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Gürsoy UK, Özdemir Kabalak M, Gürsoy M. Advances in periodontal biomarkers. Adv Clin Chem 2024; 120:145-168. [PMID: 38762240 DOI: 10.1016/bs.acc.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2024]
Abstract
Due to technologic advancements, periodontology has witnessed a boost in biomarker research over the past three decades. Indeed, with the aid of omics, our understanding of the healthy periodontium, pathogenesis of periodontal diseases, and healing after periodontal treatment has improved significantly. Yet, the traditional methods, periodontal probing and radiographies, remain the most common methods to diagnose periodontal disease and monitor treatment. Although these approaches can produce reliable diagnostic outcomes, they generally detect disease only after significant tissue degradation thus making treatment outcome highly uncertain. Accordingly, laboratories worldwide have collaborated with clinicians to design accurate, rapid and cost-effective biomarkers for periodontal disease diagnosis. Despite these efforts, biomarkers that can be widely used in early disease diagnosis and for treatment outcome prediction are far from daily use. The aim of this chapter is to give a general overview on periodontal health and diseases, and review recent advancements in periodontal biomarker research. A second aim will discuss the strengths and limitations of translating periodontal biomarker research to clinical practice. Genetic biomarkers of periodontitis are not discussed as the available confirmatory data is scarce.
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Affiliation(s)
| | | | - Mervi Gürsoy
- Periodontology, Institute of Dentistry, University of Turku, Turku, Finland; Oral Health Care, Welfare Division, City of Turku, Turku, Finland
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Lee MJ, Ryu HH, Hwang JW, Kim JR, Cho ES, Choi JK, Moon YJ. Sirt6 Activation Ameliorates Inflammatory Bone Loss in Ligature-Induced Periodontitis in Mice. Int J Mol Sci 2023; 24:10714. [PMID: 37445896 PMCID: PMC10341680 DOI: 10.3390/ijms241310714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/21/2023] [Accepted: 06/25/2023] [Indexed: 07/15/2023] Open
Abstract
Periodontitis is an inflammatory disease caused by microorganisms that induce the destruction of periodontal tissue. Inflamed and damaged tissue produces various inflammatory cytokines, which activate osteoclasts and induce alveolar bone loss and, eventually, tooth loss. Sirt6 expression suppresses inflammation and bone resorption; however, its role in periodontitis remains unclear. We hypothesized that Sirt6 has a protective role in periodontitis. To understand the role of Sirt6 in periodontitis, we compared periodontitis with ligature placement around the maxillary left second molar in 8-week-old control (C57BL/6J) male mice to Sirt6-overexpressing Tg (Sirt6Tg) mice, and we observed the resulting phenotypes using micro-CT. MDL801, a Sirt6 activator, was used as a therapy for periodontitis through oral gavage. Pro-inflammatory cytokines and increased osteoclast numbers were observed in alveolar bone tissue under periodontitis surgery. In the same condition, interestingly, protein levels from Sirt6 were the most downregulated among sirtuins in alveolar bone tissue. Based on micro-CT and CEJ-ABC distance, Sirt6Tg was observed to resist bone loss against ligature-induced periodontitis. Furthermore, the number of osteoclasts was significantly reduced in Sirt6Tg-ligated mice compared with control-ligated mice, although systemic inflammatory cytokines did not change. Consistent with this observation, we confirmed that bone loss was significantly reduced when MDL801, a Sirt6 activator, was included in the ligation mouse model. Our findings demonstrate that Sirt6 activation prevents bone loss against ligature-induced periodontitis. Thus, a Sirt6 activator may provide a new therapeutic approach for periodontitis.
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Affiliation(s)
- Myung Jin Lee
- Department of Chemistry, Case Western Reserve University, Cleveland, OH 44106, USA;
| | - Hyang Hwa Ryu
- Department of Biochemistry and Molecular Biology, Jeonbuk National University Medical School, Jeonju 54896, Republic of Korea; (H.H.R.); (J.W.H.)
| | - Jae Won Hwang
- Department of Biochemistry and Molecular Biology, Jeonbuk National University Medical School, Jeonju 54896, Republic of Korea; (H.H.R.); (J.W.H.)
| | - Jung Ryul Kim
- Department of Orthopaedic Surgery, Jeonbuk National University Medical School and Hospital, Jeonju 54896, Republic of Korea;
| | - Eui-Sic Cho
- Cluster for Craniofacial Development and Regeneration Research, Institute of Oral Biosciences, Jeonbuk National University School of Dentistry, Jeonju 54896, Republic of Korea;
| | - Jin Kyeong Choi
- Department of Immunology, Jeonbuk National University Medical School, Jeonju 54907, Republic of Korea
| | - Young Jae Moon
- Department of Biochemistry and Molecular Biology, Jeonbuk National University Medical School, Jeonju 54896, Republic of Korea; (H.H.R.); (J.W.H.)
- Department of Orthopaedic Surgery, Jeonbuk National University Medical School and Hospital, Jeonju 54896, Republic of Korea;
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Yilmaz M, Sorsa T, Demir E, Gürsoy M, Suominen A, Tervahartiala T, Räisänen IT, Gürsoy UK. Accuracy of aMMP-8 point-of-care test in indicating periodontal treatment outcomes in stage III/IV periodontitis: A 24-week follow-up study. J Periodontal Res 2023; 58:325-335. [PMID: 36618000 DOI: 10.1111/jre.13093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/20/2022] [Accepted: 12/27/2022] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To analyse the correspondence between aMMP-8 PoC test results and the clinical endpoints of non-surgical periodontal treatment in stage III/IV periodontitis. BACKGROUND The diagnostic success of the active-matrix metalloproteinase-8 (aMMP-8) point-of-care (PoC) test has been demonstrated in various studies, but the evidence of its accuracy following periodontal treatment is limited. MATERIALS AND METHODS Altogether 42 stage III/IV grade C periodontitis patients were included in this prospective diagnostic study. Clinical periodontal indices were recorded, aMMP-8 PoC test was applied and mouthrinse was collected before and at 6, 12 and 24 weeks after non-surgical periodontal treatment. Quantitative aMMP-8 levels were determined with immunofluorometric assay (IFMA) for the verification of the PoC test results. The accuracy of the aMMP-8 PoC test was assessed using previously established clinical endpoints as references. RESULTS Sensitivity and specificity of aMMP-8 PoC test to indicate clinical endpoints were ranged as follows: Sensitivity 71.4% at baseline, 39.3%-42.4% at week 6, 28.6%-32.4% at week 12 and 35.3%-42.9% at week 24; specificity 64.3%-80% at week 6, 40%-57.1% at week 12 and 56%-64.3% at week 24. CONCLUSIONS The accuracy of aMMP-8 PoC test in identifying clinical endpoints after non-surgical periodontal treatment is reduced in relation to baseline. Individual healing patterns of each diseased pocket eventually limit the accuracy of the dichotomous aMMP-8 oral rinse test during the post-treatment period.
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Affiliation(s)
- Mustafa Yilmaz
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland.,Department of Periodontology, Faculty of Dentistry, Biruni University, Istanbul, Turkey
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Esra Demir
- Department of Periodontology, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey
| | - Mervi Gürsoy
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland
| | - Auli Suominen
- Department of Community Dentistry, Institute of Dentistry, University of Turku, Turku, Finland
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Ismo T Räisänen
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Ulvi K Gürsoy
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland
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Kompuinen J, Keskin M, Yilmaz D, Gürsoy M, Gürsoy UK. Human β-Defensins in Diagnosis of Head and Neck Cancers. Cells 2023; 12:cells12060830. [PMID: 36980171 PMCID: PMC10047923 DOI: 10.3390/cells12060830] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/03/2023] [Accepted: 03/05/2023] [Indexed: 03/30/2023] Open
Abstract
Head and neck cancers are malignant growths with high death rates, which makes the early diagnosis of the affected patients of utmost importance. Over 90% of oral cavity cancers come from squamous cells, and the tongue, oral cavity, and salivary glands are the most common locations for oral squamous cell carcinoma lesions. Human β-defensins (hBDs), which are mainly produced by epithelial cells, are cationic peptides with a wide antimicrobial spectrum. In addition to their role in antimicrobial defense, these peptides also take part in the regulation of the immune response. Recent studies produced evidence that these small antimicrobial peptides are related to the gene and protein expression profiles of tumors. While the suppression of hBDs is a common finding in head and neck cancer studies, opposite findings were also presented. In the present narrative review, the aim will be to discuss the changes in the hBD expression profile during the onset and progression of head and neck cancers. The final aim will be to discuss the use of hBDs as diagnostic markers of head and neck cancers.
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Affiliation(s)
- Jenna Kompuinen
- Department of Periodontology, Institute of Dentistry, University of Turku, 20520 Turku, Finland
| | - Mutlu Keskin
- Oral and Dental Health Department, Altınbaş University, İstanbul 34147, Turkey
| | - Dogukan Yilmaz
- Department of Periodontology, Institute of Dentistry, University of Turku, 20520 Turku, Finland
- Department of Periodontology, Faculty of Dentistry, Sakarya University, Sakarya 54050, Turkey
| | - Mervi Gürsoy
- Department of Periodontology, Institute of Dentistry, University of Turku, 20520 Turku, Finland
- Welfare Division, Oral Health Care, 20101 Turku, Finland
| | - Ulvi Kahraman Gürsoy
- Department of Periodontology, Institute of Dentistry, University of Turku, 20520 Turku, Finland
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Gürsoy UK, Kantarci A. Molecular biomarker research in periodontology: A roadmap for translation of science to clinical assay validation. J Clin Periodontol 2022; 49:556-561. [PMID: 35322451 PMCID: PMC9321848 DOI: 10.1111/jcpe.13617] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 02/20/2022] [Accepted: 03/13/2022] [Indexed: 12/11/2022]
Abstract
The number of studies that aims to apply host‐ or microbe‐derived biochemical biomarkers to periodontal disease diagnosis has increased significantly during the last three decades. The biochemical markers can reflect the presence, severity, and activity of periodontal diseases; however, heterogeneities in applied laboratory methods, data presentation, statistical analysis, and data interpretation prevent the translation of candidate host‐ or microbe‐derived biochemical biomarkers to clinical assay validation. Here, we propose a roadmap for making the research outcomes comparable and re‐analysable with the ultimate goal of translating research to clinical practice. This roadmap presents reporting recommendations for host‐ or microbe‐derived biochemical biomarker studies in periodontology. We aim to make essential elements of the research work (including diagnostic criteria, clinical endpoint definitions, participant recruitment criteria, sample collection and storage techniques, biochemical and microbiological detection methods, and applied statistical analysis) visible and comparable.
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Affiliation(s)
- Ulvi Kahraman Gürsoy
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland
| | - Alpdogan Kantarci
- The Forsyth Institute, Cambridge, Massachusetts, USA.,School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
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