TREATMENT BY MORINGA OLEIFERA EXTRACT CAN REDUCE GINGIVAL INFLAMMATORY CYTOKINES IN THE RAT PERIODONTALMODEL

Introduction: Overproduction of gingival pro-inflammatory cytokines have been implicated to play a noticeable role in the pathogenesis of periodontitis, which is characterized by host-mediated destruction of soft and hard periodontal tissues. Moringa oleifera (MO) is a highly valued medicinal plant which has a wide impressive range of traditional medical applications and is an alternative medicine for synthetic drugs which are accompanied with many downsides. The aim of this study was to investigate the effect of administration of the MO extract on gingival levels of TNF-α and IL1-β in the rat periodontal model. Methods: Inflammatory periodontitis was induced using 0-3 ligatures around the neck of right mandibular first molar in male rats. MO leaf extract was solved in dimethyl sulfoxide and injected into the gum tissue directly (500mg/kg) as a pre/post-treatment. Positive control group gave indomethacin (5mg/kg) on a daily basis. Gingival levels of TNF-α and IL1-β were measured using ELISA. Results: The results of this study revealed that levels of IL1-β and TNF-α increased in the gingival tissue in a model of periodontitis compared to control group (P≤0.001). Also, the results indicated that administration of MO extract could reduce production of TNF-α and IL1-β in the gum tissue of rat periodontal model (P≤0.001). There was no significant difference between MO extract and indomethacin anti-inflammatory effects. Conclusion: It can be concluded that pre/post-treatment with MO extract due to its direct effect on inhibition of pro-inflammatory cytokines can alleviate inflammatory symptoms in a rat periodontal model. D ow nl oa de d fr om p hy ph a. ir at 4 :3 8 + 03 30 o n T hu rs da y D ec em be r 27 th 2 01 8 103 | Physiol Pharmacol 21 (2017) 102-109 Sahrakary et al. pockets around the affected teeth (Pellegrini et al., 2009; Struillou et al., 2010). Periodontal disease is a major cause of tooth loss in adults and one of the most common infectious diseases in all over the world which affected approximately 800 million people in 2016 mostly in upper-middle income countries (Ryan and Golub, 2000). Lipopolysaccharide (LPS) is a fundamental molecule which comprises the outer membrane of gramnegative bacteria. It is obvious that bacterial LPS is a major effector in the periodontitis pathology which can increase production of pro-inflammatory cytokines, including interleukin-1beta (IL-1β), IL-6 and tumor necrosis factor alpha (TNF-α) due to the motivation of the host’s immune system cells (Yamaguchi and Kasai, 2005). Constitutive overproduction of these cytokines in the gingival tissue due to the periodontitis can cause soft and hard tissue destruction (Saliva and Lang, 2005; Bansal et al., 2012). Studies indicated that inhibition of these cytokines could be a promising and effective strategy for periodontitis treatment (Pellegrini et al., 2009; Graves, 1999). Nowadays, there is a great number of drugs for treatment of periodontitis. Antibiotics which have antimicrobial effects on LPS and ability to decrease levels of inflammatory cytokines are widely used to manage periodontitis. Nonetheless, their overuse have led to the outburst of antibiotic-resistant pathogens (Rizzo et al., 2012). The use of synthetic compounds such as corticosteroids and non-steroidal anti-inflammatory drugs like indomethacin, which are commonly prescribed for the treatment of periodontitis, are associated with many side effects on human’s health, for instance stomach discomfort, heartburn and nausea. Studies have demonstrated that long-term use of indomethacin in the treatment of periodontitis resulted in the lower bone loss, although disease progression returned when the drug was stopped. So, the wide range of research to define new therapeutic approaches, including herbal medicines and plant extracts therapy is in progress (Salvi and Lang, 2005; Pellegrini et al., 2009). Thus, herbal and natural products, as an alternative for synthetic drugs, are receiving extraordinary attention for using in medical remedy. In this regard, it seems that plant extracts which don’t have any adverse effects on the host may be useful for treating inflammatory diseases (Bansal et al., 2012). Down the ages, plant-derived dietary constituents, such as polyphenols and resveratrol are profited for human’s health and play a crucial role in the prevention of human periodontal disease due to their antiinflammatory, anti-oxidant, chemo-prevention and anti-cancer effects (Rizzo et al., 2012; Bansal et al., 2012). Moringa oleifera (MO), as a member of Moringaceae family, is a highly valued medicinal plant which is distributed in many tropic regions and used for treatment of various types of diseases. Different parts of MO including leaves, roots, seeds, fruits and flowers can act as antitumor, anti-inflammatory and antibacterial markers. A great number of chemicals are existed in the MO leaf extract such as phytosterols, glycosides, tannins and amino acids (Manaheji et al., 2011). The benefits of MO administration for the treatment or prevention of oral inflammatory diseases such as periodontal disease are not quite well-known and further investigations are needed (Ndiaye et al., 2001). Thus, because of the importance of offering effective treatments with fewer adverse effects and considering the antiinflammatory and immuno-modulatory properties of MO due to the existence of saponin, terpenoids, alkaloids and also anti-inflammatory transcription factors, this study attempted to examine the antiinflammatory effects of MO on gum tissue levels of IL-1β and TNF-α in the rat periodontitis model. Materials and methods