bone Miner Res 23:750–758. https://doi.org/10.1359/jbmr.080203 CrossRefPubMedGoogle Scholar
- 25.Gomes MS, Hugo FM, Hilgert JB, Sant'Ana Filho M, Padilha DMP, Simonsick EM (2015) Apical periodontitis and incident cardiovascular events in the Baltimore Longitudinal Study of Aging. Int Endod J. https://doi.org/10.1111/iej.12468
- 31.Ribeiro FV, de Mendonça AC, Santos VR, Bastos MF, Figueiredo LC, Duarte PM (2011) Cytokines and bone-related factors in systemically healthy patients with chronic periodontitis and patients with type 2 diabetes and chronic periodontitis. J Periodontol 82:1187–1196. https://doi.org/10.1902/jop.2011.100643 CrossRefPubMedGoogle Scholar
- 32.Behfarnia P, Birang R, Pishva SS, Hakemi MG, Khorasani MM (2013) Expression levels of th-2 and th-17 characteristic genes in healthy tissue versus periodontitis. J Dent (Tehran) 10:23–31Google Scholar