Influência da insuficiência renal aguda na severidade da periodontite apical
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Data
2019-06-14
Autores
Cardoso, Carolina de Barros Morais [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
Objetivo: Este trabalho teve como objetivo verificar a influência da Insuficiência Renal Aguda (IRA) na severidade da periodontite apical (PA) em Ratos Wistar. Métodos: Foram utilizados sessenta e quatro ratos divididos em 4 grupos e 2 períodos de análise (n=8): Controle (C), IRA, PA e IRA+PA. A IRA foi induzida por meio de uma aplicação diária de Gentamicina (100 mg/Kg/dia) durante 8 dias, via intraperitoneal. A PA foi induzida pela exposição pulpar dos primeiros e segundos molares superiores e inferiores do lado direito. Após 15 e 30 dias da indução da PA, os animais foram anestesiados, a urina foi coletada para a urinálise e sedimentoscopia, e o sangue foi coletado para análise do hemograma, creatinina, proteína sérica e ureia. Em seguida, os animais foram eutanasiados, os rins coletados para análise histológica e as mandíbulas e maxilas removidas e processadas para análise histomorfométrica e imunohistoquímica para IL-6, IL-17, IL-23 e TNF-α. Resultados: Para urinálise, a quantidade de proteínas foi maior nos grupos PA, IRA e IRA+PA quando comparados ao controle, em ambos os períodos experimentais (p<0,05). Na sedimentoscopia, foram encontrados cilindros granulosos, fosfato amorfo e carbonato de cálcio nos grupos IRA e IRA+PA. No hemograma, o número de hemácias, hemoglobina e volume globular foram menores nos grupos IRA e IRA+PA em 15 e 30 dias comparados aos grupos C e PA (p<0,05); já o volume corpuscular médio foi menor no grupo IRA+PA no período de 15 dias, comparado aos demais grupos (p<0.05). Com relação ao leucograma, o número de leucócitos apresentou-se maior nos grupos IRA e IRA+PA no primeiro período experimental com diferenças estatísticas significantes (p<0,05), já no segundo período experimental os grupos PA, IRA e IRA+PA não apresentaram diferenças estatísticas significantes entre si (p>0,05). Na análise dos parâmetros bioquímicos do soro, os níveis de ureia e creatinina foram maiores nos grupos IRA e IRA+PA (p<0,05), comparados aos outros grupos experimentais em ambos os períodos. Já os níveis de proteína, se apresentaram reduzidos nos grupos PA, IRA e IRA+PA, entretanto, sem diferenças estatísticas (p>0.05). Os rins foram analisados histologicamente e foi comprovada a lesão renal em todos os animais induzidos. Com relação ao infiltrado inflamatório, no primeiro período experimental o grupo PA apresentou quatro espécimes com infiltrado discreto e quatro espécimes com infiltrado moderado, enquanto o grupo IRA+PA apresentou infiltrado discreto em todos os espécimes; já no segundo período experimental, o grupo PA apresentou infiltrado inflamatório mais intenso quando comparado ao grupo IRA+PA, apresentando, desta forma, em ambos os períodos experimentais, diferença estatística significante entre os grupos (p<0.05). Na análise histométrica, o grupo PA apresentou maior perda óssea aos 15 dias quando comparado ao grupo IRA+PA (p<0,05). No segundo período experimental, ambos os grupos com PA não apresentaram diferenças estatísticas entre si (p>0,05), embora a reabsorção óssea do grupo PA tenha sido maior. Na análise imunohistoquímica, TNF-α apresentou padrão de imunomarcação variando de alto a extremamente alto no grupo PA e predominantemente baixo a moderado em IRA+PA em ambos os períodos experimentais (p<0,05). Já IL-23 apresentou padrão de imunomarcação extremamente alto de forma predominante no grupo PA e padrão alto no grupo IRA+PA aos 15 dias (p<0,05). Para IL-6 e IL-17 não houve diferenças estatísticas entre os grupos PA e IRA+PA em ambos os períodos experimentais (p>0,05). Conclusão: A partir dos resultados obtidos, foi observado que a associação da periodontite apical com a insuficiência renal aguda leva à alterações nos parâmetros sanguíneos do hemograma, parâmetros bioquímicos do soro, no perfil inflamatório, na perda óssea e no padrão de imunomarcação da lesão periapical.
Objective: This study aimed to verify the influence of Acute Renal Failure (ARF) on the severity of apical periodontitis (AP) in Wistar rats. Methods: Sixty-four rats divided into 4 groups and 2 periods of analysis (n = 8) were used: Control (C), ARF, AP and ARF+AP. IRA was induced by daily application of Gentamicin (100 mg/kg/day) for 8 days,intraperitoneal route. AP was induced by the pulp exposure of the upper and lower right and first and second molars. After 15 and 30 days of AP induction, the animals were anesthetized, the urine was collected for urinalysis and sedimentation, and the blood was collected for hemogram, creatinine, serum protein and urea analysis. Afterwards, the animals were euthanized, the kidneys collected for histological analysis and the jaws and jaws removed and processed for histomorphometric and immunohistochemical analysis for IL-6, IL-17, IL-23 and TNF-α. Results: For urinalysis, the amount of protein was higher in the AP, ARF and ARF+AP groups when compared to the control, in both experimental periods (p <0.05). In the sedimentation, granular cylinders, amorphous phosphate and calcium carbonate were found in the ARF and ARF+AP groups. In the hemogram, the number of red blood cells, hemoglobin and globular volume were lower in the ARF and ARF+AP groups at 15 and 30 days compared to the C and AP groups (p <0.05); mean corpuscular volume was lower in the ARF+AP group in the 15-day period, compared to the other groups (p <0.05). Regarding the leukogram, the number of leukocytes was higher in the ARF and ARF+AP groups in the first experimental period with significant statistical differences (p <0.05), in the second experimental period, the groups PA, IRA and ARF+AP did not present significant statistical differences among themselves (p> 0.05). In the analysis of serum biochemical parameters, urea and creatinine levels were higher in the ARF and ARF+AP groups (p <0.05), compared to the other experimental groups in both periods. Protein levels were reduced in the AP, ARF and ARF+AP groups, however, without statistical differences (p> 0.05). The kidneys were histologically analyzed and renal damage was demonstrated in all induced animals. Regarding the inflammatory infiltrate, in the first experimental period the AP group presented four specimens with discrete infiltrate and four specimens with moderate infiltration, while the ARF+AP group showed discrete infiltrate in all the specimens; in the second experimental period, the AP group presented a more intense inflammatory infiltrate when compared to the ARF+AP group, thus presenting a statistically significant difference between the groups in both experimental periods (p <0.05). In the histometric analysis, the AP group presented greater bone loss at 15 days when compared to the ARF+AP group (p <0.05). In the second experimental period, both groups with AP did not present statistical differences (p> 0.05), although the bone resorption of the AP group was higher. In the immunohistochemical analysis, TNF-α presented immunostaining pattern ranging from high to extremely high in the AP group and predominantly low to moderate in ARF + AP in both experimental periods (p <0.05). Already IL-23 presented an extremely high immunostaining pattern predominantly in the AP group and high in the ARF+AP group at 15 days (p <0.05). For IL-6 and IL-17, there were no statistical differences between the AP and ARF+AP groups in both experimental periods (p> 0.05). Conclusion: It was observed that the association of apical periodontitis with acute renal failure leads to alterations in the blood parameters of the hemogram, serum biochemical parameters, inflammatory, bone loss and the pattern of periapical lesion immunostaining.
Objective: This study aimed to verify the influence of Acute Renal Failure (ARF) on the severity of apical periodontitis (AP) in Wistar rats. Methods: Sixty-four rats divided into 4 groups and 2 periods of analysis (n = 8) were used: Control (C), ARF, AP and ARF+AP. IRA was induced by daily application of Gentamicin (100 mg/kg/day) for 8 days,intraperitoneal route. AP was induced by the pulp exposure of the upper and lower right and first and second molars. After 15 and 30 days of AP induction, the animals were anesthetized, the urine was collected for urinalysis and sedimentation, and the blood was collected for hemogram, creatinine, serum protein and urea analysis. Afterwards, the animals were euthanized, the kidneys collected for histological analysis and the jaws and jaws removed and processed for histomorphometric and immunohistochemical analysis for IL-6, IL-17, IL-23 and TNF-α. Results: For urinalysis, the amount of protein was higher in the AP, ARF and ARF+AP groups when compared to the control, in both experimental periods (p <0.05). In the sedimentation, granular cylinders, amorphous phosphate and calcium carbonate were found in the ARF and ARF+AP groups. In the hemogram, the number of red blood cells, hemoglobin and globular volume were lower in the ARF and ARF+AP groups at 15 and 30 days compared to the C and AP groups (p <0.05); mean corpuscular volume was lower in the ARF+AP group in the 15-day period, compared to the other groups (p <0.05). Regarding the leukogram, the number of leukocytes was higher in the ARF and ARF+AP groups in the first experimental period with significant statistical differences (p <0.05), in the second experimental period, the groups PA, IRA and ARF+AP did not present significant statistical differences among themselves (p> 0.05). In the analysis of serum biochemical parameters, urea and creatinine levels were higher in the ARF and ARF+AP groups (p <0.05), compared to the other experimental groups in both periods. Protein levels were reduced in the AP, ARF and ARF+AP groups, however, without statistical differences (p> 0.05). The kidneys were histologically analyzed and renal damage was demonstrated in all induced animals. Regarding the inflammatory infiltrate, in the first experimental period the AP group presented four specimens with discrete infiltrate and four specimens with moderate infiltration, while the ARF+AP group showed discrete infiltrate in all the specimens; in the second experimental period, the AP group presented a more intense inflammatory infiltrate when compared to the ARF+AP group, thus presenting a statistically significant difference between the groups in both experimental periods (p <0.05). In the histometric analysis, the AP group presented greater bone loss at 15 days when compared to the ARF+AP group (p <0.05). In the second experimental period, both groups with AP did not present statistical differences (p> 0.05), although the bone resorption of the AP group was higher. In the immunohistochemical analysis, TNF-α presented immunostaining pattern ranging from high to extremely high in the AP group and predominantly low to moderate in ARF + AP in both experimental periods (p <0.05). Already IL-23 presented an extremely high immunostaining pattern predominantly in the AP group and high in the ARF+AP group at 15 days (p <0.05). For IL-6 and IL-17, there were no statistical differences between the AP and ARF+AP groups in both experimental periods (p> 0.05). Conclusion: It was observed that the association of apical periodontitis with acute renal failure leads to alterations in the blood parameters of the hemogram, serum biochemical parameters, inflammatory, bone loss and the pattern of periapical lesion immunostaining.
Descrição
Palavras-chave
Periodontite apical, Lesão renal aguda, Inflamação, Desordens sistêmicas, Apical periodontitis, Acute kidney injury, Inflammation, Systemic disorders