Magnetic bead-based salivary peptidome profiling for periodontal-orthodontic treatment

Progression from healthy periodontium to gingivitis and periodontitis: Insights from bioinformatics-driven proteomics - A systematic review with meta-analysis

AIM

The current study aimed to: (1) systematically review the published literature regarding the proteomics analyses of saliva and gingival crevicular fluid (GCF) in healthy humans and gingivitis and/or periodontitis patients; and (2) to identify the differentially expressed proteins (DEPs) based on the systematic review, and comprehensively conduct meta-analyses and bioinformatics analyses.

METHODS

An online search of Web of Science, Scopus, and PubMed was performed without any restriction on the year and language of publication. After the identification of the DEPs reported by the included human primary studies, gene ontology (GO), the Kyoto encyclopedia of genes and genomes pathway (KEGG), protein-protein interaction (PPI), and meta-analyses were conducted. The risk of bias among the included studies was evaluated using the modified Newcastle-Ottawa quality assessment scale.

RESULTS

The review identified significant differences in protein expression between healthy individuals and those with gingivitis and periodontitis. In GCF, 247 proteins were upregulated and 128 downregulated in periodontal diseases. Saliva analysis revealed 79 upregulated and 70 downregulated proteins. There were distinct protein profiles between gingivitis and periodontitis, with 159 and 31 unique upregulated proteins in GCF, respectively. Meta-analyses confirmed significant upregulation of various proteins in periodontitis, including ALB and MMP9, while CSTB and GSTP1 were downregulated. AMY1A and SERPINA1 were upregulated in periodontitis saliva. HBD was upregulated in gingivitis GCF, while DEFA3 was downregulated. PPI analysis revealed complex networks of interactions among DEPs. GO and KEGG pathway analyses provided insights into biological processes and pathways associated with periodontal diseases.

CONCLUSION

The ongoing MS-based proteomics studies emphasize the need for a highly sensitive and specific diagnostic tool for periodontal diseases. Clinician acceptance of the eventual diagnostic method relies on its ability to provide superior or complementary information to current clinical assessment procedures. Future research should prioritize the multiplex measurement of multiple biomarkers simultaneously to enhance diagnostic accuracy and large study cohorts are necessary to ensure the validity and reliability of research findings.

Validating proteomic biomarkers in saliva: distinguishing between health and periodontal diseases

INTRODUCTION

Periodontitis is a chronic inflammatory disease characterized by progressive soft tissue and alveolar bone loss due to interactions between microbial dental plaque and the host response. Despite extensive research on biomarkers from saliva or gingival crevicular fluid (GCF) for diagnosing periodontitis, clinical and radiological parameters remain the primary diagnostic tools.

AREAS COVERED

This review discusses the ongoing research into salivary biomarkers for periodontitis diagnosis, emphasizing the need for reliable biomarkers to differentiate between periodontal health and disease. Salivary biomarker research has gained momentum with advancements in proteomic technologies, enabling noninvasive sample collection and revealing potential candidate biomarkers.

EXPERT OPINION

Proteomic research since the early 2000s has identified promising biomarkers and provided insights into the pathogenesis of periodontitis. Bioinformatic analysis of proteomic data elucidates the underlying biological mechanisms. This review summarizes key findings and highlights common potential biomarkers identified through proteomic research in periodontology.

Saliva as a Source of Biomarkers for Periodontitis and Periimplantitis

Saliva has the potential to be used as a diagnostic and monitoring tool for various diseases if biomarkers of an adequate sensitivity and specificity could be identified. Several reviews and even meta-analyses have been performed in recent years, which have found some candidate biomarkers for periodontitis, like macrophage inflammatory protein-1 alpha, interleukin-1ß, interleukin-6, matrix metalloproteinase-8, or hemoglobin. However, none of those are currently in use to replace conventional periodontal diagnostics with a periodontal probe. For periimplantitis, to date, heterogeneity of different study protocols and implant types did not permit to discover clear biomarkers, which were able to distinguish between healthy and diseased implants. Few proinflammatory cytokines, similar to periodontitis, have been characterized as adjunct tools to clinical diagnosis. The additional determination of antimicrobial peptides, bone turnover markers, and bacteria could help to enhance sensitivity and specificity in a combined model for periodontitis and periimplantitis. Furthermore, proteomic approaches might be preferred over single biomarker determinations. A global consensus is also needed to harmonize salivary sampling methods as well as procedures of biomarker analysis to ensure future comparability.

Direct MALDI-TOF profiling of gingival crevicular fluid sediments for periodontitis diagnosis

Periodontitis is a widespread stomatological disease and represents one of the main causes of tooth loss in adults. Traditional diagnosis of periodontitis relies on the judgment by professional periodontists that cannot reveal its progression at the early stage. In this work, we characterized the gingival crevicular fluid (GCF) sediments of patients with periodontitis and healthy volunteers by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Potential protein biomarkers were selected based on the multivariate statistical analysis of the MALDI-TOF mass spectra, followed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) identification. Twelve potential protein biomarkers were identified from 17 patients compared to 7 healthy volunteers, including 5 microbial proteins and 7 human proteins, indicating the microbial composition and host response components related to the etiology of periodontitis. The panel of biomarkers was then verified with the GCF samples of another 11 patients. The 12 biomarkers also showed potential value in the early diagnosis of periodontitis. This work developed a rapid assay to screen periodontitis among populations. It can be popularized to non-periodontal specialists such as community general practitioners, benefiting the early and accurate monitoring of periodontitis. The identification of the potential biomarkers can also help in the understanding of the pathogenesis of periodontitis.

Peptidomic changes of saliva after nonsurgical treatment of stage I / II generalized periodontitis

OBJECTIVE

To explore the changes of peptidome profiles of saliva, serum and gingival crevicular fluid (GCF) before and after nonsurgical periodontal treatment in patients with generalized periodontitis (stage I / II).

SUBJECTS AND METHODS

Saliva, serum and GCF samples were collected from 17 patients at baseline (T₀ ), one week after ultrasonic supragingival scaling (T₁ ) and eight weeks after subgingival scaling and root planning (T₂ ). Matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) was carried out to detect changes in peptidomic profiles. Then nano-liquid chromatography-electrospray ionization-tandem mass spectrometry (nano-LC/ESI-MS/MS) was performed to identify potential peptide biomarkers.

RESULTS

Most of the peptides from the patients exhibited a decreasing trend from the time point of pre-treatment to that of post-treatment. Cluster analysis and scatter plots using these peptides indicated that salivary peptidome has an acceptable capability of reflecting the status of stage I / II generalized periodontitis. Seven of these peptides were successfully identified as α-1-antitrypsin, immunoglobulin κ variable 4-1, haptoglobin and immunoglobulin heavy constant γ2.

CONCLUSIONS

Certain peptides in saliva, serum and GCF were down-regulated after nonsurgical periodontal treatment, demonstrating the application prospects of saliva in monitoring and surveillance of periodontal diseases in both clinical settings and communities.

Proteomics approach for biomarkers and diagnosis of periodontitis: systematic review

Quantitative proteomic workflow based on mass spectrometry (MS) is recently developed by the researchers to screen for biomarkers in periodontal diseases comprising periodontitis. Periodontitis is known for chronic inflammatory disease characterized by progressive destruction of the tooth-supporting apparatus, yet has a lack of clear pathobiology based on a discrepancy between specified categories and diagnostic vagueness. The objective of this review was to outlined the accessible information related to proteomics studies on periodontitis. The Preferred Reporting Items for Systematical Reviews and Meta-Analysis (PRISMA) statement guides to acquaint proteomic analysis on periodontal diseases was applied. Three databases were used in this study, such as Pubmed, ScienceDirect and Biomed Central from 2009 up to November 2019. Proteomics analysis platforms that used in the studies were outlined. Upregulated and downregulated proteins findings data were found, in which could be suitable as candidate biomarkers for this disease.

Rapid diagnosis of periodontitis, a feasibility study using MALDI-TOF mass spectrometry

AIM

The aim of the present study was to assess the feasibility and diagnostic contribution of protein profiling using MALDI-TOF mass spectrometry applied to saliva, gingival crevicular fluid (GCF) and dental plaque from periodontitis and healthy subjects. We hypothesized that rapid routine and blinded MALDI-TOF analysis could accurately classify these three types of samples according to periodontal state.

MATERIALS AND METHODS

Unstimulated saliva, GCF and dental plaque, collected from periodontitis subjects and healthy controls, were analyzed by MALDI-TOF MS. Based on the differentially expressed peaks between the two groups, diagnostic decision trees were built for each sample.

RESULTS

Among 141 patients (67 periodontitis and 74 healthy controls), the decision trees diagnosed periodontitis with a sensitivity = 70.3% (± 0.211) and a specificity = 77.8% (± 0.165) for saliva, a sensitivity = 79.6% (± 0.188) and a specificity = 75.7% (± 0.195) for GCF, and a sensitivity = 72.1% (± 0.202) and a specificity = 72.2% (± 0.195) for dental plaque. The sensitivity and specificity of the tests were improved to 100% (CI 95% = [0.91;1]) and 100% (CI 95% = [0.92;1]), respectively, when two samples were tested.

CONCLUSION

We developed, for the first time, diagnostic tests based on protein profiles of saliva, GCF and dental plaque between periodontitis patients and healthy subjects. When at least 2 of these samples were tested, the best results were obtained.

Role of Salivary Biomarkers in Oral Cancer Detection

Oral cancers are the sixth most frequent cancer with a high mortality rate. Oral squamous cell carcinoma accounts for more than 90% of all oral cancers. Standard methods used to detect oral cancers remain comprehensive clinical examination, expensive biochemical investigations, and invasive biopsy. The identification of biomarkers from biological fluids (blood, urine, saliva) has the potential of early diagnosis. The use of saliva for early cancer detection in the search for new clinical markers is a promising approach because of its noninvasive sampling and easy collection methods. Human whole-mouth saliva contains proteins, peptides, electrolytes, organic, and inorganic salts secreted by salivary glands and complimentary contributions from gingival crevicular fluids and mucosal transudates. This diagnostic modality in the field of molecular biology has led to the discovery and potential of salivary biomarkers for the detection of oral cancers. Biomarkers are the molecular signatures and indicators of normal biological, pathological process, and pharmacological response to treatment hence may provide useful information for detection, diagnosis, and prognosis of the disease. Saliva's direct contact with oral cancer lesions makes it more specific and potentially sensitive screening tool, whereas more than 100 salivary biomarkers (DNA, RNA, mRNA, protein markers) have already been identified, including cytokines (IL-8, IL-1b, TNF-α), defensin-1, P53, Cyfra 21-1, tissue polypeptide-specific antigen, dual specificity phosphatase, spermidine/spermineN1-acetyltransferase , profilin, cofilin-1, transferrin, and many more. However, further research is still required for the reliability and validation of salivary biomarkers for clinical applications. This chapter provides the latest up-to-date list of known and emerging potential salivary biomarkers for early diagnosis of oral premalignant and cancerous lesions and monitoring of disease activity.

Effect of intraoral mechanical stress application on the expression of a force-responsive prognostic marker associated with system disease progression

OBJECTIVES

Malocclusion may be corrected nonsurgically by mechanical tooth movement. The plasma protein profiles of human subjects receiving the first phase of orthodontic treatment were examined to test the hypothesis that application of mechanical stresses to teeth induces systemic proteomic alterations.

METHODS

Tandem mass tag-based liquid chromatography-mass spectrometry (LC-MS/MS) was used to examine systemic proteomic alterations in subjects undergoing controlled stress application (N=10) and in volunteers not receiving treatment (N=7) at 3 time intervals within 24h. Proteins differentially expressed by the tooth movement group were functionally analyzed with "Gene Ontology" (GO) and "Search Tool to Retrieve Interacting Genes/proteins" (STRING) softwares. Enzyme-Linked Immunosorbent Assay and Western-blot were used to validate the in vivo protein alterations. An in vitro model consisting of human periodontal ligament cells (hPDLCs) under compression was used to validate the force-responsive characteristics of galectin-3 binding protein (LGALS3BP).

RESULTS

Sixteen out of the 294 proteins identified by LC-MS/MS were differentially expressed in the plasma of subjects receiving controlled mechanical stresses for moving teeth. Those proteins were clustered in biological processes related to acute inflammatory response and vesicle-related transportation. Serotransferrin, fibronectin and LGALS3BP were processed for confirmation in vivo; LGALS3BP was significantly increased in the tooth movement group. In vitro secretion of LGALS3BP in PDLCs was force-responsive.

CONCLUSIONS

Regional application of mechanical stresses stimulates systemic proteomic changes. Because serum LGALS3BP is over-expressed in different systemic diseases, including cancer, further work is needed to examine how systemic up-regulation of LGALS3BP affects the progression of those diseases.

Salivary peptidome profiling for diagnosis of severe early childhood caries

BACKGROUND

Severe early childhood caries (s-ECC), which has quite high prevalence among children, is a widespread problem with significant impacts among both developing and developed countries. At present, it is widely known that no early detective techniques and diagnostic tests could have high sensitivity and specificity when using for clinical screening of s-ECC. In this study, we had applied magnetic bead (MB)-based matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) to screen distinctive candidate biomarkers of this disease, so as to establish protein profiles and diagnostic models of s-ECC.

METHODS

Firstly, we used the technique mentioned above to detect specifically expressed peptides in saliva samples from ten children with s-ECC, separately at the time point of before, 1 and 4 weeks after dental treatment. Then a diagnostic model for s-ECC was established with the K nearest-neighbour method, which was validated in another six children in the next stage of study. After that, linear ion trap-orbitrap-mass spectrometry (LTQ-Orbitrap-MS) was performed to identify which of the proteins in saliva might be the origination of these peptides.

RESULTS

We found that seven peptide peaks were significantly different when comparing the three time points, among them two were higher, while other five were lower in the pre-treatment s-ECC group compared with post-treatment. The sensitivity and specificity of the diagnostic model we built were both 83.3 %. Two of these peptides were identified to be segments of histatin-1, which was one important secretory protein in saliva.

CONCLUSIONS

Hereby we confirmed that MB-based MALDI-TOF MS is an effective method for screening distinctive peptides from the saliva of junior patients with s-ECC, and histatin-1 may probably be one important candidate biomarker of this common dental disease. These findings might have bright prospect in future in establishing new diagnostic methods for s-ECC.

Magnetic Bead-Based Serum Peptidome Profiling in Patients with Gestational Diabetes Mellitus

Gestational diabetes mellitus (GDM) is a frequent medical condition during pregnancy. Early diagnosis and treatment of GDM are crucial for both the mother and the baby. In the present study, we aimed to identify specific biomarkers to assist in the early detection of GDM and give some clues to the possible causes of GDM by comparing serum peptide profile differences between GDM patients and healthy controls. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) was used in combination with weak cation exchange magnetic bead (WCX-MB). Levels of four peptides (4418.9, 2219.7, 2211.5, and 1533.4 Da) were significantly different. Interestingly, three of them (4418.9, 2211.5, and 1533.4 Da) were identified when GDM patients with two degrees of glucose intolerance were compared. Additionally, peptides 2211.5 and 1533.4 Da showed a decreasing trend as glucose intolerance increased, while peptide 4418.9 Da exhibited the reverse tendency. In conclusion, our study provides novel insights into the altered serum peptide profile of GDM patients. The specific candidate biomarkers may contribute to the development of GDM.

Diagnostic model of saliva peptide finger print analysis of oral squamous cell carcinoma patients using weak cation exchange magnetic beads

Whole saliva (WS) was used for diagnosis of oral squamous cell carcinoma (OSCC); two polypeptides may be used for OSCC diagnosis.

Saliva diagnostics utilizing nanotechnology and molecular technologies to detect oral squamous cell carcinoma (OSCC) has become an attractive field of study. However, no specific methods have been established. To refine the diagnostic power of saliva peptide fingerprints for the early detection of OSCC, we screened the expression spectrum of salivary peptides in 40 T1 stage OSCC patients (and healthy controls) using MALDI-TOF-MS combined with magnetic beads. Fifty proteins showed significantly different expression levels in the OSCC samples (P<0.05). Potential biomarkers were also predicted. The novel diagnostic proteomic model with m/z peaks of 1285.6 Da and 1432.2 Da are of certain value for early diagnosis of OSCC.

Toward the definition of a peptidome signature and protease profile in chronic periodontitis

PURPOSE

Chronic periodontitis (CP) is a complex immuno-inflammatory disease that results from preestablished gingivitis. We investigated potential differences in salivary peptidome in health and CP.

EXPERIMENTAL DESIGN

Saliva was collected from nine CP patients and ten healthy subjects, from which five CP and five healthy were enriched following endoProteoFASP approach, separated and identified by nanoHPLC-MALDI-TOF/TOF. Protease prediction was carried out in silico with Proteasix. Parallel gelatin and collagen (I) zymographies were performed to study proteolytic activity in CP.

RESULTS

An association of CP with increased gelatinolytic and collagenolytic activity was observed, which is mainly attributed to metalloproteases, remarkably MMP9. Protease prediction revealed distinct protease profiles in CP and in health. Peptidomic data corroborated the inflammatory status, and demonstrated that intact histatin 1 may play an important role in the defense response against oral pathogens. The application of the endoProteoFASP approach to study the salivary peptidome of CP subjects resulted in the identification of eight surrogate peptide markers, which may be used in multiplex to identify CP. These peptides belong to acidic PRP and to P-B peptide. Particularly, P-B peptide fragments exhibited domains with potential predicted antimicrobial activity, corroborating an antimicrobial function.

CONCLUSIONS AND CLINICAL RELEVANCE

The comparison between the salivary peptidome obtained by control and CP samples showed a specific association of eight peptides to CP, with remarkable predicted antimicrobial activity, which should be further validated in studies with large number of subjects.

Uncovering the molecular networks in periodontitis

Periodontitis is a complex immune-inflammatory disease that results from a preestablished infection in gingiva, mainly due to Gram-negative bacteria that colonize deeper in gingival sulcus and latter periodontal pocket. Host inflammatory and immune responses have both protective and destructive roles. Although cytokines, prostaglandins, and proteases struggle against microbial burden, these molecules promote connective tissue loss and alveolar bone resorption, leading to several histopathological changes, namely destruction of periodontal ligament, deepening of periodontal pocket, and bone loss, which can converge to attain tooth loss. Despite the efforts of genomics, transcriptomics, proteomics/peptidomics, and metabolomics, there is no available biomarker for periodontitis diagnosis, prognosis, and treatment evaluation, which could assist on the established clinical evaluation. Nevertheless, some genes, transcripts, proteins and metabolites have already shown a different expression in healthy subjects and in patients. Though, so far, 'omics approaches only disclosed the host inflammatory response as a consequence of microbial invasion in periodontitis and the diagnosis in periodontitis still relies on clinical parameters, thus a molecular tool for assessing periodontitis lacks in current dental medicine paradigm. Saliva and gingival crevicular fluid have been attracting researchers due to their diagnostic potential, ease, and noninvasive nature of collection. Each one of these fluids has some advantages and disadvantages that are discussed in this review.

Urinary peptide profiling to differentiate between minimal change disease and focal segmental glomerulosclerosis

BACKGROUND

Minimal change disease (MCD) and primary focal segmental glomerulosclerosis (FSGS) are the main causes of primary idiopathic nephrotic syndrome in children and adults, with diagnosis being essential for the appropriate choice of therapy and requiring renal biopsy. However, the presence of only normal glomeruli on renal biopsy of FSGS patients may lead to the misclassification of these patients as having MCD. The aim of this study was to (i) compare the peptide profile of MCD and FSGS patients with that of a group of healthy subjects, (ii) generate and validate a class prediction model to classify MCD and FSGS patients and (ii) identify candidate biomarkers of these glomerular entities by analysis of the urinary peptidome.

METHODS

The urinary peptide profile was analyzed by magnetic bead-based technology combined with MALDI-TOF mass spectrometry in 44 patients diagnosed of MCD (n = 22) and FSGS (n = 22). The resulting spectra were compiled and analyzed using ClinProTools software.

RESULTS

A class prediction model was developed to differentiate MCD and FSGS patients. The validation of this model correctly classified 81.8% (9/11) of MCD patients and 72.7% (8/11) of FSGS patients. Moreover, the signal with m/z 1913.60, identified as a fragment of uromodulin, and the signal with m/z 2392.54, identified as a fragment of alpha-1-antitrypsin, showed higher and lower peak areas, respectively, in FSGS patients compared with MCD patients.

CONCLUSIONS

The simple, non-invasive technique described in the present study may be a useful tool to help clinicians by confirming diagnoses achieved by renal biopsy, thereby reducing misdiagnoses and avoiding the implementation of inappropriate therapies.

Selective, bead-based global peptide capture using a bifunctional cross-linker

Peptides are important species for a variety of biological functions. Detection and analysis of these molecules can be complicated by the presence of background matrix or contaminants. Therefore, a selective method to capture peptides could provide researchers with an option to isolate these remarkable species. Our goal was to perform a set of experiments that would validate the concept of a novel, selective peptide capture, whereby peptides are isolated on functionalized magnetic beads through the use of the heterobifunctional cross-linker, Sulfo-LC-SPDP. Matrix assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) was used to monitor mass changes associated with the cross-linking reaction. MALDI-TOF MS was then used to monitor conjugation between the cross-linked peptides and sulfhydryl magnetic beads by analyzing supernatant solutions for the presence or absence of cross-linked peptide. Through these experiments, we have proof of concept data confirming that peptides can be isolated on sulfhydryl magnetic beads by using Sulfo-LC-SPDP. This method is a suitable selective global peptide isolation strategy to separate the molecules from contaminating species or sample matrix. This novel method has a variety of potential applications and detection methods.