ORIGINAL RESEARCH PAPER Gingival crevicular fluid IL-6, tPA, PAI-2, albumin levels following initial periodontal treatment in chronic periodontitis patients with or without type 2 diabetes Levent Kardes ¸ler • Nurcan Buduneli • S ¸ evki C ¸ etinkalp • David Lappin • Denis F. Kinane Received: 17 May 2010 / Revised: 13 August 2010 / Accepted: 28 August 2010 / Published online: 17 September 2010 Ó Springer Basel AG 2010 Abstract Objectives To evaluate initial periodontal treatment effects on gingival crevicular fluid (GCF) interleukin-6 (IL-6), tissue-type plasminogen activator (tPA), plasmino- gen activator inhibitor-2 (PAI-2), albumin levels in type 2 diabetic patients. Design and methods GCF samples were collected from 20 type 2 diabetic, 22 non-diabetic non-smokers all with chronic periodontitis at baseline, 1-, 3-months following initial periodontal treatment. Biochemical analysis was performed by ELISA. Data were tested by Mann–Whitney U, Wilcoxon tests. Results The total amounts of albumin, IL-6, tPA, PAI-2 decreased significantly in diabetics after treatment (1- and 3-months) whereas, only PAI-2 decreased in non-diabetic group at 3-months (p \ 0.05). There were statistically significant differences between the diabetics and non- diabetics at all time points for albumin, PAI-2 and at 1-, 3-months for GCF volume (p \ 0.050) but only at baseline for IL-6 (p \ 0.050). Conclusion Present data suggest clinical improvements are less apparent in diabetic chronic periodontitis patients as reflected by disease markers in GCF and by an increase in concentrations of inflammatory proteins IL-6, tPA, and PAI-2 in GCF of this patient group following initial perio- dontal treatment. Keywords Diabetes mellitus Á ELISA Á Gingival crevicular fluid Á IL-6 Á Plasminogen activators Á Periodontal disease Introduction Periodontitis is regarded as a chronic local oral infection that triggers not only a local but also a systemic immuno- inflammatory response [1]. Periodontitis is considered a risk factor for various systemic diseases including diabetes [2]. Obesity, insulin resistance, hyperglycemia and diabetes are strongly related to an increase in circulating levels of pro-inflammatory cytokines like interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-a). These cytokines stimulate C-reactive protein (CRP) and fibrinogen synthe- sis by the liver [3]. Periodontal disease and diabetes are highly prevalent chronic diseases and inflammation may play a critical role in their relationship [4, 5]. Studies suggest that periodontitis patients have significantly higher serum markers of inflammation such as CRP, TNF-a and IL-6 [6–8]. Type 2 diabetes mellitus (DM), on the other hand, is a multifactorial metabolic disorder characterized by chronic hyperglycemia with disturbances of carbohy- drate, fat, and protein metabolism. Defects in insulin Responsible Editor: Claudia Kasserra. L. Kardes ¸ler Á N. Buduneli (&) Department of Periodontology, School of Dentistry, Ege University, 35100 Bornova, _ Izmir, Turkey e-mail: nurcan.buduneli@ege.edu.tr; nurcanbuduneli@yahoo.com S ¸. C ¸ etinkalp Department of Metabolic Diseases and Endocrinology, School of Medicine, Ege University, _ Izmir, Turkey D. Lappin Infection and Immunity Group, Glasgow Dental School, School of Medicine, University of Glasgow, Glasgow, UK D. F. Kinane Department of Periodontology, School of Dentistry, University of Louisville, Louisville, KY, USA Inflamm. Res. (2011) 60:143–151 DOI 10.1007/s00011-010-0248-7 Inflammation Research 123