Oxidative injury and inflammatory periodontal diseases: the challenge of anti-oxidants to free radicals and reactive oxygen species

Melatonin: potential functions in the oral cavity

BACKGROUND

Melatonin is synthesized and secreted by the pineal gland and other organs. The pattern of melatonin secretion is controlled by an endogenous circadian timing system and conveys information about the light-dark cycle to the organism, thereby organizing its seasonal and circadian rhythms. Melatonin has powerful antioxidant effects, functions in an immunomodulatory role, may protect against certain cancers, delays some age-related processes, stimulates the synthesis of type I collagen fibers, and promotes bone formation.

METHODS

An extensive review was made (e.g., using PubMed, Science Direct, and Web of Knowledge) of the literature.

RESULTS

Melatonin, which is released into the saliva, may have important implications for dental disorders, especially in periodontal disease. Diseases of the periodontium are known to be aggravated by free radicals and by alterations in the immune response to microorganisms that are present in plaque. In response to periodontal inflammation, the blood and salivary levels of melatonin may increase.

CONCLUSION

Melatonin may play a role in protecting the oral cavity from tissue damage that is due to oxidative stress, and it may contribute to the regeneration of alveolar bone through the stimulation of type I collagen fiber production and the modulation of osteoblastic and osteoclastic activity.

Total Antioxidant Capacity and Antioxidant Enzymes in Serum, Saliva, and Gingival Crevicular Fluid of Preeclamptic Women With and Without Periodontal Disease

BACKGROUND

The aim of this study was to investigate the total antioxidant capacity, superoxide dismutase and glutathione peroxidase activities, and malondialdehyde levels in serum, saliva, and gingival crevicular fluid (GCF) in preeclamptic and normotensive pregnant women with and without periodontal disease.

METHODS

Forty pregnant women, consisting of 10 preeclamptic subjects with periodontal disease, 10 preeclamptic periodontally healthy subjects, 10 normotensive subjects with periodontal disease, and 10 normotensive periodontally healthy subjects, were included in this study. After clinical measurement and samplings, total antioxidant capacity, superoxide dismutase, glutathione peroxidase activities, and malondialdehyde levels in serum, saliva, and GCF of preeclamptic and normotensive pregnant women were determined, and the data were tested by non-parametric tests. Total antioxidant capacity of the clinical samples was measured using a novel automated colorimetric measurement method. Superoxide dismutase and glutathione peroxidase activities and malondialdehyde levels were determined spectrophotometrically.

RESULTS

Superoxide dismutase and glutathione peroxidase activities in GCF and serum and total antioxidant capacity in saliva, GCF, and serum were the lowest in preeclamptic women with periodontal disease. However, serum and GCF levels of malondialdehyde were the highest in this group of pregnant women.

CONCLUSIONS

Systemic and local antioxidant and total antioxidant capacities are affected by periodontal disease in addition to the impact of preeclamptic status. Similar comments may be made for the increases in systemic and local malondialdehyde levels.

Characterization of the antioxidant profile of human saliva in peri-implant health and disease

OBJECTIVES

Peri-implant disease is considered to be an inflammatory disease, but many aspects of its pathogenesis remain unknown. At present, peri-implant disease is considered to be initiated and perpetuated by a small group of predominantly Gram-negative, anaerobic, or micro-aerophilic bacteria that colonize the subgingival area. Bacteria cause the observed tissue destruction directly by toxic products and indirectly by activating host defence systems, i.e. inflammation. A variety of molecular species appears in the inflamed tissues, among them are reactive species such as free radicals and reactive oxygen species (ROS). The purpose of this study was to assess levels of various antioxidants in saliva to identify differences between the saliva of patients with healthy peri-implant tissues and patients with peri-implant disease, and to examine whether the whole saliva of those with peri-implant disease conditions might have lower levels of antioxidants than that of healthy individuals.

MATERIALS AND METHODS

Thirty healthy adult volunteers (14 men and 16 women) with implant-supported overdentures (Ankylos Biofunctional Implants) were selected from the group of patients from Tallinn Dental Clinic. Biochemical and clinical parameters evaluated were the following ones: the levels of urate, ascorbate, myeloperoxidase in saliva, total antioxidant status of saliva, pocket probing depth (mm), gingival index (0, 1, 2, or 3), and bleeding on probing (0 or 1).

RESULTS AND CONCLUSION

Total antioxidant status (TAS) of saliva and concentration of uric acid and ascorbate, which are the main salivary antioxidants, are significantly decreased in patients with peri-implant disease. TAS in healthy subjects was 0.41+/-0.10 for resting saliva and 0.31+/-0.09 for stimulated saliva; in diseased subjects TAS was 0.19+/-0.07 and 0.12+/-0.03, respectively. In healthy subjects, the concentration of urate was 307.2+/-78.06 microM/l in resting saliva and 241.5+/-89.09 microM/l in stimulated saliva. In diseased patients, the concentration of urate was 120+/-36.13 and 91.60+/-39.35 microM/l, respectively. The concentration of ascorbate did not differ in resting and stimulated saliva. In healthy subjects, it was 2.79+/-0.81 mg/l and in diseased subjects, it was 1.54+/-0.30 mg/l. This may indicate that excessive ROS production in peri-implant disease is leading to the situation of excessive oxidative stress, which may be an important factor contributing the destruction of peri-implant tissues. The importance of these findings may be the better understanding of the processes involved in the pathogenesis of peri-implant disease and that the treatment of peri-implant disease may involve adjuvant anti-oxidants supplementation together with cumulative interceptive supportive therapy concept introduced by Mombelli & Lang.

Effect of local antimicrobial agents on excisional palatal wound healing: a clinical and histomorphometric study in rats

AIM

To assess the effect of topically applied antimicrobial agents on palatal excisional wound in rats.

MATERIALS AND METHODS

Excisional wounds, 5 mm in diameter, were made in the centre of the palate of 125 Wistar male rats. In four experimental groups, chlorhexidine digluconate (CHX) 0.12% solution, 1% CHX gel, phenolic compounds solution (Listerine), amine/stannous fluoride solution (Meridol) and saline solution as a control group were applied daily for 1 min. The wound area was measured photographically and the epithelialization rate was determined histologically at 3, 7, 14 and 21 days post-surgery.

RESULTS

The mean wound area and mean distance between the epithelial margins decreased significantly with time (p<0.001) in experimental and control groups, with the greatest wound area reduction and rate of epithelialization on day 14. A significantly superior rate of wound epithelialization (p=0.03) was presented following use of 1% CHX gel and Listerine and a comparatively inferior one when the Meridol solution was applied.

CONCLUSIONS

Each tested antimicrobial agent when applied on an excisional wound with epithelial and connective tissue deficiency did not have a negative effect on the rate of wound closure. The best results were achieved with 1%CHX gel and Listerine.

The intake of fried virgin olive or sunflower oils differentially induces oxidative stress in rat liver microsomes

The effects of non-fried and fried virgin olive and sunflower oils on rat liver microsomal compositional features have been investigated. In addition, plasma antioxidants (α-tocopherol and ubiquinone 9) were investigated as well as the possible oxidative modifications suffered by virgin olive and sunflower oils during the frying process. The frying process decreased the content of α-tocopherol and phenolics in the oils and increased total polar materials. Sunflower oil was affected to a greater extent than olive oil. In rats, the intake of fried oil led to higher levels of lipid peroxidation and a lower concentration of plasma antioxidants. Microsomal fatty acid and antioxidant profiles were also altered. It seems that a strong relationship exists between the loss of antioxidants and the production of toxic compounds in the oils after frying and the extent of the peroxidative events in microsomes, which were also different depending on the fat source. The highly unsaturated sunflower oil was less resistant to the oxidative stress produced by frying and led to a higher degree of lipid peroxidation in liver microsomesin vivothan virgin olive oil.

Local Application of Melatonin Into Alveolar Sockets of Beagle Dogs Reduces Tooth Removal–Induced Oxidative Stress

BACKGROUND

The antioxidant and anti-inflammatory hormone melatonin is secreted by saliva into the oral cavity, where it may protect the mucosal and gingival tissues from radical damage. To date, no studies have addressed the potential beneficial role of melatonin in the acute inflammatory response that follows oral surgical interventions, especially tooth extractions. The aim of this study was to determine whether tooth extraction induces changes in plasma oxidative stress levels, and whether melatonin treatment may counteract these changes.

METHODS

Maxillary and mandibular premolars and molars of 16 adult Beagle dogs were extracted under general anesthesia. Eight dogs were treated with 2 mg melatonin placed into the alveolar sockets, whereas the other eight dogs received only vehicle. Lipid peroxidation (LPO) and nitrite plus nitrate (NOx) levels were determined in plasma, whereas glutathione (GSH) and glutathione disulfide (GSSG) levels and glutathione peroxidase (GPx) and reductase (GRd) activities were measured in red blood cells before and 24 hours after tooth extraction.

RESULTS

Removal of the premolars and molars caused a significant rise in plasma LPO and NOx levels and in the erythrocyte GSSG/GSH ratio, whereas melatonin treatment restored the normal values of these parameters. Also, melatonin slightly increased erythrocyte GRd activity without changing GPx activity.

CONCLUSION

For the first time to our knowledge, the results show that during the immediate postoperative period following tooth extraction, there is a significant increase of oxidative stress, which is counteracted by the administration of melatonin into the alveolar sockets.

Smelling lavender and rosemary increases free radical scavenging activity and decreases cortisol level in saliva

Free radicals/reactive oxygen species are related to many biological phenomena such as inflammation, aging, and carcinogenesis. The body possesses various antioxidative systems (free radical scavenging activity, FRSA) for preventing oxidative stress, and saliva contains such activity. In the present study, we measured the total salivary FRSA induced after the smelling of lavender and rosemary essential oils that are widely used in aromatherapy. Various physiologically active substances in saliva such as cortisol, secretory IgA, and alpha-amylase activity were found to be correlated with aroma-induced FRSA. The subjects (22 healthy volunteers) sniffed aroma for 5 min, and each subject's saliva was collected immediately. FRSA was measured using 1,1-diphenyl-2-picrylhydrazyl. The FRSA values were increased by stimulation with low concentrations (1000 times dilution) of lavender or by high-concentrations (10 times dilution) of rosemary. In contrast, both lavender and rosemary stimulations decreased cortisol levels. A significant inverse correlation was observed between the FRSA values and the cortisol levels with each concentration of rosemary stimulation. No significant changes were noted in sIgA or alpha-amylase. These findings clarify that lavender and rosemary enhance FRSA and decrease the stress hormone, cortisol, which protects the body from oxidative stress.

Relationships of anti-PAc (361-386) peptide salivary IgA antibody, eosinophils and basophils with periodontal status in the elderly

The amino acid residues 361-386 of Streptococcus mutans PAc includes an important region associated with the interaction between S. mutans and salivary components. We investigated the relationships between levels of the anti-PAc (361-386) peptide antibody (PPA) in saliva and periodontal status in 281 elderly subjects (mean age 77 years; 118 females, 163 males) by assessing dental calculus (CA), attachment loss (AL), pocket depth (PD), bleeding on probing (BOP) and various blood parameters. Enzyme-linked immunosorbent assay results revealed that subjects with a PPA level of greater than 0.1 (PPA detected group) showed a lower average value for number of sites with more than 6 mm of AL/6 points x 100/tooth (rAL6) than those with a PPA level of less than 0.1 (PPA not detected group). Furthermore, average values for rAL6 were significantly lower in the PPA detected group, and BOP, AL and rAL6 correlated positively and significantly with the percentage of eosinophils present in leukocytes in female subjects in both groups. PPA level had a negative correlation with percentages of basophils and eosinophils. The results indicate that systemic increases in numbers of eosinophils and basophils are associated with the development of periodontal diseases, while PPA level may be a useful indicator of periodontal status.

5-aminoisoquinolin-1(2H)-one, a water-soluble poly (ADP-ribose) polymerase (PARP) inhibitor reduces the evolution of experimental periodontitis in rats

BACKGROUND

Poly (ADP-ribose) polymerase (PARP), a nuclear enzyme activated by strand breaks in DNA, plays an important role in the tissue injury associated with ischaemia-reperfusion and inflammation. Recent studies have demonstrated that PARP activation plays a crucial role in the pathogenesis of acute periodontal injury.

AIM

We have investigated the effect of 5-aminoisoquinolin-1(2H)-one (5-AIQ), a water-soluble PARP inhibitor, in a rat model of periodontitis.

MATERIALS AND METHODS

Periodontitis was induced in rats by placing a 2/0 braided silk ligature around the lower left first molar. At day eight, the gingivomucosal tissue encircling the mandibular first molar was removed for biochemical and histological analysis.

RESULTS AND CONCLUSIONS

Ligation significantly induced an increased neutrophil infiltration and a positive staining for PARP activation. Ligation significantly increased Evans blue extravasation in gingivomucosal tissue and alveolar bone destruction. Intraperitonial injection of 5-aminoisoquinolin-1(2H)-one (5-AIQ) (5 mg/kg daily for eight days) significantly decreased all of the parameters of inflammation as described above. This suggests that inhibition of PARP may represent a novel approach for the treatment of periodontal disease.

Dietary influences on periodontal health in dogs and cats

A pet cannot be healthy without oral health. Periodontal is a significant disease that has local and systemic ramifications. It has been stated earlier that effective plaque control prevents gingivitis. In human beings, 90% of periodontitis occurs as the result of progression gingivitis, and this type of periodontitis can be completely prevented by plaque control. It is reasonable that dogs and cats react similarly and that effective plaque control could prevent a large percentage of periodontitis cases. Proper nutrition and effective oral hygiene are necessary components of oral health and should be jointly promoted in the management of oral disease in dogs and cats.

Relationship Between Salivary Melatonin and Severity of Periodontal Disease

BACKGROUND

Melatonin possesses antioxidant, free-radical scavenging, and immunoenhancing properties that promote fibroblast activity and bone regeneration. The aim of this study was to examine the possible links between salivary melatonin levels and the severity of periodontal disease using the community periodontal index (CPI).

METHODS

Thirty-seven patients with different degrees of periodontal disease were studied. Salivary and plasma melatonin levels (by radioimmunoassay), salivary/plasma melatonin ratio, and CPI status were collected for each patient. The Spearman correlation coefficient was used to analyze relationships among variables.

RESULTS

Data showed a significant correlation between CPI and salivary/plasma melatonin ratios. When saliva volume was controlled for, a significant correlation (P<0.05) was found between lower salivary melatonin and a worse CPI. This finding suggests that melatonin may act as a protector against free radicals produced by inflammatory periodontal diseases.

CONCLUSIONS

Salivary melatonin levels varied according to the degree of periodontal disease. As the degree of periodontal disease increased, the salivary melatonin level decreased, indicating that melatonin may act to protect the body from external bacterial insults. Therefore, melatonin may be potentially valuable in the treatment of periodontal diseases, although further research is required to validate this hypothesis.

Protective Effects of Grape Seed Proanthocyanidins Against Oxidative Stress Induced by Lipopolysaccharides of Periodontopathogens

BACKGROUND

During phagocytosis or stimulation with bacterial components, macrophages activate various cell processes, including the production of reactive oxygen species (ROS) and reactive nitrogen species (RNS), which are critical for successful defense against invading organisms. Increased levels of ROS/RNS create oxidative stress that results in tissue and bone destruction. Grape seed proanthocyanidins have been reported to possess a wide range of biologic properties against oxidative stress. In the present study, we investigated the effects of a grape seed proanthocyanidin extract (GSE) and commercial polyphenols on the production of ROS and RNS and on the protein expression of inducible nitric oxide synthase (iNOS) by murine macrophages stimulated with lipopolysaccharides (LPS) of periodontopathogens.

METHODS

Macrophages (RAW 264.7) were treated with non-toxic concentrations of either GSE or commercial polyphenols (gallic acid [GA] and [-]-epigallocatechin-3-gallate [EGCG]) and stimulated with LPS of Actinobacillus actinomycetemcomitans or Fusobacterium nucleatum, and iNOS expression was evaluated by immunoblotting. Nitric oxide (NO) production was quantified using the colorimetric Griess assay, whereas ROS production was measured with the fluorescent 123-dihydrorhodamine dye.

RESULTS

GSE strongly decreased NO and ROS production and iNOS expression by LPS-stimulated macrophages. GA also revealed a strong inhibitory effect on NO production without affecting iNOS expression but slightly increasing ROS production. EGCG showed an inhibitory effect on NO and ROS production and on iNOS expression by macrophages.

CONCLUSION

Our findings demonstrate that proanthocyanidins have potent antioxidant properties and should be considered a potential agent in the prevention of periodontal diseases.

Protection of mitochondria during cold storage of liver and following transplantation: comparison of the two solutions, University of Wisconsin and Eurocollins

Injury to allografts during ischaemia/reperfusion contribute to the development of graft failure following transplantation with significant morbidity and mortality to patients. The development of University of Wisconsin solution has significantly improved the quality of graft preservation and transplant outcome relative to formerly used solutions such as Eurocollins. The aim of this study was to further characterize mitochondrial structural and functional alterations occurring in rat livers following cold storage and transplantation. Mitochondrial impairment after prolonged storage in Eurocollins included decreased cyt. c+c1, cyt. b and cyt. a+a3 concentration and dramatic falls in the activities of the respiratory chain enzymes ubiquinol-cyt. c oxidoreductase and cytochrome oxidase. Under the same conditions the highest hydroperoxide but lowest vitamin E concentrations were also found. Although both the Eurocollins and University of Wisconsin preservation solutions have limitations in preventing oxidative injuries following cold storage and reperfusion, our data indicate that mitochondrial impairment was higher in Eurocollins- than in University of Wisconsin-stored livers. Further improvements are necessary in maintaining the stability of mitochondria in order to optimize preservations solutions used in transplantations.

Surface protease of Treponema denticola hydrolyzes C3 and influences function of polymorphonuclear leukocytes

Treponema denticola is a dominant microorganism in human periodontal lesions. One of the major virulence factors of this microorganism is its chymotrypsin-like surface protease, dentilisin. The purpose of this study was to evaluate the effect of dentilisin on human polymorphonuclear leukocytes (PMNs). We used chemiluminescence to assess production of O(-)(2) by PMNs against T. denticola ATCC 35405 and dentilisin-deficient mutant K1. T. denticola ATCC 35405 induced production of O(-)(2), whereas dentilisin-deficient K1 did not. We found that chymostatin, a protease inhibitor, strongly reduced the ability of T. denticola ATCC 35405 to induce production of, O(-)(2), whereas K1 was relatively unaffected. We also used Immunoblot and ELISA to evaluate the activation of complement by this microorganism in relation to PMNs. T. denticola ATCC 35405 hydrolyzed the alpha-chain of C3, producing iC3b. Furthermore, strain ATCC 35405 induced a larger release of MMP-9 from PMNs than strain K1. Dentilisin activated PMNs via complement pathways and may play a role in establishing periodontal lesions.

Effects of smoking and gingival inflammation on salivary antioxidant capacity

AIM

This study evaluated possible effects of smoking and gingival inflammation on salivary antioxidants in gingivitis patients.

METHODS

Twenty otherwise healthy gingivitis patients (10 self-reported smokers) and 20 periodontally and systemically healthy volunteer subjects were enrolled in the study. Whole saliva samples and full-mouth clinical periodontal recordings were obtained at baseline and one month following initial phase of treatment in gingivitis patients. Salivary cotinine, glutathione and ascorbic acid concentrations, and total antioxidant capacity were determined, and the data generated were tested by non-parametric tests.

RESULTS

Salivary cotinine measurements resulted in re-classification of three self-reported non-smokers as smokers. Smoker patients revealed significantly higher probing depths but lower bleeding values than non-smoker patients (p=0.044 and 0.001, respectively). Significant reductions in clinical recordings were obtained in non-smoker (all p<0.05) and smoker (all p<0.01) patients following periodontal treatment. Salivary total glutathione concentrations were reduced following therapy in gingivitis patients who smoke (p<0.01). Otherwise, no statistically significant differences were found between the groups in biochemical parameters at baseline or following treatment (p>0.05).

CONCLUSIONS

Within the limits of this study, neither smoking nor gingival inflammation compromised the antioxidant capacity of saliva in systemically healthy gingivitis patients.

Reactive oxygen species and human inflammatory periodontal diseases

Reactive oxygen species (ROS) have emerged as important signaling molecules in the regulation of various cellular processes. They can be generated by the mitochondrial electron transport chain in mitochondria and activation of polymorphonuclear leukocytes (PMN) during inflammatory conditions. Excessive generation of ROS may result in attack of and damage to most intracellular and extracellular components in a living organism. Moreover, ROS can directly induce and/or regulate apoptotic and necrotic cell death. Periodontal pathologies are inflammatory and degenerative diseases. Several forms of periodontal diseases are associated with activated PMN. Damage of tissues in inflammatory periodontal pathologies can be mediated by ROS resulting from the physiological activity of PMN during the phagocytosis of periodontopathic bacteria.

Lipid peroxidation: a possible role in the induction and progression of chronic periodontitis

OBJECTIVES

Reactive oxygen species (ROS) are implicated in the destruction of the periodontium during inflammatory periodontal diseases. The imbalance in oxidant/antioxidant activity may be a key factor in the damaging effects of ROS. This study aimed to determine the lipid peroxidation levels in gingival crevicular fluid and saliva, and glutathione (GSH) and glutathione peroxidase (GPx) in saliva in patients with chronic periodontitis.

METHODS

Gingival crevicular fluid and saliva were collected from 13 patients and 9 healthy control subjects during the preliminary study, and from 21 patients during the subsequent study. Lipid peroxidation level, GSH level and GPx activity were determined by spectrophotometric assay.

RESULTS

The preliminary study found that when comparing patients to healthy controls, the gingival crevicular fluid samples produced the following results, respectively: higher lipid peroxidation concentration (microm) (by sites: 167.55 vs. 53.71, p < 0.0001; by subjects: 151.99 vs. 50.66, p < 0.005) and total amount (pmol) (by sites: 93.02 vs. 8.47, p < 0.0001, by subjects: 80.44 vs. 7.84, p < 0.0005). In saliva samples, lower GSH concentration (microm) (373.04 vs. 606.67, p < 0.05), higher lipid peroxidation concentration (microm) (0.66 vs. 0.13, p < 0.0005), and no difference in GPx activity were found in patients than in those of healthy controls. The subsequent study showed statistically significant (p < 0.05) improvement of clinical periodontal parameters (plaque index, gingival index, probing attachment level, probing pocket depth and gingival crevicular fluid volume), decreases in gingival crevicular fluid lipid peroxidation levels (concentration and total amount) at the sites after the completion of phase 1 periodontal treatment. Similarly, the periodontal treatment resulted in a significant decrease of lipid peroxidation concentrations (p < 0.05), increase in GSH concentration (p < 0.001), and no change in GPx activity in saliva samples.

CONCLUSION

The increased levels of lipid peroxidation may play a role in the inflammation and destruction of the periodontium in periodontitis.

Detection of periodontopathic bacteria and an oxidative stress marker in saliva from periodontitis patients

We assessed the salivary levels of periodontopathic bacteria and 8-hydroxydeoxyguanosine (8-OHdG) in patients with periodontitis. The salivary levels of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Tannerella forsythia (formerly Bacteroides forsythus) were assessed using real-time polymerase chain reaction. The 8-OHdG levels were determined using an enzyme-linked immunosorbent assay. The salivary levels of 8-OHdG, P. gingivalis, and T. forsythia in the periodontitis patients were significantly higher than those in healthy subjects. By contrast, the A. actinomycetemcomitans level in healthy subjects was higher than that in periodontitis patients. 8-OHdG was significantly correlated with P. gingivalis. Statistically significant decreases in the levels of P. gingivalis, probing depth, bleeding on probing, and 8-OHdG were observed after initial periodontal treatment. These results suggest that the 8-OHdG levels in saliva reflect the load of periodontal pathogens. 8-OHdG could be a useful biomarker for assessing periodontal status accurately, and for evaluating the efficacy of periodontal treatment.

Interleukin-12 and interleukin-16 in periodontal disease

The immune system plays an important role in the pathological process of periodontitis. Interleukin-12 (IL-12) is produced by monocytes, macrophages and neutrophils. These cells are proinflammatory infiltrates in periodontitis tissues. High IL-12 will contribute to the immune reaction to Th1 type. IL-12 is an inducer of INF-r production. IFN-gamma itself can also activate IL-12 production. Lipopolysaccharides (LPS) of periodontopathogens are also activators of IL-12. Interleukin-16 (IL-16) can cause the high affinity of IL-2 receptors on CD4+ cells and is chemotaxis to Th1 cells and CD4+ T cells. IL-16 can stimulate monocytes to produce proinflammatory cytokines and is highly associated with inflammation including arthritis, enteritis and allergic rhinitis. However, the information on IL-12 and IL-16 in periodontitis is not clear. In this study, 105 GCF samples were collected from 19 periodontal disease patients and 6 healthy ones. The clinical periodontal indices, the habits of cigarette smoking and alcohol drinking were recorded. ELISA was used to determine the levels of IL-12 and IL16 in the GCF. In the non-smoking/non-alcohol-drinking individuals: (1) the total amount of IL-12 (but not IL-16) was significantly higher in chronic periodontitis (CP) sites than gingivitis (G) or healthy (H) sites; (2) the diseased sites (CP + G) had a significantly higher total amount of IL-12 (but not IL-16) than the H sites. Among CP sites, both the concentration and total amount of IL-16 (but not IL-12) were significantly higher in alcohol drinkers/cigarette smokers as compared to the non-drinkers/non-smokers. CP sites of the drinkers/smokers also had significantly deeper probing pocket depth than sites of those without these two habits. IL-12 and IL-16 may be related to the pathogenesis of periodontal disease, but within the periodontitis sites, IL-16 may be related to disease severity in alcohol drinkers/smokers.

Ageing and the Mediterranean diet: a review of the role of dietary fats

Consumers are becoming increasingly aware of the relationship between food and health. Concerns have been raised about dietary fats and their relative nutritional advantages or disadvantages. In investigations of the associations between health and fat intake, special emphasis has been placed on the benefits of virgin olive oil for counteracting certain neurodegenerative diseases and ageing. With respect to ageing, accumulating evidence indicates that an improvement in quality of life can be reached by modulation of the extrinsic factors that influence many ageing processes. Of the modifiable factors, nutrition appears to be one of the strongest elements known to influence the rate of ageing as well as the incidence of age-associated diseases such as atherosclerosis and neurodegenerative pathologies. This paper reviews the theory of ageing and the role of fatty acids in the mechanisms affecting its evolution. It also confirms that virgin olive oil, an essential component of the Mediterranean diet, provides large amounts of stable and not easily oxidizable fatty acids as well as remarkable quantities of powerful antioxidant molecules.

Antioxidant status (CoQ10 and Vit. E levels) and immunohistochemical analysis of soft tissues in periodontal diseases

Reactive oxygen species and antioxidant status in periodontal diseases and periodontal-related pathologies is an item of growing interest. Immunohistochemical approach may be usefully employed in the study of soft tissues affected by periodontal disease, giving valuable information on tissue morphology and vascular proliferation that depends directly on the inflammatory state. In order to study CoQ(10) and vitamin E content in healthy gingiva and in gingivitis a new adaptation to previously published methods for their determination was adopted. During gingivitis tissue displayed a large inflammatory infiltration in the lamina propria and a VEGF positive squamous epithelium. The inflammatory infiltration consisted mainly of lymphocytes, plasma cells and neutrophils. Vitamin E dramatically decreased and CoQ(10) remained unchanged despite the increased amount of cells present in the periodontally affected tissues, indicating that continuous oxidative stress which occurred in these structure affected the antioxidant pattern of the tissue.

A marker of oxidative stress in saliva: association with periodontally-involved teeth of a hopeless prognosis

The aim of this study was to determine the association between levels of a marker of oxidative stress, 8-hydroxydeoxyguanosine (8-OHdG), in saliva and the presence of teeth with a hopeless prognosis as a result of advanced periodontitis. Thirty-four periodontitis patients were divided into two groups based on the presence or absence of periodontally-involved teeth of hopeless prognosis. Salivary levels of 8-OHdG in those with were significantly higher than in subjects without periodontally-involved teeth of hopeless prognosis (4.78 +/- 0.14 ng/ml and 2.35 +/- 0.18 ng/ml, respectively). We also evaluated 8-OHdG levels in gingival crevicular fluid (GCF) of teeth with advanced periodontal destruction (mean probing depth = 7.2). In this case, 8-OHdG was detected only from those periodontally-involved teeth of hopeless prognosis, and only in some cases (8 out of 18 samples). These data suggest that periodontally-involved teeth of hopeless prognosis are a major source of salivary 8-OHdG. Measurement of salivary 8-OHdG levels may prove to be useful in identifying patients with teeth of hopeless prognosis.

Cleavage of human transferrin by Porphyromonas gingivalis gingipains promotes growth and formation of hydroxyl radicals

Porphyromonas gingivalis, a gram-negative anaerobic bacterium associated with active lesions of chronic periodontitis, produces several proteinases which are presumably involved in host colonization, perturbation of the immune system, and tissue destruction. The aims of this study were to investigate the degradation of human transferrin by gingipain cysteine proteinases of P. gingivalis and to demonstrate the production of toxic hydroxyl radicals (HO*) catalyzed by the iron-containing transferrin fragments generated or by release of iron itself. Analysis by polyacrylamide gel electrophoresis and Western immunoblotting showed that preparations of Arg- and Lys-gingipains of P. gingivalis cleave transferrin (iron-free and iron-saturated forms) into fragments of various sizes. Interestingly, gingival crevicular fluid samples from diseased periodontal sites but not samples from healthy periodontal sites contained fragments of transferrin. By using (55)Fe-transferrin, it was found that degradation by P. gingivalis gingipains resulted in the production of free iron, as well as iron bound to lower-molecular-mass fragments. Subsequent to the degradation of transferrin, bacterial cells assimilated intracellularly the radiolabeled iron. Growth of P. gingivalis ATCC 33277, but not growth of an Arg-gingipain- and Lys-gingipain-deficient mutant, was possible in a chemically defined medium containing 30% iron-saturated transferrin as the only source of iron and peptides, suggesting that gingipains play a critical role in the acquisition of essential growth nutrients. Finally, the transferrin degradation products generated by Arg-gingipains A and B were capable of catalyzing the formation of HO*, as determined by a hypoxanthine/xanthine oxidase system and spin trapping-electron paramagnetic resonance spectrometry. Our study indicates that P. gingivalis gingipains degrade human transferrin, providing sources of iron and peptides. The iron-containing transferrin fragments or the release of iron itself may contribute to tissue destruction by catalyzing the formation of toxic HO*.

Pleasant feeling from watching a comical video enhances free radical-scavenging capacity in human whole saliva

OBJECTIVE

Free radicals have been implicated in aging, mutagenesis, inflammation and other pathological conditions. We conducted a study to clarify the relation between a pleasant feeling as a psychological eustress and free radical-scavenging capacity (FRSC) in saliva.

METHODS

Saliva was collected from 27 healthy volunteers. FRSC before, during and after watching a cheerful comical video for 30 min was measured by using 1,1-diphenyl-2-picrylhydrazyl (DPPH).

RESULTS

The median values of FRSC (micromol/ml) before, at 10 and 20 min during and after watching the video were 54.5, 66.8, 66.6 and 69.4, respectively. The FRSC values obtained after watching the video were significantly higher than those before watching it (P<.001). When the FRSC before watching was taken as 1, the value for the group that felt "Very good," "Good" or "Ordinary+Dull" while watching the video for 30 min was 1.38, 1.20 or 0.98, respectively (P<.01).

CONCLUSION

Watching a comical video enhanced the FRSC in saliva; in addition, a pleasant feeling boosted it even more.

Alteration of gene expression profiles of peripheral mononuclear blood cells by tobacco smoke: implications for periodontal diseases

Alterations of the host response by tobacco smoke adversely affect the periodontium. In this study, we examined the effects of in vitro acute smoke exposure on changes in m-RNA expression of primary peripheral mononuclear blood cells through microarray analysis. Mononuclear blood cells were isolated from four healthy non-smokers and plated in culture wells. Half of the cells were then exposed to 5 min of tobacco smoke. Fluorescent c-DNA probes were prepared from the linearly amplified m-RNAs for each sample and hybridized to cDNA microarrays representing approximately 30000 human genes. Significant increases or decreases in m-RNA gene expression between non-smoke-exposed and smoke-exposed samples were identified by permutation t-test, as implemented by the Significance Analysis of Microarrays software package. After smoke exposure, the expression of 90 genes with known function was significantly elevated and the expression of 19 genes with known function was significantly depressed. In addition, 18 upregulated and 26 downregulated transcripts were expressed sequence tags with little information available on function. Approximately 20 of the significantly elevated genes had previously been reported in the literature to be associated with periodontal pathogenesis (fold changes in parentheses). These included plasminogen activator (4.4), Heat Shock Protein (Hsp) 40 kD (2.2), thrombomodulin (4.2), cytochrome c (1.8), COX-2 (2.6), interleukin-1a (1.4), chemokine ligand 1 (3.8), cathepsin L (2.0), and calgranulin A (2.1). In addition, several significantly elevated genes not previously reported in the literature may also play a role in periodontal pathogenesis, and thus warrant further investigation. These include Diphtheria toxin receptor (heparin-binding epidermal growth factor-like growth factor) (7.8), Hsp 10 kDa (1.7), Hsp 105 kD (2.1), Hsp 70 kDa (1.6), and mitogen activated protein kinase 3 (1.5). Among the significantly depressed genes that may play a protective or destructive role in periodontal pathogenesis were interferon gamma receptor 2 (0.58) and chemokine receptor 2 (0.24). Our results may be of use in the search for the molecular mechanisms for the adverse effects of tobacco smoke on the host response.

Relationship between salivary melatonin levels and periodontal status in diabetic patients

Among other functions, melatonin exerts both antioxidative and immunoregulatory roles. The indoleamine is secreted in the saliva, although its role into the mouth is not known. Diabetic patients frequently display oral cavity pathologies such as periodontal disease (PD), an inflammatory disease coursing with an increase in free radical production. Thus, we compared the degree of PD and interleukin-2 (IL-2) levels with melatonin concentrations in plasma and saliva of diabetic patients. A total of 43 diabetic patients (20 with type I and 23 with type II diabetes) and 20 age- and sex-matched controls were studied. Dental and medical history of all patients was in accordance with the criteria of the WHO. The periodontal status was evaluated by the Community Periodontal Index (CPI). Plasma and salivary melatonin levels were determined by specific commercial radioimmunoassays, and plasma IL-2 was measured using a commercial enzyme-linked immunosorbent assay kit. Diabetic patients had plasma and saliva melatonin levels of 8.98 +/- 7.14 and 2.70 +/- 2.04 pg/mL, respectively. These values were significantly lower (P < 0.001) than those obtained in plasma and saliva of controls (14.91 +/- 4.75 and 4.35 +/- 0.98 pg/mL, respectively). Plasma and salivary melatonin concentrations show a biphasic response in diabetic patients. Melatonin decreased in patients with a CPI index of 2, and then increased reaching highest levels in patients with a CPI index of 4. By contrast, IL-2 levels decreased from CPI index 1 to 4. The results indicate that, in diabetic patients, the presence of a marked impairment of the oral status, as assessed by the CPI index, is accompanied by an increase in plasma and salivary melatonin. The increase in salivary melatonin excretion may have a periodontal protective role.

Alterations in the oxidation products, antioxidant markers, antioxidant capacity and lipid patterns in plasma of patients affected by Papillon-Lefèvre syndrome

Papillon-Lefèvre syndrome (PLS) is an uncommon disease. Less than 300 cases have been described. PLS is characterized by the association between palmar plantar hyperkeratosis (PPK) and severe precocious periodontitis that results in the premature loss of both the primary and secondary dentitions. It is known that periodontitis (PE), the destructive phase of periodontal disease, is a multifactor phenomenon involving a variety of molecular species, among them free radicals and reactive oxygen species (ROS). Antioxidants have been shown to play a critical role in modulating ROS-induced damages during PE. We wondered if patients belonging to a family group with different grades of PLS severity may present altered plasma concentrations of oxidation products as well as of lipophilic antioxidants, like Coenzyme Q or vitamin E, which are molecules that possess well-known antioxidant properties and could play a role in PE processes. We also wondered about the actual plasma total antioxidant capacity of these subjects as well as a complete identification of their plasma fatty acids features, which have been never investigated before. The results we obtained indicate an impairment in the antioxidant capacity of the subjects characterized by abnormally high hydroperoxide levels and, in some cases, by altered CoQ and vitamin E contents. Moreover, an essential fatty acid deficiency (EFAD) was registered on the basis of the peculiar plasma fatty acid patterns found (i.e. low PUFA, high MUFA and high delta-9 desaturase activity). This finding would support the hypothesisby Gutteridge and co-workers (Free Radic. Res. 1998, 28: 109-114) that conditions exist in which some forms of oxidative stress can lead to changes characteristic of EFAD.

Mitochondrial dysfunctions during aging: vitamin E deficiency or caloric restriction--two different ways of modulating stress

Caloric restriction (CR), which has been demonstrated to offset the age-associated accrual of oxidative injury, involves a reduction in calory intake while maintaining adequate nutrition, preserves the activities of antioxidant enzymes in postmitotic tissues, maintains organ function, opposes the development of spontaneous diseases, and prolongs maximum life span in laboratory rodents. It has been proposed that reductions in Reactive Oxygen Species (ROS) production and cellular oxidative injury are central to the positive effects of CR. In the present investigation we studied the effect of CR and of a vitamin E deprived diet on mitochondrial structure and features in the liver of rats during aging, in order to ascertain the extent of modifications induced by these experimental conditions. CR rats displayed structural and functional mitochondrial properties (fatty acid pattern, respiratory chain activities, antioxidant levels, and hydroperoxide contents) similar to those of younger rats whilst vitamin E deficient rats appeared older than their own age. The mitochondria of the former, together with those of young rats, possessed the lowest Coenzyme Q9, hydroperoxide, and cytochrome contents as well as a suitable fatty acid membrane composition. Our study confirms that CR is a valuable tool in limiting aging-related free-radical damage also at mitochondrial liver level.

Amplified crevicular leukocyte activity in aggressive periodontal disease

Exaggerated neutrophil responses are a critical component in the pathogenesis of periodontal disease. We investigated whether leukocyte activity in aggressive periodontitis (AP) is increased compared with that in chronic periodontitis (CP) by gingival crevicular fluid (GCF) analysis of myeloperoxidase (MPO), beta-N-acetyl-hexosaminidase (beta-NAH), cathepsin D (CD), and elastase-alpha-1-proteinase inhibitor complex (alpha-1-EPI) before and 6 months after therapy. Initial AP neutrophil responses were significantly amplified compared with those in CP (MPO, 3.2-fold; beta-NAH, 37.5-fold; CD, 2.2-fold; alpha-1-EPI, 1.4-fold; p < 0.05). Surgical therapy resulted in a significant reduction of GCF markers compared with non-surgical treatment. However, the changes in clinical parameters were not different between AP and CP (P > 0.05). Analysis of the results suggests that the local inflammatory response in AP is characterized by increased release of inflammatory mediators of neutrophil origin into the GCF. Analysis of the data further suggests that surgical therapy is a more predictable method for removal of the pro-inflammatory etiology.

PMN responses in chronic periodontal disease: evaluation by gingival crevicular fluid enzymes and elastase-alpha-1-proteinase inhibitor complex

OBJECTIVES

In the present trial, the hypothesis was examined that the local PMN responses in untreated and treated chronic periodontitis can be differentiated by gingival crevicular fluid lysosomal enzyme activities and elastase-alpha-1-proteinase inhibitor complex.

METHODS

In nine subjects (average age 49.2 +/- 7.1 years) with chronic periodontitis, clinical parameters and markers of the PMN-derived inflammatory tissue response in gingival crevicular fluid (GCF) were assessed before and 6 months after surgical periodontal therapy. Myeloperoxidase (MPO), beta-N-acetyl-hexosaminidase (beta-NAH) and cathepsin D (CD) were analyzed as indicators of the PMN-associated host tissue destruction, and elastase-alpha-1-proteinase inhibitor complex (alpha-1-EPI) as the major serum protein inactivating PMN elastase. The total activities of the lysosomal enzymes MPO and beta-NAH were evaluated spectrophotometrically, the CD levels by liquid scintillation counting with [14C] hemoglobin as substrate, and the total alpha-1-proteinase inhibitor complex using a sandwich-immunoassay.

RESULTS

The clinical parameters revealed a statistical significant decrease at the 6-month reexamination. PD levels dropped from 5.40 to 2.88 mm (change 2.52 +/- 1.04 mm), the CAL scores from 6.67 to 4.43 mm (change 2.24 +/- 0.77 mm). The 30 s GCF volumes dropped from 129.8 to 68.6, displaying a change of 61.1 +/- 18.6, p </= 0.05. The decrease in total MPO, beta-NAH and CD levels (medians: 1.7/0.6 micro U MPO, 0.035/0.020 micro U beta-NAH, 1.3/0.5 ng CD) following therapy was associated with a significant drop in total GCF amounts of alpha-1-EPI from 76.3 ng at baseline to 52.4 ng after 6 months.

CONCLUSION

The clinical healing in chronic periodontal disease is associated with a downregulation of the local PMN responses following periodontal therapy. The reorganization of periodontal tissues is characterized by a decrease of lysosomal enzyme activities and the alpha-1-proteinase inhibitor complex in gingival crevicular fluid.

Resolution of Crevicular Fluid Leukocyte Activity in Patients Treated for Aggressive Periodontal Disease

BACKGROUND

Enhanced neutrophil responses play a critical role in the activation of the innate immune system and causation of aggressive periodontitis (AgP). The hypothesis that comprehensive periodontal treatment expedites resolution of amplified leukocyte activity and facilitates the reconstitution of periodontal health was tested.

METHODS

Four different gingival crevicular fluid (GCF) markers from 14 patients were characterized prior to and at 3, 6, 12, 24, and 36 months after periodontal therapy. GCF myeloperoxidase (MPO), beta-N-acetyl-hexosaminidase (beta-NAH), and beta-glucuronidase (beta-G) were determined spectrophotometrically, and cathepsin D (CD) by liquid scintillation counting using [14C] hemoglobin as substrate. The primary outcome was long-term stability of periodontal health.

RESULTS

In untreated AgP, GCF markers were significantly amplified (MPO: 1.9-fold; beta-NAH: 1.3-fold; beta-G: 1.7-fold; CD: 4.7-fold). Following periodontal therapy, the leukocyte activity was significantly dampened (0.3- to 0.5-fold), and paralleled with a sustained improvement of periodontal health (P < 0.05). Thereafter and at 3 years, GCF leukocyte responses remained on a physiologic low level compatible to normal immune function.

CONCLUSIONS

Comprehensive treatment of AP induces a downregulation of amplified crevicular neutrophil activity. The release of the innate immune system from exacerbating damage elicits a successful reconstitution of long-term periodontal health with no setbacks seen after 3 years.

New biomarker evidence of oxidative DNA damage in whole saliva from clinically healthy and periodontally diseased individuals

BACKGROUND

There is an increasing body of evidence implicating reactive oxygen species in the pathogenesis of periodontal tissue destruction. 8-Hydroxy-deoxyguanosine (8-OHdG) is one of the most commonly used markers to evaluate oxidative damage in a number of disorders including chronic inflammatory diseases. The aim of the present study was to evaluate 8-OHdG levels in whole saliva of patients with periodontitis and to assess the changes after initial treatment.

METHODS

Saliva samples were collected from 78 patients with untreated periodontitis and 17 healthy control subjects. Clinical parameters and levels of 8-OHdG were assessed first to establish a baseline and again after initial periodontal treatment from 15 patients. 8-OHdG levels were determined by enzyme-linked immunosorbent assay.

RESULTS

The mean value of 8-OHdG in the saliva of periodontally diseased subjects, 4.28 +/- 0.10 ng/ml, was significantly higher (P<0.01) than that of clinically healthy subjects (1.56 +/- 0.10 ng/ml). A significant decrease in salivary 8-OHdG was observed after therapy (P<0.01).

CONCLUSION

In the present study, we evaluated for the first time 8-OHdG levels in whole saliva of patients with periodontitis and assessed changes after initial periodontal treatment. Our study indicated that 8-OHdG levels in saliva appear to reflect the status of periodontal health.

In vitro antioxidant activities of mouthrinses and their components

OBJECTIVES

Several forms of periodontal diseases (PD) are often associated with activated phagocytosing leukocytes and contemporary free radical production. Host antioxidant defenses could benefit from mouthrinses used as adjuncts to counteract plaque-associated bacteria. The aim of the present study was to determine possible antioxidant activity (AA) of a number of antiseptic mouthrinses and of their stated active principles (AP), regardless of their efficacy as antimicrobial agents.

MATERIAL AND METHODS

The antioxidant activities of 11 mouthrinses and their active principles were tested with a specific spectrophotometric method. Comet assay was used to test whether pure chemical antioxidant activity actually corresponded to prevention of in vitro DNA fragmentation.

RESULTS

Methylsalicylate-containing mouthrinses were the most effective. Several compounds, and some vehicles, behaved as antioxidants. Fibroblast DNA fragmentation was limited by preincubation with methylsalicylate-containing mouthrinse but was unaffected by treatment with chlorexidine.

CONCLUSION

The results described herein indicate that several mouthrinses possess AA; such a property could be ascribed to either AP or vehicles or both. All the data were obtained in systems in vitro and the demonstration of in vivo AA is necessary. These findings could be useful in the treatment of some forms of PD and should be considered when arranging new mouthrinse formulations.

Feeding fried oil changes antioxidant and fatty acid pattern of rat and affects rat liver mitochondrial respiratory chain components

Fat frying is a popular food preparation method but several components like antioxidant vitamins could be lost due to oxidation and some others with toxic effects could appear. Because of such large consumption of frying oils, the effect of high temperatures on the oils is of major concern both for product quality and nutrition, taking into account that dietary fat source deeply influences several biochemical parameters, especially of mitochondrial membranes. Virgin olive oil possesses specific features for modulating the damages occurred by endogenous and exogenous oxidative stress being particularly rich in antioxidant molecules. We evaluated the extent of modifications suffered by virgin olive oil following a short-time deep fat frying procedure: vitamin E and phenolic compound as well as total antioxidant capacity (measured by ESR) decreased, while polar compounds increased. The intake of such an altered oil mainly affected the hydroperoxide and TBARS contents of mitochondrial membranes which were enhanced after the dietary treatments. Also, several mitochondrial respiratory chain components (Coenzyme Q, cytochrome b, c + c1, and a + a3) were affected.

The antioxidant capacity of saliva

BACKGROUND/AIMS

Saliva, a heterogeneous fluid comprising proteins, glycoproteins, electrolytes, small organic molecules and compounds transported from the blood, constantly bathes the teeth and oral mucosa. It acts as a cleansing solution, an ion reservoir, a lubricant and a buffer. In addition to its other host-protective properties, saliva could constitute a first line of defence against free radical-mediated oxidative stress, since the process of mastication and digestion of ingested foods promotes a variety of reactions, including lipid peroxidation. Moreover, during gingival inflammation, gingival crevicular fluid flow increases the change of saliva composition with products from the inflammatory response; this, in turn, could have some rôle in controlling and/or modulating oxidative damages in the oral cavity. This is the reason why the antioxidant capacity of saliva has led to increasing interest, and the development of techniques suitable for saliva antioxidant evaluation.

MATERIALS AND METHODS

Here, we review the current peer-reviewed literature concerning the nature and characteristics of free radicals, reactive oxygen species, oxidants, pro-oxidants and antioxidants in saliva, especially pro-oxidant and antioxidant features, as well as current methods for assessing the antioxidant capacity of saliva.

RESULTS AND CONCLUSIONS

In the last decade, several methods have been developed for assaying the antioxidant activity of saliva, indicating an increasing interest of researchers and clinicians. Unfortunately, systematic studies of saliva are still lacking, even in healthy populations.

Elevated hydroperoxide levels and antioxidant patterns in Papillon-Lefèvre syndrome

BACKGROUND

Since it has been found that reactive oxygen species seem to be involved in the pathogenesis of both periodontitis and hyperkeratotic syndromes, we studied a group of patients belonging to 3 generations of a family with different degrees of severity of Papillon-Lefèvre syndrome (PLS) to ascertain whether altered concentrations of the most important hydrophobic and hydrophilic plasma antioxidants as well as products of oxidative damage are present in PLS.

METHODS

Coenzyme Q (CoQ), vitamin E, glutathione (GSH), and uric acid were evaluated by high-performance liquid chromatography (HPLC) (supplied with electrochemical detector) techniques and hydroperoxides by a spectrophotometric method.

RESULTS

GSH and uric acid were in the range of reference values; CoQ was very low in both the child of the third generation and his mother, and these 2 subjects had the highest hydroperoxide levels. The child also had extremely low values of vitamin E. In general, all family members showed abnormally high hydroperoxide levels, with the exception of those members who are phenotypically healthy.

CONCLUSIONS

Since the subjects with the lowest hydroperoxide contents are phenotypically healthy, whereas the affected individuals presented lower antioxidant levels and very high hydroperoxide concentrations, it has been suggested that a specific antioxidant therapy could be a promising approach in treating some PLS subjects. Moreover, unexpected manifestations of heterozygosity in the child of the third generation were also detected.

Interleukin-8 and granulocyte elastase in gingival crevicular fluid in relation to periodontopathogens in untreated adult periodontitis

BACKGROUND

This study aimed to determine the relationships among interleukin (IL)-8 and granulocyte elastase levels in gingival crevicular fluid (GCF) and the concomitant presence of periodontopathogens in untreated adult periodontitis.

METHODS

GCF and subgingival plaque samples were collected from 16 patients with untreated adult periodontitis and 10 healthy control subjects. IL-8 levels were determined by enzyme-linked immunosorbent assay (ELISA). Granulocyte elastase was analyzed with a neutrophilic granulocyte-specific, low molecular weight and chromogenic substrate, L-pyroglutamyl-L-prolyl-L-valine-p-nitroanilide, and the maximal rate of elastase activity (MR-EA) was calculated. Five DNA probes were used to detect the presence of A. actinomycetemcomitans (A.a.), B. forsythus (B.f.), P. gingivalis (P.g.), P. intermedia (P.i.), and T. denticola (T.d.).

RESULTS

Lower IL-8 concentrations and higher granulocyte elastase activities were found in patients than in healthy controls as well as in diseased conditions co-infected with B.f., P.g., P.i., and T.d. as compared to healthy conditions without the target species (P <0.05). IL-8 concentrations were positively correlated with MR-EA levels in the periodontitis conditions co-infected with B.f., P.g., P.i., and T.d. (P <0.05). A wide range of IL-8 concentrations was found among 15 patients when the periodontitis condition was characterized by co-infection with B.f., P.g., P.i., and T.d. MR-EA levels in the high IL-8 group of subjects were significantly higher than those in the low IL-8 group of subjects (P <0.01).

CONCLUSIONS

The present study shows that the local host-bacteria interactions in untreated periodontitis are diverse in terms of the intensity of inflammatory responses measured by IL-8-related granulocyte elastase activity in GCF. This might reflect different phases of the inflammatory response due to shifts in host-bacteria interactions and therefore be indicative of a range of periodontal disease activity levels.