Evaluation of milk fat globule-epidermal growth factor-factor VIII and IL-1β levels in gingival crevicular fluid and saliva in periodontal disease and health

Meteorin-like levels of oral fluids in periodontal health and diseases: a comparative cross-sectional study

OBJECTIVES

Cytokines are critical role in the pathogenesis of periodontal diseases. Meteorin-like (Metrnl), a protein released in the oral mucosa, is a novel cytokine associated with various inflammatory diseases. This study aimed to evaluate levels of salivary and gingival crevicular fluid (GCF), interleukin - 1 beta (IL-1β), interleukin - 10 (IL-10), and Metrnl in periodontal disease.

MATERIALS AND METHODS

It was formed three groups of 20 individuals each: the healthy, gingivitis, and periodontitis (Stage III, Grades A and B) groups. The enzyme-linked immunosorbent assay method measured IL-1β, IL-10, and Metrnl levels in salivary and GCF samples. Clinical periodontal measurement including probing pocket depth (PD), clinical attachment loss (CAL), plaque index (PI), gingival index (GI) and percentage of bleeding on probing (%BOP); and biochemical parameters were evaluated using statistical analysis.

RESULTS

Salivary concentrations and GCF total amount of IL-1β were significantly higher in the periodontal disease groups (p < 0.001). There was no significant difference among the groups in either salivary concentrations or GCF total amount of IL-10 (p > 0.05). Salivary Metrnl concentrations were significantly lower in the periodontitis group (p = 0.002). Salivary Metrnl concentrations had significant negative correlations with %BOP, PD, and CAL (p < 0.05). GCF total amount of Metrnl had significant negative correlations with GCF total amount of IL-1β (p = 0.03). The receiver operating characteristics curve showed: area under the curve (AUC) = 0.731 for salivary Metrnl concentrations to discriminate periodontitis from periodontal health and gingivitis.

CONCLUSION

Based on the findings of this study, Metrnl, as an immunoregulatory cytokine, may have an important relationship with periodontitis. Additional studies are needed to fully elucidate the functional effect of Metrnl in periodontal disease.

CLINICAL RELEVANCE

Background In knock-out experimental studies, it has been reported that Metrnl acts as an inflammation-related immunoregulatory cytokine. The findings relating it to inflammatory diseases support the idea that Metrnl may play a role in the pathogenesis of a variety of inflammatory diseases.

ADDED VALUE OF THIS STUDY

Although Metrnl is a protein abundantly secreted in the oral mucosa, to the authors' knowledge there has been no study evaluating it in gingivitis and periodontitis, inflammatory diseases. In this study, the levels of Metrnl in oral fluids, such as GCF and saliva, were examined in the presence of different periodontal diseases.

CLINICAL IMPLICATIONS

Metrnl can be useful in distinguishing periodontal destruction from periodontal health.

Granulocyte-macrophage colony-stimulating factor (GM-CSF) in subjects with different stages of periodontitis according to the new classification

Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a multifunctional cytokine that regulates inflammatory responses in various autoimmune and inflammatory disorders.

OBJECTIVE

The purpose of this study was to analyze the gingival crevicular fluid (GCF) for GM-CSF, interleukin-1 beta (IL-1β), and macrophage inflammatory protein-1 alpha (MIP-1α) levels in patients with stage I, stage II, stage III, and stage IV periodontitis (SI-P, SII-P, SIII-P, and SIV-P).

METHODOLOGY

A total of 126 individuals were recruited for this study, including 21 periodontal healthy (PH), 21 gingivitis (G), 21 SI-P, 21 SII-P, 21 SIII-P, and 21 SIV-P patients. Plaque index (PI), gingival index (GI), presence of bleeding on probing (BOP), probing depth (PD), and attachment loss (AL) were used during the clinical periodontal assessment. GCF samples were obtained and analyzed by an enzyme-linked immunosorbent assay (ELISA).

RESULTS

GCF GM-CSF, MIP-1α, and IL-1β were significantly higher in SII-P and SIII-P groups than in PH, G, and SI-P groups (p<0.05). There was no significant difference among the PH, G, and SI-P groups in IL-1β, GM-CSF, and MIP-1α levels (p>0.05).

CONCLUSIONS

These results show that GM-CSF expression was increased in SII-P, SIII-P, and SIV-P. Furthermore, GM-CSF levels may have some potential to discriminate between early and advanced stages of periodontitis.

Gingival Crevicular Fluid Zinc- and Aspartyl-Binding Protease Profile of Individuals with Moderate/Severe Atopic Dermatitis

Atopic dermatitis (AD) is a protease-modulated chronic disorder with heterogenous clinical manifestations which may lead to an imprecise diagnosis. To date, there are no diagnostic protease tests for AD. We explored the gingival crevicular fluid (GCF) protease profile of individuals with moderate/severe AD compared to healthy controls. An exploratory case-control study was conducted. AD patients (n = 23) and controls (n = 21) were enrolled at the International Center for Clinical Studies, Santiago, Chile. Complete dermatological and periodontal evaluations (involving the collection of GCF samples) were made. The levels of 35 proteases were analyzed using a human protease antibody array in matching AD patients (n = 6) and controls (n = 6) with healthy periodontium. The GCF levels of zinc-binding ADAM8, ADAM9, MMP8, Neprilysin/CD10, aspartyl-binding Cathepsin E, serin-binding Protein convertase9, and uPA/Urokinase proteases were lower in moderate/severe AD patients compared to controls (p < 0.05). No inter-group differences in the levels of the other 28 proteases were found. MMP8, Cathepsin E, and ADAM9 were the biomarkers with the highest sensitivity and specificity regarding the detection of AD (p < 0.05). The area under receiver operating characteristic (ROC) curve for MMP8 was 0.83 and MMP8 + ADAMP9 was 0.90, with no significant differences (p = 0.132). A combined model of MMP8, Cathepsin E, and ADAM9 was not considered since it did not converge. Then, levels of MMP8 in GCF were determined using a multiplex bead immunoassay in 23 subjects with AD and 21 healthy subjects. Lower levels of MMP8 in the GCF from the AD group versus healthy group (p = 0.029) were found. This difference remained significant after adjustment by periodontitis (p = 0.042). MMP8 revealed the diagnostic potential to identify AD patients versus healthy controls, (ROC area = 0.672, p < 0.05). In conclusion, differences in the protease profile between AD and control patients were associated with MMP8, Cathepsin E, and ADAM9. Based on the multiplex assay results, MMP8 was lower in AD patients than controls, suggesting that MMP8 may be a diagnostic biomarker candidate.