Serum oxidative stress biomarkers (MDA, SOD, GSH-PX) and IL-6/TNF-α ratio as biochemical indicators of disease progression in pediatric cariogenic pulpitis.

BACKGROUND

Cariogenic pulpitis is a common pediatric oral disease in which oxidative stress and inflammatory imbalance are increasingly recognized as important pathogenic mechanisms. Biochemical markers such as malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and the serum IL-6/TNF-<span style="color: rgb(32, 33, 34); font-family: sans-serif; font-size: 16px; background-color: rgb(248, 249, 250);"> α</span> ratio may provide insight into disease severity and progression.

METHODS

A total of 64 children with cariogenic pulpitis admitted between May 2023 and October 2024 were included, along with 64 healthy children as controls. Serum MDA, SOD, GSH-Px, and IL-6/TNF-<span style="color: rgb(32, 33, 34); font-family: sans-serif; font-size: 16px; background-color: rgb(248, 249, 250);"> α</span> ratio were measured using standard biochemical assays (TBA colorimetry, xanthine oxidase method, NADPH-coupled assay, and ELISA). Group comparisons were performed, and correlations with disease stage and caries depth were analyzed using Pearson correlation coefficients.

RESULTS

Compared with controls, children with pulpitis had significantly higher MDA and IL-6/TNF-<span style="color: rgb(32, 33, 34); font-family: sans-serif; font-size: 16px; background-color: rgb(248, 249, 250);"> α</span> levels (t = 18.542 and 20.639, both P &lt; 0.001) and lower SOD and GSH-Px activities (t = 8.279 and 12.449, both P &lt; 0.001). Within the pulpitis group (30 early stage, 24 middle stage, 10 late stage), MDA levels were positively correlated with both caries depth and disease severity (r = 0.82, P &lt; 0.05), while SOD (r = -0.78, P &lt; 0.05) and GSH-Px (r = -0.75, P &lt; 0.05) were negatively correlated. The IL-6/TNF-<span style="color: rgb(32, 33, 34); font-family: sans-serif; font-size: 16px; background-color: rgb(248, 249, 250);"> α</span> ratio was positively correlated with both stage and depth (r = 0.71, P &lt; 0.05), increasing significantly with lesion depth (r = 0.56, P &lt; 0.05).

CONCLUSIONS

Elevated MDA and IL-6/TNF-<span style="color: rgb(32, 33, 34); font-family: sans-serif; font-size: 16px; background-color: rgb(248, 249, 250);"> α</span> ratio reflect greater oxidative and inflammatory burden and are associated with advanced stages of pediatric cariogenic pulpitis, whereas higher SOD and GSH-Px activities are associated with earlier disease. These biochemical indices may serve as adjunctive laboratory markers for evaluating disease progression and guiding therapeutic monitoring in pediatric pulpitis.