Open Access

ARTICLE

Inflammatory cytokine profile and circulating cortisol levels in malnourished children with necrotizing ulcerative gingivitis

Cyril O. Enwonwu^1,2, Reshma S. Phillips¹, Kofo O. Savage³

1 Department of Biomedical Sciences, School of Dentistry, University of Maryland, 666 W. Baltimore St., Rm 4G31, Baltimore, Maryland 21201, USA
2 Department of Biochemistry and Molecular Biology, School of Medicine, University of Maryland, Baltimore, Maryland, USA
3 Department of Preventive Dentistry, University of Lagos, College of Medicine, Idi-Araba, Lagos, Nigeria

* Corresponding Author: C.O. Enwonwu,

European Cytokine Network 2005, 16(3), 240-248.

Accepted 29 June 2005;

Abstract

Necrotizing ulcerative gingivitis (NUG), a periodontal disease traditionally associated with stressful lifestyles in young adults in developed countries, is very prevalent in socioeconomically deprived Nigerian children. Random incident cases (153) of NUG, along with their neighborhood village counterparts of comparable age and without NUG, as control, were recruited for this study. Anthropometric evaluation revealed widespread malnutrition and poor health in both groups of children, with more severe stunting in NUG cases. The poor nutritional status of the village children, with and without NUG, was also confirmed by markedly reduced levels of circulating micronutrients. Compared with the neighborhood children, NUG victims showed significant (p < 0.05 or < 0.001) increases in serum levels of interleukin (IL)-8 (+ 233%), IL-18 (+ 30%), IL-6 (+ 190%), IL-1β (+ 341%), IL-10 (+ 186%), with a small decrease in interferon (IFN)-γ (-19%) and nonsignificant increases in soluble tumor necrosis factor (TNF) receptors (sTNFR-p55, p75). Associated with NUG was a significant, 38% (p < 0.05) increase in plasma cortisol above the already high levels observed in the neighborhood village children, as well as some micronutrient deficiencies. The findings suggest that NUG is associated with dysregulated cytokine production, with a complex interplay of elevated levels of pro- and anti-inflammatory mediators. Such changes may serve as the common link between the seemingly unrelated risk conditions (e.g. stressful life styles, smoking, microbial infections, diabetes, malnutrition, alcoholism) traditionally implicated in the genesis of NUG, and all known to promote an increase in the blood level of cortisol, as well as a Th₁ to Th₂ cytokine shift.

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Keywords

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