Periodontics · patient case question
Which cytokine is most centrally involved in the tissue destruction of periodontitis?
Patient case: Deep pockets and a rising HbA1c
demo: 49-year-old female
chief: Bleeding gums and bad taste; she has noticed her front teeth are drifting.
history: Type 2 diabetes for eight years, most recent HbA1c 8.9 percent. Smokes half a pack a day. An implant placed at site 30 two years ago has recently begun to feel tender.
meds: Metformin, estradiol.
findings: Generalised probing depths of 5 to 6 mm with bleeding on probing at 62 percent of sites and no acute symptoms. Radiographs show generalised horizontal bone loss and saucer-shaped bone loss around the implant at 30 with bleeding and suppuration on probing.
Show answer and explanation
Correct answer: A. Interleukin-1 beta
- A. Correct. IL-1 beta is a principal pro-inflammatory mediator in periodontitis. It stimulates matrix metalloproteinase production, drives RANKL expression and therefore osteoclastic bone resorption, and amplifies the local inflammatory response. It acts alongside TNF-alpha, IL-6 and prostaglandin E2.
- B. IL-12 drives Th1 differentiation and matters in antimicrobial defence, but it is not the central mediator of periodontal tissue breakdown.
- C. IL-10 is anti-inflammatory and regulatory. It suppresses pro-inflammatory cytokine production and is protective rather than destructive.
- D. IL-4 is a Th2 cytokine that promotes B-cell responses and downregulates macrophage activation.