The influence of sex hormones on proinflammatory cytokines in gingiva of periodontally healthy premenopausal women

Markou E, Boura E, Tsalikis L, Deligianidis A, Konstantinidis A. The influence of sex hormones on proinflammatory cytokines in gingiva of periodontally healthy premenopausal women. J Periodont Res 2011; 46: 528–532. © 2011 John Wiley & Sons A/S Background and Objective: The aim of this work was to investigate any correlation between the fluctuation of levels of specific proinflammatory cytokines in gingival crevicular fluid and the fluctuation of sex hormones in peripheral blood at ovulation and progesterone peak. Material and Methods: Eighteen premenopausal women with normal and consistent menstrual cycles and healthy periodontium were included in this study. The exclusion criteria were as follows: (i) pregnancy; (ii) use of oral contraceptives; (iii) metabolic or systemic disease that might affect the periodontium; (iv) use of antimicrobial or nonsteroidal anti‐inflammatory drugs during the past 6 mo; and (v) smoking. The measurements were performed at two specific time points for each participant (i) on the day of ovulation; and (ii) on the day of the progesterone peak) and included the following: (i) plaque index; (ii) bleeding on probing; and (iii) the gingival crevicular fluid levels of interleukin (IL)‐1β, IL‐6, IL‐8 and tumor necrosis factor‐α (TNF‐α). Results: During the menstrual cycle, plaque index values remained unchanged (0.71 ± 0.07 at ovulation; 0.73 ± 0.08 at progesterone peak; p > 0.05), as did bleeding on probing (0.35 ± 0.07 at ovulation; 0.41 ± 0.07 at progesterone peak; p > 0.05). At ovulation, mean gingival crevicular fluid levels were as follows: IL‐1β, 13.3 pg/sample; IL‐6, 5.9 pg/sample; IL‐8, 18.7 pg/sample; and TNF‐α, 25.9 pg/sample. The corresponding values at progesterone peak were as follows: 14.1, 10.1, 19.5 and 26.3 pg/sample. Only IL‐6 gingival crevicular fluid levels were significantly different between ovulation and progesterone peak (p < 0.05). This could reflect sensitivity to subclinical amounts of plaque and biofilm constituents. Conclusion: The subclinical increase of IL‐6 at progesterone peak is not accompanied by clinical changes in the periodontium.