They mentioned that the pathogenesis for their findings is similar as reported for rheumatoid arthritis, i.e. depressed erythropoiesis by systemically circulating pro-inflammatory cytokines resulting from a local chronic inflammatory process. Tobacco components may also modify the production of cytokines or inflammatory mediators. likely In smokers an imbalance in cytokine production seems to occur. Elevated concentrations of IL-6 were observed in the plasma of smokers,59 as well as in the alveolar cells of healthy donors stimulated by tobacco glycoprotein.60 Nicotine, one of the most deleterious products of cigarette, has been shown to increase release of IL-6 by cultured murine osteoblasts.61 Giannopoulou et al26 indicated that smoking interferes with cytokine production.
It has also been reported that release of cytokines from peripheral neutrophils and various parameters of inflammation in plasma seem to be affected more by cigarette smoking than periodontal disease.62 Such alterations in host response may affect the reparative and regenerative potential of the periodontium in tobacco smokers. In the literature it has been identified that smoking is an important factor to affect erythrocytes and related parameters.63,64 In the present study, our first aim was to detect the effect of smoking on ACD in the existence of chronic periodontitis. Therefore, we did not analyze the inflammatory mediators. But further studies are needed that support the findings of our study with these measurements.
The current study indicates periodontitis also needs to be considered as a chronic disease and together with the effect of cigarette smoking it may cause lower numbers of erythrocytes and the levels of hemoglobin, hematocrit and iron. The BMI measures were also collected due to well recognized effect of adiposity on systemic host response.65,66 Nishida et al67 suggested that the immunological disorders or inflammation might be the reason that obese smokers tend to exhibit escalating poor periodontal status relative to non-obese and non-smoking individuals. Because of that obese patients were excluded from the study and also the difference between the groups was not significant. Some of the studies interpreted the effect of cigarette smoking on the periodontium to be indirect and due to inadequate levels of oral hygiene and increased plaque accumulation among smokers relative to non-smokers.
12,68,69 In this study, PI levels of S (+) were higher than S (?). The studies searching the effect of smoking on clinical parameters suggest that non-smokers have higher GI and BOP values than smokers.3,6,15 But, there are conflicting results those show no Drug_discovery significant difference between smokers and non-smokers70 and smokers have higher values than non-smokers.71 Pucher et al72 reported that GI and BOP values were similar in smokers and non-smokers 9 months after periodontal therapy.