Analysis of human gingival tissue and gingival crevicular fluid beta-glucuronidase activity in specific periodontal diseases

Microbial β-glucuronidases drive human periodontal disease etiology

Periodontitis is a chronic inflammatory disease associated with persistent oral microbial dysbiosis. The human β-glucuronidase (GUS) degrades constituents of the periodontium and is used as a biomarker for periodontitis severity. However, the human microbiome also encodes GUS enzymes, and the role of these factors in periodontal disease is poorly understood. Here, we define the 53 unique GUSs in the human oral microbiome and examine diverse GUS orthologs from periodontitis-associated pathogens. Oral bacterial GUS enzymes are more efficient polysaccharide degraders and processers of biomarker substrates than the human enzyme, particularly at pHs associated with disease progression. Using a microbial GUS-selective inhibitor, we show that GUS activity is reduced in clinical samples obtained from individuals with untreated periodontitis and that the degree of inhibition correlates with disease severity. Together, these results establish oral GUS activity as a biomarker that captures both host and microbial contributions to periodontitis, facilitating more efficient clinical monitoring and treatment paradigms for this common inflammatory disease.

Evaluating the activity of salivary enzymes as stress biomarkers under psychological stress and their relationship with rumination and personality traits

BACKGROUND

Salivary enzymes are used as non-invasive biomarkers to assess the activity of the sympathetic-adrenal-medullary system. The aim of this study was to evaluated levels of acid phosphatase, beta-glucuronidase and cathepsin salivary enzymes under psychological tension and their connection with rumination and personality traits.

METHODS

A total of 60 medical students, who wanted to participate in the final exam, two months before the exam, the inventory emotional control questionnaire and the neo-short form were completed. Saliva samples were taken in both the basal conditions and under exam stress.

RESULTS

A significant difference was found between the mean of level salivary enzymes in rest and under exam stress. Also, we found a positive and significant correlation between the activity of salivary enzymes and personality traits such as neuroticism, extraversion, agreeableness and rumination (p < .01, p < .05) level. Neuroticism, agreeableness and rumination predicted 45% of the variance of salivary acid phosphatase, neuroticism and rumination predicted 49% of the variance of salivary beta-glucuronidase and neuroticism, extraversion and rumination predicted 38% of the variance of salivary cathepsin under stress exam.

CONCLUSION

The results of this study show, levels of salivary enzymes may increase in individuals with traits of neuroticism, extraversion, agreeableness and rumination through response to psychological stressors.

Protein carbonyl levels in serum, saliva and gingival crevicular fluid in patients with chronic and aggressive periodontitis

Objective

This study aims at evaluating the degree of protein carbonyl (PC) levels in serum, gingival crevicular fluid (GCF) and saliva in patients who suffer from chronic periodontitis (CP) and generalized aggressive periodontitis (GAP).

Materials and methods

A total of 110 individuals took part in the study. Of this number, 35 were CP patients, 43 GAP patients, and the remaining 32 were healthy controls. Measurements regarding the serum, saliva and GCF PC levels were obtained by high-performance liquid chromatography.

Results

No statistically significant difference was found in serum PC levels between the groups (P > 0.05). In terms of salivary levels, the CP group demonstrated a significantly higher level (P < 0.05) of PC level compared to the GAP group. However, the difference was not found statistically significant when the comparison was drawn with the control group (p > 0.05).

The GCF PC level in the CP group had a significantly higher level of concentration compared to the other groups (P < 0.05), whereas the relevant values in the control group were higher than the values in the GAP group (P < 0.05). GCF PC total values (/30 s) were higher in the CP group than the remaining groups (P < 0.05), whereas the relevant values in the GAP group were higher than the values in the control group (P < 0.05). It could be stated that GCF PC levels were significantly correlated, either positively or negatively, with all clinical periodontal parameters (p < 0.05).

Conclusions

The results obtained suggest that PC levels of serum and salivary in periodontitis, when compared to periodontal health, do not seem to change considerably. However, in the CP group, a statistically significant increase in PC levels of GCF was observed. This finding suggests the salient role of local protein carbonylation in the periodontal area in CP. That the CP group had a higher level of PC level than the GAP group underscores the higher protein oxidation levels in CP patients.

Comparative analysis of gingival crevicular fluid β-glucuronidase levels in health, chronic gingivitis and chronic periodontitis

Background and Objectives:

Current methods available for periodontal disease diagnosis are seriously deficient in terms of accuracy, in the ability to predict ongoing or future disease activity and indeed in determining whether previously diseased sites are in an arrested phase or still active. One area that is receiving a great deal of attention is the biochemical investigation of gingival crevicular fluid (GCF). β-glucuronidase (βG) is one of the enzymes found in GCF that is involved in degradation of the ground substance and fibrillar components of host connective tissue. GCF βG activity might be a good indicator or predictor of periodontal disease activity. This study was conducted to estimate and compare the GCF βG levels in patients with healthy periodontium, chronic gingivitis, and chronic periodontitis.

Methodology:

Subjects were classified into three groups of 20 patients each; healthy individuals, chronic gingivitis, and chronic periodontitis. After recording the plaque index, gingival index and probing pocket depth, 1 μL GCF was collected by placing a calibrated microcapillary pipette extracrevicularly and transferred to sterile plastic vials containing 350 μL of normal saline with 1% bovine serum albumin. Analysis of βG was done by spectrophotometry

Results:

βG levels in GCF were significantly higher in chronic periodontitis group (mean value - 2.04743), followed by chronic gingivitis group (mean - 1.11510) and healthy group (0.53643).

Conclusion:

Increased βG levels were observed in patients with increased periodontal destruction, hence GCF βG levels can be used as biochemical marker for periodontal disease activity.

Estimation of salivary β-glucuronidase activity as a marker of periodontal disease: A case control study

Aim:

The aim of the present study was to estimate the salivary β-glucuronidase level in healthy and diseased periodontium and to correlate the level with clinical measurement.

Materials and Methods:

70 patients were included in this study with the age ranging from 30 to 65 years. Both males and females were included. They were divided into two groups: Control having healthy periodontium (n = 20) and experimental having diseased periodontium (n = 50). The parameters recorded were probing pocket depth, probing attachment level, gingival index, β-glucuronidase activity in the saliva, number of white blood cells, neutrophils, lymphocytes count, and platelet count.

Results:

It was observed that there was an increase in the level of salivary β-glucuronidase in the experimental subjects than in the control patients, and a significant positive linear relationship existed between salivary β-glucuronidase level and probing pocket depth in the experimental group.

Conclusion:

Level of salivary β-glucuronidase increases during inflammation in the periodontium.

Proteome data set of human gingival crevicular fluid from healthy periodontium sites by multidimensional protein separation and mass spectrometry

BACKGROUND AND OBJECTIVE

Gingival crevicular fluid has been of major interest for many decades as a valuable body fluid that may serve as a source of biomarkers for both periodontal and systemic diseases. Owing to its very small sample size, submicroliter volumes, identification of its protein composition by classical biochemical methods has been limited. The advent of highly sensitive mass spectrometric technology has permitted large-scale identification of protein components of many biological samples. This technology has been employed to identify the protein composition of gingival crevicular fluid from inflamed and periodontal sites. In this report, we present a proteome data set of gingival crevicular fluid from healthy periodontium sites.

MATERIAL AND METHODS

A combination of a periopaper collection method with application of multidimensional protein separation and mass spectrometric technology led to a large-scale documentation of the proteome of gingival crevicular fluid from healthy periodontium sites.

RESULTS

The approaches used have culminated in identification of 199 proteins in gingival crevicular fluid of periodontally healthy sites. The present gingival crevicular fluid proteome from healthy sites was compared and contrasted with those proteomes of gingival crevicular fluid from inflamed and periodontal sites, as well as serum. The cross-correlation of the gingival crevicular fluid and plasma proteomes permitted dissociation of the 199 identified gingival crevicular fluid proteins into 105 proteins (57%) that can be identified in plasma and 94 proteins (43%) that are distinct and unique to the gingival crevicular fluid microenvironment. Such analysis also revealed distinctions in protein functional categories between serum proteins and those specific to the gingival crevicular fluid microenvironment.

CONCLUSION

Firstly, the data presented herein provide the proteome of gingival crevicular fluid from periodontally healthy sites through establishment of innovative analytical approaches for effective analysis of gingival crevicular fluid from periopapers both at the level of complete elusion and with removal of abundant albumin, which restricts identification of low-abundant proteins. Secondly, it adds significantly to the knowledge of gingival crevicular fluid composition and highlights new groups of proteins specific to the gingival crevicular fluid microenvironment.

Assessment of aprotinin influence on periodontal clinical status and matrix metalloproteinases 1, 2 and their tissue inhibitors saliva concentrations in patients with chronic periodontitis

PURPOSE

Assessment of the effect of treatment with aprotinin-containing drug on the clinical status of the periodontal tissue and on the concentrations of metalloproteinases released in the course of periodontitis (MMP-1, MMP-2) as well as their tissue inhibitors (TIMP-1 and TIMP-2) in the saliva of patients with chronic periodontitis (CP).

MATERIAL/METHODS

The study involved 25 subjects with CP (39-68 years), including 16 women and 9 men. The patients were prescribed aprotinin preparation to be taken for 2 weeks. The control group (C) involved 14 healthy subjects (41-65 years), including 10 women and 4 men. Two periodontal indices were assessed: the approximal plaque index (API) and bleeding on probing index (BOP). Periodontal pocket depth and clinical attachment level were also evaluated. The concentrations of MMP-1 and MMP-2 as well as TIMP-1 and TIMP-2 were determined by the ELISA method.

RESULTS

The mean salivary MMP-1 concentration in patients with CP was significantly higher before and after treatment, as compared to healthy subjects. The mean salivary MMP-2 concentration in CP patients at baseline was also higher as compared to the C group and increased after treatment. The mean salivary TIMP-1 and TIMP-2 concentration in CP patients was higher as compared to C group and increased after treatment.

CONCLUSIONS

Since the mean MMPs levels were found to be growing it can be assumed that aprotinin has no significant effect on the regulation of MMPs in the saliva of CP patients. It thus seems that aprotinin application after scaling has no additional therapeutic effect.

The negative effect of platelet-rich plasma on the growth of human cells is associated with secreted thrombospondin-1

OBJECTIVE

Earlier studies have suggested that platelet-rich plasma (PRP) enhances oral wound healing because of its concentrated growth factors. Few studies have investigated whether negative regulators exist in the PRP and influence its biological effects on human wound healing. The aim of this study was to investigate whether PRP contains an angiogenesis inhibitor, thrombospondin-1 (TSP-1), and whether this factor negatively affects human cells associated with oral healing in vitro.

STUDY DESIGN

Using centrifugation, platelet-poor plasma (PPP) and PRP were obtained sequentially from 20 volunteers. We used an Alamar Blue assay to compare the proliferation rates of various oral cells, cocultured for 6 days with different concentrations of PRP and PPP. The levels of TSP-1 in PRP were estimated using ELISA. Finally, we tested the antiproliferative effect of purified TSP-1 protein on oral cell cultures.

RESULTS

After 6 days of incubation, there were significantly more cells in the low-PRP-concentration group (<5%) and fewer cells in the high-PRP-concentration group (15%-30%). The ELISA showed that the quantities of TSP-1 were approximately 183.3 +/- 21.6 microg/mL in PRP lysate and 9.7 +/- 1.6 microg/mL in the supernatant of the 30% PRP gel. Serial concentrations of exogenous TSP-1, corresponding to those of the 30% PRP gel, dose-dependently inhibited oral cell proliferation.

CONCLUSION

Within the limits of this study, the proliferation of oral cells significantly decreased when treated with high concentrations of PRP. Abundant secretion of TSP-1 from concentrated PRP may contribute to the antiproliferative effect.

Protein carbonyl levels in serum and gingival crevicular fluid in patients with chronic periodontitis

OBJECTIVE

Evidence reveals the role of reactive oxygen species (ROS) in many pathologies including periodontitis. Protein carbonylation is the most widely used biomarker for oxidative damage to proteins, and reflects cellular damage induced by ROS. In this study protein carbonyl (PC) levels in serum and gingival crevicular fluid (GCF) in patients with chronic periodontitis (CP) was evaluated.

MATERIALS AND METHODS

Thirty-three patients with CP and 24 healthy controls were included in the study. Following the clinical measurements and samplings, total protein levels in serum and GCF were determined by Bradford method, and serum and GCF PC levels were measured by modified Levine method.

RESULTS

PC levels in serum and GCF were significantly higher in the CP group compared to the control group (p<0.05). In all subjects, serum and GCF PC levels showed statistically significant positive correlations with all clinical parameters (p<0.05).

CONCLUSIONS

The results suggest that both systemic and local/periodontal protein carbonylation increase in CP compared to health and that elevated levels of PCs may be a sign of oxidative damage in periodontitis and correlate well with the periodontal status.

Analysis of superoxide dismutase activity levels in gingiva and gingival crevicular fluid in patients with chronic periodontitis and periodontally healthy controls

OBJECTIVES

Superoxide dismutase (SOD) is an antioxidant enzyme that acts against superoxide, an oxygen radical, released in inflammatory pathways and causes connective tissue breakdown. In this study, SOD activities in gingiva and gingival crevicular fluid (GCF) from patients with chronic periodontitis (CP) and periodontally healthy controls were compared.

MATERIAL AND METHODS

Twenty-six CP patients and 18 controls were studied. In patients, teeth with moderate-to-severe periodontal breakdown and > or =5 mm pockets that required full-thickness flap surgery in the right or left maxillary quadrant, and in controls, teeth scheduled for extraction for orthodontic reasons were studied. After the clinical measurements (probing depth, clinical attachment level, gingival index, gingival bleeding index, plaque index), GCF samples were collected. Tissue samples were harvested from the same teeth, during flap operation in patients and immediately after tooth extraction in controls. SOD activities were spectrophotometrically assayed. The results were statistically analysed.

RESULTS

Gingival SOD activity was significantly higher in the CP group than in controls (p<0.05). No significant difference was found in GCF SOD activity between the groups (p>0.05). Correlations between gingival and GCF SOD activities were not statistically significant in CP and control groups (p>0.05).

CONCLUSION

In CP, SOD activity seems to increase in gingiva, probably as a result of a higher need for SOD activity and protection in gingiva in CP than in periodontal health, while not significantly changing in GCF, suggesting a weak SOD activity in GCF in periodontal disease state. The weak correlation between gingival and GCF SOD activities suggests distinct actions of these SODs.

Beta-glucuronidase activity in saliva: relationship to clinical periodontal parameters

BACKGROUND

Beta-glucuronidase (betaG) in gingival crevicular fluid (GCF), a marker of neutrophil influx into the crevicular environment, has previously been shown to be correlated with periodontal clinical parameters at individual sites (probing depth and clinical attachment level). Furthermore, elevated levels of betaG were found to be a risk factor for periodontal attachment loss. Analysis of betaG in saliva may be a measure of crevicular neutrophil influx for the whole mouth. The purpose of this cross-sectional study was to evaluate the relationship between betaG activity in saliva and periodontal clinical parameters in subjects demonstrating various levels of periodontal disease.

METHODS

The study population consisted of 380 subjects (108 males and 272 females). A sample of unstimulated whole saliva and a venous blood sample were obtained from each subject, and a periodontal examination, which included measurement of probing depth (PD), attachment level (AL), and gingival index (GI) was performed. The unmodified saliva samples were frozen at -20 degrees C and analyzed for betaG activity. The blood samples were analyzed for number of white blood cells, neutrophils, monocytes, lymphocytes, and platelets. Statistical analysis was conducted to determine the association between salivary betaG activity and the whole-mouth clinical periodontal parameters, complete blood count, smoking status, and age.

RESULTS

Highly significant correlations between salivary betaG activity and mean probing depth (MPD), mean gingival index (MGI), and the number of sites with probing depth > or = 5 mm were found. When subjects were divided into tertiles based on their MPD and MGI, elevated salivary betaG activity was detected in subjects in the 2 upper tertiles. Logistic regression modeling was used to determine which of the clinical or laboratory parameters were able to identify patients with at least 4 sites with PD > or = 5 mm. Salivary betaG activity > or = 100 produced an odds ratio (OR) of 3.77. In comparison, current and former smokers had an OR of 3.15 and 2.29, respectively. CONLCUSIONS: The results suggest that a significant association exists between periodontal clinical parameters and salivary betaG activity. Due to the non-invasive and simple nature of saliva collection, this association should be studied to determine its usefulness as a screening test for periodontitis, and a means of monitoring the response to treatment.

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.

Levels of leukotriene B4 in gingival crevicular fluid and gingival tissue in specific periodontal diseases

BACKGROUND

Leukotriene B4 (LTB4), a product of the lipoxygenase pathway of arachidonic acid metabolism, exhibits numerous activities that can account for most of the features of host responses seen in periodontal diseases. The aim of the present study was to examine the role of LTB4 in the pathogenesis of specific periodontal diseases.

METHODS

LTB4 levels were investigated in gingival crevicular fluid (GCF) and gingival tissue (GT) samples of 10 patients with chronic periodontitis (CP), 12 patients with generalized aggressive periodontitis (GAgP), 6 patients with localized aggressive periodontitis (LAgP), 6 patients with gingivitis (G), and 6 periodontally healthy subjects (H). Periodontal status was evaluated by measuring probing depth, gingival index, papillary bleeding index, and plaque index. LTB4 was extracted from the samples by solid-phase method using C18 cartridge and was purified by high performance liquid chromatographic method and then analyzed by radioimmunoassay.

RESULTS

All patient groups had significantly higher levels of GCF and GT LTB4 compared to the control group (P<0.005). The CP patients had the highest LTB4 levels compared to those in other patient groups (P<0.005). GAgP, LAgP, and G groups had similar amounts of GCF and GT LTB4 (P>0.005). When the data were expressed as concentration, the CP group was found to have higher concentration of LTB4, compared to that of control group (P<0.005). GAgP, LAgP, and G groups had similar LTB4 concentration compared to that of control group (P>0.005). No significant difference was found between GAgP, LAgP, and G groups (P>0.005). The CP group had higher LTB4 concentration compared to both GAgP and LAgP groups (P<0.005). Although the CP group had a higher GCF LTB4 concentration compared to G group, this difference did not reach significance (P>0.005). No significant correlation was found between GCF and GT LTB4 levels and clinical parameters.

CONCLUSIONS

The results of the present study indicate that LTB4 is likely to be an important mediator in regulating inflammatory responses in the human periodontal tissues. This lipid mediator may play an important role in the pathophysiology of periodontal disease.