Dental and Medical Problems

Dent Med Probl
Index Copernicus (ICV 2020) – 128.41
MEiN – 70 pts
CiteScore (2021) – 2.0
JCI – 0.22
Average rejection rate (2021) – 81.35%
ISSN 1644-387X (print)
ISSN 2300-9020 (online)
Periodicity – quarterly

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Dental and Medical Problems

2012, vol. 49, nr 1, January-March, p. 88–94

Publication type: review article

Language: Polish

Wybrane wykładniki humoralne destrukcji tkanek w diagnostyce periodontologicznej

Selected Humoral Factors Related to Tissue Destruction in Periodontal Diagnosis

Łukasz Konopka1,, Ewa Brzezińska-Błaszczyk1,

1 Zakład Immunologii Doświadczalnej Uniwersytetu Medycznego w Łodzi

Streszczenie

Zapalenie przyzębia jest rozpoznawane niemal wyłącznie na podstawie oceny klinicznej i radiologicznej. Niemniej jednak, ocena parametrów klinicznych i radiologiczna ocena stopnia utraty kości dostarcza informacji o dotychczasowym przebiegu procesów destrukcyjnych w przyzębiu, ale nie wskazuje na obecną aktywność choroby ani nie pozwala przewidzieć jej rozwoju. Współczesny pogląd na patogenezę zapalenia przyzębia sugeruje, że odpowiedź gospodarza na bakterie i ich produkty jest istotnym czynnikiem determinującym wystąpienie i progresję periodontitis. Mediatory reakcji immunologiczno-zapalnej, zaangażowane w destrukcję przyzębia są wykrywane w płynie kieszonki dziąsłowej (GCF). Występowanie czynników humoralnych w GC F może znaleźć zastosowanie w ocenie aktywności choroby przyzębia oraz wyników zastosowanej terapii. W pracy omówiono przydatność diagnostyczną enzymów gospodarza, tj. metaloproteinaz, fosfatazy alkalicznej, β-glukuronidazy, elastazy, mieloperoksydazy oraz katepsyn. Autorzy opisują również diagnostyczną użyteczność osteokalcyny i osteopontyny – markerów obrotu kostnego.

Abstract

Periodontitis is diagnosed almost solely on the basis of clinical assessment and radiographical findings. Nevertheless, clinical parameters and radiographic bone loss offer information about past periodontal tissue destruction and neither explain the present condition of the disease activity nor predict the future. Current understanding of the pathogenesis of periodontitis suggests that modulation of host response by bacterial products is an important determinant of the onset and progression of periodontal diseases. Several inflammatory and immune mediators implicated in periodontal destruction have been identified in gingival crevicular fluid (GCF). The presence of host-derived humoral factors in GCF might have a great value in evaluating both periodontal disease activity and the result of periodontal therapy. In this review diagnostic utility of host-derived enzymes, that is matrix metalloproteinases, alkaline phosphatase, β-glucuronidase, elastase, myeloperoxidase and cathepsins, is discussed. The authors also described the usefulness of molecular markers of bone turnover such as osteocalcin and osteopontin.

Słowa kluczowe

zapalenie przyzębia, płyn kieszonki dziąsłowej, diagnostyka, biomarkery

Key words

periodontitis, gingival crevicular fluid, diagnosis, biomarkers

References (57)

  1. Tenenbaum H.C., Tenenbaum H., Zohar R.: Future treatment and diagnostic strategies for periodontal diseases. Dent. Clin. North Am. 2005, 49, 677–694.
  2. Loos B.G., Tjoa S.: Host-derived diagnostic markers for periodontitis: do they exist in gingival crevice fluid? Periodontology 2000, 2005, 39, 53–72.
  3. L amster I.B., Ahlo J.K.: Analysis of gingival crevicular fluid as applied to the diagnosis of oral and systemic diseases. Ann. NY Acad. Sci. 2007, 1098, 216–229.
  4. O swal S., Dwarakanath C.D.: Relevance of gingival crevice fluid components in assessment of periodontal disease – A critical analysis. J. Indian Soc. Periodontol. 2010, 14, 282–286.
  5. Lamster I.B.: Evaluation of components of gingival crevicular fluid as diagnostic tests. Ann. Periodontol. 1997, 2, 123–137.
  6. Buduneli N., Kinane D.F.: Host-derived diagnostic markers related to soft tissue destruction and bone degradation in periodontitis. J. Clin. Periodontol. 2011, 38, 85–105.
  7. Offenbacher S., Collins J.G., Heasman P.A.: Diagnostic potential of host response mediators. Adv. Dent. Res. 1993, 7, 175–181.
  8. Sorsa T., Tjäderhane L., Konttinen Y.T., Lauhio A., Salo T., Lee H.M., Golub L.M., Brown D.L., Mäntylä P.: Matrix metalloproteinases: contribution to pathogenesis, diagnosis and treatment of periodontal inflammation. Ann. Med. 2006, 38, 306–321.
  9. Konopka Ł., Brzezińska-Błaszczyk E.: Rola metaloproteinaz w chorobach jamy ustnej – nowe możliwości terapii. Dent. Med. Probl. 2008, 45, 229–235.
  10. Verstappen J., Von den Hoff J.W.: Tissue inhibitors of metalloproteinases (TIMPs): their biological functions and involvement in oral disease. J. Dent. Res. 2006, 85, 1074–1084.
  11. Tüter G., Kurtiş B., Serdar M.: Effects of phase I periodontal treatment on gingival crevicular fluid levels of matrix metalloproteinase-1 and tissue inhibitor of metalloproteinase-1. J. Periodontol. 2002, 73, 487–493.
  12. Ilgenli T., Vardar-Sengul S., Gürkan A., Sorsa T., Stackelberg S., Köse T., Atilla G.: Gingival crevicular fluid matrix metalloproteinase-13 levels and molecular forms in various types of periodontal diseases. Oral Dis. 2006, 12, 573–579.
  13. Silva N., Dutzan N., Hernandez M., Dezerega A., Rivera O., Aguillon J.C., Aravena O., Lastres P., Pozo P., Vernal R., Gamonal J.: Characterization of progressive periodontal lesions in chronic periodontitis patients: levels of chemokines, cytokines, matrix metalloproteinase-13, periodontal pathogens and inflammatory cells. J. Clin. Periodontol. 2008, 35, 206–214.
  14. Gürkan A., Emingil G., Saygan B.H., Atilla G., Cinarcik S., Köse T., Berdeli A.: Gene polymorphisms of matrix metalloproteinase-2, -9 and -12 in periodontal health and severe chronic periodontitis. Arch. Oral Biol. 2008, 53, 337–345.
  15. Pozo P., Valenzuela M.A., Melej C., Zaldívar M., Puente J., Martínez B., Gamonal J.: Longitudinal analysis of metalloproteinases, tissue inhibitors of metalloproteinases and clinical parameters in gingival crevicular fluid from periodontitis-affected patients. J. Periodontal Res. 2005, 40, 199–207.
  16. Alpagot T., Bell C., Lundergan W., Chambers D.W., Rudin R.: Longitudinal evaluation of GCF MMP-3 and TIMP-1 levels as prognostic factors for progression of periodontitis. J. Clin. Periodontol. 2001, 28, 353–359.
  17. Beklen A., Tüter G., Sorsa T., Hanemaaijer R., Virtanen I., Tervahartiala T., Konttinen Y.T.: Gingival tissue and crevicular fluid cooperation in adult periodontitis. J. Dent. Res. 2006, 85, 59–63.
  18. Visse R., Nagase H.: Matrix metalloproteinases and tissue inhibitors of metalloproteinases: structure, function and biochemistry. Circ. Res. 2003, 92, 827–839.
  19. Rai B., Kharb S., Jain R., Anand S.C.: Biomarkers of periodontitis in oral fluids. J. Oral Sci. 2008, 50, 53–56.
  20. Ingman T., Tervahartiala T., Ding Y., Tschesche H., Haerian A., Kinane D.F., Konttinen Y.T., Sorsa T.: Matrix metalloproteinases and their inhibitors in gingival crevicular fluid and saliva of periodontitis patients. J. C lin. Periodontol. 1996, 23, 1127–1132.
  21. Mäntylä P., Stenman M., Kinane D.F., Tikanoja S., Luoto H., Salo T., Sorsa T.: Gingival crevicular fluid collagenase2 (MMP-8) test stick for chair-side monitoring of periodontitis. J. Periodontal Res. 2003, 38, 436–439.
  22. Konopka Ł.: Ocena korelacji poziomu Interleukiny (IL)-1β, IL-8 i metaloproteinazy (MMP)-8 w płynie dziąsłowym u pacjentów z przewlekłym zapaleniem przyzębia. Rozprawa doktorska, Łódź 2011.
  23. Marcaccini A.M., Meschiari C.A., Zuardi L.R., de Sousa T.S., Taba M. Jr., Teofilo J.M., Jacob-Ferreira A.L., Tanus-Santos J.E., Novaes A.B. Jr., Gerlach R.F.: Gingival crevicular fluid levels of MMP-8, MMP-9, TIMP-2, and MPO decrease after periodontal therapy. J. Clin. Periodontol. 2010, 37, 180–190.
  24. Hernández M., Martínez B., Tejerina J.M., Valenzuela M.A., Gamonal J.: MMP-13 and TIMP-1 determinations in progressive chronic periodontitis. J. Clin. Periodontol. 2007, 34, 729–735.
  25. Malhotra R., Grover V., Kapoor A., Kapur R.: Alkaline phosphatase as a periodontal disease marker. Indian J. Dent. Res. 2010, 21, 531–536.
  26. Perinetti G., Paolantonio M., Femminella B., Serra E., Spoto G.: Gingival crevicular fluid alkaline phosphatase activity reflects periodontal healing/recurrent inflammation phases in chronic periodontitis patients. J. Periodontol. 2008, 79, 1200–1207.
  27. Daltaban O., Saygun I., Bal B., BaloΊ K., Serdar M.: Gingival crevicular fluid alkaline phosphatase levels in postmenopausal women: effects of phase I periodontal treatment. J. Periodontol. 2006, 77, 67–72.
  28. Nakashima K., Roehrich N., Cimasoni G.: Osteocalcin, prostaglandin E2 and alkaline phosphatase in gingival crevicular fluid: their relations to periodontal status. J. Clin. Periodontol. 1994, 21, 327–333.
  29. Castro C.E., Koss M.A., López M.E.: Intracytoplasmic enzymes in gingival crevicular fluid of patients with aggressive periodontitis. J. Periodontal Res. 2011, 46, 522–527.
  30. Ozçaka O., Biçakci N., Pussinen P., Sorsa T., Köse T., Buduneli N.: Smoking and matrix metalloproteinases, neutrophil elastase and myeloperoxidase in chronic periodontitis. Oral Dis. 2011, 17, 68–76.
  31. Subrahmanyam M.V., Sangeetha M.: Gingival crevicular fluid a marker of the periodontal disease activity. Indian J. Clin. Biochem. 2003, 18, 5–7.
  32. Jin L.J., Soder P.O., Leung W.K., Corbet E.F., Samaranayake L.P., Soder B., Davies W.I.: Granulocyte elastase activity and PGE2 levels in gingival crevicular fluid in relation to the presence of subgingival periodontopathogens in subjects with untreated adult periodontitis. J. Clin. Periodontol. 1999, 26, 531–540.
  33. Albandar J.M., Kingman A., Lamster I.B.: Crevicular fluid level of beta-glucuronidase in relation to clinical periodontal parameters and putative periodontal pathogens in early-onset periodontitis. J. Clin. Periodontol. 1998, 25, 630–639.
  34. Murray M.C., Mooney J., Kinane D.F.: The relationship between elastase and lactoferrin in healthy, gingivitis and periodontitis sites. Oral Dis. 1995, 1, 106–109.
  35. Gustafsson A., Asman B., Bergström K.: Elastase and lactoferrin in gingival crevicular fluid: possible indicators of a granulocyte-associated specific host response. J. Periodontal Res. 1994, 29, 276–282.
  36. Ozdemir B., Ozcan G., Karaduman B., Teoman A.I., Ayhan E., Ozer N., Us D.: Lactoferrin in gingival crevicular fluid and peripheral blood during experimental gingivitis. Eur. J. Dent. 2009, 3, 16–23.
  37. Tsai C.C., Kao C.C., Chen C.C.: Gingival crevicular fluid lactoferrin levels in adult periodontitis patients. Aust. Dent. J. 1998, 43, 40–44.
  38. Kaner D., Bernimoulin J.P., Kleber B.M., Heizmann W.R., Friedmann A.: Gingival crevicular fluid levels of calprotectin and myeloperoxidase during therapy for generalized aggressive periodontitis. J. Periodontal Res. 2006, 41, 132–139.
  39. Buchmann R., Hasilik A., Van Dyke T.E., Lange D.E.: Resolution of crevicular fluid leukocyte activity in patients treated for aggressive periodontal disease. J. Periodontol. 2002, 73, 995–1002.
  40. Goto T., Yamaza T., Tanaka T.: Cathepsins in the osteoclast. J. Electron Microsc. 2003, 52, 551–558.
  41. Drake F.H., Dodds R.A., James I.E., Connor J.R., Debouck C., Richardson S.: Cathepsin K but not cathepsins B, L, or S, is abundantly expressed in human osteoclasts. J. Biol. Chem. 1996, 271, 12511–12516.
  42. Garg G., Pradeep A.R., Thorat M.K.: Effect of nonsurgical periodontal therapy on crevicular fluid levels of cathepsin K in periodontitis. Arch. Oral Biol. 2009, 54, 1046–1051.
  43. Strbac G.D., Monov G., Cei S., Kandler B., Watzek G., Gruber R.: Levels in the crevicular fluid of dental implants: a pilot study. J. Clin. Periodontol. 2006, 33, 302–308.
  44. Mogi M., Otogoto J.: Expression of cathepsin-K in gingival crevicular fluid of patients with periodontitis. Arch. Oral Biol. 2007, 52, 894–898.
  45. Kennett C.N., Cox S.W., Eley B.M.: Investigations into the cellular contribution to host tissue proteases and inhibitors in gingival crevicular fluid. J. Clin. Periodontol. 1997, 24, 424–431.
  46. Kunimatsu K., Yamamoto K., Ichimaru E., Kato Y., Kato I.: Cathepsins B, H and L activities in gingival crevicular fluid from chronic adult periodontitis patients and experimental gingivitis subjects. J. Periodontal Res. 1990, 25, 69–73.
  47. Ichimaru E., Tanoue M., Tani M., Tani Y., Kaneko T., Iwasaki Y., Kunimatsu K., Kato I.: Cathepsin B in gingival crevicular fluid of adult periodontitis patients: identification by immunological and enzymological methods. Inflamm. Res. 1996, 45, 277–282.
  48. Kinney J.S., Ramseier C.A., Giannobile W.V.: Oral fluid-based biomarkers of alveolar bone loss in periodontitis. Ann. NY Acad. Sci. 2007, 1098, 230–251.
  49. Bullon P., Goberna B., Guerrero J.M., Segura J.J., Perez-Cano R., Martinez-Sahuquillo A.: Serum, saliva, and gingival crevicular fluid osteocalcin: their relation to periodontal status and bone mineral density in postmenopausal women. J. Periodontol. 2005, 76, 513–519.
  50. Lee A.J., Walsh T.F., Hodges S.J., Rawlinson A.: Gingival crevicular fluid osteocalcin in adult periodontitis. J. C lin. Periodontol. 1999, 26, 252–256.
  51. Kido J., Nakamura T., Asahara Y., Sawa T., Kohri K., Nagata T.: Osteopontin in gingival crevicular fluid. J. Periodontal Res. 2001, 36, 328–333.
  52. Sharma C.G., Pradeep A.R.: Gingival crevicular fluid osteopontin levels in periodontal health and disease. J. Periodontol. 2006, 77, 1674–1680.
  53. Sharma C.G., Pradeep A.R.: Plasma and crevicular fluid osteopontin levels in periodontal health and disease. J. Periodontal Res. 2007, 42, 450–455.
  54. Huynh Q.N., Wang S., Tafolla E., Gansky S.A., Kapila S., Armitage G.C., Kapila Y.L.: Specific fibronectin fragments as markers of periodontal disease status. J. Periodontol. 2002, 73, 1101–1110.
  55. Figueredo C.M., Gustafsson A.: Increased amounts of laminin in GCF from untreated patients with periodontitis. J. Clin. Periodontol. 2000, 27, 313–318.
  56. Konopka Ł., Brzezińska-Błaszczyk E.: Mediatory reakcji immunologiczno-zapalnej jako biomarkery zapaleń przyzębia. Dent. Med. Probl. 2011, 48, 236–242.
  57. Konopka Ł., Brzezińska-Błaszczyk E.: Cytokiny w płynie kieszonki dziąsłowej jako potencjalne markery diagnostyczne i prognostyczne zapalenia przyzębia. Dent. Med. Probl. 2010, 47, 206–213.