A 2-year longitudinal study of elastase in human gingival crevicular fluid and periodontal attachment loss

Abstract The purpose of this study is to determine whether gingival crevicular fluid (GCF) elastase total activity (TA) and concentration (EC) correlate with and predict progressive attachment loss (AL). 75 previously untreated patients with moderate periodontitis were recruited. GCF was collected from 16 molar and pre-molar mesiobuccal sites and probing attachment loss (PAL), probing depth (PPD), gingival index (GI), gingival bleeding index (GBI) and plaque index (PLI) were measured, PAL and PPD were measured with an electronic, constant pressure probe. Patients were given basic periodontal treatment prior to baseline when the above procedures were repeated. In addition, carefully localised radiographs were taken of the test teeth and repeated annually. Patients were seen at 3 months intervals to 2 years and the procedures were repeated. 119 AL sites were detected and 89 of these were rapid AL sites (RAL) and 30 were gradual AL sites (GAL). Elastase levels (TA & EC) at RAL sites were significantly higher (p≤0.0001) than paired control sites in the same patient at both the attachment loss time (ALT) and the prediction time (PT). The mean levels (TA & EC) over the study period at GAL sites were significantly higher (p≤0.0001) than paired control sites in the same patient. Using a critical value (CV) of 125 μU/30 s (TA) and 400 μU/μL (EC) in 2×2 contingency tables showed a sensitivity of 100% and specificity of 99.95% (TA) and a sensitivity of 100% and specificity of 99.91% (EC) at the PT with very similar values at the ALT. Patient level comparisons showed that the mean elastase levels (TA & EC) were significantly higher (p≤0.0001) at RAL and GAL sites than non-attachment loss (NAD sites in AL patients and that the mean levels were significantly higher (p≤0.0001) in AL patients than NAL patients. All these results indicate that these CVs for GCF elastase activity may serve as a predictors of future attachment loss.     

The relationship between gingival crevicular fluid cathepsin B activity and periodontal attachment loss in chronic periodontitis patients: a 2-year longitudinal study

This study aims to determine whether gingival crevicular fluid (GCF) cathepsin B levels, total activity (TA) and concentration (EC) predict progressive attachment loss (AL). Seventy-five previously untreated patients with moderate periodontitis were recruited. GCF was collected from 16 molar and premolar mesiobuccal sites and probing attachment level (PAL) and probing depth (PPD) were measured with an electronic probe. Gingival, gingival bleeding and plaque indices were then scored. Prior to baseline patients were given basic periodontal treatment after which the above procedures were repeated. Carefully localized radiographs were taken of the test teeth and repeated annually. Patients were seen 3-monthly for 2 yr and the procedures were repeated. One hundred and twenty-one AL sites, 90 rapid AL (RAL) and 31 gradual AL (GAL), in 49 patients were detected. Cathepsin B levels (TA & EC) at RAL sites were significantly higher (p<0.0001) than paired control sites at the attachment loss time (ALT) and prediction time (PT). Mean levels (TA & EC) over the study period at GAL sites were significantly higher (p<0.0001) than paired control sites. Using a critical value (CV) of 7.5 μU/30 s (TA) and 30 μU /μL (EC) showed a sensitivity of 100% and specificity of 99.83% (TA) and 100% and 99.75%(EC) at both ALT & PT. Mean cathepsin B levels (TA & EC) were significantly higher (p<0.0001) at RAL and GAL sites than nonattachment loss (NAL) sites in AL patients in intrapatient comparisons and mean patient levels were significantly higher (p<0.0001) in AL patients than NAL patients in interpatient comparisons. These results indicate that GCF cathepsin B may serve as a predictor of attachment loss.     

Longitudinal evaluation of prostaglandin E2 (PGE2) and periodontal status in HIV+ patients

The study aim was to determine whether prostaglandin E(2) (PGE(2)) in gingival crevicular fluid (GCF) could serve as a risk factor for periodontitis in human immunodeficiency virus-positive (HIV(+)) patients. Clinical measurements, including gingival index (GI), plaque index, bleeding index, probing depth (PD), attachment loss (AL) and GCF samples were taken from two healthy sites (including sites with gingival recession, GI=0; PD< or =3 mm; AL< or =2 mm), three gingivitis sites (GI>0; PD< or =3 mm; AL=0) and three periodontitis sites (GI>0; PD> or =5 mm; AL> or =3 mm) of each of the 30 patients at baseline and 6-month visits. GCF samples were also taken by means of paper strips. GCF PGE(2) levels were determined by a sandwich ELISA. The progressing site was defined as a site which had 2 mm or more attachment loss during the 6-month study period. The mean amounts of PGE(2) were significantly higher in gingivitis and periodontitis sites than in healthy sites (p<0.0001). GCF levels of PGE(2) were significantly correlated with probing depth, attachment loss, CD4(+) cells, viral load, age and smoking pack-years at baseline and 6-month visits (0.0001相似文献   

The association between gingival crevicular fluid TGF-beta1 levels and periodontal status in HIV-1(+) patients

BACKGROUND: The purpose of this study was to investigate the relationship between transforming growth factor-beta 1 (TGF-beta1) in gingival crevicular fluid (GCF) and the periodontal status of subjects who were positive for the human immunodeficiency virus (HIV)-1. METHODS: Medical and demographic variables, including age, cigarette smoking, CD4 cell count, and viral load values, were recorded. At the baseline and 6-month visits, gingival index (GI), plaque index, bleeding on probing, probing depth (PD), and attachment loss (AL) were recorded, and GCF samples were taken with paper strips from three periodontitis sites (GI >0; PD > or =5 mm; AL > or =3 mm), three gingivitis sites (GI >0; PD < or =3 mm; AL = 0), and two healthy sites (GI = 0; PD < or =3 mm; AL < or =2 mm) in 25 subjects who were HIV-1(+). GCF TGF-beta1 levels were determined by enzyme-linked immunosorbent assays. A statistical software package was used to analyze the data. RESULTS: The mean amounts of GCF TGF-beta1 were greater in gingivitis and periodontitis sites than in healthy sites (P <0.0001). GCF levels of TGF-beta1 correlated with PD, AL, age, smoking pack-years, CD4 cell count, and viral load at the baseline and 6-month visits (0.0001 < P <0.05). An active site was defined as a site that had > or =2 mm new AL during the 6-month study period. An active patient was defined as a patient who had one or more active site(s) during the study period. Repeated-measures analysis of 18 active sites versus 182 inactive sites indicated that GCF TGF-beta1 levels were higher in active sites than in inactive sites (P <0.0001). Eleven of the 25 study subjects had active sites at the end of the 6-month study period. The mean GCF TGF-beta1 level and the mean AL and PD for these 11 active subjects were higher than for the 14 inactive subjects (P <0.0001). CONCLUSION: In subjects who are HIV-1(+), sites with high GCF levels of TGF-beta1 are at significantly greater risk for the progression of established periodontitis.     

Longitudinal evaluation of GCF MMP-3 and TIMP-1 levels as prognostic factors for progression of periodontitis

BACKGROUND: To determine whether matrix metalloproteinase-3 (MMP-3) and tissue inhibitor of metalloproteinases-1 (TIMP-1) in gingival crevicular fluid (GCF) could serve as prognostic factors for the progression of periodontitis, we monitored GCF MMP-3 and TIMP-1 and periodontal status of selected sites in 40 medically healthy subjects over a 6-month period. METHOD: Clinical measurements including gingival index (GI), plaque index, bleeding on probing, suppuration, probing depth (PD), attachment loss (AL), and GCF samples were taken from 2 healthy sites (including sites with gingival recession, GI=0 PD < or =3 mm; AL < or =2 mm) and 2 periodontitis sites (GI > or =1; PD > or =5 mm; AL > or =3 mm) of each patient at baseline, 3-month and 6-month visits by means of sterile paper strips. GCF levels of MMP-3 and TIMP-1 were determined by sandwich ELISA assays. RESULTS: The mean amounts of MMP-3 and TIMP-1 in diseased sites were significantly higher than in healthy sites (p<0.0001). Significantly higher GCF levels of MMP-3 and TIMP-1 were found at progressing sites than in nonprogressing periodontitis sites (0.001 or =2 mm loss of attachment during 6- month study period. GCF levels of MMP-3 were highly correlated with clinical measurements taken at baseline, 3-month and 6-month visits (p<0.001). TIMP-1 levels were only moderately correlated with probing depth and attachment level (p<0.01). Step-wise multiple regression analysis was performed to construct models for the prediction of probing depth and attachment loss increases. The most parsimonious regression models which had the best R2 values included the following variables and accounted for the indicated % of variability. The regression model for the prediction of probing depth increase included MMP-3, smoking pack-years, TIMP-1 and accounted for 53% of the variability. The best model for the prediction of attachment loss increase included MMP-3, smoking pack-years, age, TIMP-1 and explained 59% of the variability. CONCLUSION: These data indicate that sites with high GCF levels of MMP-3 and TIMP-1 are at significantly greater risk for progression of periodontitis.     

Detection of stable and active periodontitis sites by clinical assessment and gingival crevicular acute-phase protein levels

The aim of the present study was to investigate whether incipient periodontal disease breakdown could be associated with changes in gingival crevicular fluid (GCF) acute-phase protein levels. In addition, the potential of clinical indices to act as predictors of significant attachment level (AL) change was investigated. AL measurements were taken at baseline and 3 months using the Florida Probe stent handpiece from a total of 384 sites in 38 patients. The average standard deviation of duplicate AL measurements was 0.423. When the tolerance method was used to detect significant AL change, 3.9% of the sites lost attachment. When a less stringent criterion of AL change of ≥1 mm was used 9.9% of the sites lost attachment during the 3-month period. With the exception of probing depth, baseline clinical parameters failed to predict AL change. Fourteen active periodontitis sites that demonstrated significant attachment loss were paired to stable periodontitis sites within the same patient. The levels of four acute-phase proteins, namely α2-macroglobulin (α2-M), α1-antitrypsin (α1-AT), transferrin (TF) and lactoferrin (LF), and also albumin (Alb) were assessed in the same gingival crevicular fluid sample using sandwich ELISAs. Results were expressed either as ng/30 s and ng/μg Alb. Acute-phase protein levels in GCF failed to differentiate between active and stable periodontitis sites at baseline. In conclusion, the degree of gingival inflammation of the tissues adjacent to the crevice/pocket seems to influence the levels of protease inhibitors and iron-binding proteins in GCF to a greater extent than probing attachment loss.     

Longitudinal evaluation of GCF IFN-gamma levels and periodontal status in HIV+ patients

BACKGROUND/AIM: Loss of periodontal support and related tooth loss is a common finding among HIV+ patients. The etiology of this destruction may be an increase in the levels of pro-inflammatory cytokines and subsequent increase in periodontal disease activity. The purpose of this study was to investigate the associations between gingival crevicular fluid interferon gamma (GCF IFN-gamma) and clinical measures of periodontal disease in HIV+ individuals. We monitored GCF IFN-gamma and periodontal status of selected sites in 33 HIV+ subjects over a 6-month period. METHOD: Clinical measurements including gingival index, plaque index, bleeding on probing, probing depth, attachment loss (AL), and GCF samples were taken from four lower incisors and the upper right posterior sextant of each patient at baseline and 6-month visits by means of sterile paper strips. GCF levels of IFN-gamma were determined by sandwich ELISA assays. A progressing site was defined as a site that had 2 mm or more AL during the 6-month study period. RESULTS: Twenty-five of the 264 examination sites showed 2 mm or more clinical AL during the 6-month study period. Significantly higher GCF levels of IFN-gamma were found at progressing sites than in nonprogressing sites (p < 0.001). GCF levels of IFN-gamma were highly correlated with clinical measurements taken at baseline and 6-month visits (0.001相似文献   

Cathepsin B/L-, elastase-, tryptase-, trypsin- and dipeptidyl peptidase IV-like activities in gingival crevicular fluid

20 chronic periodontitis patients were given a full periodontal examination, including measurements of probing depth, clinical attachment loss, gingival index, bleeding index and plaque index. At a second visit, gingival crevicular fluid (GCF) was collected from the deepest accessible probing site of each tooth. The patients then received scaling, root planing and other appropriate nonsurgical treatment. GCF was collected from the same sites as sampled pretreatment and clinical parameters were measured again. Cathepsin B/L-, elastase-, tryptase-, trypsin-, and dipeptidyl peptidase IV-like activities in GCF samples were determined by fluorimetric assay with peptidyl derivatives of 7-amino-4-trifluoromethyl coumarin. Following treatment, there were reductions in all clinical parameters and all protease activities. Most were statistically significant both on a patient level using average patient values and on a site level using either individual patient or pooled patient data. As in previous pre-treatment comparisons, post-treatment protease levels correlated positively and significantly with the corresponding clinical parameters at patient and site levels. The reductions and correlations were more marked for total enzyme activities than concentrations. GCF protease levels appear to reflect the clinical status of periodontal lesions and may thus be of value in monitoring disease activity.     

Relationship between gingival crevicular fluid levels of aspartate aminotransferase and active tissue destruction in treated chronic periodontitis patients

Data from several sources demonstrate that disease-active and disease-inactive periodontal pockets exist, and that disease progression occurs in bursts of activity. Currently used diagnostic procedures do not distinguish between disease-active and disease-inactive sites at any given point in time. We report the results of studies aimed at determining whether levels of the enzyme aspartate aminotransferase (AST) in gingival crevicular fluid (GCF) are associated with disease activity as assessed by the level of gingival inflammation and probing attachment loss. 25 previously treated periodontitis patients participating in a quarterly recall maintenance program, who had experienced recurrent periodontal deterioration, served as experimental subjects. Patients were evaluated at 3-month intervals for 2 years. Values for plaque index, gingival index, and probing attachment level were recorded, and 30-second samples of gingival fluid harvested from the mesiobuccal aspect of the 4 first molars and the distal of the 4 lateral incisors. GCF volume was measured using a Periotron 6000, and AST activity was measured by a standard method. Sites were ranked in a hierarchy based on the degree of certainty of attachment loss as well as the severity of gingival inflammation, and the relationship of the values to AST levels was determined. Three models were used to analyze the resulting data, and all led to the same conclusion. Maximum enzyme level was significantly elevated at sites with confirmed disease activity as assessed by attachment loss, with maximum AST levels 725 units higher at these sites, on average, than at other sites (p less than 0.0001). Our data support the idea that an objective diagnostic test, based on levels of AST in GCF, that distinguishes between disease-active and disease-inactive sites may be possible.     

Cathepsin B/L-, elastase-, tryptase-, trypsin- and dipeptidyl peptidase IV-like activities in gingival crevicular fluid: Correlation with clinical parameters in untreated chronic periodontitis patients

20 untreated chronic periodontitis patients were given a full periodontal examination, including measurements of probing depth (PD), clinical attachment loss (CAL), gingival index (GI), bleeding index (BI) and plaque index (Pl.I.). At a second visit, gingival crevicular fluid (GCF) was collected on filter paper strips from the deepest accessible probing site of each tooth. GCF volumes were determined and the samples eluted into buffer. Protease activities in the resulting eluates were assayed with peptidyl derivatives of 7-amino-4-trifluoromethyl coumarin (AFC). Cathepsin B/L-like activity was determined with Bz-Val-Lys-Lys-Arg-AFC, elastase-like activity with MeOSuc-Ala-Ala-Pro-Val-AFC, tryptase-like activity with Z-Ala-Ala-Lys-AFC, trypsin-like activity with Z-Gly-Gly-Arg-AFC and dipeptidyl peptidase (DPP) IV-like activity with Ala-Pro-AFC. Total enzyme activities and enzyme concentrations both correlated positively with all clinical parameters in linear regression analysis. This was true on both a patient level, using mean patient values, and a site level, using either individual patient or pooled patient data. Most of these correlations were statistically significant, although the proportion was greater for total enzyme activity than concentration. With total activities, correlations with different enzymes and parameters generally followed the order: cathepsin B/L-greater than elastase- greater than DPP IV- greater than trypsin- greater than tryptase-like activity and PD greater than CAL greater than GI greater than BI greater than Pl.I respectively. Total enzyme activities had good diagnostic specificity and sensitivity as predictors of clinical parameters in this cross-sectional study, suggesting that GCF proteases might provide useful information on the periodontal condition.     

龈沟液中神经肽P物质与慢性牙周炎关系临床研究

目的:探讨龈沟液中神经肽P物质(SP)与慢性牙周炎发生发展的关系.方法:研究组48 例,对照组45 例,研究组口内各选1 个牙周炎牙位、对照组各选1 个健康牙位收集龈沟液样本,采用放射免疫分析技术分别测定2 组龈沟液SP含量;记录牙龈指数(GI)、牙周袋探诊深度(PD)、附着丧失(AL)、牙槽骨吸收(ABL)情况,并进行与SP的相关性分析.结果:研究组SP含量显著高于对照组(t＝9.92,P<0.01);轻度牙周炎SP含量及牙周临床指标与对照组相比,均有显著差异(P<0.01);轻度牙周炎龈沟液SP含量与GI无显著相关性,但与PD、AL、ABL之间,以及中、重度牙周炎龈沟液SP含量与GI之间,均呈显著性相关(P＜0.05);中、重度牙周炎SP含量与PD、AL、ABL之间均呈非常显著性相关(P<0.01).结论:龈沟液中SP含量与慢性牙周炎的发生发展密切相关,可以反映牙周组织的破坏程度;测定患者龈沟液中SP含量,对于判断病情、指导治疗具有重要意义.     

吸烟对牙周基础治疗效果影响的研究

目的评价吸烟与非吸烟慢性牙周炎患者牙周基础治疗1个月后的疗效差异。方法选择36例慢性牙周炎患者,吸烟组20例,非吸烟组16例,基线时两组牙周炎病情相似。从牙列的4个象限选取探诊深度在5～9mm范围的位点1～2个,吸烟组108个位点,非吸烟组88个位点,观察这些位点在牙周基础治疗前、治疗后1个月临床指标的变化,包括菌斑指数(PLI),牙龈出血指数(BI),牙周袋探诊深度(PPD)和附着丧失(AL);在作临床观察的同时,对治疗前后龈沟液白介素(IL)-1β进行检测。结果治疗前(基线时)两组PLI、BI、PPD、AL以及IL-1β差异不显著,牙周基础治疗1个月后,两组的各项指标均有明显的改善,但吸烟组改善程度明显低于非吸烟组(P<0.05)。结论慢性牙周炎患者,吸烟者牙周基础治疗的效果差于     

侵袭性牙周炎龈沟液中白介素-8 的检测

目的：检测侵袭性牙周炎（AgP）龈沟液中白细胞介素（IL-8）的总量和浓度并探讨其与牙周临床指标的关系。方法：采用常规滤纸条法收集侵袭性牙周炎实验组患牙（T1）和健康牙（T2）各位点及正常对照组（C）各位点的龈沟液（GCF）样本,用ELISA法检测各样本中IL-8的总量和浓度。结果：3组受检牙龈沟液中IL-8的总量和浓度不同。侵袭性牙周炎患牙组GCF中IL-8总量高于健康牙位组（P〈0．05）及正常对照组;而3组中IL-8浓度差异也有显著性,侵袭性牙周炎患牙组GCF中IL-8的浓度高于健康牙位组（P〈0．05）和正常对照组;虽然GCF中IL-8浓度与牙周探诊深度（PD）、牙龈出血指数（BOP）、附着丧失（AL）无相关关系;但IL-8总量与以上牙周临床指标相关。结论：在侵袭性牙周炎患者龈沟液中IL-8是参与牙周炎症反应的重要调节因子。     

The associations between gingival crevice fluid matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1 and periodontitis in human immunodeficiency virus-positive patients

BACKGROUND AND OBJECTIVE: The study aimed to determine whether matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in gingival crevice fluid could serve as prognostic factors for the progression of periodontitis in human immunodeficiency virus (HIV) -positive patients. Activated inflammatory cells produce inflammatory mediators, which stimulate the production of MMPs and their inhibitors. It is likely that the compromised immune system contributes to the pathogenesis of periodontitis in HIV-positive patients. METHODS: Clinical measurements including gingival index, plaque index, bleeding index, probing depth, attachment loss, and gingival crevice fluid samples were taken from two healthy sites (including sites with gingival recession, gingival index = 0; probing depth < or = 3 mm; attachment loss < or = 2 mm), three gingivitis sites (gingival index > 0; probing depth < or = 3 mm; attachment loss = 0) and three periodontitis sites (gingival index > 0; probing depth > or = 5 mm; attachment loss > or = 3 mm) of each of the 35 patients at baseline visits and 6-month visits by means of paper strips. Gingival crevice fluid levels of MMP-9 and TIMP-1 were determined by sandwich enzyme-linked immunosorbent assays. RESULTS: The mean amounts of MMP-9 and TIMP-1 in the gingivitis and periodontitis sites sites were significantly higher than in the healthy sites (P < 0.0001). The progressing site was defined as a site that had 2 mm or more attachment loss during the 6-month study period. Gingival crevice fluid levels of MMP-9 were significantly correlated with probing depth, attachment loss, TIMP-1, age, smoking pack years, and viral load values at baseline and 6-month visits (0.0001 < P < 0.001). TIMP-1 levels were only correlated with CD4, viral load, attachment loss, and MMP-9 (0.001 < P < 0.01). Repeated measures analysis of 11 active sites vs. 269 inactive sites indicated that MMP-9 and TIMP-1 levels were significantly higher in active sites than in inactive sites (P < 0.0001). These data indicate that sites with high ginigval crevice fluid levels of MMP-9 and TIMP-1 in HIV-positive patients are at significantly greater risk for progression of periodontitis.     

The subgingival microflora and gingival crevicular fluid cytokines in refractory periodontitis

Abstract Refractory periodontitis manifests as a rapid, unrelenting, progressive loss of attachment despite the type and frequency of therapy. This study examined possible relationships between cytokine levels in gingival crevicular fluid (GCF), occurrence of specific periodontopathic microflora. and disease activity in patients with refractory periodontitis. Refractory periodontitis patients (7 male and 3 female) were selected on the basis of history and longitudinal clinical observations. In each patient. 2 teeth with pocket depths greater than 6 mm were selected and individual acrylic stents were fabricated with reference grooves for each site. The sites were examined at both baseline and 3 months later. The pattern and amount of alveolar bone resorption were assayed by quantitative digital subtraction radiography. Pocket depth and attachment loss were measured with a Florida Probe. The gingival index was measured at 4 sites around each sample tooth. Sites were divided into active sites (2.1 mm loss of attachment in 3 months) or inactive sites (2.0 mm loss of attachment in 3 months). The distribution and prevalence of the predominant microflora in active and inactive sites were compared using anaerobic culture and indirect immunofluorescence. Interleukin-1β, 2, 4, 6 and tumor necrosis factor-α (TNF-α) levels in gingival crevicular fluid (GCF) were quantified by ELISA. Prevotella intermedia and Eikenella corrodens significantly decreased in inactive sites but remained the same in active sites after 3 months. The active sites revealed significantly higher GCF levels of IL-2 and IL-6 than inactive sites at both baseline and at 3 months. IL-1β was also significantly greater in active sites than in inactive sites at 3 months. Alveolar bone loss in active sites correlated with increased GCF levels of IL-1β and 1L-β. These results suggest that GCF levels of IL-1β, IL-2 and IL-6 and P. intermedia and E. corrodens in subgingival plaque may serve as possible indicators of disease activity in refractory periodontitis.     

侵袭性牙周炎患者龈沟液中有机酸的研究

检测侵袭性牙周炎(aggressive periodontitis,AgP)患者龈沟液中7种有机酸的浓度,探讨其与AgP的关系.方法应用高效毛细管电泳技术,检测38例AgP患者152个位点和14名牙周健康对照者56个位点龈沟液中甲酸、琥珀酸、乙酸、乳酸、丙酸、丁酸和异戊酸的浓度,比较AgP组和健康对照组之间、AgP患者不同袋深组之间龈沟液中有机酸浓度的差别,分析出血指数(bleedingindex,BI)、探诊深度(probing depth,PD)和附着丧失(attachment loss,AL)与有机酸浓度的相关关系.结果 AgP组龈沟液中琥珀酸(1.00 mmoL/L)、乙酸(24.13 mmol/L)、乳酸(8.33 mmoL/L)、丙酸(4.37 mmoL/L)、丁酸(2.33 mmol/L)和异戊酸(2.63 mmol/L)的浓度均显著高于健康对照组(依次为0.33、11.35、3.88、2.07、0.00、0.00 mmoL/L,P<0.05),甲酸浓度(7.08 mmoL/L)显著低于健康对照组(14.03 mmoL/L,P<0.05);除乳酸外其余6种有机酸在不同袋深组间浓度差异均有统计学意义(P<0.05);AgP组甲酸浓度与BI、PD和AL呈负相关,BI与琥珀酸、乙酸、乳酸、丙酸和丁酸浓度呈正相关,PD和AL与琥珀酸、乙酸、丙酸、丁酸和异戊酸浓度呈正相关.结论 AgP的病变状况町能与龈沟液中琥珀酸、乙酸、丙酸、丁酸和异戊酸浓度升高而甲酸浓度降低有关.     

Relationship between levels of aspartate aminotransferase in gingival crevicular fluid and conventional measures of periodontal status assessed using PocketWatch: a cross-sectional study

The aim of this cross-sectional study was to determine, using PocketWatch, the relationship between the level of aspartate aminotransferase (AST) in gingival crevicular fluid (GCF) and conventional measures of periodontal status, such as probing depth, attachment level, bleeding on probing and gingival index, in patients with untreated chronic periodontitis. A total of 15 patients with chronic periodontitis were enrolled. Their periodontal status and AST levels in their GCF were measured (n = 93) and statistically analyzed. There was a statistically significant difference in AST levels between diseased periodontal sites and healthy sites (p < 0.0001). The coefficients of correlation between AST levels and probing depth, attachment level and gingival index at all sites were 0.436, 0.266 and 0.468 (Spearman rank correlation). The correlation coefficients were too small to show a definite relationship between AST levels and individual measures of clinical periodontal status. However, AST levels may help to confirm clinical observations in patients with chronic periodontitis before therapy, since AST levels differentiate active and inactive periodontal diseased sites.     

Prediction and diagnosis of attachment loss by enhanced chemiluminescent assay of crevicular fluid alkaline phosphatase levels

The current study aimed to apply a novel enhanced chemiluminescence assay in the analysis of gingival crevicular fluid (GCF) alkaline phosphatase (ALP) levels from patients with untreated adult periodontitis. 3666 sites in 25 patients were monitored prior to and after attachment loss was detected with a Florida disc probe. Parameters assessed were, relative attachment level, probing pocket depth, occurrence of bleeding on probing (single episode), GCF volume (microliter), total ALP levels (microIU/30 s sample time) and ALP concentration (IU/l). After recruiting patients to the study, all measures were taken at baseline and 3 months later, prior to the institution of non-surgical periodontal therapy at active sites. Thresholds for determining attachment loss were calculated using a modification of the tolerance method. The mesio-buccal sites of all teeth had GCF samples collected. The size of individual patient thresholds used to define whether attachment loss had occurred, was dependent upon the discomfort felt by that patient during electronic probing, with a positive correlation existing between discomfort on probing (10 cm visual analogue scale) and threshold size (R = 0.52, p < 0.049). A total of 274 sites (7.5%) experienced attachment loss of which 39 sites had GCF samples available for analysis. Total ALP levels were significantly higher at baseline for sites that progressed to attachment loss than paired controls (p < 0.003), but all other parameters showed no differences (p > 0.1). There were significant increases in total ALP levels and GCF volumes for active sites between baseline and 3 month measures (p < 0.01), but not for control sites or test site ALP concentration (p > 0.8). The diagnostic accuracy for GCF ALP as a predictor of future attachment loss (threshold 900 microIU/30 s) was 64%, with +ve and -ve predictive values of 62% and 68%. When a threshold of 1300 microIU/30 s was selected for ALP as a marker of recent or currently active disease, diagnostic accuracy and +ve/-ve predictive values were 77% and 77%/76%, respectively. These results indicate that total GCF ALP levels may serve as a predictor of future or current disease activity.     

GCF IL-1beta profiles in periodontal disease

OBJECTIVES: Studies suggest a genetic influence on levels of interleukin-1beta (IL-1beta) in gingival crevicular fluid (GCF). Levels of IL-1beta in GCF, however, are also dependent upon the clinical parameters at the site of collection, including probing depth (PD) and level of attachment (AL). To examine this issue, IL-1beta in GCF was evaluated from patients with varying degrees of periodontal disease. The influence of both the status of the patient and the probing depth at the sampled sites were considered in the analysis. MATERIAL AND METHODS: GCF IL-1beta was determined by ELISA at 6-8 molar sites from 29 non-smoking adults with mild, moderate, or severe periodontal disease at baseline, 2 weeks, and 24 weeks following scaling and root planing. For later analysis, patients were dichotomized on the basis of disease severity (mild/moderate vs severe). Sampled sites were classified at baseline by PD as, shallow (<4 mm), intermediate (4-6 mm), or deep (>6 mm). RESULTS: PD and AL were each strongly correlated with IL-1beta levels at baseline. However, patients with severe disease had higher levels of IL-1beta in each PD category than those with mild/moderate disease. As compared to patients with mild/moderate disease, IL-1beta levels in shallow sites from patients with severe disease was elevated nearly 2 fold (p<0.001). IL-1beta levels were reduced in all groups at 2 weeks and were still significantly reduced in patients with mild/moderate disease at 24 weeks. At 24 weeks IL-1beta returned to near baseline levels in patients with severe disease. CONCLUSION: While PD and AL are each associated with increased GCF IL-1beta, patients with severe disease show higher IL-1beta GCF levels in shallow sites, suggesting that high GCF IL-1beta expression is in part a host trait, and not strictly a function of clinical parameters.     

Gingival crevicular fluid leptin levels in periodontitis patients with long-term and heavy smoking

BACKGROUND: The aim of the present study was to evaluate gingival crevicular fluid (GCF) leptin levels and the influence of long-term and heavy smoking on GCF leptin levels in patients with chronic periodontitis. METHODS: In this study, 143 individuals were divided into three groups: non-smokers (NS), smokers (S), and control (C). Three subgroups of NS and S were grouped as follows: a) probing depth (PD) 5 mm. For each patient, PD, gingival index (GI), plaque index (PI), gingival bleeding time index (GBTI), and clinical attachment level (CAL) values were recorded. The GCF leptin levels obtained from sampling sites were determined by using enzyme-linked immunosorbent assay kits. RESULTS: The GCF leptin levels were found significantly lower in the a and b subgroups in the S group than those in the NS group (P <0.05). The inflammatory markers GI and GBTI showed significant correlations with leptin in NS (P <0.05). CONCLUSIONS: Our results suggest that higher leptin GCF levels in healthy sites in periodontitis patients may play a protective role in periodontal disease. Further studies are needed to determine the cellular origin of the leptin in the gingiva and the effect of plasma leptin levels on GCF leptin concentrations.