Sains Malaysiana 54(4)(2025): 1005-1024

http://doi.org/10.17576/jsm-2025-5404-04

IL-1β Expression and Change Following SRP in Gingival Crevicular Fluid in Patients with Periodontitis: A Systematic Review and Meta-Analysis

(Pengekspresan dan Perubahan IL-1β Mengikuti SRP dalam Cecair Krevikular Gingival pada Pesakit dengan Periodontitis: Suatu Kajian Sistematik dan Meta-Analisis)

JUAN WANG^1,2, QING LIU¹, JINPIN YU¹, JIALING LI³, BIN CHEN^1,* & YINGCHUN DONG¹

¹Department of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Institute of Stomatology, Nanjing University, Nanjing, Jiangsu, China

²Haixiacheng Community Health Service Centre, Jianye District, Nanjing, China

³Department of Orthodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Institute of Stomatology, Nanjing University, Nanjing, Jiangsu, China

Received: 27 September 2024/Accepted: 16 December 2024

Abstract

Periodontitis is a chronic inflammatory periodontal lesion, characterised by progressive destruction of connective tissue and continuous loss of marginal bone surrounding the teeth. Cytokines and chemokines play a role in the pathogenesis of chronic periodontitis (CP). Among these, IL-1β is considered one of the most important inflammatory factors and tissue-destructive cytokines. Despite numerous investigations identifying the role of IL-1β in gingival crevicular fluid (GCF) in bone resorption and connective tissue destruction, the efficacy of GCF IL-1β in assisting the diagnosis and predicting the progression of CP remains undetermined. The objective of this study was to ascertain whether IL-1β can be used as a diagnostic and progressive biomarker for CP. To this end, GCF IL-1β levels were compared between periodontally healthy controls and subjects diagnosed with CP, as well as between subjects before and after scaling and root planning (SRP) for CP. Additionally, the correlations between GCF IL-1β levels and various clinical parameters, including probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), plaque index (PI), and gingival index (GI), were analysed within the CP group. A comprehensive search of the PubMed, Embase and Cochrane databases was conducted from their inception up to 1 April 2022. The electronic search terms employed were ‘periodontitis OR periodontal diseases’ AND ‘Interleukin-1β OR IL-1β’ AND ‘gingival crevicular fluid’. The review includes cross-sectional, case series, single arm studies, prospective and retrospective cohort studies, as well as randomised controlled trials (RCTs) and non-RCTs. The studies that compared IL-1β levels (either the concentration or the total amount) between healthy controls and subjects with CP, or between subjects with CP before and after SRP, were included in the review. The meta-analysis was conducted using Review Manager 5.3. The analysis included data from 50 studies comprising 1,502 patients. The concentration, total amount of GCF IL-1β, and GCF volume in subjects with CP were found to be significantly higher than in healthy controls (P < 0.01). The concentrations of GCF IL-1β in CP group decreased significantly at 1 month (P = 0.04), 1.5 months and 3 months following SRP compared with the preoperative baseline (P < 0.01). The total amounts of GCF IL-1β in CP group decreased significantly at postoperative 1 month, 1.5 months, 3 months, and 6 months compared with the baseline, and the P-values are all less than 0.01 except P =0.02 for 1.5 months. GCF volumes in CP group decreased significantly at 1 months, 3 months, and 6 months following SRP compared with the baseline (P < 0.01). The total amount of GCF IL-1β was found to be correlated positively and closely with BOP (r=0.894, P=0.041) in CP group. No significant correlations were identified between the total amount of IL-1β and other clinical parameters, nor between the concentration of IL-1β and any clinical parameter (P > 0.05). GCF IL-1β may serve as a diagnostic and progressive biomarker of chronic periodontitis (CP). The measurement of GCF IL-1β levels may prove beneficial in the diagnosis of initial periodontitis, the assessment of the therapeutic efficacy of SRP for CP, the determination of disease severity and activity, and the prediction of CP progression. 

Keywords: Chronic periodontitis; gingival crevicular fluid; IL-1β; periodontal diseases; scaling & root planning

Abstrak

Periodontitis adalah lesi periodontal radang kronik, dicirikan oleh kemusnahan progresif tisu penghubung dan kehilangan berterusan tulang marginal di sekeliling gigi. Sitokin dan kemokin memainkan peranan dalam patogenesis periodontitis kronik (CP). Antaranya, IL-1β dianggap sebagai salah satu faktor keradangan yang paling penting dan sitokin yang merosakkan tisu. Walaupun banyak penyelidikan mengenal pasti peranan IL-1β dalam cecair krevikular gingival (GCF) dalam penyerapan tulang dan pemusnahan tisu penghubung, keberkesanan GCF IL-1β dalam membantu diagnosis dan meramalkan perkembangan CP masih tidak dapat ditentukan. Objektif kajian ini adalah untuk memastikan sama ada IL-1β boleh digunakan sebagai biopenanda diagnostik dan progresif untuk CP. Untuk tujuan ini, tahap GCF IL-1β dibandingkan antara kawalan sihat periodontal dan subjek yang didiagnosis dengan CP, serta antara subjek sebelum dan selepas penskalaan dan perancangan akar (SRP) untuk CP. Selain itu, korelasi antara tahap GCF IL-1β dan pelbagai parameter klinikal, termasuk kedalaman probing (PD), tahap lampiran klinikal (CAL), pendarahan semasa probing (BOP), indeks plak (PI) dan indeks gingival (GI) dianalisis dalam kumpulan CP. Carian komprehensif bagi pangkalan data PubMed, Embase dan Cochrane telah dijalankan daripada penubuhannya sehingga 1 April 2022. Istilah carian elektronik yang digunakan ialah 'periodontitis ATAU penyakit periodontal' DAN 'Interleukin-1β ATAU IL-1β' DAN 'cecair krevikular gingiva'. Kajian itu termasuk keratan rentas, siri kes, kajian lengan tunggal, kajian kohort prospektif dan retrospektif, serta ujian terkawal rawak (RCT) dan bukan RCT. Kajian yang membandingkan tahap IL-1β (sama ada kepekatan atau jumlah keseluruhan) antara kawalan sihat dan subjek dengan CP atau antara subjek dengan CP sebelum dan selepas SRP telah dimasukkan dalam semakan. Meta-analisis telah dijalankan menggunakan Pengurus Kajian 5.3. Analisis termasuk data daripada 50 kajian yang terdiri daripada 1,502 pesakit. Kepekatan, jumlah amaun GCF IL-1β dan GCF dalam subjek dengan CP didapati jauh lebih tinggi daripada kawalan sihat (P <0.01). Kepekatan GCF IL-1β dalam kumpulan CP menurun dengan ketara pada 1 bulan (P = 0.04), 1.5 bulan dan 3 bulan selepas SRP berbanding dengan garis dasar praoperasi (P <0.01). Jumlah keseluruhan GCF IL-1β dalam kumpulan CP menurun dengan ketara pada 1 bulan, 1.5 bulan, 3 bulan dan 6 bulan selepas operasi berbanding dengan garis dasar dan nilai-P semuanya kurang daripada 0.01 kecuali P = 0.02 selama 1.5 bulan. Jumlah GCF dalam kumpulan CP menurun dengan ketara pada 1 bulan, 3 bulan dan 6 bulan selepas SRP berbanding dengan garis dasar (P <0.01). Jumlah keseluruhan GCF IL-1β didapati berkorelasi secara positif dan rapat dengan BOP (r=0.894, P=0.041) dalam kumpulan CP. Tiada korelasi yang ketara dikenal pasti antara jumlah IL-1β dan parameter klinikal lain, mahupun antara kepekatan IL-1β dan mana-mana parameter klinikal (P > 0.05). GCF IL-1β boleh berfungsi sebagai biopenanda diagnostik dan progresif periodontitis kronik (CP). Pengukuran tahap GCF IL-1β mungkin terbukti bermanfaat dalam diagnosis periodontitis awal, penilaian keberkesanan terapeutik SRP untuk CP, penentuan keterukan dan aktiviti penyakit serta ramalan perkembangan CP.

Kata kunci: Cecair krevikal gingiva; IL-1β; penskalaan & perancangan akar; penyakit periodontal; periodontitis kronik

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