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Szustkiewicz-Karoń A, Schönborn M, Patrycja Pasieka, Płotek A, Maga P, Gregorczyk-Maga I. Biomarkers of Cardiovascular Diseases in Saliva and Gingival Crevicular Fluid: A Review. Angiology 2023; 74:909-947. [PMID: 36268801 DOI: 10.1177/00033197221134757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Due to the fact that cardiovascular diseases (CVDs) have become the most serious problem in public health, there is a need for new and efficient methods for screening and early detection. In the recent literature, saliva and gingival crevicular fluid (GCF) have been gaining recognition as sources of many potential biomarkers of various systemic diseases, mainly because of correlation between the level of some compounds in the blood and saliva and association between the composition of saliva and health status. In this review, we summarize published findings of patients with atherosclerosis, arterial hypertension, coronary artery disease (CAD), acute coronary syndrome (ACS), and stroke in the context of clinical utility of saliva and GCF in diagnosing and assessing CVD severity. We hypothesize that substances in saliva including inflammatory markers, enzymes, or hormones might become novel contributors to the diagnosis and screening of CVDs. In particular, C-reactive protein (CRP), tumor necrosis alpha (TNFα), and cortisol seem to be the most promising. However, further investigation is warranted to determine the most effective markers and methods for their analysis.
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Affiliation(s)
| | - Martyna Schönborn
- Faculty of Medicine, Department of Angiology, Jagiellonian University Medical College, Kraków, Poland
- Doctoral School of Medical and Health Sciences, Jagiellonian University, Kraków, Poland
| | - Patrycja Pasieka
- Faculty of Medicine, Department of Angiology, Jagiellonian University Medical College, Kraków, Poland
| | - Anna Płotek
- Faculty of Medicine, Department of Angiology, Jagiellonian University Medical College, Kraków, Poland
| | - Paweł Maga
- Faculty of Medicine, Department of Angiology, Jagiellonian University Medical College, Kraków, Poland
| | - Iwona Gregorczyk-Maga
- Faculty of Medicine, Institute of Dentistry, Jagiellonian University Medical College, Kraków, Poland
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Rathnayake N, Gustafsson A, Norhammar A, Kjellström B, Klinge B, Rydén L, Tervahartiala T, Sorsa T. Salivary Matrix Metalloproteinase-8 and -9 and Myeloperoxidase in Relation to Coronary Heart and Periodontal Diseases: A Subgroup Report from the PAROKRANK Study (Periodontitis and Its Relation to Coronary Artery Disease). PLoS One 2015; 10:e0126370. [PMID: 26132583 PMCID: PMC4488442 DOI: 10.1371/journal.pone.0126370] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 04/01/2015] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Matrix metalloproteinase (MMP) -8, -9 and myeloperoxidase (MPO) are inflammatory mediators. The potential associations between MMP-8, -9, MPO and their abilities to reflect cardiovascular risk remains to be evaluated in saliva. The objective of this study was to investigate the levels and associations of salivary MMP-8, -9, MPO and tissue inhibitors of metalloproteinase (TIMP)-1 in myocardial infarction (MI) patients and controls with or without periodontitis. MATERIALS AND METHODS 200 patients with a first MI admitted to coronary care units in Sweden from May 2010 to December 2011 and 200 controls matched for age, gender, residential area and without previous MI were included. Dental examination and saliva sample collection was performed 6-10 weeks after the MI in patients and at baseline in controls. The biomarkers MMP -8, -9, MPO and TIMP-1 were analyzed by time-resolved immunofluorescence assay (IFMA), Western blot and Enzyme-Linked ImmunoSorbent Assay (ELISA). RESULTS After compensation for gingivitis, gingival pockets and smoking, the mean salivary levels of MMP-8 (543 vs 440 ng/mL, p = 0.003) and MPO (1899 vs 1637 ng/mL, p = 0.02) were higher in non-MI subjects compared to MI patients. MMP-8, -9 and MPO correlated positively with clinical signs of gingival/periodontal inflammation while TIMP-1 correlated mainly negatively with these signs. The levels of latent and active forms of MMP-8 did not differ between the MI and non-MI groups. Additionally, MMP-8, MPO levels and MMP-8/TIMP-1 ratio were significantly higher in men compared to women with MI. CONCLUSIONS This study shows that salivary levels of the analyzed biomarkers are associated with periodontal status. However, these biomarkers could not differentiate between patients with or without a MI. These findings illustrate the importance to consider the influence of oral conditions when analyzing levels of inflammatory salivary biomarkers.
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Affiliation(s)
- Nilminie Rathnayake
- Karolinska Institutet, Department of Dental Medicine, Division of Periodontology, Stockholm, Sweden
- * E-mail:
| | - Anders Gustafsson
- Karolinska Institutet, Department of Dental Medicine, Division of Periodontology, Stockholm, Sweden
| | - Anna Norhammar
- Karolinska Institutet, Karolinska University Hospital Solna, Department of Medicine, Cardiology Unit, Stockholm, Sweden
| | - Barbro Kjellström
- Karolinska Institutet, Karolinska University Hospital Solna, Department of Medicine, Cardiology Unit, Stockholm, Sweden
| | - Björn Klinge
- Karolinska Institutet, Department of Dental Medicine, Division of Periodontology, Stockholm, Sweden
- Department of Periodontology, Faculty of Odontology, Malmo University, Malmo, Sweden
| | - Lars Rydén
- Karolinska Institutet, Karolinska University Hospital Solna, Department of Medicine, Cardiology Unit, Stockholm, Sweden
| | - Taina Tervahartiala
- University of Helsinki, Helsinki University Central Hospital, Department of Oral and Maxillofacial Diseases, Helsinki, Finland
| | - Timo Sorsa
- Karolinska Institutet, Department of Dental Medicine, Division of Periodontology, Stockholm, Sweden
- University of Helsinki, Helsinki University Central Hospital, Department of Oral and Maxillofacial Diseases, Helsinki, Finland
- University of Helsinki, Helsinki University Central Hospital, Department of Periodontology, Helsinki, Finland
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Nizam N, Basoglu OK, Tasbakan MS, Holthöfer A, Tervahartiala T, Sorsa T, Buduneli N. Do salivary and serum collagenases have a role in an association between obstructive sleep apnea syndrome and periodontal disease? A preliminary case-control study. Arch Oral Biol 2014; 60:134-43. [PMID: 25455127 DOI: 10.1016/j.archoralbio.2014.09.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 08/29/2014] [Accepted: 09/22/2014] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Despite increasing evidence for an association of obstructive sleep apnea syndrome (OSAS) and periodontal disease, the pathophysiological linking mechanisms remain unclear. This study aims to evaluate the salivary and serum matrix metalloproteinase-2, -8, -9 (MMP-2, -8, -9), tissue inhibitor of matrix metalloproteinase-1 (TIMP-1), myeloperoxidase (MPO), neutrophil elastase (NE), neutrophil gelatinase-associated lipocalin (NGAL), as well as degree of activation of MMP-2, -9 of patients with and without OSAS. DESIGN A total of 50 individuals were included in the study. There were 13, 17 and 20 individuals, respectively in the control (non-OSAS) group, mild-to-moderate OSAS and severe OSAS groups. Saliva, serum samples and clinical periodontal parameters were collected. Biofluid samples were analysed by immunofluorometric assay (IFMA), enzyme-linked immunosorbent assay (ELISA), western immunoblotting and gelatine zymography. Statistical analyses were performed using D'Agostino-Pearson omnibus normality test, Kruskal-Wallis test and Spearman rho rank correlation analysis. RESULTS There were no statistically significant differences in clinical periodontal parameters between the study groups. Salivary NE and proMMP-2 levels were significantly lower in the OSAS groups than the control group (p<0.05). Serum proMMP-9 concentration and the degree of MMP-9 activation in saliva were significantly lower in the severe OSAS group than the control group (p<0.05). There were significant correlations between salivary and serum proMMP-9 and -2 concentrations (p<0.05). Serum proMMP-2, NE and salivary proMMP-9 and -2 negatively correlated with indicators of OSAS severity (p<0.05). CONCLUSIONS The present findings do not support a pathophysiological link between the severity of OSAS and clinical periodontal status via neutrophil enzymes or MMPs.
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Affiliation(s)
- Nejat Nizam
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - Ozen K Basoglu
- Department of Chest Diseases, School of Medicine, Ege University, İzmir, Turkey
| | - Mehmet S Tasbakan
- Department of Chest Diseases, School of Medicine, Ege University, İzmir, Turkey
| | - Anna Holthöfer
- University of Helsinki, Institute of Dentistry and Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, Helsinki, Finland
| | - Taina Tervahartiala
- University of Helsinki, Institute of Dentistry and Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, Helsinki, Finland
| | - Timo Sorsa
- University of Helsinki, Institute of Dentistry and Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, Helsinki, Finland; Division of Periodonlogy, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Nurcan Buduneli
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey.
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Marfil-Álvarez R, Mesa F, Arrebola-Moreno A, Ramírez-Hernández JA, Magán-Fernández A, O'Valle F, Galindo-Moreno P, Catena A. Acute myocardial infarct size is related to periodontitis extent and severity. J Dent Res 2014; 93:993-8. [PMID: 25139359 DOI: 10.1177/0022034514548223] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Cardiovascular disease has been associated with 40% of deaths in high-income countries and 28% in lower-income countries. The relationship between periodontitis and acute myocardial infarction is well documented, but it has not been established whether the extent and severity of periodontitis influence the infarct size. This cross-sectional and analytic study was designed to investigate the association of chronic periodontitis extent and severity with acute myocardial infarct size as indicated by serum cardiac troponin I and myoglobin levels. Sociodemographic, periodontal, cardiologic, and hematologic variables were gathered in 112 consecutive patients with myocardial infarction. The extent (Arbes Index) and severity (Periodontal Inflammatory Severity Index) of the chronic periodontitis were significantly associated with troponin I levels after controlling for sociodemographic and clinical confounders (change in R (2) = .041, p < .02, and R (2) = .031, p = .04). However, only the extent index accounted for levels of myoglobin (change in R (2) = .030, p < .05), total leukocytes (change in R (2) = .041 p < .02), and neutrophils (change in R (2) = .059, p < .01). Mediated regression analysis showed that leukocytes and neutrophils may underlie these observed relationships of chronic periodontitis with troponin I and myoglobin. To our knowledge, this study contributes the first research data demonstrating that the extent and severity of periodontitis is positively associated with acute myocardial infarct size as measured by serum troponin I and myoglobin levels.
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Affiliation(s)
- R Marfil-Álvarez
- Department of Periodontics, School of Dentistry, University of Granada, Spain
| | - F Mesa
- Department of Periodontics, School of Dentistry, University of Granada, Spain
| | - A Arrebola-Moreno
- Department of Cardiology, "Vírgen de las Nieves" Hospital and University of Granada, Spain
| | - J A Ramírez-Hernández
- Department of Cardiology, "Vírgen de las Nieves" Hospital and University of Granada, Spain
| | - A Magán-Fernández
- Department of Periodontics, School of Dentistry, University of Granada, Spain
| | - F O'Valle
- Departments of Pathology, School of Medicine and Biopathology and Medicine Regenerative Institute, University of Granada, Spain
| | - P Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Spain
| | - A Catena
- Department of Experimental Psychology, School of Psychology, University of Granada, Spain
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Caseiro A, Ferreira R, Quintaneiro C, Pereira A, Marinheiro R, Vitorino R, Amado F. Protease profiling of different biofluids in type 1 diabetes mellitus. Clin Biochem 2012; 45:1613-9. [PMID: 22975642 DOI: 10.1016/j.clinbiochem.2012.08.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 08/20/2012] [Accepted: 08/26/2012] [Indexed: 12/11/2022]
Abstract
OBJECTIVES We aimed to disclose the proteolytic events underlying type 1 diabetes and related complication through protease profiling in the bodily fluids serum, urine and saliva. DESIGN AND METHODS Zymography followed by LC-MS/MS was performed for protease identification and quantitative comparison of proteolytic activity between healthy, type 1 diabetic patients with no complications and with retinopathy and nephropathy. Western blotting was also accomplished for MMP-9 and MMP-2 identification and expression analysis. RESULTS Only MMP-2 and MMP-9 were observed in serum with significantly increased levels and activity observed in diabetic patients. In urine and saliva other proteases besides MMPs were identified by MS and presented disease-dependent activity variations. Among these are complex MMP-9/Neutrophil gelatinase-associated lipocalin, aminopeptidase N, azurocidin and kallikrein 1 with more activity noticed in type 1 diabetes patients with nephropathy and/or retinopathy. CONCLUSION Our data highlight the usefulness of urine and saliva for the monitoring of type-1 diabetes-related proteolytic events, where aminopeptidase N, azurocidin and kallikrein 1 appear as promising screening targets for type 1 diabetes-related complications.
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Affiliation(s)
- Armando Caseiro
- QOPNA, Mass Spectrometry Center, Department of Chemistry, University of Aveiro, Aveiro, Portugal
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