OBJECTIVE: The aim of this study was to: (1) evaluate the anti-inflammatory effects of cannabidiol (CBD) on primary cultures of human gingival fibroblasts (HGFs) and (2) to clinically monitor the effect of CBD in subjects with periodontitis. BACKGROUND: The use of phytocannabinoids is a new approach in the treatment of widely prevalent periodontal disease. MATERIALS AND METHODS: Cannabinoid receptors were analyzed by western blot and interleukin production detected using enzyme immunoassay. Activation of the Nrf2 pathway was studied via monitoring the mRNA level of heme oxygenase-1. Antimicrobial effects were determined by standard microdilution and 16S rRNA screening. In the clinical part, a placebo-control double-blind randomized study was conducted (56 days) in three groups (n = 90) using dental gel without CBD (group A) and with 1% (w/w) CBD (group B) and corresponding toothpaste (group A - no CBD, group B - with CBD) for home use to maintain oral health. Group C used dental gel containing 1% chlorhexidine digluconate (active comparator) and toothpaste without CBD. RESULTS: Human gingival fibroblasts were confirmed to express the cannabinoid receptor CB2. Lipopolysaccharide-induced cells exhibited increased production of pro-inflammatory IL-6 and IL-8, with deceasing levels upon exposure to CBD. CBD also exhibited antimicrobial activities against Porphyromonas gingivalis, with an MIC of 1.5 μg/mL. Activation of the Nrf2 pathway was also demonstrated. In the clinical part, statistically significant improvement was found for the gingival, gingival bleeding, and modified gingival indices between placebo group A and CBD group B after 56 days. CONCLUSIONS: Cannabidiol reduced inflammation and the growth of selected periodontal pathogenic bacteria. The clinical trial demonstrated a statistically significant improvement after CBD application. No adverse effects of CBD were reported by patients or observed upon clinical examination during the study. The results are a promising basis for a more comprehensive investigation of the application of non-psychotropic cannabinoids in dentistry.
- MeSH
- antiflogistika terapeutické užití farmakologie MeSH
- chlorhexidin terapeutické užití farmakologie analogy a deriváty MeSH
- dospělí MeSH
- dvojitá slepá metoda MeSH
- faktor 2 související s NF-E2 MeSH
- fibroblasty * účinky léků MeSH
- gingiva * účinky léků MeSH
- gingivitida * farmakoterapie MeSH
- hemoxygenasa-1 MeSH
- interleukin-6 analýza MeSH
- interleukin-8 účinky léků MeSH
- kanabidiol * farmakologie terapeutické užití MeSH
- kultivované buňky MeSH
- lidé středního věku MeSH
- lidé MeSH
- parodontitida farmakoterapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
Úvod: Cílem této studie bylo porovnat hodnoty interleukinu-6 v pupečníkové a periferní krvi novorozence. Klinickým cílem bylo zjistit, zda lze vyšetřením krve z pupečníku nahradit brzký postnatální odběr periferní krve. Pacienti a metody: Do studie byli zahrnuti novorozenci (< 35. týden gestace) narození v roce 2016–2018 ve Fakultní nemocnici Olomouc. U těchto novorozenců se zároveň podařilo odebrat dostatečné množství krve z pupečníku. Výsledky: Párový odběr se zdařil u 73 novorozenců. Mezi pupečníkovou a periferní hodnotou interleukinu-6 byl zjištěn významný rozdíl (p < 0,001). Medián prvního měření (pupečníková krev) byl 6,5 ng/l, medián druhého měření (periferní krev) 56 ng/l. Nárůst je téměř desetinásobný. Závěr: Hodnoty interleukinu-6 z pupečníkové krve a z časného postnatálního odběru se podstatně liší. Na tuto skutečnost je nutné myslet při jeho klinickém využití.
Introduction: The aim of this study was to compare interleukin-6 values in umbilical cord and peripheral blood of newborns. The clinical goal was to determine whether the examination of cord blood can replace early postnatal peripheral blood collection. Patients and methods: Study included premature newborns (< 35th week of gestation) born in 2016-2018 at Olomouc University Hospital. At the same time, it was possible to collect a sufficient amount of blood from the umbilical cord in these newborns. Results: Paired sampling was successful in 73 of these newborns. A significant difference (p < 0,001) was found between the umbilical cord and peripheral interleukin-6 values. The median of the first measurement (cord blood) was 6,5 ng/l, the median of the second measurement (peripheral blood) was 56 ng/l. The increase is almost ten times bigger. Conclusion: The difference of values between interleukin-6 from umbilical cord blood and from early postnatal collection are significantly different and it is necessary to keep it in mind during its clinical use.
- MeSH
- fetální krev imunologie MeSH
- interleukin-6 * analýza izolace a purifikace krev MeSH
- krev imunologie MeSH
- lidé MeSH
- novorozenec nedonošený imunologie krev MeSH
- novorozenec MeSH
- novorozenecká sepse diagnóza etiologie imunologie prevence a kontrola MeSH
- prospektivní studie MeSH
- pupečník imunologie krevní zásobení MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- Publikační typ
- práce podpořená grantem MeSH
- Klíčová slova
- siltuximab,
- MeSH
- chemokin CXCL13 analýza MeSH
- hormony kůry nadledvin terapeutické užití MeSH
- hyperplazie velkých lymfatických uzlin * diagnóza farmakoterapie klasifikace MeSH
- interleukin-6 analýza antagonisté a inhibitory škodlivé účinky MeSH
- klinická studie jako téma MeSH
- kongresy jako téma MeSH
- léková rezistence MeSH
- lidé MeSH
- management nemoci MeSH
- monoklonální protilátky aplikace a dávkování škodlivé účinky terapeutické užití MeSH
- multiorgánové selhání etiologie MeSH
- protinádorové látky imunologicky aktivní terapeutické užití MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- novinové články MeSH
Zápal je všeobecná obranná reakcia tela proti rôznym škodlivým podráždeniam. Diagnostika zápalového procesu a monitorovanie jeho liečby je založené na kombinácii klinických a laboratórnych nálezov. Biochemické zápalové markery slúžia obvykle na podporu diagnózy infekcie, na jej monitorovanie a sledovanie efektívnosti antiinfekčnej liečby. Zápalový marker je potrebné vyberať podľa klinického stavu s ohľadom na zradnosť a nedostatky markerov, so znalosťou ich dynamiky a s ohľadom na dĺžku anamnézy. Ako optimálny postup pri zistení bakteriálnej infekcie sa odporúča vyšetrovať viaceré proteíny akútnej fázy. Je úlohou lekára určiť, kedy, za akých okolností, a ktorý marker nechať vyšetriť s ohľadom na to, aby pacient bol včas správne diagnostikovaný a dostal adekvátnu liečbu, a na druhú stranu, aby nebol zbytočne iatrogenizovaný a aby zdravotnícke zariadenie zbytočne neprichádzalo o financie.
Inflammation is the general defense response of the body against various harmful irritations. Diagnosis of the inflammatory process and monitoring of its treatment is based on a combination of clinical and laboratory findings. Biochemical inflammatory markers usually serve to support the diagnosis of the infection, to monitor it, and to monitor the effectiveness of anti-infective treatment. The inflammatory marker should be selected according to the clinical condition with regard to the treachery and deficiencies of the markers, with knowledge of their dynamics and with regard to the length of the anamnesis. As an optimal procedure for detecting bacterial infection, it is recommended to screen for several acute phase proteins. The role of the physician is to determine when, under which circumstances, and which markers to have examined, with a view to ensuring that the patient is correctly diagnosed in time and receives appropriate treatment, and on the other hand, that he is not unnecessarily iatrogenized and that the medical facility does not lose money unnecessarily.
- MeSH
- biologické markery * MeSH
- C-reaktivní protein analýza MeSH
- interleukin-6 analýza MeSH
- lidé MeSH
- orosomukoid analýza MeSH
- prokalcitonin analýza MeSH
- zánět * diagnóza MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
OBJECTIVE: To determine the concentration of interleukin-6 (IL-6) in the cervical fluid in women with spontaneous preterm labor with intact fetal membranes (PTL) complicated by intra-amniotic infection (the presence of both microbial invasion of the amniotic cavity and intra-amniotic inflammation), or sterile intra-amniotic inflammation (the presence of intra-amniotic inflammation alone). METHODS: Eighty women with singleton pregnancies complicated by PTL between gestational ages 22 + 0 and 34 + 6 weeks were included in this retrospective cohort study. Samples of amniotic and cervical fluids were collected at the time of admission. Amniotic fluid samples were obtained via transabdominal amniocentesis, and cervical fluid was obtained using a Dacron polyester swab. Microbial invasion of the amniotic cavity was diagnosed based on the combination of culture and molecular biology methods. The concentration of IL-6 in the amniotic and cervical fluids were measured using an automated electrochemiluminescence immunoassay method. Intra-amniotic inflammation was defined as an amniotic fluid IL-6 concentration ≥3000 pg/mL. RESULTS: The presence of intra-amniotic infection and sterile inflammation was identified in 15% (12/80) and 26% (21/80) of the women, respectively. Women with intra-amniotic infection (median: 587 pg/mL; p = .01) and with sterile intra-amniotic inflammation (median: 590 pg/mL; p = .005) had higher concentrations of IL-6 in the cervical fluid than those without intra-amniotic inflammation (intra-amniotic infection: median 587 pg/mL vs. without inflammation, median: 136 pg/mL; p = .01; sterile intra-amniotic inflammation, median: 590 pg/mL vs. without inflammation, p = .005). No differences were found in the concentrations of IL-6 in the cervical fluid between women with intra-amniotic infection and sterile intra-amniotic inflammation (p = .81). CONCLUSION: In pregnancies with PTL, both forms of intra-amniotic inflammation are associated with elevated concentrations of IL-6 in the cervical fluid.
- MeSH
- chorioamnionitida * diagnóza MeSH
- gestační stáří MeSH
- interleukin-6 analýza MeSH
- lidé MeSH
- novorozenec MeSH
- plodová voda MeSH
- předčasná porodní činnost * diagnóza MeSH
- předčasný odtok plodové vody * MeSH
- retrospektivní studie MeSH
- těhotenství MeSH
- zánět MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVE: To determine the association between microbial invasion of the amniotic cavity (MIAC) and/or intra-amniotic inflammation (IAI) and the cervical prevalence of Gardnerella vaginalis DNA in pregnancies with preterm prelabor rupture of membrane (PPROM). METHOD: In total, 405 women with singleton pregnancies complicated with PPROM were included. Cervical fluid and amniotic fluid samples were collected at the time of admission. Bacterial and G. vaginalis DNA were assessed in the cervical fluid samples using quantitative PCR technique. Concentrations of interleukin-6 and MIAC were evaluated in the amniotic fluid samples. Loads of G. vaginalis DNA ≥ 1% of the total cervical bacterial DNA were used to define the cervical prevalence of G. vaginalis as abundant. Based on the MIAC and IAI, women were categorized into four groups: with intra-amniotic infection (both MIAC and IAI), with sterile IAI (IAI without MIAC), with MIAC without IAI, and without either MIAC or IAI. RESULTS: The presence of the abundant cervical G. vaginalis was related to MIAC (with: 65% vs. without: 44%; p = 0.0004) but not IAI (with: 52% vs. without: 48%; p = 0.70). Women with MIAC without IAI had the highest load of the cervical G. vaginalis DNA (median 2.0 × 104 copies DNA/mL) and the highest presence of abundant cervical G. vaginalis (73%). CONCLUSIONS: In women with PPROM, the presence of cervical G. vaginalis was associated with MIAC, mainly without the concurrent presence of IAI.
- MeSH
- cervix uteri mikrobiologie MeSH
- chorioamnionitida mikrobiologie MeSH
- dospělí MeSH
- Gardnerella vaginalis izolace a purifikace MeSH
- interleukin-6 analýza MeSH
- lidé MeSH
- plodová voda chemie mikrobiologie MeSH
- předčasný odtok plodové vody mikrobiologie MeSH
- prospektivní studie MeSH
- těhotenství MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: Preterm prelabor rupture of the membranes (PPROM) is frequently complicated by intraamniotic inflammatory processes such as intraamniotic infection and sterile intraamniotic inflammation. Antibiotic therapy is recommended to patients with PPROM to prolong the interval between this complication and delivery (latency period), reduce the risk of clinical chorioamnionitis, and improve neonatal outcome. However, there is a lack of information regarding whether the administration of antibiotics can reduce the intensity of the intraamniotic inflammatory response or eradicate microorganisms in patients with PPROM. OBJECTIVE: The first aim of the study was to determine whether antimicrobial agents can reduce the magnitude of the intraamniotic inflammatory response in patients with PPROM by assessing the concentrations of interleukin-6 in amniotic fluid before and after antibiotic treatment. The second aim was to determine whether treatment with intravenous clarithromycin changes the microbial load of Ureaplasma spp DNA in amniotic fluid. STUDY DESIGN: A retrospective cohort study included patients who had (1) a singleton gestation, (2) PPROM between 24+0 and 33+6 weeks, (3) a transabdominal amniocentesis at the time of admission, and (4) intravenous antibiotic treatment (clarithromycin for patients with intraamniotic inflammation and benzylpenicillin/clindamycin in the cases of allergy in patients without intraamniotic inflammation) for 7 days. Follow-up amniocenteses (7th day after admission) were performed in the subset of patients with a latency period lasting longer than 7 days. Concentrations of interleukin-6 were measured in the samples of amniotic fluid with a bedside test, and the presence of microbial invasion of the amniotic cavity was assessed with culture and molecular microbiological methods. Intraamniotic inflammation was defined as a bedside interleukin-6 concentration ≥745 pg/mL in the samples of amniotic fluid. Intraamniotic infection was defined as the presence of both microbial invasion of the amniotic cavity and intraamniotic inflammation; sterile intraamniotic inflammation was defined as the presence of intraamniotic inflammation without microbial invasion of the amniotic cavity. RESULTS: A total of 270 patients with PPROM were included in this study: 207 patients delivered within 7 days and 63 patients delivered after 7 days of admission. Of the 63 patients who delivered after 7 days following the initial amniocentesis, 40 underwent a follow-up amniocentesis. Patients with intraamniotic infection (n = 7) and sterile intraamniotic inflammation (n = 7) were treated with intravenous clarithromycin. Patients without either microbial invasion of the amniotic cavity or intraamniotic inflammation (n = 26) were treated with benzylpenicillin or clindamycin. Treatment with clarithromycin decreased the interleukin-6 concentration in amniotic fluid at the follow-up amniocentesis compared to the initial amniocentesis in patients with intraamniotic infection (follow-up: median, 295 pg/mL, interquartile range [IQR], 72-673 vs initial: median, 2973 pg/mL, IQR, 1750-6296; P = .02) and in those with sterile intraamniotic inflammation (follow-up: median, 221 pg/mL, IQR 118-366 pg/mL vs initial: median, 1446 pg/mL, IQR, 1300-2941; P = .02). Samples of amniotic fluid with Ureaplasma spp DNA had a lower microbial load at the time of follow-up amniocentesis compared to the initial amniocentesis (follow-up: median, 1.8 × 104 copies DNA/mL, 2.9 × 104 to 6.7 × 108 vs initial: median, 4.7 × 107 copies DNA/mL, interquartile range, 2.9 × 103 to 3.6 × 107; P = .03). CONCLUSION: Intravenous therapy with clarithromycin was associated with a reduction in the intensity of the intraamniotic inflammatory response in patients with PPROM with either intraamniotic infection or sterile intraamniotic inflammation. Moreover, treatment with clarithromycin was related to a reduction in the load of Ureaplasma spp DNA in the amniotic fluid of patients with PPROM <34 weeks of gestation.
- MeSH
- antibakteriální látky terapeutické užití MeSH
- bakteriální infekce etiologie prevence a kontrola MeSH
- chorioamnionitida etiologie prevence a kontrola MeSH
- DNA bakterií analýza MeSH
- dospělí MeSH
- interleukin-6 analýza MeSH
- klarithromycin terapeutické užití MeSH
- klindamycin terapeutické užití MeSH
- kohortové studie MeSH
- lidé MeSH
- penicilin G terapeutické užití MeSH
- plodová voda chemie MeSH
- předčasný odtok plodové vody * MeSH
- retrospektivní studie MeSH
- těhotenství MeSH
- Ureaplasma genetika MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Research Support, N.I.H., Extramural MeSH
- Klíčová slova
- tocilizumab,
- MeSH
- biologické markery MeSH
- COVID-19 * diagnóza komplikace krev mortalita patologie prevence a kontrola MeSH
- farmakoterapie COVID-19 MeSH
- humanizované monoklonální protilátky terapeutické užití MeSH
- interleukin-6 * analýza antagonisté a inhibitory MeSH
- klinická studie jako téma MeSH
- klinické laboratorní techniky MeSH
- lidé MeSH
- SARS-CoV-2 patogenita MeSH
- statistika jako téma MeSH
- syndrom uvolnění cytokinů MeSH
- Check Tag
- lidé MeSH
- MeSH
- antigeny CD14 analýza MeSH
- biologické markery analýza MeSH
- C-reaktivní protein analýza MeSH
- interleukin-6 analýza MeSH
- kultivační vyšetření krve metody MeSH
- leukocytární L1-antigenní komplex analýza MeSH
- lidé MeSH
- novorozenec MeSH
- novorozenecká sepse * diagnóza MeSH
- prokalcitonin analýza MeSH
- receptory IgG analýza MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- MeSH
- biologické markery MeSH
- cerkláž cervikální MeSH
- chorioamnionitida klasifikace patofyziologie prevence a kontrola MeSH
- inkompetence hrdla děložního * chirurgie diagnostické zobrazování MeSH
- interleukin-6 analýza MeSH
- lidé MeSH
- plodová voda imunologie mikrobiologie účinky léků MeSH
- předčasný porod prevence a kontrola MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH