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Macrophage cell activation with acute apical abscess contents determined by interleukin-1 Beta and tumor necrosis

Ezilmara L R Sousa1, Frederico C Martinho2, Fabio R M Leite3

  • 1Department of Restorative Dentistry, Endodontics Division, Piracicaba Dental School, State University of Campinas, UNICAMP, Piracicaba, São Paulo, Brazil; Department of Conservative Dentistry, Endodontics Division, Pelotas School of Dentistry.

Journal of Endodontics
|September 11, 2014
PubMed
Abstract

Insights

Acute apical abscess (AAA) exudates have higher endotoxin levels and stimulate macrophages more than root canal samples. Intracanal medication reduces bacteria and endotoxins, lowering inflammatory potential.

Area of Science:

  • Endodontology
  • Immunology
  • Microbiology

Background:

  • Investigated antigenic activity of bacterial contents from acute apical abscesses (AAAs) and paired root canal samples.
  • Assessed stimulation capacity on macrophage cells via interleukin (IL)-1 beta and tumor necrosis factor alpha (TNF-α) levels.
  • Evaluated immune response throughout root canal treatment.

Purpose of the Study:

  • To compare the antigenic activity and inflammatory potential of AAA exudates versus root canal contents.
  • To determine the effect of root canal treatment stages on bacterial load, endotoxin levels, and macrophage stimulation.
  • To evaluate the efficacy of calcium hydroxide + chlorhexidine gel intracanal medication.

Main Methods:

  • Collected paired samples from 10 subjects at different root canal treatment stages (RCS1, RCS2, RCS3).
  • Utilized 16S rDNA PCR for bacterial detection and limulus amebocyte lysate assay for endotoxin quantification.
  • Stimulated Raw 264.7 macrophages and measured IL-1 beta and TNF-α levels via ELISA.

Main Results:

  • AAA exudates showed higher endotoxin levels and macrophage stimulation capacity than root canal samples (RCS1).
  • Chemomechanical preparation (RCS2) significantly reduced endotoxins and bacterial load, decreasing cellular stimulation.
  • Intracanal medication (RCS3) further improved bacterial and endotoxin removal, leading to lower macrophage stimulation.

Conclusions:

  • AAA exudates possess greater inflammatory potential due to higher endotoxin levels.
  • Root canal treatment, particularly chemomechanical preparation and intracanal medication, effectively reduces bacteria and endotoxins.
  • Intracanal medication with Ca(OH)2 + CHX gel diminishes the inflammatory capacity of root canal contents.
Keywords:
Endodonticsendotoxinsinstrumentationroot canal and abscess

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