Salivary level of interleukin 32 alpha and tumer necrotic factor alpha in periodontitis and healthy individuals a cross_sectional study
Abstract
https://doi.org/10.31386/dmj.2026.20.2.3
Abstract
Background and objective: Periodontitis is an inflammatory disease that causes progressive destruction of periodontal tissues. Cytokines such as tumor necrosis factor-alpha (TNF-α) and interleukin-32 alpha (IL-32α) are believed to play key roles in its pathogenesis. This research aimed to evaluate the salivary levels of TNF-α and IL-32α among patients with different severities of chronic periodontitis and periodontally healthy individuals in Kirkuk City, Iraq.
Methods: This cross-sectional study included 90 systemically healthy individuals aged 20–55 years, divided into four groups: healthy controls, and patients with mild, moderate, or severe periodontitis, according to the 1999 AAP classification. Unstimulated saliva samples were collected and analyzed for TNF-α and IL-32α concentrations using ELISA(Enzyme-Linked Immunosorbent Assay). Clinical parameters such as plaque index, probing pocket depth, and clinical attachment loss were recorded. Data were analyzed using ANOVA, correlation analysis, and ROC curve assessment.
Results: Both TNF-α and IL-32α levels were significantly elevated in periodontitis patients compared to healthy individuals, with a progressive increase corresponding to disease severity. TNF-α showed strong correlations with clinical parameters and higher diagnostic accuracy, especially in severe cases (84.78%). IL-32α also increased with severity but had lower diagnostic performance.
Conclusion: Salivary TNF-α and IL-32α are elevated in chronic periodontitis and correlate with disease severity. TNF-α, in particular, may serve as a reliable non-invasive biomarker for diagnosing and monitoring periodontal inflammation. Further research is recommended to explore their utility in broader populations and longitudinal settings.
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References
2. Saliem SS, Bede SY, Cooper PR, Abdulkareem AA, Milward MR, Abdullah BH. Pathogenesis of periodontitis–A potential role for epithelial-mesenchymal transition. Jpn Dent Sci Rev. 2022;58:268–78.
3. Hajishengallis G. Periodontitis: from microbial immune subversion to systemic inflammation. Nat Rev Immunol. 2015;15(1):30–44.
4. Alwan Z, Mohammed A. Assessment of salivary TNF-α level in patients with different severities of periodontitis. Mustansiria Dent J. 2023;19(1):20–8.
5. Kinane DF, Stathopoulou PG, Papapanou PN. Periodontal diseases. Nat Rev Dis Prim. 2017;3(1):1–14.
6. Zhou J, Yao Y, Jiao K, Zhang J, Zheng X, Wu F, et al. Relationship between gingival crevicular fluid microbiota and cytokine profile in periodontal host homeostasis. Front Microbiol. 2017;8:2144.
7. Lee J, Lee JB, Song HY, Son MJ, Li L, Rhyu IC, et al. Diagnostic models for screening of periodontitis with inflammatory mediators and microbial profiles in saliva. Diagnostics. 2020;10(10):820.
8. SPEEKSEL BV. Speekseldiagnostiek: een overzicht van de toegenomen mogelijkheden. Ned Tijdschr Tandheelkd. 2020;127:561–6.
9. Kim H, Kim E, Park AK, Shin Y, Kang J, Lim J, et al. Detection of association between periodontitis and polymorphisms of IL‐1β+ 3954 and TNF‐α‐863 in the Korean population after controlling for confounding risk factors. J Periodontal Res. 2020;55(6):905–17.
10. Jain P, Ved A, Dubey R, Singh N, Parihar AS, Maytreyee R. Comparative evaluation of serum tumor necrosis factor α in health and chronic periodontitis: A case–control study. Contemp Clin Dent. 2020;11(4):342–9.
11. Neurath N, Kesting M. Cytokines in gingivitis and periodontitis: from pathogenesis to therapeutic targets. Front Immunol. 2024;15:1435054.
12. Mo C, Huang M, Yan F, Song M, Fan J, Zhang J, et al. Correlation Between Gut Microbiota Composition and Serum Interleukin 17 (IL-17) in Mice With Type 2 Diabetes and Experimental Periodontitis. Cureus. 2024;16(8).
13. Sun L, Girnary M, Wang L, Jiao Y, Zeng E, Mercer K, et al. IL-10 Dampens an IL-17–Mediated Periodontitis-Associated Inflammatory Network. J Immunol [Internet]. 2020 Apr 1;204(8):2177–91. Available from: https://doi.org/10.4049/jimmunol.1900532
14. Zhang J, Wang AX, Wu Y, Zhang S. IL-1 receptor antagonist (IL-1RA) suppresses a hyper-IL-17 response-mediated bone loss in a murine experimental periodontitis. Arch Oral Biol. 2022;144:105555.
15. Pathak JL, Fang Y, Chen Y, Ye Z, Guo X, Yan Y, et al. Downregulation of macrophage-specific act-1 intensifies periodontitis and alveolar bone loss possibly via TNF/NF-κB signaling. Front Cell Dev Biol. 2021;9:628139.
16. Papathanasiou E, Conti P, Carinci F, Lauritano D, Theoharides TC. IL-1 superfamily members and periodontal diseases. J Dent Res. 2020;99(13):1425–34.
17. Zhang Y, Kuang W, Li D, Li Y, Feng Y, Lyu X, et al. Natural killer-like B cells secreting interleukin-18 induces a proinflammatory response in periodontitis. Front Immunol. 2021;12:641562.
18. Salimetrics LLC, SalivaBio LLC. Saliva collection and handling advice. State Coll PA Salimetrics LLC, SalivaBio LLC. 2011;1.
19. Öngöz Dede F, Gökmenoğlu C, Deveci ET, Çelen S, Avci B, Kara C, et al. Increased levels of interleukin‐32 isoforms alpha, beta, gamma, and delta in the gingival crevicular fluid and plasma of the patients with periodontitis. J Periodontal Res. 2021;56(1):83–92.
20. Layedh NH, Al-Rubbaey YA, Fahad AH, Al-Roubaey DAA. Salivary IL-6 and TNF-α in patients with periodontitis. Ann Trop Med Public Heal. 2021;317–25.
21. Pulivarthi P, Chava VK, Gunupati S. Salivary tumor necrosis factor-alpha levels in periodontitis associated with diabetes mellitus after low level laser therapy as an adjunct to scaling and root planning: A randomized clinical trial. J Indian Soc Periodontol. 2022;26(3):236–44.
22. Yousefimanesh H, Maryam R, Mahmoud J, Mehri GB, Mohsen T. Evaluation of salivary tumor necrosis factor-alpha in patients with the chronic periodontitis: A case-control study. J Indian Soc Periodontol. 2013;17(6):737–40.
23. Kim JY, Kim HN. Changes in inflammatory cytokines in saliva after non-surgical periodontal therapy: a systematic review and meta-analysis. Int J Environ Res Public Health. 2021;18(1):194.
24. Dede FO, Balli U, Durmuslar MC, Dogan SB, Avci B, Ayas B, et al. Evaluation of IL-32 levels in gingival tissue and serum of experimental periodontitis model. J Turgut Ozal Med Cent. 2017;24(3).
25. de Faria JB, de Souza Furtado TC, de Assunção TSF, Abdalla DR, Andrade FM, Bertoldo BB, et al. Immunological evaluation of the crevicular fluid in patients with gingivitis, periodontitis, and peri-implantitis: a 1-year cross-sectional study. Res Soc Dev. 2021;10(13):e41101320756–e41101320756.
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Duhok Medical Journal (DMJ)
College of Medicine, University of Duhok
Duhok, Iraq
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