Proinflammatory Cytokines in the Saliva, Gingival Crevicular Fluid and Serum of Diabetic Patients with Periodontal Disease

Periodontal disease (PD) is a complication of diabetes mellitus (or diabetes). Various proinflammatory cytokines are expressed in the saliva, gingival crevicular fluid (GCF) and serum of diabetic patients with PD. The aim of this study was to review the proinflammatory cytokinees that are expressed in the saliva, GCF and serum of diabetic patients with PD. The addressed focused question was "Which proinflammatory cytokines are expressed in the saliva, GCF and serum of diabetic patients with PD?" Databases were explored from 1991 up to and including May 2013 using various combinations of keywords. Articles published only in English were included. Historic reviews, unpublished data, and review articles were excluded. Levels of interleukin (IL)-6 are higher in the saliva, serum and GCF of diabetic patients with PD compared to healthy controls. IL-1β and tumor necrosis factor-alpha (TNF-α) are higher in the serum and GCF of diabetic patients in PD compared to healthy controls. Weak evidence also GCF and serum suggested that resistin and visfatin are also dysregulated in diabetic patients with PD compared to controls. Raised levels of proinflammatory cytokines (including IL-1β, IL-6 and TNF-α) in the saliva, serum and GCF of diabetic patients with PD may be a valuable tool in the early detection of PD. Elevated concentrations of proinflammatory cytokines in the saliva, serum and/or GCF may also be indicative of "latent" diabetes in undiagnosed individuals.