Clinical Oral Investigations

, Volume 20, Issue 7, pp 1617–1624 | Cite as

Can apical periodontitis affect serum levels of CRP, IL-2, and IL-6 as well as induce pathological changes in remote organs?

  • Jinxiu Zhang
  • Xiaojing HuangEmail author
  • Bingling Lu
  • Chengfei Zhang
  • Zhiyu Cai
Original Article



The aim of this study was to investigate whether apical periodontitis (AP) could cause systemic cytokine elevation and pathological changes in remote organs in an experimental animal model.

Materials and methods

AP was induced in 36 Sprague Dawley (SD) rats. Serum levels of C-reactive protein (CRP), interleukin 2 (IL-2), and interleukin 6 (IL-6) were measured by enzyme-linked immunosorbent assays at different time intervals (0, 6, 12, 24, 48, and 96 h and 1, 2, 3, 4, 5, and 6 weeks) after pulp exposure. Multiple organs (the aortic arch, myocardium, liver, and spleen) were collected for histological observation. The results were analyzed by one-way analysis of variance (ANOVA).


Serum levels of CRP, IL-2, and IL-6 were significantly elevated at all time points assessed after 6, 24, and 96 h, respectively. The peak values of serum cytokines (CRP 6.363 ± 0.05 ng/ml, IL-2 21.997 ± 0.15 ng/L, and IL-6 2.406 ± 0.02 ng/L) were reached at 1, 4, and 2 weeks, respectively, followed by a decline. Time-dependent reversible histopathological changes were detected in the aortic arch, myocardium, and spleen, whereas irreversible changes were found in the liver.


AP elevated the levels of CRP, IL-2, and IL-6 in rat blood serum, causing reversible changes in the aortic arch, myocardium, and spleen as well as irreversible changes in the liver.

Clinical relevance

AP may trigger a systemic immune response, impair remote organs, and affect the general health of patients.


Apical periodontitis Cytokines Aortic arch Liver 



We are very grateful to the Comparative Medicine Department of Fuzhou General Hospital of Nanjing Military Command for their assistance with the animal experiments.

Compliance with ethical standards


This study was funded by the National Natural Science Foundation of China (grant no. 81271131) and the Key Project of the Natural Science Foundation of Fujian Province, China (grant no. 2012Y0029).

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

All applicable international, national, and/or institutional guidelines for the care and use of animals were followed.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Jinxiu Zhang
    • 1
  • Xiaojing Huang
    • 1
    Email author
  • Bingling Lu
    • 1
  • Chengfei Zhang
    • 2
  • Zhiyu Cai
    • 3
    • 4
  1. 1.Department of Endodontics and Operative Dentistry, School and Hospital of StomatologyFujian Medical UniversityFuzhouChina
  2. 2.Comprehensive Dental Care, Endodontics, Faculty of DentistryThe University of Hong Kong, Prince Philip Dental HospitalHong KongChina
  3. 3.Fujian Medical University Union HospitalFuzhouChina
  4. 4.School and Hospital of StomatologyFujian Medical UniversityFuzhouChina

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