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Systemic inflammatory acute-phase response following palatal graft harvesting in rats
Maayan Atzmon1, Nirit Tagger-Green1, Roni Kolerman1
1Department of Periodontology, Tel Aviv University, Israel.
Background:
Surgical injury triggers a stereotypical cascade of responses known as the systemic inflammatory response (SIR). To the best of our knowledge, the SIR following palatal graft harvesting has not been previously investigated.
Objectives:
The aim of the study was to examine the magnitude of the SIR following palatal graft harvesting in Wistar rats by assessing serum levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-18, peripheral white blood cell (WBC) counts (differential and absolute counts of lymphocytes, neutrophils, monocytes, eosinophils, and basophils); and anemia-related parameters (red blood cell (RBC) count, hemoglobin (Hgb), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC)).
Material And Methods:
A total of 48 male Wistar rats were included in the study. A 4.2-mm palatal wound was created using a biopsy punch in the middle of the palate. Blood samples were collected before surgery and at 24, 48, 72, and 96 h postoperatively. Serum levels of TNF-α, IL-6 and IL-18 were measured using enzyme-linked immunosorbent assay (ELISA), and complete blood counts were analyzed with an automated blood cell counter on the day of sacrifice.
Results:
TNF-α levels peaked on day 1, IL-18 on day 2, and IL-6 on day 3. All cytokine levels returned to baseline by day 4. A significant 40% decrease in WBC count was observed on day 1, primarily due to a 47% reduction in lymphocyte count despite a significant 50% increase in neutrophil count. Red blood cell count, Hgb and HCT decreased significantly by 25%, 23% and 23%, respectively, with the greatest reductions observed on days 1, 1 and 2. All values returned to baseline by day 4.
Conclusions:
The dynamics of SIR following palatal graft harvesting resemble those observed after other minor surgical procedures. The findings support the classification of periodontal and oral surgery as minor surgery. Changes in blood cell counts and cytokine levels may help identify situations requiring closer monitoring to promote optimal wound healing.