IL6 and alkaline phosphatase measurement: During AP, macrophages exhibit a polarization switch towards M1, whereas disease exacerbation during symptomatic AP is associated with a reduced M2 differentiation profile, based on the reduced surface expression of CD163 along with higher IL-6 and IL-23 levels, which supports the role of the macrophages in the severity of apical lesions that can be triggered by endodontic bacterial antigens [32].