Glycosaminoglycans of human gingival epithelium and connective tissue

Trial Waste in Hyaluronic Acid-Related Randomised Controlled Trials

BACKGROUND

A notable obstacle in applying the findings of hyaluronic acid (HA)-related randomised controlled trials (RCTs) to real-world patient treatment is trial waste (TW). To date, the extent of TW in RCTs for HA is not clear.

OBJECTIVES

To analyse the extents of TW within HA-RCTs and identify protective factors against TW.

METHODS

In July 2024, we searched the ClinicalTrials database using the 'hyaluronic acid' as keyword. We documented the data available and then explored PubMed and Scopus for the publication status. Reporting adequacy was evaluated using the CONSORT checklist. Design limitations were analysed based on bias risk and whether the article referenced a relevant systematic review. Subsequently, we evaluated extent of TW (unpublished studies, insufficient reporting and design flaws).

RESULTS

One hundred and eighty-four RCTs met the inclusion criteria. The analysis of TW excluded 53 RCTs completed after June 2020 that remained unpublished. Among the remaining 131 RCTs, 72 were published, 47 had adequate reporting and 19 had design limitations. Taken together, 96 RCTs (73.3%) exhibited at least one characteristic of TW. Characteristics of these RCTs included early registration (p < 0.001) and the absence of a multi-blind approach (p = 0.007). Registration prior to 2014 (p < 0.001) and the open-label or single-blinding design (p = 0.003) emerged as independent risk factor for TW.

CONCLUSION

We delineated the features of 184 HA-related RCTs. 73.3% of the RCTs included in TW analysis exhibited TW. The diverse traits of the different TW indicators identified could serve as valuable insights for conducting future HA-RCTs more rationally and efficiently.

Effect of hyaluronic acid on palatal wound healing: A systematic review

OBJECTIVES

To evaluate the efficacy of topically applied hyaluronic acid on wound healing (patient-reported outcomes and clinical healing) after a palatal autogenous gingival graft is harvested.

MATERIALS AND METHODS

A systematic search was performed in April 2024 in eleven electronic databases. Two investigators independently screened the references for inclusion. Outcomes of interest included postoperative pain, analgesic consumption, complete epithelialization, and color match, which were synthesized using narrative synthesis.

RESULTS

A total of 535 results were identified and eight articles were included in the systematic review. Hyaluronic acid use on the palatal donor site had a better response to healing and wound size compared to the control sites with no agent applied. Hyaluronic acid demonstrated a positive effect in the form of complete epithelialization, and color match, with improved patient-reported outcomes such as post-operative pain.

CONCLUSION

Within the limitations of this systematic review, it can be concluded that hyaluronic acid shows a strong potential to improve patient-reported outcomes and clinical wound healing at the graft donor site on the palate. Future studies are required to clarify the optimal concentration, frequency of application, and synergistic effect when HA is combined with other interventions.

CLINICAL RELEVANCE

Within the limitations of this systematic review, it can be concluded that hyaluronic acid shows a strong potential to improve patient-reported outcomes and clinical wound healing at the graft donor site on the palate. Future studies are required to clarify the optimal concentration, frequency of application, and synergistic effect when HA is combined with other interventions.

Adjunctive use of hyaluronic acid in the treatment of gingival recessions: a systematic review and meta-analysis

OBJECTIVES

To explore the efficacy of Hyaluronic acid as an adjunctive in treatment of gingival recessions (GR).

MATERIALS AND METHODS

A systematic literature search was performed in several electronic databases, including Medline/ PubMed, Embase, CENTRAL and LILACS. Recession improvement was evaluated through multiple outcome variables. The Cochrane Risk of Bias tool and the ROBINS-I tool were used to assess the quality of the included trials. Weighted Mean Differences (WMDs) and 95% confidence intervals (CIs) between test and control sites were estimated through meta-analysis using a random-effect model for the amount of Relative Root Coverage (RRC).

RESULTS

A total of 3 randomised studies were deemed as eligible for inclusion. Their data were also used for pooling the effect estimates. Overall analysis of RRC (3 studies) presented a WMD of 7.49% (p = 0.42; 95% CIs -10.88, 25.86) in favour of adjunctive use of hyaluronic acid during Coronally Advanced Flap (CAF) technique, although statistical significance was not reached. Statistical heterogeneity was found to be high (I2 = 80%).

CONCLUSIONS

Within their limitations, the present data indicate that the local application of Hyaluronic acid does not lead to additional clinical benefits when used as an adjunctive to the treatment of GR with CAF. However, due to the high heterogeneity among the studies, additional well-designed RCTs are needed to provide further evidence on this clinical indication for the use of Hyaluronic acid.

CLINICAL RELEVANCE

In the frame of the current review, the adjunctive use of Hyaluronic acid does not additionally improve the clinical outcomes obtained during treatment of GR with CAF.

Quantitative, compositional, and immunohistochemical analyses of chondroitin sulfate, dermatan sulfate, and hyaluronan in internal organs of deer (Cervus nippon centralis and C. n. yesoensis) and cattle (Bos taurus)

Chondroitin sulfate (CS) + dermatan sulfate (DS) and hyaluronan (HA) concentrations and the sulfation patterns of CS-DS in the cartilaginous tissues and alimentary canals of Honshu Sika deer, Hokkaido Sika deer, and cattle were investigated in the present study. CS + DS concentrations were high in cartilaginous tissues, namely, the trachea and scapular cartilage region (5- 12 g*), and low in the alimentary canal (~0.3 g*). HA concentrations were low in cartilaginous tissues and the alimentary canal (~0.2 g*). All tissues mainly contained A-type [HexAGalNAc(4-sulfate)] and C-type [HexAGalNAc(6-sulfate)] CS + DS. The ratios of A-type/C-type CS + DS were 1.2- 3.1 and 0.9- 16.4 in cartilaginous tissues and the alimentary canal, respectively. CS + DS predominantly comprised β-D-GlcA and α-L-IdoA in cartilaginous tissues and the alimentary canal, respectively. The alimentary canal characteristically contained up to 14 % highly sulfated E-type [HexAGalNAc(4,6-disulfate)] and D-type [HexA(2-sulfate)GalNAc(6-sulfate)] CS + DS. The specific distributions of CS and DS were immunohistochemically confirmed using CS + DS-specific antibodies. Although the omasum of cattle is more likely to have higher concentrations of CS + DS and HA, no significant species differences were observed in the concentrations or sulfation patterns of CS + DS among species for Honshu Sika deer, Hokkaido Sika deer, and cattle. (*per 100 g of defatted dry tissue).

The molecular weight of hyaluronic acid influences metabolic activity and osteogenic differentiation of periodontal ligament cells

OBJECTIVE

While HA is present naturally in periodontal tissues, its molecular weight can vary widely in vivo. The objective of this study was to directly compare the biological reactions of periodontal ligament cells to four distinct molecular weights of hyaluronic acid (HA).

MATERIALS AND METHODS

Immortalized human periodontal ligament cells (PDL-hTERT) were cultured for 21 days in culture medium alone (control) or enriched with osteogenic supplements (OS group). Other 4 experimental groups were cultured in OS medium with the addition of HA with different molecular weights (HMW, MMW, LMW, and ULMW). The cell morphology was examined daily. WST1 assays were performed to evaluate metabolic activity. Von Kossa staining and calcium deposition assay were used to analyze osteogenic differentiation and mineralization.

RESULTS

Cell morphology remained unaltered in all groups. Cells stimulated with OS alone or with the addition of hyaluronan showed all the typical microscopic appearance of osteogenic differentiation. Metabolic activity increased in all groups over time. Hyaluronan stimulated greater metabolic activity than the control group, with LMW HA and MMW HA showing the most significant increase. All groups showed mineral deposits and calcium deposition after 21 days of stimulation.

CONCLUSION

Our results suggest that hyaluronan can promote metabolic activity and mineralization of PDL-hTERT cells, with LMW HA being the most effective.

CLINICAL RELEVANCE

These results shed light on how the various molecular weight fractions of HA promote tissue regeneration and repair, as well as help to identify an optimal molecular weight range for this application in periodontal tissues.

Modification of gingival proteoglycans by reactive oxygen species: potential mechanism of proteoglycan degradation during periodontal diseases

Reactive oxygen species (ROS) overproduction and oxidative stress are increasingly being implicated in the extracellular matrix (ECM) degradation associated with chronic inflammatory conditions, such as periodontal diseases. The present study investigated the effects of ROS exposure on the proteoglycans of gingival tissues, utilizing an in vitro model system comprised of supra-physiological oxidant concentrations, to ascertain whether gingival proteoglycan modification and degradation by ROS contributed to the underlying mechanisms of ECM destruction during active gingivitis. Proteoglycans were purified from ovine gingival tissues and exposed to increasing H₂O₂ concentrations or a hydroxyl radical (·OH) flux for 1 h or 24 h, and ROS effects on proteoglycan core proteins and sulfated glycosaminoglycan (GAG) chains were assessed. ROS were capable of degrading gingival proteoglycans, with ·OH species inducing greater degradative effects than H₂O₂ alone. Degradative effects were particularly manifested as amino acid modification, core protein cleavage, and GAG chain depolymerization. Proteoglycan core proteins were more susceptible to degradation than GAG chains with H₂O₂ alone, although core proteins and GAG chains were both extensively degraded by ·OH species. Proteoglycan exposure to ·OH species for 24 h induced significant core protein amino acid modification, with decreases in glutamate, proline, isoleucine, and leucine; and concomitant increases in serine, glycine, and alanine residues. As clinical reports have previously highlighted proteoglycan core protein degradation during chronic gingivitis, whereas their sulfated GAG chains remain relatively intact, these findings potentially provide further evidence to implicate ROS in the pathogenesis of active gingivitis, complementing the enzymic mechanisms of periodontal tissue destruction already established.

Role of hyaluronan in regulating self-renewal and osteogenic differentiation of mesenchymal stromal cells and pre-osteoblasts

Objectives

The aim of the study was to investigate the impact of two hyaluronan (HA) formulations on the osteogenic potential of osteoblast precursors.

Materials and methods

Proliferation rates of HA-treated mesenchymal stromal ST2 and pre-osteoblastic MC3T3-E1 cells were determined by 5-bromo-20-deoxyuridine (BrdU) assay. Expression of genes encoding osteogenic differentiation markers, critical growth, and stemness factors as well as activation of downstream signaling pathways in the HA-treated cells were analyzed by quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and immunoblot techniques.

Results

The investigated HAs strongly stimulated the growth of the osteoprogenitor lines and enhanced the expression of genes encoding bone matrix proteins. However, expression of late osteogenic differentiation markers was significantly inhibited, accompanied by decreased bone morphogenetic protein (BMP) signaling. The expression of genes encoding transforming growth factor-β1 (TGF-β1) and fibroblast growth factor-1 (FGF-1) as well as the phosphorylation of the downstream signaling molecules Smad2 and Erk1/2 were enhanced upon HA treatment. We observed significant upregulation of the transcription factor Sox2 and its direct transcription targets and critical stemness genes, Yap1 and Bmi1, in HA-treated cells. Moreover, prominent targets of the canonical Wnt signaling pathway showed reduced expression, whereas inhibitors of the pathway were considerably upregulated. We detected decrease of active β-catenin levels in HA-treated cells due to β-catenin being phosphorylated and, thus, targeted for degradation.

Conclusions

HA strongly induces the growth of osteoprogenitors and maintains their stemness, thus potentially regulating the balance between self-renewal and differentiation during bone regeneration following reconstructive oral surgeries.

Clinical relevance

Addition of HA to deficient bone or bony defects during implant or reconstructive periodontal surgeries may be a viable approach for expanding adult stem cells without losing their replicative and differentiation capabilities.

Electronic supplementary material

The online version of this article (10.1007/s00784-020-03259-8) contains supplementary material, which is available to authorized users.

Effect of topically applied hyaluronic acid on pain and palatal epithelial wound healing: An examiner-masked, randomized, controlled clinical trial

BACKGROUND

This study aims to evaluate the effects of two different concentrations of topical hyaluronic acid (HA) on postoperative patient discomfort and wound healing of palatal donor sites after free gingival graft (FGG) surgery.

METHODS

Thirty-six patients requiring FGG were randomly assigned into three groups in an examiner-masked, randomized, controlled clinical trial. After harvesting palatal grafts, 0.2% and 0.8% HA gels were used in test groups 1 and 2, respectively. Gels were applied on donor sites and protected with periodontal dressing in the test groups, whereas the wound was covered only with periodontal dressing in the control group. On days 3, 7, 14, and 21, pain and burning sensation were recorded using a visual analog scale (VAS) as well as other parameters such as complete epithelization (CE) and color match on days 3, 7, 14, 21, and 42.

RESULTS

Test groups experienced less pain than the control group on days 3 and 7 (P <0.001 and P <0.001, respectively). Mean VAS score for burning sensation was higher in the control group on day 3 compared with test groups 1 and 2 (P = 0.03 and P = 0.02, respectively). CE in all patients was achieved on day 21 in both test groups, whereas it was achieved on day 42 in the control group. The test groups showed higher color match scores than the control group on days 21 (P <0.001 and P <0.001, respectively) and 42 (P = 0.004 and P = 0.002, respectively).

CONCLUSION

Topical application of HA exhibits positive impact on postoperative pain and burning sensation, and accelerates palatal wound healing in terms of epithelization and color match.

Activity of two hyaluronan preparations on primary human oral fibroblasts

Background and Objective

The potential benefit of using hyaluronan (HA) in reconstructive periodontal surgery is still a matter of debate. The aim of the present study was to evaluate the effects of two HA formulations on human oral fibroblasts involved in soft tissue wound healing/regeneration.

Material and Methods

Metabolic, proliferative and migratory abilities of primary human palatal and gingival fibroblasts were examined upon HA treatment. To uncover the mechanisms whereby HA influences cellular behavior, wound healing‐related gene expression and activation of signaling kinases were analyzed by qRT‐PCR and immunoblotting, respectively.

Results

The investigated HA formulations maintained the viability of oral fibroblasts and increased their proliferative and migratory abilities. They enhanced expression of genes encoding type III collagen and transforming growth factor‐β3, characteristic of scarless wound healing. The HAs upregulated the expression of genes encoding pro‐proliferative, pro‐migratory, and pro‐inflammatory factors, with only a moderate effect on the latter in gingival fibroblasts. In palatal but not gingival fibroblasts, an indirect effect of HA on the expression of matrix metalloproteinases 2 and 3 was detected, potentially exerted through induction of pro‐inflammatory cytokines. Finally, our data pointed on Akt, Erk1/2 and p38 as the signaling molecules whereby the HAs exert their effects on oral fibroblasts.

Conclusion

Both investigated HA formulations are biocompatible and enhance the proliferative, migratory and wound healing properties of cell types involved in soft tissue wound healing following regenerative periodontal surgery. Our data further suggest that in gingival tissues, the HAs are not likely to impair the healing process by prolonging inflammation or causing excessive MMP expression at the repair site.

Hyaluronan-mediated mononuclear leukocyte binding to gingival fibroblasts

OBJECTIVES

Binding of mononuclear leukocytes to hyaluronan cable structures is a well-known pathomechanism in several chronic inflammatory diseases, but has not yet described for chronic oral inflammations. The aim of this study was to evaluate if and how binding of mononuclear leukocytes to pathologic hyaluronan cable structures can be induced in human gingival fibroblasts.

MATERIAL AND METHODS

Experiments were performed with human gingival fibroblasts and peripheral blood mononuclear cells (PBMCs) from three healthy blood donors. Gingival fibroblasts were stimulated with (1) tunicamycin, (2) polyinosinic/polycytidylic acid (Poly:IC), and (3) lipopolysaccharides (LPS) to simulate (1) ER stress and (2) viral and (3) bacterial infections, respectively. Fibroblasts were then co-incubated with PBMCs, and the number of bound and fluorescently labeled PBMCs was assessed using a fluorescence reader and microscopy. For data analysis, a linear mixed model was used.

RESULTS

Hyaluronan-mediated binding of PBMCs to gingival fibroblasts was increased by tunicamycin and Poly(I:C) but not by LPS. Hyaluronidase treatment and co-incubation with hyaluronan transport inhibitors reduced this binding.

CONCLUSIONS

Results suggest that hyaluronan-mediated binding of blood cells might play a role in oral inflammations. A potential superior role of viruses needs to be confirmed in further clinical studies.

CLINICAL RELEVANCE

The linkage between pathological hyaluronan matrices and oral infections opens up potential applications of hyaluronan transport inhibitors in the treatment of chronic oral inflammations.

Treatment of gingivitis with hyaluronan

OBJECTIVES

Hyaluronic acid (hyaluronan) is a glycosaminoglycan with anti-inflammatory and antiedematous properties. It was evaluated in a gel formulation for its effect in the treatment of plaque-induced gingivitis.

METHOD

In a randomised double-blind study, 50 male subjects with plaque-induced gingivitis were divided into two groups and used a verum or placebo gel twice daily additionally to oral hygiene for a 3-week treatment period. Clinical indices (API, Turesky index, PBI) and crevicular fluid variables (peroxidase, lysozyme) were determined at baseline and after 4, 7, 14 and 21 days, respectively.

RESULTS

Significant improvements could be found for all clinical variables in both groups. The verum group showed significant improvement in the study area for the plaque indices beginning with day 4 (P = 0.011) and the PBI beginning with day 7 (P = 0.001) in comparison with the placebo group. The crevicular fluid variables were significantly improved in the centre of the studied inflammation area in the verum group. Here all studied sites had significant decreases in peroxidase (176.72-128.75 and 188.74-128.75 U/L) and lysozyme (1.27-0.27 and 1.30-0.33 mg/L) activities after 7, 14 and 21 days (P between 0.034 and < 0.001), whereas in the placebo group only one site showed a significant decrease for lysozyme (1.74-0.75 mg/L) after 7 and 21 days (P = 0.048 and 0.025).

CONCLUSIONS

These data suggest that a hyaluronan containing gel has a beneficial effect in the treatment of plaque-induced gingivitis.

Cellulite: a review

Gynoid lipodystrophy (cellulite) is an extremely controversial topic. A lack of knowledge regarding specific aetiopathogenic factors, as well as the opportunism of some professionals and the media, has fuelled debate regarding the scientific basis of this condition. This article reviews the clinical, epidemiological, histopathological and therapeutic aspects of cellulite.

Detection and possible biological role of chondroitinase and heparitinase enzymes produced by Porphyromonas gingivalis W50

Gingival crevicular fluid levels of the glycosaminoglycan (GAG) chondroitin-4-sulphate (C-4-S) have received increased attention as potential indicators of periodontal tissue turnover. However, little is known about the relationship between crevicular fluid connective tissue metabolites and microbial factors. In this study Porphyromonas gingivalis, a periodontopathogen, was investigated for its ability to degrade the GAGs C-4-S, dermatan sulphate (DS) and heparan sulphate (HS) in vitro. The effect of P. gingivalis extracts on the proteoglycans (PG) derived from human gingiva were also investigated. The presence of chondroitinase and heparitinase eliminase enzymes were identified from the vesicle fraction of P. gingivalis W50. These enzymes were extracted from the vesicle fraction by a differential centrifugation technique and partially purified by non-denaturing gel filtration chromatography which revealed heparitinase enzyme peaks at 200 and 150 kDa and chondroitinase at 70 kDa. Gingival proteoglycans for use as substrates were purified using 4 M guanidinium chloride extraction and anion exchange chromatography; these proteoglycans contained 48% DS, 27% C-4-S and 13% HS P. gingivalis chondroitinase and heparitinase enzymes were capable of the degradation of C-4-S and HS but not DS GAGs. The presence of chondroitinase enzymes produced by P. gingivalis may influence levels of connective tissue metabolites in crevicular fluid. Furthermore these enzymes, particularly the heparitinase, may be involved in the initial permeation of the gingival epithelium, permitting the ingress of further microbial virulence factors.

Age changes in the rat temporomandibular joint articular disc: a biochemical study on glycosaminoglycan content

The temporomandibular joint (TMJ) articular discs were removed from female Sprague-Dawley rats 3, 5, 10, 32, 90 and 130 weeks of age. Glycosaminoglycans (GAGs) were extracted from the discs by heat treatment, alkali treatment and digestion with Pronase E, and purified by precipitation with cetylpyridinium chloride and ethanol. The concentration of total GAG was highest in the 3 week extracts and tended to decrease with age. Dermatan sulphate was the predominant GAG detected in all age groups along with chondroitin sulphate, hyaluronic acid and heparan sulphate. The disaccharides obtained from chondroitin sulphate were delta Di-4S, delta Di-6S and delta Di-0S, with delta Di-4S being the predominant isomer followed by delta Di-6S for all ages of all the GAG examined. The concentration of chondroitin sulphate showed a decrease with age. Quantitative changes of GAG with age may be related to functional changes in TMJ discs.

Turnover in periodontal connective tissues: dynamic homeostasis of cells, collagen and ground substances

The connective tissues of the periodontium are composed of two soft tissues and two hard tissues--each of which has unique features. This review considers the constituents of normal, healthy periodontal connective tissues together with an appraisal of the changes in the connective tissue matrices of the periodontium which occur during the development of periodontitis. Recent developments in this field have paved the way for new and exciting vistas in periodontal diagnosis and regeneration which, ultimately, are two important goals in periodontal therapy.

Sulfate-reducing bacteria in the periodontal pocket

This report is the first to describe the occurrence of sulfate-reducing bacteria in the human mouth. Samples of subgingival dental plaque were examined for the presence of sulfate-reducing bacteria. Using enrichment cultures, sulfate-reducing bacteria were detected in 25 (58%) of 43 individuals, and in 39 (48%) of the 82 samples. Pure isolates of sulfate-reducing bacteria, obtained from a limited number of enrichment cultures, belonged to the genera Desulfobacter and Desulfovibrio. These genera are also the predominant sulfate-reducing bacteria in the human large intestine. The sulfate-reducing bacteria use sulfate as terminal electron acceptor to oxidize low-molecular-weight organic compounds, mainly products of microbial fermentation such as acetate, lactate etc. The numbers of sulfate-reducing bacteria in the mouth are assumed to be limited by sulfate. Potential sources of sulfate in the subgingival area include free sulfate in pocket fluid and glycosaminoglycans from periodontal tissues.

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.

Proteoglycan changes in carcinogen (4NQO)-treated rat tongue mucosa

The purpose of this study was to undertake preliminary analyses of the extracellular proteoglycans in carcinogen [4-nitroquinoline N-oxide (4NQO)]-treated rat tongue mucosa. Experimental rats were exposed to twice-weekly applications of 4NQO in propylene glycol for six months, after which the animals were killed. Control and 4NQO-treated tissues were subjected to sequential aqueous extractions of proteoglycans under associative and dissociative conditions, followed by alkaline cleavage of protein-glycosaminoglycan linkages to yield a glycosaminoglycan residue. Tissues subjected to 4NQO applications contained smaller proportions of proteoglycans which were readily soluble under associative and dissociative conditions. Proportionately more proteoglycan remained strongly associated with other intercellular tissue components, being released only by alkaline cleavage. These biochemical alterations in preinvasive 4NQO-treated epithelium and connective tissues, together with an observed associated change in water retention by the connective tissue, occurred prior to actual neoplastic invasion and suggest differences in macromolecular conformation and orderliness. We hypothesize that these changes are related to the phenomenon of neoplastic epithelial invasion.

Heterogeneity of fibroblasts derived from human free and attached gingiva. Glycosaminoglycan synthesis and effects of phenytoin (PHT) treatment

Two fibroblast populations derived from free and attached gingiva (FGF, AGF) have been compared in cell culture. They exhibited the same morphology and similar cytoskeletal staining patterns, but were different in glycosaminoglycan (GAG) synthesis. FGF released larger quantities of GAGs than AGF in the medium. The extracellular accumulation of hyaluronic acid was higher in FGF than in AGF, whilst the reverse pattern was observed intracellularly. In the case of sulphated GAGs the extracellular concentration, compared to HA, was higher in AGF, while the intracellular concentration was higher in FGF. The two cell populations responded differently to phenytoin (PHT) administration. PHT treatment increased the proportion of intracellular sulphated GAGs in AGF and of extracellular sulphated GAGs in FGF.

The effect of glycosylaminoglycans on the mineralization of sheep periodontal ligament in vitro

The effect of removal of glycosylaminoglycans on the mineralization of sheep periodontal ligament was determined using enzyme digests followed by incubation in solutions supersaturated with respect to hydroxyapatite at pH 7.4. TEM revealed that control periodontal ligament remained unmineralized. However, tissue from which glycosylaminoglycans had been removed contained plate-like crystals arranged parallel to and within the collagen fibrils. Electron probe and electron diffraction studies suggested that the crystals were apatitic with a similar order of crystallinity to dentine, and a Ca:P ratio of 1.61. In addition, the glycosylaminoglycan content of periodontal ligament, cementum and alveolar bone was compared using cellulose acetate electrophoresis. Periodontal ligament contained predominantly dermatan sulfate while cementum and alveolar bone contained mostly chondroitin sulfate. A role for glycosylaminoglycans in maintaining the unmineralized state of the periodontal ligament is suggested. Control of expression of specific proteoglycan species on a spatially restricted basis is presumably central to this role.

Gingival crevicular fluid: biomarkers of periodontal tissue activity

The lack of precise clinical criteria for assessment of periodontal disease has led to a search for alternative means of determining active disease sites, prognosis of future sites of breakdown, and response to therapy. This review highlights the potential array of biomarkers present in gingival crevicular fluid and which may relate to existing or predicted tissue regions undergoing metabolic change and derived from bacterial or host-cell-derived products. Among the former may be listed endotoxin, amines, butyrate, and a variety of enzymes and their inhibitors, such as trypsin-like proteases and bacterial collagenase. Arising from host cells is a variety of leucocytic hydrolase enzymes, lactoferrin, and lysozyme. These appear to be useful inflammatory markers and may be distinguished from products of connective tissue breakdown which include collagenous and non-collagenous products, including collagen peptides, osteonectin, and fibronectin. The proteoglycans have found particular favor as biomarkers of possible bone-resorptive activity. Attention has also been directed at the immune response, including comment on immunoglobulins, complement, eicosanoids, and cytokines. This review lists available information on the presence of these in gingival sulcus fluid and wherever possible relates their presence to disease activity.

The effect of rate of eruption on periodontal ligament glycosylaminoglycan content and enamel formation in the rat incisor

The rate of eruption of rat mandibular incisors was either increased by cutting one tooth out of occlusion or eliminated by means of pinning. The effects of such changes in eruption rate on the sulphated glycosylaminoglycan content of the periodontal ligaments was analysed. The length of the enamel secretory zone and the composition of the developing enamel matrix protein was also compared. Sulphated glycosylaminoglycan content of the periodontal ligament increased fourfold (P < 0.001) during accelerated eruption but decreased to a corresponding extent (P < 0.001) in the absence of eruption, when compared with controls. The length of the enamel secretory zone was also significantly reduced in the immobilised teeth, although the protein content was similar compared with controls. The results demonstrate the differential response to varied eruption rates of the periodontal ligament and enamel, particularly in respect of the extracellular matrix. The data are consistent with the view that the ground substance of the periodontal ligament plays a role in the generation of the eruptive force.

Glycosaminoglycans and periodontal disease: analysis of GCF by safranin O

The purpose of this study was to quantify glycosaminoglycans (GAG) released into the gingival crevicular fluid (GCF) during health, gingivitis, and adult periodontitis. The investigation tested the hypothesis that increased amounts of GAG can be measured in GCF associated with gingivitis and adult periodontitis as compared to health. An individual patient's sampling sites were assigned to either a health (control) group or 1 of 3 experimental groups, gingivitis, periodontal "maintenance" (perio-M), or periodontal "non-maintenance" (perio-NM) according to standard clinical criteria of pocket probing depth, bleeding on probing, and radiographic evidence of bone loss. The perio-M group was defined as a periodontal patient who had received a dental prophylaxis and/or root planning within 6 months prior to GCF collection. The perio-NM group had received no periodontal therapy during the previous 6 months. Subsequent to air-drying and isolation, GCF was collected by a microcapillary pipette held at the gingival margin. All fluid samples were digested overnight at 37 degrees C with 25 micrograms of papain and analyzed for GAG content using a chondroitin-4-sulfate standard. Data generated from safranin "O" dye binding assays of GAG revealed 4.41 +/- 9.82 ng GAG from the health (control) group (n = 23); the gingivitis group (n = 13) showed 15.23 +/- 11.85 ng GAG/sample; perio-M group (n = 11) showed 23.64 +/- 12.98 ng GAG/sample and the perio-NM group (n = 12) exhibited 119.08 +/- 33.14 ng GAG/sample.(ABSTRACT TRUNCATED AT 250 WORDS)

Partial characterization of proteoglycans synthesized by human gingival epithelial cells in culture

Proteoglycans (PGs) were extracted from the [35S]-sulfate labelled medium and cell layer of proliferating human gingival epithelial cells and analyzed by ion exchange and molecular sieve chromatography, and by SDS-PAGE. The majority of the incorporated radioactivity secreted into the medium eluted from a DEAE Sephacel ion exchange column as a single peak at 0.44 M NaCl with a small shoulder at 0.52 M NaCl. This material, when chromatographed on Sepharose CL-6B contained two species--a quantitatively major peak at K(av) = 0.30 (M(r) congruent to 235,000 on SDS-PAGE) and a quantitatively minor peak at K(av) = 0.39. The major peak was sensitive to alkaline borohydride, shifting to K(av) = 0.45, and nitrous acid degradation, indicating the presence of heparan sulfate PG with glycosaminoglycan chains with M(r) congruent to 26,000. The minor peak is chondroitin/dermatan sulfate PG with glycosaminoglycan chains of M(r) = 22,200 as indicated by sensitivity to alkaline borohydride (shifting to K(av) = 0.48) and chondroitin ABC lyase digestion. The [35S]-sulfate labelled material from the cell layer eluted in a broad peak between 0-0.50 M NaCl from DEAE Sephacel. Chromatography of this material on Sepharose CL-6B revealed the presence of three peaks at K(av) = 0.20, 0.31, and 0.75. The largest peak (K(av) = 0.20 and M(r) congruent to 245,000 on SDS-PAGE) shifted elution position to K(av) = 0.50 after alkaline borohydride treatment and was completely sensitive to nitrous acid degradation. These results indicate that this peak contains heparan sulfate PG with glycosaminoglycan chains of M(r) congruent to 20,000. Two peaks containing [35S]-sulfate labelled glycosaminoglycan chains were detected by chromatography of the cell layer extract over Sepharose CL-6B with K(av)S = 0.42 (M(r) congruent to 30,500) and 0.75 (M(r) congruent to 5300). The larger peak was predominantly chondroitin/dermatan glycosaminoglycan as indicated by susceptibility to chondroitin ABC lyase while the chains at K(av) = 0.75 were predominantly heparan sulfate with 83% susceptibility to nitrous acid. These results indicate that cultured human gingival epithelial cells synthesize and secrete principally heparan sulfate PGs with small amounts of chondroitin/dermatan sulfate PGs. This work will serve as a basis for future studies designed to examine those factors involved in regulation of PG synthesis by these cells.

The effect of periodontal disease on sulphated glycosylaminoglycan distribution in the sheep periodontium

The glycosylaminoglycan (GAG) distribution in the soft periodontal tissues of the sheep was investigated topographically in healthy tissue and the changes associated with periodontal disease determined and correlated with increasing disease severity. Total sulphated GAG content was determined spectrophotometrically and the proportions of individual GAGS measured after separation by cellulose acetate electrophoresis. In healthy tissue, total sulphated GAG distribution was found to mirror that described previously for collagen, being highest in the gum-pad region and adjacent to alveolar bone. This changed markedly in relation to periodontal disease. Early disease-related changes in GAGs were first detected adjacent to alveolar bone. In severely diseases tissue, an overall increase in sulphated GAG, particularly in the gum-pad region, was present. Increasing disease severity was accompanied by a decrease in dermatan sulphate and a concomitant increase in the proportion of chondroitin-4-sulphate. These changes may be due to the combined effects of chronic inflammation and alterations to the mechanical loading of the tissue owing to loss of attachment.

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.

Distribution of chondroitin sulfate and dermatan sulfate in normal and inflamed human gingivae

The effect of inflammation on the distribution of chondroitin sulfate and dermatan sulfate proteoglycans was assessed after normal and inflamed human gingivae were stained with monoclonal antibodies against these extracellular matrix macromolecules. The tissues were obtained following periodontal surgery and reacted with specific antibodies after pre-treatment with chondroitinase ACII or chondroitinase ABC, and staining was visualized by the immunoperoxidase technique. The results indicated that these two proteoglycans were present in both the 4-sulfated and 6-sulfated isomeric forms. While chondroitin sulfate appeared to be uniformly distributed throughout the connective tissue, dermatan sulfate showed greater intensity of staining in the areas immediately subjacent to the epithelium. Positive staining for chondroitin sulfate was noted in the intercellular spaces of the epithelium. In inflamed tissues, there was significant staining associated with 4-sulfated dermatan sulfate and chondroitin sulfate, but this had lost the structured pattern of staining noted in normal sections. The 6-sulfated isomeric forms were greatly reduced in inflamed tissues and tended to show a predilection to be localized within the perivascular tissues. In the inflamed tissues, there was intense staining for chondroitin sulfate associated with the infiltrating inflammatory cells. These findings corroborate earlier biochemical studies on normal and inflamed gingival tissues. The specific tissue localization of dermatan sulfate and chondroitin sulfate in tissues damaged by inflammation indicates that, as opposed to the large loss of collagenous material noted during inflammation, there is not a corresponding large loss of proteoglycan. Indeed, at specific inflammatory foci, the intensity of staining for these macromolecules may intensify.

Glycosaminoglycan patterns in gingival proteoglycans of rat with age

Among the potential biochemical indices that are closely associated with craniofacial development are the proteoglycans. Gingival segments from the palate of 4-, 6-, 8-, 12- and 18-week-old rats were incubated for 4 h in medium containing [3H]-glucosamine and [35S]-Na2SO4, and subjected to proteoglycan isolation and glycosaminoglycan analysis. Two distinct proteoglycan fractions differing in the degree of sulphation were obtained by ion-exchange chromatography. The incorporation of both labels in the undersulphated fraction increased with age; there was a pronounced decrease with age in the sulphated proteoglycan fraction. The undersulphated proteoglycans showed an age-dependent decrease in hyaluronic acid, and increase in dermatan sulphate and chondroitin 4- and 6-sulphates. Gel filtration of the sulphated proteoglycan fraction yielded high and low molecular-weight proteoglycans, the glycosaminoglycans of which were particularly rich (61-76%) in dermatan sulphate. Smaller quantities of chondroitin 4- and 6-sulphates, and heparan sulphate were also present. All glycosaminoglycans showed a decrease in content with age. The findings suggest a possible correlation between gingival proteoglycan/glycosaminoglycan patterns and development.

Proteoglycans of bovine cementum: isolation and characterization

The proteoglycans associated with the mineralized matrix of bovine cementum have been studied biochemically and their distribution within this tissue localized immunohistochemically. Both hyaluronate and proteoglycans were fractionated by DEAE-Sephacel ion-exchange chromatography. The proteoglycans eluted in three separate peaks of which two contained alkali labile protein associated with glycosaminoglycans, and one appeared as free glycosaminoglycan chains. Analysis of the glycosaminoglycans identified chondroitin sulfate as the predominant species, although minor quantities of dermatan sulfate and heparan sulfate were also identified. Agarose-acrylamide gel electrophoresis and Sepharose CL-6B molecular sieve chromatography of the proteoglycans indicated them to be smaller in size with respect to periodontal ligament and gingival proteoglycans, but similar to bone and dentine proteoglycans. Amino acid analyses indicated subtle differences between cementum and bone proteoglycans. Using a monoclonal antibody (9-A-2) which recognizes the unsaturated disaccharide of chondroitinase ACII-digested glycosaminoglycans, chondroitin sulfate was identified in the pericellular environment within the lacunae housing the cementoblasts as well as in the extracellular matrix of cementum.

Characterization of fibroblasts derived from human periodontal ligament and gingiva

Growth characteristics and macromolecular synthesis of fibroblasts derived from human periodontal ligament (PDLF) and gingiva (GF) have been compared in cell culture. Cells were isolated from explants and plated at 500,000 cells/100 mm culture dish (day 0) with daily changes of culture medium. DNA histograms were obtained by flow microfluorimetric analysis to confirm the growth state of the cell cultures. Human PDLF cultures became confluent at day 6 as determined by cell number and cell cycle analysis while GF were confluent by day 4. Initially, DNA content of logarithmically growing cells was significantly greater in GF cultures; however, when confluent, DNA content and cell number was greater in PDLF cultures. Total protein content in GF was slightly greater than PDLF until day 7 but this difference was not significant. Analysis of collagen and noncollagen protein synthesis revealed a greater trend in noncollagen protein synthesis in the GF cultures compared to PDLF cultures. Analysis of glycosaminoglycans in the culture medium of GF and PDLF revealed similar distributions of components. In the cellular fraction, GF had greater amounts of hyaluronic acid and heparin and lesser amounts of chondroitin sulfates A and C than PDLF cultures. The results indicate that the growth characteristics of PDLF and GF, although similar in many respects, do exhibit specific differences in proliferative rates and macromolecular synthesis. The differences observed in these parameters may be important during in vivo events, such as guided tissue regeneration, where significant functional differences are observed between gingival connective tissue and periodontal ligament connective tissue.

Histochemical localization of hyaluronate in human oral epithelium using a specific hyaluronate-binding probe

Biochemical data suggest that gingival epithelium contains hyaluronate, but there is little histochemical information about its localization. Hyaluronate was here visualized in gingival and buccal mucosa using a specific probe derived from the hyaluronate binding region of cartilage proteoglycan. Hyaluronate was found both in the gingival and buccal epithelium, but its localization was correlated with the type of keratinization. In the keratinized epithelium of gingiva, whether ortho- or parakeratotic, the intercellular spaces from basal to upper spinous layers displayed strong staining, most intense in the middle spinous cell layer. The uppermost vital cell layers as well as the cornified cell layer remained unstained. In the non-keratinized epithelium of buccal mucosa and the local non-keratinized areas of gingiva, only the basal cells and the lowermost spinous cell layers stained for hyaluronate, whereas the majority of the upper epithelium was negative. Electron microscopic examination of the basal and spinous cell layers displayed hyaluronate, both associated with the cell surface and free in the intercellular space. The subepithelial connective tissue showed positive but diffuse staining in all specimens.

A biochemical and immunohistochemical study of the proteoglycans of alveolar bone

The purpose of this investigation was to study the proteoglycans in alveolar bone of three animal species. Alveolar bone was obtained from humans, pigs, and rabbits. Portions were fixed, sectioned, and stained with monoclonal antibodies against keratan sulfate and chondroitin sulfate. In other samples, biochemical analyses were performed. After removal of the organic matrix by 4 mol/L guanidinium HCl extraction in the presence of proteinase inhibitors, proteoglycans in the mineralized matrix were extracted with 4 mol/L guanidinium HCl/0.5 mol/L EDTA/proteinase inhibitors, and characterized on the basis of their glycosaminoglycan content (cellulose acetate membrane electrophoresis), charge (DEAE-Sephacel and hydroxylapatite chromatography), size (Sepharose CL-6B chromatography and agarose/polyacrylamide gel electrophoresis), and amino acid content. The results indicated that keratan sulfate could be detected immunohistochemically and biochemically in rabbit bone only. The predominant glycosaminoglycan in pig and human alveolar bone was chondroitin sulfate, although some hyaluronate, dermatan sulfate, and heparan sulfate were also detected. The proteoglycans were found to be slightly smaller than gingival proteoglycans, but similar to those in cementum, dentin, and other bones. In addition to intact proteoglycans, some free glycosaminoglycan chains were also extracted from the mineralized matrix. Amino acid analyses showed some subtle differences between alveolar bone proteoglycan and those of the soft tissues of the periodontium.

Immunohistochemical localization of chondroitin sulfate and dermatan sulfate proteoglycan in human gingival connective tissue

This study investigated the immunohistochemical localization of chondroitin sulfate (chondroitin, 4-sulfate and 6-sulfate) and dermatan sulfate proteoglycan (PG) in human gingival connective tissue, using monoclonal antibodies. Dermatan sulfate was found to be widespread in connective tissue, with an especially strong response shown in collagen fiber bundles under the epithelial basement membrane. Chondroitin 4-sulfate occurred widely in connective tissue but showed only a weak response. Chondroitin 6-sulfate was located in peripheral blood vessels. Chondroitin was not detected in gingival connective tissue.

Histochemical localization at the electron microscopic level of sulfated glycosaminoglycans in the rat gingiva

Using the high iron diamine thiocarbohydrazide silver proteinate (HID-TCH-SP) staining technique, we investigated ultrastructural localization of sulfated glycosaminoglycans (GAGs) in the rat gingiva shortly after eruption, especially those associated with internal and external basal laminae. In the apical portion of the internal basal lamina, HID-TCH-SP stain deposits were distributed mainly in the region of the lamina lucida located between the lamina densa and the distal surface membrane of the junctional epithelium and inside the depression of the distal surface membrane adjacent to the basal lamina. Stain deposits were also detected on the surface membrane of the cytoplasmic protrusion. Interestingly, the density of HID-TCH-SP stain deposits in the internal basal lamina was highest in the apical portion of the junctional epithelium and decreased in the coronal direction, finally tending to disappear completely. On the other hand, in the external basal lamina the deposits were localized in the whole region of the basal lamina or at both sites of the lamina densa. HID-TCH-SP stain deposits were also detected external to the lamina densa in the basement membrane associated with capillaries and in the connective tissue where they were distributed in close relation to collagen fibrils. Testicular hyaluronidase digested most HID-TCH-SP stain deposits in the connective tissue, whereas those in the region of basement membranes resisted this enzymatic digestion.

A biochemical study of glycosaminoglycans in the palatal rugae of the monkey (Macaca fascicularis)

Glycosaminoglycans (GAG) were extracted from the connective tissue of the palatal rugae, separated by electrophoresis and compared with the results obtained for the remaining palatal mucosal and gingival connective tissues. The GAG content of the rugae (3.01 mg/g defatted dry weight) was higher than in the remaining palatal mucosa (2.33 mg/g defatted dry weight) or gingiva (1.68 mg/g defatted dry weight). Dermatan sulphate was the predominant GAG in both the palatal rugae (48% of total GAG) and the remaining palatal mucosa (50%) followed by hyaluronic acid (33 and 31% respectively). The results do not support previous histochemical observations in which the rugae appeared to be rich in hyaluronic acid.

Detection of high-risk groups and individuals for periodontal diseases: laboratory markers from analysis of gingival crevicular fluid

Gingival crevicular fluid is regarded as a promising medium for the detection of markers of periodontal diseases activity. The collection protocols are straight forward and non-invasive and can be performed at specific sites of interest in the periodontium. Because the fluid accumulates at the gingival margin, it will contain potential markers derived not only from the host tissues and serum but also the subgingival microbial plaque, and thus an extremely broad range of candidate molecules may be investigated. However, the ability to successfully describe indicators of current disease activity and predictors of future disease is dependent not only upon the choice of the biochemical marker but also on the accurate description of the health status of the sample sites using currently available clinical and radiographic methods. Areas of study which currently show the most promise involve the analysis of host enzyme activities directed against components of the extracellular matrix, the nature of the glycosaminoglycans released into the sulcus and the concentration in gingival crevicular fluid of certain mediators of the inflammatory process, most notably prostaglandin E2.

Immunohistological demonstration of osteonectin in normal bone tissue and in bone tumors

Osteonectin is a noncollagenous protein of bone which is believed to be bone specific, since its concentration in bone tissue is 500- to 1000-fold higher than in other connective tissues. Immunohistochemistry with polyclonal osteonectin antibodies shows a highly specific marking of actively matrix-producing osteoblasts. Osteonectin is involved in the process of osteoid maturation and mineralization. Immunohistochemistry of osteonectin antibodies proved to be a valuable tool in the diagnosis of bone tumors. Since osteonectin production seems to be an early event in the differentiation of cells of the osteoblastic lineage, immunoreactivity of osteonectin antibodies is observed in types of osteosarcoma lacking osteoid production (anaplastic, fibroblastic) while corresponding types of soft tissue tumors remain unstained.

Glycosaminoglycans of human alveolar bone

Bone proteoglycan was extracted and the glycosaminoglycan (GAG) components identified. Chondroitin-4-sulphate was the major GAG detected and represented 93.8% of the total GAG extracted. In addition, hyaluronic acid (1.3%), dermatan sulphate (3.1%) and heparan sulphate (1.8%) were identified as minor constituents.

Quantification and analysis of the glycosaminoglycans in human odontogenic cyst linings

Glycosaminoglycans (GAG) were extracted from the connective tissue of 15 dental cysts, 2 dentigerous cysts and 7 keratocysts, and separated electrophoretically and chromatographically. Hyaluronic acid (dental, 2.38; dentigerous, 3.98; keratocyst, 3.19 micrograms uronic acid/mg lyophilized tissue) was the major GAG detected, with lesser amounts of heparin (dental, 1.70; dentigerous, 1.95; keratocyst, 1.80 micrograms uronic acid/mg lyophilized tissue) and chrondroitin-4-sulphate (dental, 1.33; dentigerous, 2.85; keratocyst, 1.37 micrograms uronic acid/mg lyophilized tissue). It is suggested that enzymic release of these GAGs allows their diffusion into the luminal fluid where they may contribute to expansile cyst growth.

Glycosaminoglycans in human gingival crevicular fluid during orthodontic movement

Glycosaminoglycans (GAG) in gingival crevicular fluid (GCF) were investigated by cellulose acetate electrophoresis of simultaneously collected samples from the mesial and distal surfaces of teeth in 3 groups of young persons. In a control group, which had not undergone orthodontic treatment, a major band of hyaluronic acid (HA) and a minor band of chondroitin sulphate (CS) were present. No differences in the mean content of either GAG between the mesial and distal surfaces were detected. From teeth undergoing movement by fixed appliances (active group), a raised mean level of CS was present in GCF from the surface towards which movement was directed. Teeth held passively by an appliance following cessation of active movement (retention group) showed raised levels of CS at mesial and distal surfaces. A heparan sulphate-like GAG was commonly present in this group only. No significant increase in the levels of HA were detected at the mesial and distal surfaces of either the active or the retention groups, despite increased GCF flow rates unassociated with more severe gingival inflammation. The GAG composition of GCF, particularly CS, appears to reflect changes occurring in the deeper periodontal tissues of alveolar bone and periodontal ligament during orthodontic treatment.

The glycosaminoglycan constituents of alveolar and basal bone of the rabbit

Proteoglycan was extracted from alveolar and basal bone of New Zealand White rabbits using a sequential extraction procedure. Proteoglycans not associated with the bone mineral represented 1% of the total organic matrix whereas proteoglycans associated with the mineral represented 20% of the alveolar organic matrix and 12% of the basal organic matrix. Chondroitin-4-sulphate and keratan sulphate were identified in both alveolar and basal bone following protease treatment of the proteoglycan extracts and enzymic digestion with chondroitinase AC, ABC and keratanase. Differences were observed in the percentage of each glycosaminoglycan (GAG) in the total organic matrix. In alveolar bone samples, keratan sulphate and chondroitin-4-sulphate is present in equal proportions. In basal bone chondroitin-4-sulphate represents approximately half the value found in alveolar bone and keratan sulphate about a quarter. The extracts were examined by gel filtration on Sepharose 4B under associative conditions. The 280 nm absorbance profiles of proteoglycan from alveolar and basal bone were essentially similar with three main peaks evident, including molecular weight material in excess of 2 X 10(6). The bulk of the bone GAG appeared in the medium molecular weight range with trace amounts in lower molecular weight fractions.