Effects of Calcium Hydroxide Intracanal Medications on T Helper (Th1, Th2, Th9, Th17, and Tfh) and Regulatory T (Treg) Cell Cytokines in Apical Periodontitis: A CONSORT RCT

Flavia F.C. Teixeira; Flavia G.R. Cardoso; Nadia S. Ferreira; Bruna J.M. Corazza; Marcia M.C. Valera; Gustavo G. Nascimento; Frederico C. Martinho

doi:10.1016/j.joen.2022.04.010

Effects of Calcium Hydroxide Intracanal Medications on T Helper (Th1, Th2, Th9, Th17, and Tfh) and Regulatory T (Treg) Cell Cytokines in Apical Periodontitis: A CONSORT RCT

Flavia F.C. Teixeira, Flavia G.R. Cardoso, Nadia S. Ferreira, Bruna J.M. Corazza, Marcia M.C. Valera, Gustavo G. Nascimento, Frederico C. Martinho^*

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

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Abstract

Introduction: This Consolidated Standards of Reporting Trials randomized clinical trial investigated T helper (Th1, Th2, Th9, Th17, and Tfh) and regulatory T (Treg) cell–type cytokines and their networks in apical periodontitis (AP). We also assessed the effects of calcium hydroxide [Ca(OH)2] intracanal medications (ICMs) on helper T and Treg cell–type cytokines. Methods: Twenty teeth with primary endodontic infection and apical periodontitis were randomly divided into two groups: Ca(OH)2 + saline solution (n = 10) and Ca (OH)2 + 2% chlorhexidine-gel (n = 10). Samples were collected from the periradicular tissue fluid (PTF) before (PTFs1) and after 14 days of ICMs (PTFs2). The Human High Sensitivity T Cell Panel was used to quantify target T-helper (Th)1: interelukin (IL)-2, IL-12, and interferon-gamma (IFN-γ); Th2: IL-4, IL-5, and IL-13; Th9: IL-9; Th17: IL-17; T follicular helper cells (Tfh): IL-21; and Treg-cell-type cytokine: IL-10. Results: Th1-type cytokines were higher than Th2-type ones, at PTFs1. Positive (+) associations were found among all Th1-type cytokines and all Th2-type cytokines. There were negative (-) correlations between all Th1- and Th2-type cytokines. Size of radiolucent lesions and symptoms (tenderness to percussion and/or pain on palpation) were positively correlated with Th1-type cytokines, IL-17, and IL-21 but negatively correlated with Th2-type cytokines and IL-10 (all, P <.001). Both ICMs increased Th2-type cytokines and IL-10 (P <.05) and decreased Th1-type cytokines, IL-17, and IL-21 (P <.05), with no differences among them (P >.05). Conclusions: Complex T-cell cytokine networks are involved in AP. Both Ca(OH)2 ICMs effectively increased IL-4, IL-5, IL-10, and IL-13 and lowered IL-2, IL-12, IL-17, IL-21, and IFN-γ.

Original language	English
Journal	Journal of Endodontics
Volume	48
Issue	8
Pages (from-to)	975-984
Number of pages	10
ISSN	0099-2399
DOIs	https://doi.org/10.1016/j.joen.2022.04.010
Publication status	Published - Aug 2022

Keywords

Cytokines
endodontics
inflammation
intracanal medication
root canal
T-helper

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10.1016/j.joen.2022.04.010

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Teixeira, F. F. C., Cardoso, F. G. R., Ferreira, N. S., Corazza, B. J. M., Valera, M. M. C., Nascimento, G. G., & Martinho, F. C. (2022). Effects of Calcium Hydroxide Intracanal Medications on T Helper (Th1, Th2, Th9, Th17, and Tfh) and Regulatory T (Treg) Cell Cytokines in Apical Periodontitis: A CONSORT RCT. Journal of Endodontics, 48(8), 975-984. https://doi.org/10.1016/j.joen.2022.04.010

@article{54048af1738b48deaceba7cd49e4be68,

title = "Effects of Calcium Hydroxide Intracanal Medications on T Helper (Th1, Th2, Th9, Th17, and Tfh) and Regulatory T (Treg) Cell Cytokines in Apical Periodontitis: A CONSORT RCT",

abstract = "Introduction: This Consolidated Standards of Reporting Trials randomized clinical trial investigated T helper (Th1, Th2, Th9, Th17, and Tfh) and regulatory T (Treg) cell–type cytokines and their networks in apical periodontitis (AP). We also assessed the effects of calcium hydroxide [Ca(OH)2] intracanal medications (ICMs) on helper T and Treg cell–type cytokines. Methods: Twenty teeth with primary endodontic infection and apical periodontitis were randomly divided into two groups: Ca(OH)2 + saline solution (n = 10) and Ca (OH)2 + 2% chlorhexidine-gel (n = 10). Samples were collected from the periradicular tissue fluid (PTF) before (PTFs1) and after 14 days of ICMs (PTFs2). The Human High Sensitivity T Cell Panel was used to quantify target T-helper (Th)1: interelukin (IL)-2, IL-12, and interferon-gamma (IFN-γ); Th2: IL-4, IL-5, and IL-13; Th9: IL-9; Th17: IL-17; T follicular helper cells (Tfh): IL-21; and Treg-cell-type cytokine: IL-10. Results: Th1-type cytokines were higher than Th2-type ones, at PTFs1. Positive (+) associations were found among all Th1-type cytokines and all Th2-type cytokines. There were negative (-) correlations between all Th1- and Th2-type cytokines. Size of radiolucent lesions and symptoms (tenderness to percussion and/or pain on palpation) were positively correlated with Th1-type cytokines, IL-17, and IL-21 but negatively correlated with Th2-type cytokines and IL-10 (all, P <.001). Both ICMs increased Th2-type cytokines and IL-10 (P <.05) and decreased Th1-type cytokines, IL-17, and IL-21 (P <.05), with no differences among them (P >.05). Conclusions: Complex T-cell cytokine networks are involved in AP. Both Ca(OH)2 ICMs effectively increased IL-4, IL-5, IL-10, and IL-13 and lowered IL-2, IL-12, IL-17, IL-21, and IFN-γ.",

keywords = "Cytokines, endodontics, inflammation, intracanal medication, root canal, T-helper",

author = "Teixeira, {Flavia F.C.} and Cardoso, {Flavia G.R.} and Ferreira, {Nadia S.} and Corazza, {Bruna J.M.} and Valera, {Marcia M.C.} and Nascimento, {Gustavo G.} and Martinho, {Frederico C.}",

note = "Publisher Copyright: {\textcopyright} 2022 American Association of Endodontists",

year = "2022",

month = aug,

doi = "10.1016/j.joen.2022.04.010",

language = "English",

volume = "48",

pages = "975--984",

journal = "Journal of Endodontics",

issn = "0099-2399",

publisher = "Elsevier Inc.",

number = "8",

}

Teixeira, FFC, Cardoso, FGR, Ferreira, NS, Corazza, BJM, Valera, MMC, Nascimento, GG & Martinho, FC 2022, 'Effects of Calcium Hydroxide Intracanal Medications on T Helper (Th1, Th2, Th9, Th17, and Tfh) and Regulatory T (Treg) Cell Cytokines in Apical Periodontitis: A CONSORT RCT', Journal of Endodontics, vol. 48, no. 8, pp. 975-984. https://doi.org/10.1016/j.joen.2022.04.010

Effects of Calcium Hydroxide Intracanal Medications on T Helper (Th1, Th2, Th9, Th17, and Tfh) and Regulatory T (Treg) Cell Cytokines in Apical Periodontitis: A CONSORT RCT. / Teixeira, Flavia F.C.; Cardoso, Flavia G.R.; Ferreira, Nadia S. et al.
In: Journal of Endodontics, Vol. 48, No. 8, 08.2022, p. 975-984.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Effects of Calcium Hydroxide Intracanal Medications on T Helper (Th1, Th2, Th9, Th17, and Tfh) and Regulatory T (Treg) Cell Cytokines in Apical Periodontitis

T2 - A CONSORT RCT

AU - Teixeira, Flavia F.C.

AU - Cardoso, Flavia G.R.

AU - Ferreira, Nadia S.

AU - Corazza, Bruna J.M.

AU - Valera, Marcia M.C.

AU - Nascimento, Gustavo G.

AU - Martinho, Frederico C.

PY - 2022/8

Y1 - 2022/8

N2 - Introduction: This Consolidated Standards of Reporting Trials randomized clinical trial investigated T helper (Th1, Th2, Th9, Th17, and Tfh) and regulatory T (Treg) cell–type cytokines and their networks in apical periodontitis (AP). We also assessed the effects of calcium hydroxide [Ca(OH)2] intracanal medications (ICMs) on helper T and Treg cell–type cytokines. Methods: Twenty teeth with primary endodontic infection and apical periodontitis were randomly divided into two groups: Ca(OH)2 + saline solution (n = 10) and Ca (OH)2 + 2% chlorhexidine-gel (n = 10). Samples were collected from the periradicular tissue fluid (PTF) before (PTFs1) and after 14 days of ICMs (PTFs2). The Human High Sensitivity T Cell Panel was used to quantify target T-helper (Th)1: interelukin (IL)-2, IL-12, and interferon-gamma (IFN-γ); Th2: IL-4, IL-5, and IL-13; Th9: IL-9; Th17: IL-17; T follicular helper cells (Tfh): IL-21; and Treg-cell-type cytokine: IL-10. Results: Th1-type cytokines were higher than Th2-type ones, at PTFs1. Positive (+) associations were found among all Th1-type cytokines and all Th2-type cytokines. There were negative (-) correlations between all Th1- and Th2-type cytokines. Size of radiolucent lesions and symptoms (tenderness to percussion and/or pain on palpation) were positively correlated with Th1-type cytokines, IL-17, and IL-21 but negatively correlated with Th2-type cytokines and IL-10 (all, P <.001). Both ICMs increased Th2-type cytokines and IL-10 (P <.05) and decreased Th1-type cytokines, IL-17, and IL-21 (P <.05), with no differences among them (P >.05). Conclusions: Complex T-cell cytokine networks are involved in AP. Both Ca(OH)2 ICMs effectively increased IL-4, IL-5, IL-10, and IL-13 and lowered IL-2, IL-12, IL-17, IL-21, and IFN-γ.

AB - Introduction: This Consolidated Standards of Reporting Trials randomized clinical trial investigated T helper (Th1, Th2, Th9, Th17, and Tfh) and regulatory T (Treg) cell–type cytokines and their networks in apical periodontitis (AP). We also assessed the effects of calcium hydroxide [Ca(OH)2] intracanal medications (ICMs) on helper T and Treg cell–type cytokines. Methods: Twenty teeth with primary endodontic infection and apical periodontitis were randomly divided into two groups: Ca(OH)2 + saline solution (n = 10) and Ca (OH)2 + 2% chlorhexidine-gel (n = 10). Samples were collected from the periradicular tissue fluid (PTF) before (PTFs1) and after 14 days of ICMs (PTFs2). The Human High Sensitivity T Cell Panel was used to quantify target T-helper (Th)1: interelukin (IL)-2, IL-12, and interferon-gamma (IFN-γ); Th2: IL-4, IL-5, and IL-13; Th9: IL-9; Th17: IL-17; T follicular helper cells (Tfh): IL-21; and Treg-cell-type cytokine: IL-10. Results: Th1-type cytokines were higher than Th2-type ones, at PTFs1. Positive (+) associations were found among all Th1-type cytokines and all Th2-type cytokines. There were negative (-) correlations between all Th1- and Th2-type cytokines. Size of radiolucent lesions and symptoms (tenderness to percussion and/or pain on palpation) were positively correlated with Th1-type cytokines, IL-17, and IL-21 but negatively correlated with Th2-type cytokines and IL-10 (all, P <.001). Both ICMs increased Th2-type cytokines and IL-10 (P <.05) and decreased Th1-type cytokines, IL-17, and IL-21 (P <.05), with no differences among them (P >.05). Conclusions: Complex T-cell cytokine networks are involved in AP. Both Ca(OH)2 ICMs effectively increased IL-4, IL-5, IL-10, and IL-13 and lowered IL-2, IL-12, IL-17, IL-21, and IFN-γ.

KW - Cytokines

KW - endodontics

KW - inflammation

KW - intracanal medication

KW - root canal

KW - T-helper

UR - http://www.scopus.com/inward/record.url?scp=85131819766&partnerID=8YFLogxK

U2 - 10.1016/j.joen.2022.04.010

DO - 10.1016/j.joen.2022.04.010

M3 - Journal article

C2 - 35487475

AN - SCOPUS:85131819766

SN - 0099-2399

VL - 48

SP - 975

EP - 984

JO - Journal of Endodontics

JF - Journal of Endodontics

IS - 8

ER -

Effects of Calcium Hydroxide Intracanal Medications on T Helper (Th1, Th2, Th9, Th17, and Tfh) and Regulatory T (Treg) Cell Cytokines in Apical Periodontitis: A CONSORT RCT

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