Interestingly, IgA levels positively correlated with serum C-reactive protein suggesting the involvement of oral infection on systemic inflammation and coronary artery disease prevalence [7]. The primary function of B cells is to produce antigen-specific Ig. Naive B cells present the amazing ability to alter the effector function of Ig molecule by isotype Etoposide order switching, which is a critical component of B cell differentiation and generation of protective humoral immune responses [8]. Recently, it has been demonstrated that some Th-secreted cytokines is essential to stimulate naïve B cells to produce Ig. Interleukin (IL)-21 induces naive

B cells to switch expression of IgA, especially IgA1. In addition, IL-10 amplifies secretion of IgA induced by IL-21 [9], consistent with the role of IL-10 in regulating IgA responses [10]. In contrast, IL-4 dramatically attenuates IL-21-induced switching to IgA secretion while the neutralization of endogenous IL-4 increases the levels of IgM and IgA [9]. In addition to B cell antigen receptor and receptors for cytokines such as IL-4, IL-10, IL-21, the CD40, an integral

membrane protein found on the surface of several cells, upregulates the expression of DNA-editing enzyme called activation-induced cytidine buy Dactolisib deaminase (AID) and triggers the induction of somatic hypermutation (SHM) and class-switch recombination (CSR) from IgM to IgG or IgA [11–13]. It has been proposed that IL-21 in combination with CD40 costimulation is even more effective in inducing IgA production

by B cells [14]. Therefore, the presence of IL-21/IL-10/CD40L has been proposed to be critical for isotype switching to IgA by naïve B cells. To date, the possible relationship between the mediators related to Ig production and the levels of IgA was not evaluated in chronic periodontitis subjects. Therefore, the aim of this study was to assess the gingival levels of IL-21, IL-21 receptor (IL-21R), IL-4, IL-10 and CD40 ligand (CD40L) and the salivary levels of IgA in chronic periodontitis subjects, when compared to periodontally healthy ones. Subjects.  Thirty systemically healthy individuals, 15 with chronic periodontitis and 15 periodontally healthy subjects (aged 34–60 years) Etomidate were selected from the population referred to the Periodontal Clinic of Guarulhos University, from January 2009 until July 2010. Subjects who fulfilled the following described inclusion/exclusion criteria were invited to participate in the study. All eligible subjects were informed of the nature, potential risks, and benefits of their participation in the study and signed their informed consent. This study protocol was previously approved by the Guarulhos University’s Ethics Committee in Clinical Research (protocol # 100/2007). Inclusion and exclusion criteria.  All subjects should be >30 years old and present at least 15 teeth (excluding third molars).