Levels of interleukin 1 beta in tissue from sites of active periodontal disease

Interleukin 1 beta is a potent bone resorptive cytokine which also mediates soft tissue destruction through the stimulation of prostaglandin production, and the induction of collagenase and other proteases. This constellation of activities suggests a role for IL-1 beta in the pathogenesis of human periodontitis. Levels of IL-1 beta were therefore determined in tissue obtained from (1) diseased, active (2) diseased, inactive and (3) healthy sites from 12 patients with destructive adult periodontitis. Disease activity was defined as attachment loss of greater than or equal to 2.5 mm, as determined by sequential probing and the tolerance method. IL-1 beta was extracted from homogenates of tissue biopsies taken at surgery, and levels were quantified by ELISA. IL-1 beta was found to be present in most patient tissue samples, with levels ranging from 0-82 ng/ml. Disease active sites had higher IL-1 beta levels (p less than 0.05) than inactive and healthy sites. Diseased inactive sites were divided into 2 groups, those losing small amounts of attachment (0.5-2.0 mm, worsening sites) and those which showed no change or attachment gain (stable sites). Stable diseased sites had IL-1 beta levels which were comparable to those found in healthy sites, and which were significantly different from active sites (p less than 0.02). Worsening sites had IL-1 beta levels intermediate between the levels in stable and active sites. Detection of disease activity occurred more frequently at sites with IL-1 beta levels greater than 25 ng/ml (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Lipid peroxidation levels and total oxidant status in serum, saliva and gingival crevicular fluid in patients with chronic periodontitis

OBJECTIVES

Increased levels of reactive oxygen species lead to oxidative stress. Recent data suggest increased lipid peroxidation (LPO) levels and oxidative stress in periodontitis. Malondialdehyde (MDA), a significant LPO product, increases in oxidative stress. In this study, MDA levels and total oxidant status (TOS) in serum, saliva and gingival crevicular fluid (GCF) were investigated in patients with chronic periodontitis (CP).

MATERIALS AND METHODS

Thirty-six CP patients and 28 periodontally healthy controls were included in the study. Following clinical measurements and samplings, MDA and TOS levels were measured by high-performance liquid chromatography and a novel automatic colorimetric method, respectively.

RESULTS

While the saliva and GCF MDA levels, and serum, saliva and GCF TOS values were significantly higher in the CP group than the control group (p<0.05), no significant difference in serum MDA levels was found (p>0.05). Strong positive correlations were observed between periodontal parameters and MDA and TOS levels (p<0.05).

CONCLUSIONS

The results revealed that LPO significantly increased locally in the periodontal pocket/oral environment, while TOS displayed both systemic and local increases in periodontitis. The findings suggest that increased LPO and TOS may play an important role in the pathology of periodontitis, and are closely related to the clinical periodontal status.

Differential expression of RANKL and osteoprotegerin in gingival crevicular fluid of patients with periodontitis

The receptor activator for NF-kappaB ligand (RANKL) plays an important role in osteoclast formation. A recent study with animal models suggests the involvement of RANKL in the pathogenesis of this periodontal disease. However, no one has examined the level of RANKL in the body fluid of human subjects. This communication reports on the in vivo concentrations of RANKL and the RANKL decoy receptor osteoprotegerin (OPG) in the gingival crevicular fluid (GCF) of periodontal subjects with severe, moderate, and mild forms of the disease. An increased concentration of RANKL and a decreased concentration of OPG were detected in GCF from patients with periodontitis (*p < 0.05 vs. control subjects). The ratio of the concentration of RANKL to that of OPG in the GCF was significantly higher for periodontal disease patients than for healthy subjects (*p < 0.01). Taken together, these data suggest that RANKL and OPG contribute to osteoclastic bone destruction in periodontal disease.

ABBREVIATIONS

GCF, gingival crevicular fluid; IL, interleukin; OPG, osteoprotegerin; RANKL, receptor activator for NF-kappaB ligand.

New biomarker evidence of oxidative DNA damage in whole saliva from clinically healthy and periodontally diseased individuals

BACKGROUND

There is an increasing body of evidence implicating reactive oxygen species in the pathogenesis of periodontal tissue destruction. 8-Hydroxy-deoxyguanosine (8-OHdG) is one of the most commonly used markers to evaluate oxidative damage in a number of disorders including chronic inflammatory diseases. The aim of the present study was to evaluate 8-OHdG levels in whole saliva of patients with periodontitis and to assess the changes after initial treatment.

METHODS

Saliva samples were collected from 78 patients with untreated periodontitis and 17 healthy control subjects. Clinical parameters and levels of 8-OHdG were assessed first to establish a baseline and again after initial periodontal treatment from 15 patients. 8-OHdG levels were determined by enzyme-linked immunosorbent assay.

RESULTS

The mean value of 8-OHdG in the saliva of periodontally diseased subjects, 4.28 +/- 0.10 ng/ml, was significantly higher (P<0.01) than that of clinically healthy subjects (1.56 +/- 0.10 ng/ml). A significant decrease in salivary 8-OHdG was observed after therapy (P<0.01).

CONCLUSION

In the present study, we evaluated for the first time 8-OHdG levels in whole saliva of patients with periodontitis and assessed changes after initial periodontal treatment. Our study indicated that 8-OHdG levels in saliva appear to reflect the status of periodontal health.

Relationship between sulcular sulfide level and oral malodor in subjects with periodontal disease

BACKGROUND

The relationship between oral malodor and sulfide levels in periodontal pockets (pS) has not yet been determined. The aims of this study were: 1) to identify the correlation among oral malodor, pS levels, and the BANA (benzoyl-DL-arginine-naphthylamide) test and 2) to recognize the interaction between oral malodor, demographic factors, tongue coating, and periodontal condition.

METHODS

Eighty-one periodontal patients participated in this study. A portable sulfide monitor and organoleptic method were used to evaluate oral malodor. Demographic data included age, gender, race, and smoking habits. The volume of tongue coating and periodontal condition for all teeth were assessed. The pS levels of 3 different radiographic bone loss (RBL) sites: RBL < 2 mm, healthy; RBL > or = 2 to < 4 mm; low to moderate; RBL > or = 4 mm, severe, were measured using an industrial sulcular sulfide-monitoring device. Subgingival plaque samples from the above 3 sites and tongue scraping were examined by the BANA test.

RESULTS

The volume of tongue coating (P<0.001), extent of periodontal disease (P<0.05), pS levels of the sites with low to moderate bone loss (P<0.05), and BANA score of tongue scrapings (P<0.05) were significantly associated with oral malodor. Stepwise multiple regression analysis examined the degree of association between oral malodor and potential explanatory variables. The volume of tongue coating and percent of sites BOP (bleeding on probing) were significantly associated with oral malodor. Females and smoking habit were negatively correlated with organoleptic measurements.

CONCLUSIONS

The pS level of the representative sites with low to moderate bone loss demonstrated a modest association with oral malodor. Oral malodor in periodontal patients was primarily associated with tongue coating and gingival inflammation.

Calprotectin in gingival crevicular fluid correlates with clinical and biochemical markers of periodontal disease

Clinical and biochemical markers of periodontal disease have been used for precise objective diagnosis of periodontal inflammation. Interleukin 1beta (IL-1beta) and prostaglandin E2 (PGE2), inflammatory factors, levels in gingival crevicular fluid (GCF) of patients with periodontal disease are elevated and have been studied as biochemical markers. The levels of calprotectin, a leukocyte protein, in body fluids of patients with some inflammatory diseases are raised. Recently, we detected calprotectin in GCF and its concentrations in periodontal pockets were higher than those in healthy gingival crevices. In this study, we investigated the correlations between GCF calprotectin levels and clinical indicators (probing depth and bleeding on probing, BOP), and the IL-1beta or PGE2 levels in GCE Probing depth and BOP at 130 sites of 110 subjects with periodontal or other oral diseases were examined, then GCF samples were collected and their calprotectin, IL-1beta and PGE2 were determined by ELISA. The calprotectin level correlated positively with the probing depth and was significantly higher at BOP-positive than BOP-negative sites. There were significant, positive correlations between the calprotectin and IL-1beta or PGE2 concentrations. These results indicate that the calprotectin level in GCF correlates well with clinical and biochemical markers of periodontal disease and suggest that calprotectin may be useful for evaluating the extent of periodontal inflammation.

Interleukin-1 beta (IL-1 beta) levels in gingival crevicular fluid from adults with previous evidence of destructive periodontitis. A cross sectional study

We have estimated the levels of Interleukin-1 beta (IL-1 beta) by ELISA in gingival crevicular fluid (GCF) at 58 sites from 37 patients with adult periodontitis. GCF was collected for 5 s on filter papers and a 2nd sample was collected for 30 s 1 min later. 68/116 strips yielded detectable levels of IL-1 beta. IL-1 beta was present in both the 1st and 2nd samples at 28 sites, in the 1st only at 4 sites and in the 2nd only at 8 sites; 18 sites were below the level of detection for the assay. When the concentrations of IL-1 beta were calculated in the original volume of GCF on each strip, the mean value for positive strips was 34.16 +/- 29.45 (SD) pg/microliters with a range from 1.75 to 97.13 pg/microliters. There were no statistically significant correlations with the plaque index, bleeding index or probable crevice depth (pocket depth). The results indicate that IL-1 is present in the GCF from a proportion of sites with evidence of previous periodontal destruction.

Substance P and neurokinin A in gingival crevicular fluid in periodontal health and disease

The aims of the present study were to investigate whether the tachykinins substance P and neurokinin A were present in gingival crevicular fluid in both periodontal health and disease and to study the relationship with periodontal inflammation. Gingival crevicular fluid (GCF) was collected from a healthy, a gingivitis and a periodontitis site in 20 subjects with periodontitis and from a healthy site in 20 subjects without periodontitis. The volume of GCF was measured and each sample subsequently analysed for substance P and neurokinin A by radioimmunoassay. There were significantly increased levels of substance P-like immunoreactivity (SP-LI) and neurokinin A-like immunoreactivity (NKA-LI) in gingivitis and periodontitis sites compared with healthy sites. Both tachykinins were significantly elevated in periodontitis affected subjects, with significantly more tachykinin-like immunoreactivity at healthy sites in periodontitis affected compared with periodontally-healthy subjects. Despite the considerable individual variation in the levels of SP-LI and NKA-LI, both tachykinins were present at levels at which they could have biological activity. It is concluded that substance P and neurokinin A may have a rôle in the pathogenesis of periodontal disease and that further investigations could prove useful in clarifying the mechanisms through which neuropeptides could modulate periodontal health and disease.

Evaluation of t-PA, PAI-2, IL-1βand PGE2in gingival crevicular fluid of rheumatoid arthritis patients with periodontal disease

AIMS

This study was undertaken to compare periodontal conditions, gingival crevicular fluid (GCF) levels of tissue-type plasminogen activator (t-PA), its inhibitor plasminogen activator inhibitor-2 (PAI-2), interleukin-1beta (IL-1beta), prostaglandin E(2) (PGE(2)) in rheumatoid arthritis (RA) patients and control groups.

METHODS

Twenty-three RA patients, 17 systemically healthy patients with periodontal disease (PD), and 17 systemically and periodontally healthy subjects were recruited. GCF samples were obtained from two single-rooted teeth. Full-mouth clinical periodontal measurements were recorded at six sites/tooth. GCF samples were analysed using relevant ELISA kits. Data were tested statistically by appropriate tests.

RESULTS

Total amounts of t-PA, PAI-2 and PGE(2) in GCF samples of the healthy control group were significantly lower than the other groups (p<0.05). The RA group exhibited a higher total amount of t-PA in GCF samples than the PD group (p<0.05). PAI-2, IL-1beta and PGE(2) total amounts were similar in RA and PD groups (p>0.05).

CONCLUSION

The coexistence of RA and periodontitis does not seem to affect clinical periodontal findings or systemic markers of RA. Similar inflammatory mediator levels in RA and PD groups, despite the long-term usage of corticosteroids, non-steroidal anti-inflammatory drugs, suggest that RA patients may have a propensity to overproduce these inflammatory mediators.

Evaluation of osteocalcin and pyridinium crosslinks of bone collagen as markers of bone turnover in gingival crevicular fluid during different stages of orthodontic treatment

Osteocalcin (Oc) and the collagen cross-links pyridinoline (Pyr) and deoxypyridinoline (dPyr) are used as markers of bone turnover in metabolic bone diseases. The aims of this study were: 1) to establish if Oc, Pyr and dPyr can be detected in GCF and 2) using the orthodontic tooth movement model of alveolar bone resorption to evaluate GCF levels of osteocalcin and these collagen cross-links as markers of bone breakdown. Plaque, colour and bleeding indices, probing measurements and GCF samples were collected at two sites in each of 20 adolescents, during 4 stages of fixed appliance therapy: (1) prior to appliance fit, (2) post appliance fit, (3) during active retraction of the maxillary canines, (4) during retention. GCF was collected onto filter paper strips and the volume determined by weighing. An ELISA kit was used for the detection of osteocalcin, whereas Pyr and dPyr were assayed using high performance liquid chromotography (HPLC). Wilcoxon signed ranks test and Bonferroni correction revealed statistically significant increases in plaque (p= 0.012), GCF volume (p=0.024) and osteocalcin concentration (p=0.012), between stages 1 and 2. There were no statistically significant differences between the other variables at this stage or between any of the variables at stages 2 and 3, or between stages 3 and 4. All but 3 of the GCF samples yielded detectable osteocalcin, with large site and subject variation. The median values of osteocalcin and osteocalcin concentration of all the samples were 87.5 pg and 66 pg/microl, with a range of 0-1,248 pg, 0-1,572 pg/microl. The detection of osteocalcin in GCF during every stage, the wide variation between subjects, and the lack of a consistent pattern related to stages of orthodontic treatment, suggests that osteocalcin may merely be a constituent of GCF associated with the developing dentition, which would reduce its potential as a marker of bone turnover in this group. None of the 16 GCF samples analysed for Pyr and dPyr gave a positive result. This study confirms that fitting an orthodontic appliance results in plaque accumulation and increased gingival inflammation, and that GCF volume is the most sensitive indicator of that inflammation. Osteocalcin was detected in GCF collected from adolescents, whereas Pyr and dPyr could not be detected. Further work is required to establish whether GCF osteocalcin levels can be used as a marker of bone turnover, and whether improvements in the sensitivity of detecting Pyr & dPyr make further study of these promising bone markers worthwhile.

Gingival interleukin-6 concentration following phase I therapy

There is little information available on the effects of periodontal therapy on tissue levels of interleukin-6 (IL-6). This study compares IL-6 concentrations in gingiva and gingival crevicular fluid (GCF) from patients requiring surgical procedures following Phase I periodontal therapy. Sites requiring surgery due to "unresolved" intrabony pockets were compared to sites not requiring surgery ("resolved") in each patient. Resolved sites had minimal histologic evidence of chronic inflammation and IL-6 accumulation; unresolved sites contained a substantial number of chronic inflammatory cells and IL-6 was widely distributed. IL-6 levels in GCF were significantly greater at resolved than at unresolved gingival sites (P < 0.001); however, IL-6 tissue levels were significantly greater at unresolved than in resolved gingival sites (P < 0.01). These results suggest that IL-6 levels were elevated in gingival connective tissue adjacent to intrabony pockets which had not been resolved following Phase I therapy. Thus, intrabony pocket resolution may be affected by accumulation of IL-6 in the adjacent gingival connective tissue, which may result from increased rates of synthesis or reduced rates of release from gingiva into the GCF.

The influence of diabetes on gingival crevicular fluid beta-glucuronidase and interleukin-8

OBJECTIVES

Polymorphonuclear neutrophil (PMN) dysfunction is associated with diabetes. We examined the gingival crevicular fluid (GCF) beta-glucuronidase (BG) and interleukin-8 (IL-8) levels of periodontitis patients with and without type 2 diabetes mellitus (DM).

MATERIAL AND METHODS

Forty five adults with type 2 DM and 32 adults without DM, both with chronic periodontitis were enrolled. GCF was collected from eight posterior sites in each quadrant, and periodontal parameters were recorded. GCF was assayed for IL-8 by ELISA and BG by a fluorometric assay.

RESULTS

GCF IL-8 was positively correlated with probing depth (PD), and GCF BG but not clinical attachment level (CAL), bleeding on probing (BOP), or plaque index (PI). In contrast, GCF BG was strongly correlated with each of the clinical measures of periodontal disease. Subjects with DM significantly lower levels of both BG (73.0+/-44.8 versus 121.9+/-84.6 pg/sample; p=0.002) and IL-8 (32.1+/-33.1 versus 90.8+/-83.2 pg/sample; p<0.0001) even after adjustments for age, gender, PD, CAL, BOP, and PI. Neither BG nor IL-8 was correlated with HbA1c levels in subjects with DM.

CONCLUSION

These data suggest that an inadequate local response by PMN, partially explained by an altered chemokine gradient, may contribute to periodontal disease in patients with type 2 DM.

Calcitonin gene-related peptide in gingival crevicular fluid in periodontal health and disease

The aims of the present study were to investigate whether calcitonin gene-related peptide (CGRP) was present in gingival crevicular fluid in both periodontal health and disease and to study the relationship with periodontal inflammation. Gingival crevicular fluid (GCF) was collected from a healthy, a gingivitis and a periodontitis site in 18 subjects with periodontitis and from a healthy site in 19 subjects without periodontitis. The volume of GCF was measured and each sample subsequently analysed for CGRP by radioimmunoassay. In subjects with periodontitis, CGRP immunoreactivity (CGRP-IR) was not detected in any periodontitis sites, nor in 67% of gingivitis and 28% of periodontally-healthy sites. The total amount of CGRP-IR was significantly elevated in periodontally healthy (p=0.0015) and gingivitis (p=0.027) compared with periodontitis sites. CGRP-IR was present in 89% of the healthy sites sampled in control subjects at comparable levels to those in healthy sites in periodontitis subjects. It is concluded that in periodontal inflammation, particularly in deep pockets, constituents of GCF process and degrade CGRP.

Characterization of the antioxidant profile of human saliva in peri-implant health and disease

OBJECTIVES

Peri-implant disease is considered to be an inflammatory disease, but many aspects of its pathogenesis remain unknown. At present, peri-implant disease is considered to be initiated and perpetuated by a small group of predominantly Gram-negative, anaerobic, or micro-aerophilic bacteria that colonize the subgingival area. Bacteria cause the observed tissue destruction directly by toxic products and indirectly by activating host defence systems, i.e. inflammation. A variety of molecular species appears in the inflamed tissues, among them are reactive species such as free radicals and reactive oxygen species (ROS). The purpose of this study was to assess levels of various antioxidants in saliva to identify differences between the saliva of patients with healthy peri-implant tissues and patients with peri-implant disease, and to examine whether the whole saliva of those with peri-implant disease conditions might have lower levels of antioxidants than that of healthy individuals.

MATERIALS AND METHODS

Thirty healthy adult volunteers (14 men and 16 women) with implant-supported overdentures (Ankylos Biofunctional Implants) were selected from the group of patients from Tallinn Dental Clinic. Biochemical and clinical parameters evaluated were the following ones: the levels of urate, ascorbate, myeloperoxidase in saliva, total antioxidant status of saliva, pocket probing depth (mm), gingival index (0, 1, 2, or 3), and bleeding on probing (0 or 1).

RESULTS AND CONCLUSION

Total antioxidant status (TAS) of saliva and concentration of uric acid and ascorbate, which are the main salivary antioxidants, are significantly decreased in patients with peri-implant disease. TAS in healthy subjects was 0.41+/-0.10 for resting saliva and 0.31+/-0.09 for stimulated saliva; in diseased subjects TAS was 0.19+/-0.07 and 0.12+/-0.03, respectively. In healthy subjects, the concentration of urate was 307.2+/-78.06 microM/l in resting saliva and 241.5+/-89.09 microM/l in stimulated saliva. In diseased patients, the concentration of urate was 120+/-36.13 and 91.60+/-39.35 microM/l, respectively. The concentration of ascorbate did not differ in resting and stimulated saliva. In healthy subjects, it was 2.79+/-0.81 mg/l and in diseased subjects, it was 1.54+/-0.30 mg/l. This may indicate that excessive ROS production in peri-implant disease is leading to the situation of excessive oxidative stress, which may be an important factor contributing the destruction of peri-implant tissues. The importance of these findings may be the better understanding of the processes involved in the pathogenesis of peri-implant disease and that the treatment of peri-implant disease may involve adjuvant anti-oxidants supplementation together with cumulative interceptive supportive therapy concept introduced by Mombelli & Lang.

Gingival crevicular fluid osteocalcin in adult periodontitis

This study aimed to detect the levels of osteocalcin in gingival crevicular fluid (GCF) from healthy (< or =3 mm sulcus depth and non-bleeding) and diseased sites (> or =6 mm probing depth and bleeding) in subjects with adult periodontitis, in order to further investigate its potential as a possible marker of the disease process. Periodontal probing depths, attachment levels and gingival indices were recorded from one healthy and one diseased site in each of 20 subjects with adult periodontitis. Both GCF accumulated in the periodontal pocket or sulci and GCF flowing into the periodontal pocket or sulci over a three-minute interval were sampled. The amounts of osteocalcin in each GCF sample was determined using immunoassays. A mean of 2.34 ng/site (2.7 microg/ml) osteocalcin was found at diseased sites and a mean of 2.47 ng/site (5.47 microg/ml) was found at healthy sites for the accumulated GCF collection method. A mean of 0.17 ng/ site (2.17 microg/ml) osteocalcin was found at diseased sites and a mean of 0.14 ng/ site (1.85 microg/ml) at healthy sites for the flow method of GCF collection. There were no statistically significant differences between osteocalcin levels in diseased and healthy sites in subjects with adult periodontitis.

Local application of n-3 or n-6 polyunsaturated fatty acids in the treatment of human experimental gingivitis

BACKGROUND

Polyunsaturated fatty acids have the potential to attenuate inflammation by the synthesis of mediators of the 15-lipoxygenase pathways, which show opposite effects to the pro-inflammatory arachidonic acid metabolites such as leukotriene B4 (LTB4).

AIMS

The aim of this clinical study was to evaluate the effects of topical application of n-6 or n-6 polyunsaturated fatty acids in patients with experimental gingivitis.

METHODS

In each subject, similar teeth served as experimental and control over a 21-day non-hygiene phase and a 9-day resolving phase. Efficacy assessment was based on the bleeding on probing frequency (BOP) and the gingivocrevicular fluid volume (GCF). GCF was determined by inserting a filter paper strip for 30 s and measurements were performed on a Periotron 8000. The LTB4 concentration was analyzed by reversed-phase high-pressure liquid chromatography.

RESULTS

After 21 days of plaque growth, the BOP, GCF and LTB4 levels were significantly increased in all groups, with no differences between the control and experimental side. Rinsing of an area with established gingivitis for a 9-day period significantly reduced the GCF in the n-6 group (71.9 (18.7) versus 47.4 (11.4) Periotron Units, median (inter quartile range)).

CONCLUSION

The topical application of n-6 or n-6 fatty acids failed to inhibit the development of experimental gingivitis. Rinsing with n-6 fatty acids could reduce the level of GCF in established experimental gingivitis.

Cathepsin B, alpha2-macroglobulin and cystatin levels in gingival crevicular fluid from chronic periodontitis patients

Gingival crevicular fluid (GCF) was collected from 16 molar and premolar sites in each of 20 chronic periodontitis patients before and after periodontal therapy using filter paper strips. These were eluted individually into buffer for determination of cathepsin B and its endogenous inhibitors, alpha2-macroglobulin and cystatin. Cathepsin B activity was assayed with a fluorogenic peptide substrate, alpha2-macroglobulin by enzyme-linked immunosorbent assay and cystatin activity by inhibition of papain. Total amounts of enzyme and inhibitor per GCF sample decreased after treatment and correlated positively with pocket depth and gingival, bleeding and plaque indices. These comparisons were nearly always statistically significant for pooled site data and sometimes so for mean patient values. The amounts of alpha2-macroglobulin and cystatin were greater than those of cathepsin B and, surprisingly, enzyme and inhibitor levels correlated positively with each other. Experiments with purified reagents, however, demonstrated that the cathepsin B: alpha2-macroglobulin complex was still active against the low molecular weight substrate and that cystatin levels in GCF are probably insufficient to inhibit the enzyme substantially These factors may explain why GCF cathepsin B activity reflects the clinical status of periodontal lesions and has been identified in another study as a promising indicator of disease progression.

Gingival fluid IL-1 beta and IL-6 levels in menopause

Menopause and oophorectomy without estrogen therapy (ED) have been associated with increased production of bone-active cytokines by peripheral blood mononuclear cells. The current study extended evaluation to gingival crevicular fluid (GCF) levels of interleukin (IL)-1 beta and IL-6 in such subjects compared to premenopausal and postmenopausal estrogen-treated females (ES). 13 ED and 13 ES Caucasians with a history of moderate-severe adult periodontitis provided GCF from 1-3 clinically identical sites each (5-6 mm probing depth, 5-7 mm clinical attachment loss, bleeding on probing). 30 s GCF samples were obtained and evaluated for IL-1 beta and IL-6 levels using two-site enzyme-linked immunosorbent assays (ELISAs). The frequency of GCF IL-1 beta-positive subjects was elevated in ED versus ES (92% versus 23%; p < 0.0004, chi 2 analysis). IL-6 was detected more frequently in ED subjects (23% versus 8%; not significant); however, the frequency of IL-6 detection was low in both groups due to short sampling times. These data support the concept that clinical conditions causing low estrogen environments allow increased local production of the bone-active cytokine IL-1 beta, and perhaps IL-6.

Expression of endothelin-1 in gingival epithelial cells

OBJECTIVES AND BACKGROUND

Endothelin-1 (ET-1) is a 21-amino acid peptide with multifunctional regulation. ET-1 expresses in various cells during inflammation. The present study aimed to examine the ET-1 expression in oral epithelial cells after infection with the periodontal pathogen and to investigate the presence of ET-1 in human inflamed and uninflamed gingival tissues.

MATERIALS AND METHODS

The KB cells were infected with Porphyromonas gingivalis and the expression level of ET-1 was examined using reverse transcription-polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA). The immunohistochemical analysis of ET-1 was performed in gingival tissues obtained from patients. In addition, the ET-1 mRNA expression in each tissue was also investigated by RT-PCR.

RESULTS

The expression of ET-1 in KB cells was strongly induced by the P. gingivalis infection. On the other hand, the strong immunoreactivity for ET-1 was observed in the epithelium and vascular endothelial cells of the inflamed gingival tissue. Furthermore, the level of ET-1 mRNA was greater in the inflamed tissues.

CONCLUSION

These results suggested that the expression level of ET-1 in gingival epithelial cells might be enhanced during the periodontal inflammation.

Gingival crevicular fluid osteopontin levels in periodontal health and disease

BACKGROUND

Osteopontin (OPN), a glycosylated phosphoprotein, is a bone matrix component produced by osteoblasts, osteoclasts, and macrophages as a multifunctional cytokine. OPN anchors osteoclasts to the bone surface, and its absence leads to impaired bone resorption. The aim of the present study was to assess the relation between clinical parameters and concentrations of OPN within gingival crevicular fluid (GCF) from inflamed gingiva and periodontitis sites and, subsequently, after the treatment of periodontitis sites.

METHODS

A total of 45 subjects were divided into the following three groups based on modified gingival index (MGI) and Ramfjord periodontal disease index (PDI) scores: healthy (group I), gingivitis (group II), and chronic periodontitis (group III). A fourth group consisted of 15 subjects from group III, 6 to 8 weeks after treatment (i.e., scaling and root planing [SRP]). GCF samples collected from each patient were quantified for OPN using the enzymatic immunometric assay. Further, the correlation between OPN levels in situ with clinical parameters was analyzed in all groups and before and after treatment in periodontitis patients.

RESULTS

The highest mean OPN concentration in GCF (14.347 microg/ml) was observed in group III, and the lowest mean OPN concentration in GCF (2.522 microg/ml) was observed in group I. Its levels in group III decreased to 8.419 microg/ml after treatment (group IV). Further, GCF OPN levels in all the groups showed a statistically significant positive correlation with clinical attachment loss (P <0.05).

CONCLUSIONS

OPN levels increase in GCF from healthy to periodontitis states, and periodontal treatment results in the reduction of OPN levels. The data indicate that OPN may play a key role in, and could be considered a biomarker of, periodontal disease progression.

Cystatin A in gingival crevicular fluid of periodontal patients

Cystatins are physiological inhibitors of cysteine proteinases which are widely distributed in human tissues and fluids. In the present study we analysed both the cystatin activity and the different cystatin isoforms in gingival crevicular fluid and saliva samples of nine periodontitis patients. All crevicular fluid samples, which were collected with filter paper points, showed cystatin activity ranging from 7-67 units/mg protein. The mean cystatin activity (24 units/mg protein) was significantly lower (p < 0.05) than that of the saliva samples (mean 93 units/mg protein). The cystatin isoforms in the crevicular fluid were further characterized by immunoblotting with specific antibodies against cystatin C, S, SN and A. While they were clearly present in saliva, cystatin C, cystatin S and cystatin SN could not be detected in any of the crevicular fluid samples. Remarkably, cystatin A was found in all the crevicular fluids as well as in the saliva samples. It is concluded that the cystatin activity found in crevicular fluid is caused, at least partially, by cystatin A. Furthermore, the gingival crevicular fluid is not a major contributor of cystatin C, S and SN activity in saliva.

Prostaglandin E2 level in gingival crevicular fluid from patients with Down syndrome

The levels of prostaglandin E2 (PGE2) and interleukin-1 beta (IL-1 beta) were determined in gingival crevicular fluid (GCF) collected from patients with gingivitis: 15 Down syndrome children and 15 controls. The mean level of PGE2 in GCF was significantly higher (P < 0.05) in the Down syndrome group (10.0 pg/microliters GCF) than in the control group (4.6 pg/microliters GCF). In GCF samples collected from sites characterized as noninflamed, the mean level of PGE2 was significantly higher (P < 0.001) in the Down syndrome group than in the controls. The mean level of PGE2 in samples from inflamed sites, on the other hand, did not differ between the two groups. The mean level of IL-1 beta was not significantly higher in the Down syndrome group than in the controls. This study shows that the level of PGE2 detected in GCF from Down syndrome patients is increased, a fact that may be of importance in the pathogenesis of the periodontal disease frequently seen in these patients.

Platelet-activating factor levels of serum and gingival crevicular fluid in nonsmoking patients with periodontitis and/or coronary heart disease

The purpose of the present study was to investigate systemic and local levels of platelet-activating factor (PAF), a potent proinflammatory mediator implicated in cardiovascular pathophysiology in adult nonsmoking patients with periodontitis with or without coronary heart disease (CHD). Eighty-seven volunteers, 25 periodontitis patients, 19 periodontitis with CHD patients, 19 CHD patients, and 24 healthy controls were included, and periodontal conditions were assessed. Gingival crevicular fluid (GCF) and venous blood were collected, and PAF levels were measured by enzyme-linked immunosorbent assay. PAF levels in serum (303.3 ± 204 pg/ml) and in GCF (26.3 ± 6 pg/μl) of the periodontitis group with CHD, the periodontitis group (serum, 302.4 ± 241 pg/ml and GCF, 26.3 ± 8 pg/μl) and the CHD group (serum, 284.7 ± 192 pg/ml and GCF, 20.8 ± 6 pg/μl) were significantly higher than the healthy control group (serum, 65.4 ± 35 pg/ml and GCF, 7.7 ± 3 pg/μl; p < 0.05). In summary, the present study could demonstrate that in patients with periodontitis, the inflammatory mediator PAF is released into serum at least in the same range as for patients with coronary heart disease. However, no additive effects were seen when both conditions were present.

Changes in vasoactive intestinal peptide in gingival crevicular fluid in response to periodontal treatment

AIMS

To evaluate the role of the anti-inflammatory neuropeptide vasoactive intestinal peptide (VIP) in periodontal health and disease and to determine the effects of periodontal treatment, resulting in a return to periodontal health, on the levels of VIP in gingival crevicular fluid (GCF).

METHODS

At baseline, 10 subjects with periodontitis (nine females, one male, mean age 43.0, SD 7.3) started a course of non-surgical periodontal treatment. Clinical indices were measured at one periodontitis and one clinically healthy site at an initial visit and at 8 weeks after the completion of treatment in each subject. A 30-s sample of GCF was collected from each test site using perio paper strips. The volume of GCF was measured and each sample subsequently analysed for VIP by radioimmunoassay. One healthy site was sampled from each member of a control group (10 females, mean age 29.9, SD 8.2 years) with clinically healthy gingiva and no periodontitis.

RESULTS

The clinical condition of all periodontitis sites improved as a result of periodontal treatment. The levels of VIP (pg/30 s sample) in periodontitis-affected sites fell significantly from 302.0 (SD 181.2) at the initial visit to 78.0 (54.4) after treatment, p = 0.007. The reduction in the concentration of VIP (pg/ micro L) in GCF from 524.3 (322.3) to 280.8 (280.2) was not statistically significant. The levels of VIP in clinically healthy sites fell from 115.5.5 (74.3) to 77.8 (32.3), n.s. and the concentration changed little from 883.8 (652.1) to 628.7 (323.3), n.s. There were substantially smaller amounts of VIP (25.8, SD 12.8) pg in healthy sites sampled from control subjects.

CONCLUSIONS

VIP is present in GCF in greater quantities in periodontitis-affected than clinically healthy sites. In addition, the reduction in inflammation resulting from effective periodontal treatment is associated with a reduction in the levels of VIP in gingival crevicular fluid.

Hepatocyte growth factor in saliva: a possible marker for periodontal disease status

Hepatocyte growth factor (HGF) acts as a mitogen, motogen, morphogen and anti-apoptotic factor for various kinds of epithelial cells. We previously showed that periodontal fibroblasts secreted an HGF-like chemoattractant for a gingival epithelial cell line and found that HGF content in gingival crevicular fluid was well correlated with probing depth, gingival index, and interleukin-1beta concentration. To examine whether HGF in whole (mixed) saliva would be a useful marker for periodontal disease status, we investigated the relationship between salivary HGF levels and clinical parameters of 65 adults (50 men and 15 women). Unstimulated whole (mixed) saliva was collected from each subject and the HGF level was determined with an ELISA kit. After sample collection, probing depths and bleeding on probing were monitored. Significant correlations were found between salivary HGF levels and the number of probing depths exceeding 4 mm (r = 0.541), the number of probing depths exceeding 6 mm (r = 0.683), the deepest probing depth of each subject (r = 0.558) and the percentage of sites positive for bleeding on probing (r = 0.511). These results suggest that salivary HGF may be a novel marker for periodontal diagnosis in screening tests.