Periodontal health related-inflammatory and metabolic profiles of patients with end-stage renal disease: potential strategy for predictive, preventive, and personalized medicine

Abstract

Objectives: To compare the periodontal health related-inflammatory and metabolic differences between patients with end-stage renal disease (ESRD) and healthy controls (HC), and to identify potential biomarkers in gingival crevicular fluid (GCF) and serum of ESRD patients for predictive, preventive, and personalized medicine (PPPM).

Methods: Patients with ESRD (ESRD group; n = 52) and healthy controls (HC group; n = 44) were recruited. Clinical periodontal parameters were recorded. The differential metabolites in the GCF and serum were identified by liquid chromatography/mass spectrometry (LC/MS). Inflammatory markers including interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), and C-reactive protein (CRP) were also assessed.

Results: In the ESRD group, IL-8 and CRP were significantly higher in GCF, whereas IL-6 and CRP were significantly higher in serum, compared with HC group (all P < 0.05). In the case of GCF, taurine levels were positively correlated with IL-8 levels in both groups (all P < 0.05). In the case of serum, l-phenylalanine and p-hydroxyphenylacetic acid levels were positively correlated with CRP levels in both groups (all P < 0.05). Significant positive correlations were observed between metabolites (including pseudouridine, l-phenylalanine, and p-hydroxyphenylacetic acid) and IL-6 levels only in ESRD group.

Conclusions: IL-8 and CRP are potential inflammatory makers that reflect the periodontal health of ESRD individual, which may be considered the valuable predictive diagnostics in the agreement with PPPM philosophy. Besides, metabolites of taurine in GCF as well as l-phenylalanine and p-hydroxyphenylacetic acid in serum are possible biomarkers correlated with inflammatory markers. All these biomarkers may also be highly recommended as a novel predictive/diagnostic tool for the assessment of inflammatory status from the perspectives of PPPM in view of susceptible population and individual screening.

Keywords: C-reactive protein; COVID-19; Chronic kidney disease; Disease-specific metabolic profile; End-stage renal disease; Gingival crevicular fluid; Inflammation; Interleukin-6; Interleukin-8; Mass spectrometry; Metabolites; Periodontal health; Predictive preventive personalized medicine; Serum.

Fig. 1

Metabolic profile of serum based on LC–MS. a Heatmap of metabolites between the ESRD group and the HC group. b PCA score plot model of serum samples. c OPLS-DA score plot of serum samples. d OPLS-DA permutation plot of serum samples. LC–MS, liquid chromatography/mass spectrometry; ESRD, end-stage renal disease; HC, healthy controls; OPLS-DA, orthogonal partial least-squares discriminant analysis; PCA, principal component analysis

Fig. 2

Metabolic profile of GCF based on LC–MS. a Heatmap of metabolites between ESRD group and HC group. b PCA score plot model of GCF samples. c OPLS-DA score plot of GCF samples. d OPLS-DA permutation plot of GCF samples. LC–MS, liquid chromatography/mass spectrometry; ESRD, end-stage renal disease; HC, healthy controls; OPLS-DA, orthogonal partial least-squares discriminant analysis; PCA, principal component analysis