THE MAIN CYTOKINES OF INFLAMMATORY RESPONSE IN PERIODONTAL TISSUES, THERAPEUTICAL TARGETS: A REVIEW

Abstract

Nowadays, inflammatory and inflammatory-dystrophic periodontal diseases are widespread in Ukraine and in many other countries. Today we have no complete and correct idea of the etiology and pathogenesis of periodontitis, thus, the ethiotropic therapy of inflammatory periodontal lesions does not solve the problem completely. Periodontitis and self-destruction of periodontal tissues also can trigger entire cascades of inflammatory and adaptive reactions in periodontal tissues. These reactions are regulated by cytokines and chemokines up to 44 names which interact with numerous receptors on cells, activate and cause the migration of macrophages, neutrophils and lymphocytes, as well as support the transformation and proliferation of the lymphocytes. Cytokines as therapeutic targets for the treatment of different diseases have been considered for a long time – that includes autoimmune diseases, collagenoses, tumors and cardiovascular lesions, in our opinion we should pay attention to such opportunities for the treatment of inflammatory and inflammatory-dystrophic periodontal lesions. The role of pro-iflammatory cytokines and chemokines in development of acute and chronic periodontitis was described for TNF-α, IFN-γ, TGF-β, IL-1 (IL-1α and 1β, interleukin 1 antagonist, IL-18), IL-2, IL-5 (eosinophilic colony-stimulating factor), IL-6, IL-8, IL-12, IL-17, IL-21, IL-23, IL-33. Anti-inflammatory properties were described for IL-4, IL-10, IL-13, IL-22, IL-35. For different therapeutic needs a row of immunobiological experimental medicines was created, some of them were approved for clinical usage in cases of autoimmune and allergic diseases. They are: “Anakinra”, “Mepolizumab”, “Reslizumab”, “Siltuximab”, “Tocilizumab”, “Sarilumab”, “Clazakizumab”, “Olokizumab”, “Sirukumab”, “Elsilimomab”, “Levilimab”, “HuMax-IL8”, “Ustekinumab”, “Secukinumab”, “Ixekizumab”, “Brodalumab”, “Guselkumab”, “Tildrakizumab”, “Riskankizumab”. Despite the lack of a complete picture of the pathogenesis of periodontal disease, some involved cytokines and their receptors in periodontal tissues are considered as markers of inflammation and regeneration processes, as well as therapeutic targets for the use of immunobiological blockers (monoclonal antibodies). Of course, such therapy is developed for systemic inflammatory and autoimmune diseases but the likelihood of their use in periodontology also looks promising.