Adjuvant effects of <i>Saccharomyces cerevisiae</i> in the treatment of experimental periodontitis in rats undergoing chemotherapy

GARCIA, Valdir Gouveia; ROCHA, Tiago Esgalha da; GOMES, Natália Amanda; MIESSI, Daniela Maria Janjácomo; NUERNBERG, Marta Aparecida Alberton; RODRIGUES, João Victor Soares; CARDOSO, Jânderson de Medeiros; ERVOLINO, Edilson; THEODORO, Letícia Helena

doi:10.1590/1678-7757-2023-0135

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Original Article • J. Appl. Oral Sci. 31 • 2023 • https://doi.org/10.1590/1678-7757-2023-0135 linkcopy

Adjuvant effects of Saccharomyces cerevisiae in the treatment of experimental periodontitis in rats undergoing chemotherapy

Authorship SCIMAGO INSTITUTIONS RANKINGS

Surgical procedures, radiotherapy, and chemotherapy, individually or in association, are current oncological treatments. Among the most used chemotherapy drugs, 5-fluorouracil (5FU) is an antimetabolite with a broad spectrum of action. This study evaluated the effects of probiotics (PRO) as an adjuvant to the treatment of experimental periodontitis (EP) in rats immunosuppressed with 5FU.

Methodology 108 rats were randomly allocated to six different groups: EP; SS – systemic treatment with saline solution (SS); 5FU – systemic treatment with 5FU; 5FU+PRO – systemic treatment with 5FU, followed by the local administration of Saccharomyces cerevisiae ; 5FU+SRP – systemic treatment with 5-FU, followed by scaling and root planing (SRP); and 5FU+SRP+PRO – systemic treatment with 5FU followed by local treatments with SRP and PRO. Immunosuppression was obtained at two points: at the time of ligature installation and after 48 h. Six animals from each group were euthanized at seven, 15, and 30 d and hemimandibles were collected and processed for histopathological, histometric, and immunohistochemical analysis. Data were subjected to statistical analysis (α=5%).

Results At 7 d, the 5FU+PRO group showed less bone resorption and better structured connective tissue compared with the EP, SS, 5FU+SRP, and 5FU+SRP+PRO groups. At 15 d, the 5FU+SRP group showed a greater intensity of the inflammatory response (p<0.05). At 30 d, the 5FU+SRP+PRO group showed better structured bone tissue and a higher percentage of bone tissue (PBT) than the EP, SS, 5FU, and 5FU+PRO groups (p<0.05).

Conclusion The use of Saccharomyces cerevisiae as monotherapy or as an adjuvant to periodontal therapy may have a positive effect on bone repair in immunosuppressed conditions.

Cancer; Periodontitis; Periodontology; Probiotics; Chemotherapy; Fluorouracil; Animal model

PARAMETERS AND SCORES	PERCENTAGE OF SAMPLES (%)
	EXPERIMENTAL GROUPS
	EP			SS			5FU			5FU+SRP			5FU+PRO			5FU+SRP+PRO
	7 d	15 d	30 d	7 d	15 d	30 d	7 d	15 d	30 d	7 d	15 d	30 d	7 d	15 d	30 d	7 d	15 d	30 d
I NTENSITY OF LOCAL INFLAMMATORY RESPONSE
(1) no inflammation	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-
(2) mild inflammation (up to 1/3 of the cells are inflammatory)	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-
(3) moderate inflammation (from 1/3 to 2/3 of the cells are inflammatory)	33	67	67	33	67	67	-	-	-	-	-	100	33	100	33	-	67	100
(4) severe inflammation (more than 2/3 of the cells are inflammatory)	67	33	33	67	33	33	100	100	100	100	100	-	67	-	67	100	33	-
MEDIAN	3	2	2	3	2	2	3	3* ^†	3* ^†	3	3* ^†	2 ^‡βµ	3	2 ^‡¶β	3 ^¶µ	3	2 ^‡¶	2 ^‡α
EXTENT OF INFLAMMATORY PROCESS
(1) no inflammation	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-
(2) extending only to part of the connective tissue in the furcation region	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-
(3) extending throughout the connective tissue in the furcation region	33	67	67	33	67	67	-	-	-	-	67	100	-	100	100	-	67	100
(4) extending throughout the connective tissue and bone in the furcation region	67	33	33	67	33	33	100	100	100	100	33	-	100	-	-	100	33	-
MEDIAN	3	2	2	3	2	2	3	3* ^†	3* ^†	3	2 ^‡β	2 ^‡β	3	2 ^‡β	2 ^‡β	3	2 ^‡β	2 ^‡β
EXTERNAL ROOT RESORPTION (CEMENTUM AND DENTIN)
(1) absent	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-
(2) only inactive resorption areas	-	-	-	-	-	-	-	-	-	-	-	33	-	-	33	-	-	33
(3) few active resorption areas	100	100	100	100	100	100	-	33	100	100	100	67	100	100	67	100	100	67
(4) many active resorption areas	-	-	-	-	-	-	100	67	-	-	-	-	-	-	-	-	-	-
MEDIAN	2	2	2	2	2	2	3* ^†	3	2 ^β	2 ^‡	2	2	2 ^‡	2	2	2 ^‡	2	2
ALVEOLAR BONE RESORPTION
(1) within normal patterns	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-
(2) small amount of bone resorption areas	-	-	-	-	-	-	-	-	-	-	-	33	-	-	-	-	-	33
(3) moderate amount of bone resorption areas	100	100	100	67	67	67	-	-	-	-	-	67	100	100	100	-	67	67
(4) large amount of bone resorption areas	-	-	-	33	33	33	100	100	100	100	100	-	-	-	-	100	33	-
MEDIAN	2	2	2	2	2	2	3	3	3	3	3	2 ^‡β	2 ^‡¶	2 ^‡¶	2 ^‡	3α	2	2 ^‡β
CONNECTIVE TISSUE STRUCTURING PATTERN
(1) moderate number of fibroblasts and large amount of collagen fibers (dense connective tissue)	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-
(2) moderate amount of both fibroblasts and collagen fibers	-	-	-	-	-	-	-	-	-	-	-	33	-	-	-	-	-	100
(3) small amount of both fibroblasts and collagen fibers	-	33	33	-	33	33	-	-	-	-	100	67	100	100	67	-	33	-
(4) severe tissue breakdown with necrotic areas	100	67	67	100	67	67	100	100	100	100	-	-	-	-	33	100	67	-
MEDIAN	3	3	3	3	3	3	3	3	3	3	2 ^‡β	2* ^†‡β	2* ^†‡¶	2 ^‡	2	3α	3	2* ^{†‡ αβµ}
BONE ALVEOLAR STRUCTURING PATTERN
(1) regularly contoured bone trabeculae lined with active osteoblasts, including areas of new bone formation	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-
(2) irregularly contoured bone trabeculae lined with active osteoblasts and osteoclasts	-	-	-	-	-	-	-	-	-	-	-	33	-	-	-	-	-	33
(3) irregularly contoured bone trabeculae lined with active osteoclasts	67	67	100	67	67	100	-	-	-	67	67	67	67	67	100	33	100	67
(4) areas of necrotic bone and irregularly contoured bone trabeculae lined with active osteoclasts	33	33	-	33	33	-	100	100	100	33	33	-	33	33	-	67	-	-
MEDIAN	2	2	2	2	2	2	3	3	3*	2	2	2 ^‡	2	2	2	3	2 ^‡	2 ^‡β

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[TFN1] Symbols: *: significant difference compared with the EP group at the same experimental period; †: significant difference compared with SS at the same experimental period; ‡: significant difference compared with 5FU at the same experimental period; ¶: significant difference compared with SRP at the same experimental period; α: significant difference compared with PRO at the same experimental period; β: significant difference compared with 7 d in the same experimental group; µ: significant difference compared with 15 d in the same experimental group.