Proteoglycans of oral tissues

Tunnel technique with cross-linked hyaluronic acid in addition to subepithelial connective tissue graft, compared with connective tissue graft alone, for the treatment of multiple gingival recessions: 6-month outcomes of a randomized clinical trial

OBJECTIVES

The aim of this study was to investigate differences in clinical and esthetic outcomes in the treatment of multiple gingival recession types 1 and 2, using the modified coronally advanced tunnel technique (MCAT) combined with subepithelial connective tissue graft (SCTG), with or without cross-linked hyaluronic acid (HA).

MATERIALS AND METHODS

A total of 24 patients with 266 multiple gingival recessions (GR) were enrolled in the study (133 recessions per group). MCAT was combined with SCTG and HA on the test side, while MCAT with SCTG was used on the control side. Clinical parameters were measured at baseline and 6 months post-operatively. Visual analogue scales (VAS) and questionnaires were used to assess patient-rated outcomes, and the root coverage esthetic score (RES) was used for professional esthetic evaluation.

RESULTS

No significant improvement in root coverage was observed as a result of adding HA. After 6 months, mean root coverage (MRC) was 85% for SCTG + HA group and 83% for SCTG group (p = 0.9819). Complete root coverage (CRC) was observed in 91% (test) and 93% (control) of the cases (p = 0.9001). Professional assessment of soft tissue texture (STT) using RES showed a significant difference (0.94 versus 0.69, p = 0.0219) in favor of the experimental group.

CONCLUSIONS

Both treatments were similarly effective in treating multiple GRs and led to comparable improvements in clinical parameters. However, application of HA improved the appearance of soft tissue texture.

CLINICAL RELEVANCE

Adjunctive application of HA in the MCAT + SCTG procedure may improve STT results.

The Unifying Hypothesis of Alzheimer's Disease: Heparan Sulfate Proteoglycans/Glycosaminoglycans Are Key as First Hypothesized Over 30 Years Ago

The updated "Unifying Hypothesis of Alzheimer's disease" (AD) is described that links all the observed neuropathology in AD brain (i.e., plaques, tangles, and cerebrovascular amyloid deposits), as well as inflammation, genetic factors (involving ApoE), "AD-in-a-Dish" studies, beta-amyloid protein (Aβ) as a microbial peptide; and theories that bacteria, gut microflora, gingivitis and viruses all play a role in the cause of AD. The common link is the early accumulation of heparan sulfate proteoglycans (HSPGs) and heparan sulfate glycosaminoglycans (GAGs). HS GAG accumulation and/or decreased HS GAG degradation is postulated to be the key initiating event. HS GAGs and highly sulfated macromolecules induce Aβ 1-40 (but not 1-42) to form spherical congophilic maltese-cross star-like amyloid core deposits identical to those in the AD brain. Heparin/HS also induces tau protein to form paired helical filaments (PHFs). Increased sulfation and/or decreased degradation of HSPGs and HS GAGs that occur due to brain aging leads to the formation of plaques and tangles in AD brain. Knockout of HS genes markedly reduce the accumulation of Aβ fibrils in the brain demonstrating that HS GAGs are key. Bacteria and viruses all use cell surface HS GAGs for entry into cells, including SARS-CoV-2. Bacteria and viruses cause HS GAGs to rapidly increase to cause near-immediate aggregation of Aβ fibrils. "AD-in-a-dish" studies use "Matrigel" as the underlying scaffold that spontaneously causes plaque, and then tangle formation in a dish. Matrigel mostly contains large amounts of perlecan, the same specific HSPG implicated in AD and amyloid disorders. Mucopolysaccharidoses caused by lack of specific HS GAG enzymes lead to massive accumulation of HS in lysosomal compartments in neurons and contribute to cognitive impairment in children. Neurons full of HS demonstrate marked accumulation and fibrillization of Aβ, tau, α-synuclein, and prion protein (PrP) in mucopolysaccharidosis animal models demonstrating that HS GAG accumulation is a precursor to Aβ accumulation in neurons. Brain aging leads to changes in HSPGs, including newly identified splice variants leading to increased HS GAG sulfation in the AD brain. All of these events lead to the new "Unifying Hypothesis of Alzheimer's disease" that further implicates HSPGs /HS GAGs as key (as first hypothesized by Snow and Wight in 1989).

Commercial Local Pharmacotherapeutics and Adjunctive Agents for Nonsurgical Treatment of Periodontitis: A Contemporary Review of Clinical Efficacies and Challenges

Periodontal infections tend to be site-specific, mostly confined to the periodontal pocket. With the surge of antibiotic-resistant bacteria, the trend is shifting towards other therapeutic modalities, especially locally delivered approaches that include other pharmacotherapeutic drugs and medical devices. This narrative review aimed to provide insights into the clinical efficacy of local drug delivery and adjunctive agents used in nonsurgical management of periodontitis. Electronic (PubMed/MEDLINE, CENTRAL, and EMBASE) and bibliographic searches of past systematic reviews were carried out to identify previous publications on the topic. Only relevant literature and randomized controlled trials published in English were selected. In addition, a literature review was developed based on the selected articles. Experimental drugs or agents were excluded. This review highlights the clinically proven and commercially available therapeutic agents related to the management of periodontal disease with comparisons of their clinical efficacies and challenges. A vast array of commercial local pharmacotherapeutic agents had been clinically tested, but the methodologies and clinical results varied within and between each agent used, causing difficulty in drawing conclusions and providing support to the superiority of one agent over another. Considering the benefit-cost ratio with the modest clinical results, the long-term usefulness of these agents remains debatable.

Tendinopathy: Pathophysiology, Therapeutic Options, and Role of Nutraceutics. A Narrative Literature Review

Tendinopathies are very common in general population and a huge number of tendon-related procedures take place annually worldwide, with significant socio-economic repercussions. Numerous treatment options are commonly used for tendon disorders. Besides pharmacological and physical therapy, nutrition could represent an additional tool for preventing and treating this complex pathology that deserve a multidisciplinary approach. In recent years, nutraceutical products are growing up in popularity since these seem to favor the prevention and the healing processes of tendon injuries. This narrative literature review aims to summarize current understanding and the areas of ongoing research about the management of tendinopathies with the help of oral supplementation.

Potential involvement of chondroitin sulfate A in the pathogenesis of ameloblastoma

Ameloblastoma is classified as a benign odontogenic tumor characterized by locally invasive behavior and high risk of recurrence. Here, we evaluate a potential role for glycosaminoglycan, a structural component of cell membranes and extracellular matrix, in ameloblstoma pathogenesis. We subjected formalin-fixed, paraffin-embedded tissue sections of 34 cases of ameloblastoma, 10 of odontogenic keratocyst, and 17 of dentigerous cyst to immunohistochemistry using monoclonal antibodies recognizing chondroitin sulfate A (CS-A), heparan sulfate (HS), and keratan sulfate (KS). Expression levels of CS-A in epithelial component and stroma of ameloblastoma were significantly higher than those in odontogenic keratocyst and dentigerous cyst. Moreover, CS-A in ameloblastoma was more strongly expressed in stellate reticulum-like cells than in amelobast-like cells with statistical significance. On the other hand, expression levels of HS and KS in epithelial component and stroma of ameloblastoma were lower compared with CS-A. These results overall reveal that among these odontogenic lesions, CS-A is preferentially expessed in ameloblastoma, suggesting potential pathogenetic role probably in cytodifferention of tumor cells to stellate reticulum-like cells.

Effects of topically applied agents on intra-oral wound healing in a rat model: a clinical and histomorphometric study

OBJECTIVES

Topically applied chlorhexidine and hyaluronan have many studies supporting their use to enhance oral wound healing. Allantoin is widely used topically to promote epithelial proliferation and wound healing, with very little scientific evidence to support such uses. This study investigated and compared the influence of these agents on the healing of intra-oral excisional wounds with large epithelial and connective tissue defects.

METHODS

Excisional wounds, 3 mm in diameter, were made at the centre of the palate of 125 Wistar male albino rats. Five animals constituted the baseline group at time 0. The remaining animals were divided into four experimental and one control groups, in which chlorhexidine digluconate gel 0.2% (Perio.Kin®), hyaluronan gel (Gengigel®), allantoin 0.5% in vehicle gel, vehicle gel alone and nothing were applied daily to the wounds. The wound areas were measured photographically and the epithelialization rates were determined histologically at 0, 3, 7, 14 and 21 days post-surgery.

RESULTS

The mean wound area and mean distance between the epithelial margins decreased significantly with time in all experimental and control groups (P < 0.05). A significant rate of wound area reduction was observed following the use of Perio.Kin® and Gengigel® at 7 and 14 days. Perio.Kin® showed a significant rate of wound epithelialization at 7 days. Allantoin did not positively or negatively affect wound healing.

CONCLUSIONS

None of the tested agents had a negative effect on the rate of wound healing when applied on an excisional wound with epithelial and connective tissue defect. Positive results were achieved with Perio.Kin® and Gengigel®.

Biomechanical behavior of oral soft tissues

BACKGROUND

Little attention has been given to understanding the variation in biomechanical behavior of oral soft tissues, and this represents an obstacle for the development of biomaterials that perform with appropriate biomechanical characteristics. With this as our motivation, a uniaxial mechanical analysis was performed on lingual and buccal aspects of the attached gingiva, alveolar mucosa, and buccal mucosa to gain insight into human tissue performance and site-specific mechanical variation.

METHODS

A discrete quantitative mechanical evaluation of each soft tissue region using tensile, dynamic compression, and stress relaxation analysis was conducted to correlate tissue structure with function as assessed histologically.

RESULTS

Results confirm the keratinized gingiva to have increased tensile strength (3.94 ± 1.19 MPa) and stiffness (Young modulus of 19.75 ± 6.20 MPa) relative to non-keratinized mucosal regions, where densely arranged elastin fibers contribute to a tissue with increased viscoelastic properties. Dynamic compression analysis indicated the instantaneous modulus (E(int)), steady modulus (E(s)), and peak stress increased with loading frequency and strain amplitude, with the highest values found in the buccal attached gingiva.

CONCLUSION

These investigations quantify the biomechanical properties of oral soft tissues and show region-to-region variation that details structure-function relationships and provides key parameters to aid development of biomaterials that perform with appropriate biomechanical properties.

Preservation of Rabbit Aorta Elastin From Degradation by Gingival Fibroblasts in an Ex Vivo Model

Objective— Embryo-like gingival healing properties are attributed to the gingival fibroblast (GF) and could be used as a model for other types of healing dysfunctions. Abdominal aortic aneurysm (AAA) formation is associated with elastin degradation and increase in matrix metalloproteinase (MMP)-9 activity. We aimed to validate the concept of using GF healing properties in arteries.

Methods and Results— We evaluated MMP-9 and its tissue inhibitor (TIMP-1) in rabbit aortic rings cultured in collagen gels with or without GFs and observed throughout 21 days. We also performed cocultures of human smooth muscle cells (hSMCs) with either gingival, dermal, or adventitial fibroblasts, and alone (control). In control arteries, elastic fibers became spontaneously sparse. In presence of GFs, elastic fibers were preserved. There was a dramatically reduced protein level of MMP-9 in coculture of aorta and GFs, in contrast with control aorta. MMP-9 expression was unaffected by GFs. MMP-9 inhibition was related to increased TIMP-1 secretion, TIMP-1 forming a complex with MMP-9. Cell cocultures of hSMC with GFs showed similar results. Dermal and adventitial fibroblasts did not affect MMP-9.

Conclusions— Elastic fiber degradation was specifically preserved by GFs via reduction of MMP-9 protein level by increasing TIMP-1 synthesis. Vascular transfer of gingival fibroblasts could be a promising approach to treat AAA.

Comparative35S-sulfate and3H-proline metabolism within the interdental septal bone and adjacent periodontal ligament

Tooth movements require rapid remodeling of the periodontal ligament (PDL) and adjacent alveolar bone. Our objective was to compare the regional metabolism of sulfated-glycosaminoglycans (sGAG) within the PDL and adjacent alveolar bone and compare it to the metabolism of collagenous proteins using radioautographic techniques. Rats were injected with either (3)H-proline or (35)S-sulfate and maxillae were removed at 1, 6, and 12 hr 1-7 days later. Silver grains were counted over the PDL and adjacent alveolar bone and the incorporation and removal rates for each radioisotope were determined. In general, net collagenous protein incorporation and removal were greatest within the distal and net sGAG incorporation and removal were greatest within the mesial compartments of the periodontium. The rate of removal of (3)H-proline was significantly greater within the distal alveolar bone surface than the adjacent PDL at all levels (P < 0.001). In contrast, the rate of removal of (35)S-sulfate was significantly greater in the PDL than within the adjacent mesial surface of the interdental septum at all levels (P < 0.001). The mesial surfaces of the interdental septum had a slower rate of removal of both isotopes than distal surfaces at all levels (P < 0.001). Our data suggest significant regional differences in the metabolism of (35)S-sulfate and (3)H-proline within the PDL and alveolar bone, which likely result from the characteristics of the forces produced by the adjacent teeth and may be a factor in the remodeling of the alveolar wall coincident to tooth movement.

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.

Modulation of extracellular matrix synthesis and alkaline phosphatase activity of periodontal ligament cells by mechanical stress

BACKGROUND

Loss of occlusal function has been reported to induce atrophic changes in the periodontal ligament. It is likely that mechanical stress triggers the biological response of periodontal ligament. However, there have been few reports studying the correlation between mechanical stress of varying magnitude and periodontal ligament cell activities such as extracellular matrix (ECM) synthesis.

OBJECTIVE

The objective of this study is to clarify the influence of the mechanical stress on changes in mRNA expression levels of type I collagen and decorin genes, as well as alkaline phosphatase (ALP) activity in response to mechanical stress of varying magnitude.

METHODS

Bovine periodontal ligament cells were cultured on flexible-bottomed culture plates and placed on the BioFlex Loading Stations. Cells were elongated at 6 cycles/min (5 s on and 5 s off) at each of six levels of stretch (0.2, 1.0, 2.0, 3.0, 10, 18% increase in the surface area of the bottom) for 48 h. We measured mRNA expression levels of type I collagen and decorin genes using quantitative reverse transcription-polymerase chain reaction (RT-PCR), and ALP activity in periodontal ligament cell culture under cyclic mechanical stretching.

RESULTS

Mechanical tensional stress of low magnitude induced the increase of both type I collagen and decorin mRNA expression without changing ALP activity in periodontal ligament cells. Mechanical tensional stress of high magnitude induced the increase of type I collagen and decorin mRNA expression while decreasing ALP activity.

CONCLUSION

These results suggest that different magnitude of tensional force induces different responses from periodontal ligament cells, and that mechanical stress plays an important role in remodeling and functional regulation of periodontal ligament.

Analysis of the relationship between the severity of periodontal destruction and proteoglycan metabolism of gingiva and gingival crevicular fluid

BACKGROUND

Although it is well-described that proteoglycans (PGs) are among the major non-collagenous components of the matrix which are degraded during periodontal diseases, the relationship between PG metabolism and seventy of periodontal breakdown, the extent of degradation of PGs together with the resulting end-products, and the elimination pathways of these catabolic end-products is likely to need further clarification.

OBJECTIVE

The main aim of the present study was to analyze the possible impact of severity of periodontal destruction on PG metabolism of gingiva and gingival crevicular fluid (GCF).

MATERIAL AND METHODS

For this purpose, gingiva and GCF samples obtained from patients (n = 45) exhibiting sites (n = 57) with moderate periodontal breakdown (MP) or severe periodontal breakdown (SP) were analyzed for PG metabolism via spectrophotometric determination of uronic acid levels. Gingiva and GCF samples were obtained from the same sites in every patient to analyze the possible relationship between uronic acid content of gingival tissue and GCF.

RESULTS

No significant differences were found in uronic acid levels between sites with MP and SP (p > 0.05). The uronic acid content of GCF and gingiva showed significant overlaps between MP and SP sites and uronic acid levels did not present any constant correlation with the clinical parameters (p > 0.05). In a similar manner, uronic acid content of GCF and gingival tissue was not correlated (p > 0.05).

CONCLUSION

The lack of a significant correlation between the uronic acid content of gingival tissue and GCF may suggest that the passage of PG metabolites from gingiva to GCF is likely to be under the influence of multifactorial interactions rather than being linear. As a general measure of PG metabolism, uronic acid levels do not seem to be related with the severity of periodontal destruction and tend to act as different measures when compared to traditional clinical parameters.

Proteoglycans and orthodontic tooth movement

Proteoglycans represent an important and diverse family of extracellular matrix components within the connective tissues of the periodontium. This review focuses on the function and metabolism of the various proteoglycans in periodontal tissues, such as alveolar bone and periodontal ligament, and considers their potential fate in response to an orthodontic force. Such considerations provide an important background in evaluating the potential for proteoglycan metabolites, alongside other connective tissue metabolites, as biomarkers for assessing the deep-seated metabolic changes and as a diagnostic tool in monitoring orthodontic tooth movement.

Reactive oxygen species: a potential role in the pathogenesis of periodontal diseases

The pathological events leading to the destruction of the periodontium during inflammatory periodontal diseases are likely to represent complex interactions involving an imbalance in enzymic and non-enzymic degradative mechanisms. This paper aims to review the increasing body of evidence implicating reactive oxygen species (ROS), derived from many metabolic sources, in the pathogenesis of periodontal tissue destruction. ROS are generated predominantly by polymorphonuclear leukocytes (PMN) during an inflammatory response and are regarded as being highly destructive in nature. The detection of ROS oxidation products, the elevation of iron and copper ions, which catalyse the production of the most reactive radical species, and the identification of an imbalance in the oxidant/antioxidant activity within periodontal pockets, suggests a significant role for ROS in periodontal tissue destruction. In vitro studies have shown that ROS are capable of degrading a number of extracellular matrix components including proteoglycans, resulting in the modification of amino acid functional groups, leading to fragmentation of the core protein, whilst the constituent glycosaminoglycan chains undergo limited depolymerisation. The identification and characterisation of connective tissue metabolites in gingival crevicular fluid (GCF) resulting from the degradation of periodontal tissues, notably alveolar bone, provides further evidence for a role for ROS in tissue destruction associated with inflammatory periodontal diseases.

Isolation and analysis of a novel acidic polysaccharide from the case of squid pen

A new non-sulphated acidic polysaccharide with an average molecular mass of 55 kDa was isolated from squid pen case after papain digestion and beta-elimination. This polysaccharide contains mainly L-iduronic acid, D-glucuronic acid, D-galactosamine, D-glucosamine and significant amounts of neutral sugars as glucose, galactose and fucose. The polysaccharide was not degraded to the relative disaccharides by chondroitinases ABC, AC and B, hyaluronidase and keratanase or by treatment with heparinases, suggesting a structure different from those of known glycosaminoglycans. The polysaccharide cannot form self aggregates.

Molecular pathogenesis of root dentin caries

Human dentin has a higher content of organic matrix and more non-ideal hydroxyapatite than human enamel. Ultrastructural studies indicate that root caries involves both mineral dissolution and breakdown of the organic matrix. Factors involved in the root caries process seem more complicated than those in enamel caries. Moreover, the distinct roles of acids and enzymes and the sequence of events in the root caries process are not well-understood. Although Streptococcus mutans and Actinomyces viscosus are considered to be major pathogenic micro-organisms of root caries, their roles in degradation of the organic matrix components of root dentin need clarification. The purpose of this paper is to review the basic composition of root dentin and the roles of acids and both endogenous and bacterial enzymes in the root caries process.

Histochemical studies of glycosaminoglycans in developing periodontal ligaments of ICR mice

Although the periodontal ligament (PL) contains an abundance of glycosaminoglycans (GAGs), there are only a few histochemical studies describing GAGs in the developing PL. In the present study, the relationship between the formation of principal fibers and the molecular species of GAGs in the developing PL was examined by light microscopic histochemistry. Jcl:ICR mice were killed on day 0 to day 28 after birth. Paraffin-embedded tissue sections were routinely made and stained with hematoxylin-eosin (H&E), Azan, or the sensitized high iron diamine (S-HID) procedure combined with enzyme digestions. Before tooth eruption, thin threads of collagen fibers in the PL assembled and constructed principal fibers, which projected from both the side of the alveolar bone and the root of the tooth. After tooth eruption, the principal fibers from both sides were tightly entangled. In the developing PL, the molecular species of GAGs was mainly dermatan sulfate. Moreover, the relative amount of dermatan sulfate increased together with the maturation of the principal fibers, while the principal fibers adjacent to the alveolar bone and cementum contained chondroitin sulfate. These results suggest that dermatan sulfate contributes to collagen fiber assembly in the PL and that chondroitin sulfate relates to PL adhesion to the alveolar bone and to the cementum of the root.

Proteoglycans at the bone-implant interface

The widespread success of clinical implantology stems from bone's ability to form rigid, load-bearing connections to titanium and certain bioactive coatings. Adhesive biomolecules in the extracellular matrix are presumably responsible for much of the strength and stability of these junctures. Histochemical and spectroscopic analyses of retrievals have been supplemented by studies of osteoblastic cells cultured on implant materials and of the adsorption of biomolecules to titanium powder. These data have often been interpreted to suggest that proteoglycans permeate a thin, collagen-free zone at the most intimate contact points with implant surfaces. This conclusion has important implications for the development of surface modifications to enhance osseointegration. The evidence for proteoglycans at the interface, however, is somewhat less than compelling due to the lack of specificity of certain histochemical techniques and to possible sectioning artifacts. With this caveat in mind, we have devised a working model to explain certain observations of implant interfaces in light of the known physical and biological properties of bone proteoglycans. This model proposes that titanium surfaces accelerate osseointegration by causing the rapid degradation of a hyaluronan meshwork formed as part of the wound-healing response. It further suggests that the adhesive strength of the thin, collagen-free zone is provided by a bilayer of decorin proteoglycans held in tight association by their overlapping glycosaminoglycan chains.

Proteoglycans (PGs) in the larval amphibian tooth as visualized by cuprolinic blue

Proteoglycans (PGs) were localized in the predentine and dentine of young larvae from the urodelan species Salamandra salamandra. After cuprolinic blue (CB) staining at the critical electrolyte concentration of 0.1 M MgCl2, CB-positive, electron dense filaments with considerable variations in length and width were found in the collagen-free zone adjacent to the odontoblast processes (length up to 1.3 microns, width 21 nm), in predentine (660 nm/3.2 nm), in dentine around (20 nm/9 nm) and in the dentine tubules (35-150 nm/8 nm). Size classes very likely represent different PGs.

The modification of alveolar bone proteoglycans by reactive oxygen species in vitro

Reactive oxygen species (ROS) are being increasingly implicated in the connective tissue degradation associated with chronic inflammatory conditions, such as periodontal disease. The present study investigated the effects of ROS on the proteoglycans (PG) of alveolar bone which are important structural components within the periodontium. PG were isolated from ovine alveolar bone and exposed to increasing concentrations of hydrogen peroxide (H2O2) or to a hydroxyl radical (.OH) flux for 1 h or 24 h, and the degradation products examined for depolymerisation and chemical modification of the PG structure. ROS were demonstrated to be capable of degrading alveolar bone PG in vitro, the .OH species resulting in greater modification than H2O2. The degradative effects observed included cleavage of the protein core and depolymerisation of the GAG chains. The core proteins were more susceptible to degradation than the GAG chains in the presence of H2O2 alone, although both the core proteins and the GAG chains were extensively degraded in the presence of a .OH flux for both 1 h and 24 h. Exposure of the PG to .OH for 24 h resulted in significant modification to the amino acid composition with decreases in the proportion of leucine and the complete loss of proline, tyrosine and phenylalanine evident. The results highlight the potential role of ROS as an important mechanism in considering the pathology of periodontal tissue destruction.

Immunochemical detection of the proteoglycans decorin and biglycan in human gingival crevicular fluid from sites of advanced periodontitis

This study characterized proteoglycan metabolites present in gingival crevicular fluid (GCF) collected from sites with clinical evidence of advanced periodontal disease. The metabolites were purified by anion-exchange chromatography from which a chondroitin sulphate rich fraction was identified by cellulose acetate electrophoresis. Sodium dodecylsulphate-polyacrylamide gel electrophoresis of this fraction revealed a broad silver-staining band with mol. wt 55-65 k and Western blotting suggested that this band was immunoreactive with CS-56, a monoclonal antibody for chondroitin sulphate. Digestion of the metabolite with chondroitinase ABC (protease-free) led to the loss of the silver-staining band. Dot-blot analysis identified components in this fraction that were immunoreactive for the monoclonal/polyclonal antibodies against the C-termino of decorin and biglycan. Amino acid analysis revealed the composition of the proteoglycan metabolite to be rich in glycine, serine and glutamic acid. Immunochemical and biochemical analyses were compared with those of proteoglycan purified from human alveolar bone. Changes in the amino acid composition were noted, suggesting the proteoglycan metabolite has undergone extensive modification and fragmentation to the protein core. The results suggest that the proteoglycan metabolite from GCF represented a degradation product originating from the active destruction of the alveolar bone. They provide further support for the proposal that the appearance of proteoglycan metabolites in GCF is a biomarker for active destruction of alveolar bone, the biochemical analysis of which provides important information on mechanisms involved in the pathology of periodontal diseases.

Molecular size distribution analysis of human gingival proteoglycans and glycosaminoglycans in specific periodontal diseases

In order to determine the molecular-size distribution of gingival proteoglycans (PGs) and glycosaminoglycans (GAGs) both in periodontal health and disease states, gingival tissues were obtained from patients with early onset periodontitis (EOP) and adult periodontitis (AP) and also from periodontally healthy subjects. Gel filtration chromatography of gingival PGs revealed different profiles for periodontally diseased and healthy gingiva. Healthy gingiva was mainly composed of high-molecular size proteins and PGs, while diseased gingival tissue presented a decrease in high-molecular size PG forms and a shift towards low-molecular size proteins and PGs. This indicates the degradation of PG macromolecules during periodontal disease activity. Furthermore, this shift towards low-molecular size forms was more intense in EOP patients when compared to AP patients. Gel filtration of gingival GAGs also demonstrated depolymerization of GAGs, with low-molecular size GAGs being more intense in periodontally diseased gingiva, while healthy gingival GAGs profile was mainly composed of high-molecular size GAGs. Similar to the profile of gingival PGs, low-molecular size gingival GAGs were more prominent in gingival tissue from patients with EOP. These findings suggest that both PGs and GAGs, essential components of the extracellular matrix (ECM), are depolymerized during periodontal disease activity, which is more prominent in EOP. Since the basic feature of periodontal disease is matrix degradation, ECM components, more specifically PGs and GAGs, are likely to provide valuable information for a better understanding of periodontal disease activity.

Characterization of fibromodulin isolated from bovine periodontal ligament

Although several proteoglycans (PGs) have been reported in bovine periodontal ligament (PDL), the composition of PGs in PDL has been poorly characterized. In the present study, we isolated and characterized keratan sulfate-substituted PG (fibromodulin) in bovine PDL. Fibromodulin was purified from 4 M guanidine hydrochloride (GdmCl) extracts of bovine PDL tissues using DEAE Sephacel ion-exchange chromatography and preparative electrophoresis. Fibromodulin appeared as a single polydisperse band with an apparent molecular weight (MW) of 80,000 (80 kDa) on SDS-PAGE. Digestion of fibromodulin with keratanase or neuraminidase reduced the apparent molecular size, and N-glycanase treatment produced core protein bands of around 40 kDa. Fibromodulin reacted with keratan sulfate monoclonal antibody (5D4) and fibromodulin polyclonal antibodies (alpha-FM). The keratanase-digested fibromodulin reacted with alpha-FM, but not with 5D4. These data suggest that fibromodulin is one of the small PGs in the PDL-matrix and may fulfill construction and maintenance functions in this tissue.

Degradation of glycosaminoglycans by reactive oxygen species derived from stimulated polymorphonuclear leukocytes

The effect of reactive oxygen species (ROS), generated by in vitro stimulation of isolated PMN upon the main GAG components of mineralised and non-mineralised connective tissues was investigated. PMN were isolated from whole blood and the production of the ROS superoxide (O2.-) and hydroxyl radicals (.OH) was stimulated by the addition of phorbol myristyl acetate (PMA) and PMA/FeCl3-EDTA chelate respectively and their production assessed over a 24 h period. The glycosaminoglycans (GAG), hyaluronan, chondroitin 4-sulphate and dermatan sulphate, were exposed to the ROS fluxes, incubated at 37 degrees C for 1 h and 24 h. GAG fragmentation was examined by gel exclusion chromatography and modification to hexuronic acid and hexosamine residues determined. Stimulation of PMN with PMA resulted in a burst of O2.- production for 1 h, which was sustained at a reduced level for 24 h. Fragmentation of GAG was observed for all GAG examined. Modification to the GAG was evident, with hyaluronan being more susceptible to loss of GAG residues than sulphated GAG. Modification of sugar residues increased with the incubation time and loss of the hexuronic acid residues was greater than loss of hexosamine residues. Addition of FeCl3-EDTA chelate, which led to the generation of .OH and was sustained over the 24 h period, demonstrated similar trends of GAG modification although increased degradation and loss of hexosamine and hexuronic acid were observed. GAG chains are constituents of PGs and their modification is likely to affect the function of these macromolecules and be of importance in considering the pathogenesis of inflammatory diseases, including periodontal diseases.

Adsorption of chondroitin-4-sulphate and heparin onto titanium: effect of bovine serum albumin

The adsorption of chondroitin-4-sulphate (C4S) and heparin onto titanium has been studied in the absence and presence of bovine serum albumin (BSA). Isotherm data (0.02 M calcium acetate, pH 6.8) have shown that BSA in solution and BSA-coated titanium result in decreased adsorption for both C4S and heparin. For the BSA in solution data, C4S/heparin and BSA may compete for the same sites on the titanium surface via calcium ions, or alternatively in the case of heparin, complexes of heparin and BSA form in solution, leading to less binding due to steric effects. Evidence of an interaction between heparin and BSA in solution has been shown in this study, there being negligible interaction between C4S and BSA. BSA adsorption from solution investigated in the presence of C4S/heparin decreases with increasing C4S/heparin solution concentration. This may be due to a glycosaminoglycan (GAG) induced conformational change of BSA from a compact to an extended structure. The decreased adsorption onto BSA-coated titanium may be due to masking of the GAG binding sites, this effect being greater for C4S. Desorption of BSA from the pre-coated titanium in the presence of C4S and heparin is <10% and <30% respectively, indicating that BSA is strongly bound to the titanium surface.

Expression of heparan sulphate and small dermatan/chondroitin sulphate proteoglycans in chronically inflamed human periodontium

Proteoglycans (PGs) function in regulating aspects of cell behavior, such as proliferation, adhesion, and migration. In this report, we investigated the localization of three heparan sulphate PGs (basement membrane [BM] heparan sulphate PG, CD44, and syndecan-1) and two small dermatan/chondroitin sulphate PGs (decorin and biglycan) in chronically inflamed human periodontium. Frozen sections were analyzed by immunofluorescence microscopy. In inflamed tissue, BM heparan sulphate PG showed reduced immunostaining in subepithelial and subendothelial basement membrane. Loss of CD44 and syndecan-1 was common in epithelial cells of inflamed periodontal tissue. Suprabasal keratinocytes of epithelium expressed involucrin, a cornified envelope protein and marker for epithelial differentiation, while the expression of syndecan-1 was weak or absent. In contrast, expression of the mesenchymal variant of CD44 and syndecan-1 was strong in infiltrating lymphocytes. Small dermatan/chondroitin sulphate PGs, decorin and biglycan, were also present in markedly reduced amounts in the periodontal connective tissue in chronic inflammation. In addition, decorin localized in the connective tissue along short rod-like structures. The results suggest that proteoglycan-dependent intercellular adhesion of keratinocytes is decreased and that adhesion of lymphocytes to matrix molecules via cell surface PGs increased in chronic inflammation. Disappearance of adhesion-modulating small dermatan/chondroitin sulphate PGs may further regulate cell migration in inflamed periodontium.

The chemical modification of glycosaminoglycan structure by oxygen-derived species in vitro

The effect of reactive oxygen species (ROS) on the chemical structure of glycosaminoglycans (GAG) was studied in order to consider their role in connective tissue damage during an inflammatory disease state such as periodontal disease. GAG were exposed to a radical generating system for 1 h and analysed by gel filtration for fragmentation and chemically with respect to uronic acid, hexosamine and sulfate content. Non-sulfated GAG, hyaluronan and chondroitin, were most susceptible to depolymerisation and chemical modification of uronic acid and hexosamine residues by ROS. Depolymerisation and chemical modification of sulfated GAG, chondroitin 4-sulfate, dermatan sulfate and heparan sulfate was significantly less than for non-sulfated GAG. The highly sulfated GAG heparin showed minimal depolymerisation by ROS, but uronic acid residues were readily modified. Analysis of the ROS-exposed residues suggests that uronic acid is capable of degrading to a 3-carbon aldehyde, malondialdehyde. Chondroitin sulfate exposed to ROS resulted in marginal desulfation. The results suggest that the presence of sulfate on the GAG chain may protect the molecule against ROS attack. However, chemical modification of GAG may affect proteoglycan function and be of importance in considering connective tissue destruction in a variety of pathological situations, including periodontal disease.

Isolation and characterization of the proteoglycans synthesized by adult human pulp fibroblasts in vitro

The proteoglycans synthesized by fibroblasts derived from healthy human adult dental pulps have been isolated and characterized on the basis of their glycosaminoglycan content, molecular size and charge. The proteoglycans were identified by their labelling with [35S] sulphate and susceptibility to digestion by papain. The sulphated glycosaminoglycans associated with the proteoglycans were identified following specific enzymatic and chemical degradations as chondroitin sulphate, dermatan sulphate and heparan sulphate. Dermatan sulphate and chondroitin sulphate and heparan sulphate were the principal glycosaminoglycans associated with the cell layers. The proteoglycans could be fractionated on the basis of their charge and size into a number of heterogeneous pools. The principal proteoglycans isolated were small and contained either chondroitin sulphate or dermatan sulphate and most likely correspond to decorin and biglycan. Other molecules with features similar to versican and syndecan were also identified.

Ultrastructural localization of glycosaminoglycans in human gingival connective tissue using cupromeronic blue

Human gingiva was stained with cupromeronic blue according to Scott's critical electrolyte concentration technique in order to localize glycosaminoglycans (GAG) in the electron microscope. Identification was performed by digestion with chondroitinase AC, ABC and heparinase. The GAG were localized in three compartments of the connective tissue: the supra-alveolar fiber apparatus, the loose connective tissue and the basement membranes. In the supra-alveolar fiber apparatus, consisting mainly of densely packed parallel collagen fibrils, dermatan sulfate GAG are regularly attached to the d-band of the collagen fibrils. The precipitates (6-7 nm in diameter) aggregate to thicker precipitates (up to 16 nm), thus possibly providing stability to the fiber system. In the loose connective tissue with sparse collagen fibrils dermatan and chondroitin sulfate GAG form very large precipitates (up to 30 nm in diameter and 400 nm length) which interconnect the few collagen fibrils. The basement membranes of the epithelium and capillary endothelium contain heparan sulfate GAG as fine precipitates (4-6 nm in diameter) which form a meshwork. These findings are consistent with the Scott model (1) for the interactions among glycans and glycans and collagen fibrils in connective tissues.

Proteoglycans in cementum- and enamel-related predentin of young mouse incisors as visualized by cuprolinic blue

In rodent incisors, dentin associated with cementum (root-analogue dentin) appears to differ considerably from that associated with enamel (crown-analogue dentin), both with respect to the composition of certain matrix components and the mineral. Since it is not known whether these dentin portions also differ with respect to their proteoglycans, the morphological appearance and spatial distribution of these components was studied in predentin by employing cuprolinic blue, a dye selective for proteoglycans. Lower incisors of five-day-old mice were stained with the dye and processed for electron microscopic examination. Cuprolinic blue-positive precipitates were found in both cementum- and enamel-related predentin. In cementum-related predentin these structures were thick and short. In the enamel-related portion, however, they were long, slender and frequently stellate-shaped. The number of precipitates was similar between the two predentin portions and also no differences were found between the basal and the apical (adjacent to the mineralization front) aspects of the predentin layers. It is suggested that the differences in proteoglycan architecture among the predentin layers is somehow related to differences in the three-dimensional collagenous meshwork or to different patterns of mineralization.

Glycosaminoglycans from two human malignant mesothelioma cell lines: determination, distribution, and effect of platelet-derived growth factor on their synthesis

The synthesis and distribution of glycosaminoglycans (GAGs) were studied in two human malignant mesothelioma cell lines: one with fibroblast-like morphology and the other with epithelial differentiation. Analyses using highly sensitive high-pressure liquid chromatography techniques and agarose gel electrophoresis showed that these cells produce not only hyaluronan (HA) but also galactosaminoglycans (GalAGs, chondroitin sulfate and (or) dermatan sulfate) and heparan sulfate (HS). In both cell lines most of the HA (87-90%) and GalAGs (57-66%) are secreted into the extracellular matrix. Although HS is mainly bound to the cell surface in fibroblast-differentiated cells (75%), in epithelial type cells only 40% occurs in the cell-associated fraction. The amounts of secreted GAGs are 6- to 8-fold higher in epithelial than in fibroblast-like mesothelioma cultures. In cells with the fibroblast phenotype, the beta-homodimer of platelet-derived growth factor (PDGF) in a concentration of 1.5 ng/mL stimulates HA and GalAG synthesis 5-fold and that of HS 10-fold, whereas higher concentrations suppress this stimulatory effect. The stimulatory effect, observed at low concentrations of this growth factor, was completely blocked by the addition of antibodies against this factor. In epithelially differentiated cells, the production of all GAGs was suppressed after addition of this factor, even at low concentrations. We therefore suggest that mesothelioma cells can produce GAGs, the synthesis of which is dependent on the presence and concentration of PDGF beta-homodimer. The differences between the two cell lines regarding the effect of this growth factor on GAG synthesis indicates that the regulation of this synthesis is complex, other factors also being important.

The role of proteoglycans in hard and soft tissue repair

Healing of soft and hard tissues results from a progression of events initiated by injury and directed toward reestablishing normal structure and function. The ubiquity of proteoglycans in mammalian tissues virtually guarantees their involvement in tissue restitution. The dramatic advances in cellular and molecular biology in recent years have added significantly to understanding the specific roles played by proteoglycans in wound repair processes.

Characterization of proteoglycan metabolites in human gingival crevicular fluid during orthodontic tooth movement

Previous studies have identified glycosaminoglycans in gingival crevicular fluid (GCF) associated with a variety of clinical conditions, notably those involving bone resorptive activity. GCF was here collected from around teeth undergoing active orthodontic movement. Proteoglycan metabolites were purified from GCF by anion-exchange chromatography using fast performance liquid chromatography. Sulphated glycosaminoglycan was associated with the most highly anionic protein fractions IV, V and VI, and biochemical analysis was restricted to these fractions. Analysis included glycosaminoglycan content by cellulose acetate electrophoresis, molecular size by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE), Western blotting and amino acid analyses. Fraction IV contained hyaluronan (18.7%) and chondroitin sulphate (10.9%), fraction V heparan sulphate (29.5%) and chondroitin sulphate (19.6%) and fraction VI chondroitin sulphate only (21.3%). SDS-PAGE revealed two Coomassie blue bands in fraction V of 72 and 60 kDa and two further bands in fraction VI of 71 and 56 kDa. These proteoglycans appeared resistant to digestion by chondroitinase ABC or heparinase III, although the glycosaminoglycan chains underwent degradation after protein-core removal. The molecular mass and amino acid composition of the chondroitin sulphate proteoglycan fractions showed a close similarity to those of human alveolar bone proteoglycan. The presence of heparan sulphate proteoglycan in GCF in association with orthodontic movement is in accord with previous reports. The findings support the view that proteoglycans in GCF are 'biomarkers', notably those associated with active resorption of alveolar bone.

The influence of age on collagen and non-collagen protein production by human gingival epithelial cells

The effects of donor age on the proliferation and secretory phenotype of cultured human gingival epithelial cells were investigated. Pure cultures of epithelial cells were isolated from human gingiva of old (61-75 yr) and young (18-30 yr) adults and serially cultivated in a serum-free medium at 37 degrees C in humidified air containing 5% CO2. For each experiment, cells were seeded at 150/mm2 and the medium changed every other day. Cell number, collagen and non-collagen protein production and relative collagen synthesis (percentage collagen synthesized) were determined at days 2, 4, 6 and 8. Epithelial strains from old and young adults became confluent by day 8 and there were no differences in their rates of proliferation. Likewise there was no difference in collagen production between the two groups; however, cells from elderly individuals produced significantly less non-collagen protein. Over time the decrease in non-collagen protein production ranged from 56% below the non-collagen protein levels of epithelium from young adults at day 2 to 24% below at day 8. The reduction of non-collagen protein coupled with the unchanged secretion of collagen resulted in a statistically significant increase in relative collagen synthesis by epithelial cells from elderly individuals. These differences in non-collagen protein production and relative collagen synthesis by cultured gingival epithelium of old adults suggest a selective conversion in protein secretion.

Isolation and characterization of bovine gingival proteoglycans versican and decorin

1. We have isolated, chemically and immunologically characterized versican and decorin from bovine gingiva. 2. Versican was of large molecular weight and the molecular size of the core protein was estimated to be greater than 200 kDa. 3. The glycosaminoglycan chains were susceptible to chondroitinase ABC and N-linked oligosaccharides were present on the protein core of the molecule. 4. Immunological studies provided evidence that a hyaluronic acid binding region was present in the core protein of versican. 5. The overall structure was similar to that of versican isolated from bovine sclera. 6. Decorin had a molecular weight of 102 kDa and its glycosaminoglycan chain was completely digested by specific glycosidases. 7. The partially deglycosylated core protein had a molecular weight of 55 kDa and N-linked oligosaccharides were present on the molecule.

A biochemical analysis of human periodontal tissue proteoglycans

Proteoglycans synthesized by periodontal (gingival, periodontal ligament, dental follicle) fibroblasts were analysed by SDS/polyacrylamide and agarose gel electrophoresis after being labelled with radioactive sulphate. Medium, cell membrane and extracellular matrix fractions were analysed separately. Samples were treated with chondroitinase AC, chondroitinase ABC, heparitinase or a combination of chondroitinase ABC and heparitinase before electrophoretic separation of proteoglycans. Antibodies to versican and decorin were used to identify these molecules by Western immunoblots. For steady-state metabolic radiolabelling of fibroblasts, medium and cell membrane fractions contained about equal proportions of radiolabelled proteoglycans (about 43%), whereas less radioactivity (about 14%) was found in proteoglycans of the matrix fraction. Periodontal fibroblasts produce six major proteoglycans: versican, a high-molecular-mass chondroitin sulphate proteoglycan (CSPG); decorin, a dermatan sulphate proteoglycan (DSPG); a membrane-associated heparan sulphate proteoglycan (HSPG); two medium- or matrix-associated HSPGs; and a 91 kDa membrane-associated CSPG. Variation in decorin molecular size was observed in mass cultures of fibroblasts. Similar polydispersity in molecular size of decorin was seen in several clones established from one mass culture.