Soluble Neuropilin-1 in gingival crevicular fluid from periodontitis patients: An exploratory cross-sectional study

High levels of soluble neuropilin -1 in critically ill multiple trauma/surgical patients

PURPOSE

Critically ill trauma/surgical patients may experience excessive inflammation, immune and coagulation dysregulation, leading to multiple organ failure (MOF), carrying high mortality rates. Neuropilin-1 (NRP-1) and its soluble isoform (sNRP-1) are implicated in immune response regulation, inflammation, and vascular permeability. This study aimed to investigate the possible role of sNRP-1 in trauma/surgical patients in the intensive care unit (ICU).

PATIENTS AND METHODS

This prospective observational study was conducted in a 31-bed ICU and included 81 patients, 43 of whom were trauma/surgical patients and 38 of whom were matched medical patients, comprising the control group. sNRP-1, interleukin (IL)-6, IL-8, and IL-10 levels were measured on admission to the ICU (within 48 hours).

RESULTS

Trauma/surgical patients had significantly higher sNRP-1 (p = 0.027), IL-6, IL-8, and IL-10 levels (p<0.05) compared to medical patients. In the entire cohort, sNRP-1 correlated positively with the international normalized ratio (INR) (p = 0.017), the activated partial thromboplastin time (p = 0.026), fibrinogen (p = 0.027), alanine aminotransferase (p = 0.024), and C-reactive protein (p = 0.004). Moreover, sNRP-1 correlated negatively with total protein (p = 0.035), albumin (p = 0.005), and platelets (p = 0.033).

CONCLUSION

sNRP-1 levels were elevated in critically ill trauma/surgical patients compared to matched medical ICU patients. Further research is needed to elucidate the exact role of sNRP-1 in these patients' pathophysiology.

The role of neuropilin in bone/cartilage diseases

Bone remodeling is the balance between osteoblasts and osteoclasts. Bone diseases such as osteoporosis and osteoarthritis are associated with imbalanced bone remodeling. Skeletal injury leads to limited motor function and pain. Neurophilin was initially identified in axons, and its various ligands and roles in bone remodeling, angiogenesis, neuropathic pain and immune regulation were later discovered. Neurophilin promotes osteoblast mineralization and inhibits osteoclast differentiation and its function. Neuropolin-1 provides channels for immune cell chemotaxis and cytokine diffusion and leads to pain. Neuropolin-1 regulates the proportion of T helper type 17 (Th17) and regulatory T cells (Treg cells), and affects bone immunity. Vascular endothelial growth factors (VEGF) combine with neuropilin and promote angiogenesis. Class 3 semaphorins (Sema3a) compete with VEGF to bind neuropilin, which reduces angiogenesis and rejects sympathetic nerves. This review elaborates on the structure and general physiological functions of neuropilin and summarizes the role of neuropilin and its ligands in bone and cartilage diseases. Finally, treatment strategies and future research directions based on neuropilin are proposed.

IL-23/IL-17 axis levels in gingival crevicular fluid of subjects with periodontal disease: a systematic review

BACKGROUND

The IL-23/IL-17 axis plays an important role in the immunopathogenesis of periodontal disease. A systematic review was conducted to synthesize all research reporting on the levels of the IL-23/IL-17 axis in gingival crevicular fluid (GCF) from subjects with gingivits, and periodontitis, compared to healthy controls.

METHODS

The protocol followed the PRISMA, and Cochrane guidelines, and was registered with the Open Science Framework (OSF): https://doi.org/10.17605/OSF.IO/7495V . A search was conducted in the electronic databases PubMed/MEDLINE, Scopus, Google Schoolar, and Cochrane from November 15th, 2005, to May 10th, 2023. The quality of the studies was assessed using the JBI tool for cross-sectional studies.

RESULTS

The search strategy provided a total of 2,098 articles, of which 12 investigations met the inclusion criteria. The total number of patients studied was 537, of which 337 represented the case group (subjects with gingivitis, and chronic periodontitis), and 200 represented the control group (periodontally healthy subjects). The ages of the patients ranged from 20 to 50 years, with a mean (SD) of 36,6 ± 4,2, of which 47% were men, and 53% were women. 75% of the investigations collected GCF samples with absorbent paper strips, and analyzed cytokine IL-17 levels individually. In addition, qualitative analysis revealed that there are differences between IL-23/IL-17 axis levels in subjects with chronic periodontitis, gingivitis and healthy controls.

CONCLUSIONS

Thus, IL-23/IL-17 axis levels could be used in the future as a diagnostic tool to distinguish between periodontal diseases.

New Biosensor for Determination of Neuropilin-1 with Detection by Surface Plasmon Resonance Imaging

Neuropilin-1 is transmembrane protein with soluble isoforms. It plays a pivotal role in both physiological and pathological processes. NRP-1 is involved in the immune response, formation of neuronal circuits, angiogenesis, survival and migration of cells. The specific SPRI biosensor for the determination of neuropilin-1 was constructed using mouse monoclonal antibody that captures unbound NRP-1 form body fluids. The biosensor exhibits linearity of the analytical signal between 0.01 and 2.5 ng/mL, average precision value 4.7% and recovery between 97% and 104%. The detection limit is 0.011 ng/mL, and the limit of quantification is 0.038 ng/mL. The biosensor was validated by parallel determination of NRP-1 in serum and saliva samples using the ELISA test, with good agreement of the results.

Relationship between soluble neuropilin-1 in the gingival crevicular fluid of early pregnant women and different severities of periodontitis: A cross-sectional study

Background

Pregnancy exacerbates the periodontal inflammation; however, the biological mediators involved are not well characterized. Neuropilins (NRPs) are transmembrane glycoproteins involved in physiological and pathogenic processes such as angiogenesis and immunity but its relationship with periodontal disease in pregnant women has not been studied.

Objective

To explore the soluble Neuropilin-1 (sNRP-1) levels in gingival crevicular fluid (GCF) samples during early pregnancy and its association with the periodontitis severity and periodontal clinical parameters.

Methods

80 pregnant women were recruited, and GCF samples were collected. Clinical data and periodontal clinical parameters were recorded. sNRP-1 expression was determined by ELISA assay. The relationship between sNRP-1(+) pregnant women with the severity of periodontitis and periodontal clinical parameters was determined by Kruskal-Wallis and Mann-Whitney tests. Spearman's test estimated the correlation between sNRP-1 levels and periodontal clinical parameters.

Results

Periodontitis was classified as mild in 27.5% (n = 22) women, moderate in 42.5% (n = 34), and severe in 30% (n = 24). sNRP-1 expression was higher in the GCF of pregnant with severe (41.67%) and moderate (41.17%) periodontitis compared than in those with mild periodontitis (18.8%). The sNRP-1(+) pregnant had a higher BOP (76.5% v/s 57%; p = 0.0071) and PISA (1199.5 mm2 v/s 880.2 mm2; p = 0.0282) compared with sNRP-1(-). A positive correlation between sNRP-1 levels in GCF and BOP (p = 0.0081) and PISA (p = 0.0398) was observed.

Conclusions

The results suggest that sNRP-1 could be involved in periodontal inflammation during pregnancy.

Gingival crevicular fluid lipocalin-2 and semaphorin3A in stage III periodontitis: Non-surgical periodontal treatment effects

BACKGROUND AND OBJECTIVE

Identification of biomarkers to assess individual risk and monitor periodontal health status is important. Research on lipocalin-2 (LCN2) and semaphorin3A (Sema3A) is lacking. This study aimed to evaluate gingival crevicular fluid (GCF) LCN2, Sema3A, and tumor necrosis factor-α (TNF-α) levels in periodontally healthy (H), gingivitis (G), and periodontitis (P) patients, and their changes following non-surgical periodontal therapy.

METHODS

Sixty systemically healthy and non-smoker participants, diagnosed as periodontally healthy, gingivitis, and stage III grade C periodontitis, were recruited (n = 20/group). Clinical periodontal parameters were recorded and GCF samples were obtained at baseline from all groups; for group P, these were repeated one and three months following non-surgical periodontal treatment. GCF LCN2, Sema3A, and TNF-α levels were evaluated with enzyme-linked immunosorbent assay.

RESULTS

GCF LCN2, Sema3A, and TNF-α total amounts were significantly higher in disease groups than group H (p < .001). Between P and G groups, only TNF-α levels were significantly different (p < .001). Non-surgical periodontal therapy resulted in significant improvement of all clinical parameters and significant decreases of GCF LCN2 and TNF-α levels, at both time points, compared with baseline (p < .001). Sema3A levels remained unchanged following treatment (p > .05). LCN2 and TNF-α levels were significantly positively correlated with clinical parameters. LCN2 (AUC [area under the curve] = 0.94) and TNF-α (AUC = 0.98) levels were similarly accurate in differentiating between periodontal disease (whether G or P) and healthy controls.

CONCLUSIONS

LCN2 and TNF-α levels in GCF are correlated with clinical parameters and could prove useful as non-invasive screening tools for periodontitis.

Bone Marrow Mesenchymal Stem Cells (BMSCs) Enhance Endometrial Stromal Cell Migration and Epithelial-Mesenchymal Transition in Adenomyosis Through Upregulation of Neuropilin 1

Hormone support (estrogen and progesterone) is a key factor in decidualization and embryo implantation. Elevated levels of estrogen lead to luteal phase defects through Neuropilin 1, a membranecytoskeleton junction protein. This study aimed to explore the effect of BMSCs on endometrial stromal cells (ESCs) in adenomyosis. ESCs obtained from patients with adenomyosis were cocultured with BMSCs in the absence of presence of Neuropilin 1 inhibitor followed by analysis of expression of decidualization-related genes by RT-qPCR and western blot, cell viability by MTT assay, cell invasion and migration by Transwell assay, oxidative stress factors by ROS kit. Treatment with Neuropilin 1 inhibitor significantly decreased ESC proliferation and invasion, blocked epithelialmesenchymal transition (EMT) process, and restrained decidualization with a downregulation of decidualization-related genes. Furthermore, inhibition of Neuropilin 1 exerted effects through estrogen regulation. However, co-culture with BMSCs restored ESC activity by promoting Neuropilin expression and enhanced intrauterine ESC decidualization. In conclusion, Neuropilin 1 inhibitor restrains decidualization through estrogen regulation which can be abrogated by estrogen receptor antagonists. BMSCs restore the damaged ESC decidualization through increasing Neuropilin 1 expression, which provides new insights into the adverse effect of Neuropilin 1 on human ESCs, suggesting that BMSC is a potential therapeutic drug candidate for adenomyosis.

Predictive Periodontitis: The Most Promising Salivary Biomarkers for Early Diagnosis of Periodontitis

The primary cause of tooth loss in the industrialized world is periodontitis, a bacterial anaerobic infection whose pathogenesis is characterized by composite immune response. At present, the diagnose of periodontitis is made by a complete status check of the patient’s periodontal health; full-mouth plaque score, full-mouth bleeding score, probing depth, clinical attachment level, bleeding on probing, recessions, mobility, and migration are evaluated in order to provides a clear picture of the periodontal conditions of a single patient. Chair-side diagnostic tests based on whole saliva could be routinely used by periodontists for a very early diagnosis of periodontitis, monitoring, prognosis, and management of periodontal patients by biomarker detection, whose diagnostic validity is related to sensitivity and specificity. Recent paper reviews and meta-analyses have focused on five promising host derived biomarkers as candidate for early diagnosis of periodontitis: MMP-8 (Metalloproteinase-8), MIP-1α (Macrophage inflammatory protein-1 alpha), IL-1 β (Interleukin-1 beta), IL-6 (Interleukin-6), and HB (Hemoglobin), and their combinations. Chair-side Lab-on-a-chip (LOC) technology may soon become an important part of efforts to detect such biomarkers in saliva medium to improve worldwide periodontal health in developed nations as well as in underserved communities and poor countries. Their applications in preventive and predictive medicine is now fundamental, and is aimed at the early detection of risk factors or the presence or evolution of the disease, and in personalized medicine, which aims to identify tailor-made treatments for individual patients. The aim of the present paper is to be informative about host derived periodontal biomarkers and, in particular, we intend to report information about the most important immune response derived biomarkers and Hemoglobin as candidates to be routinely utilized in order to obtain a chair-side early diagnosis of periodontal disease.

Soluble neuropilin-1 in gingival crevicular fluid is associated with rheumatoid arthritis: An exploratory case-control study

BACKGROUND

To explore the soluble Neuropilin-1 (sNRP-1) concentrations in gingival crevicular fluid (GCF) and the periodontal clinical status of patients with Rheumatoid Arthritis (RA).

MATERIALS AND METHODS

We conducted an exploratory study with 40 study participants, 20 with RA, and 20 healthy controls. Clinical and periodontal data were recorded, and GCF samples were obtained. sNRP-1 levels in GCF were determined by ELISA assay. Descriptive statistics, Mann-Whitney U test, Unpaired t-test, logistic regression model, and Area Under Receiver Operating Characteristic Curve (AUC-ROC) were made to explore the diagnostic performance accuracy.

RESULTS

RA patients had significantly higher levels of sNRP-1 in GCF (p ​= ​0.0447). The median levels of GCF-sNRP-1 were 208.85 ​pg/μl (IQR 131.03) in the RA group compared to 81.46 ​pg/μl (IQR 163.73) in the control group. We observed an association between the GCF-sNRP-1 concentrations and the RA diagnosis (OR:1.009; CI 1.00-1.001; p ​= ​0.047). The diagnosis of chronic periodontitis was also associated with RA (OR: 6.9; CI 1.52-31.37; p ​= ​0.012). Moreover, the AUC-ROC of GCF-sNRP-1 concentrations combined with periodontal clinical parameters such as periodontal probing depth and periodontal inflamed surface area was 0.80.

CONCLUSION

This exploratory case-control study shows that RA patients had significantly higher levels of sNRP-1 in GCF. New longitudinal studies are necessary to evaluate the role of NRP-1 in periodontal tissues and consider it an oral biomarker with clinical value in RA.